Common symptoms of Alzheimer's dementia that are easily recognizable by families / Sintomas comuns da demência de Alzheimer facilmente reconhecíveis pelas famílias

ABSTRACT. The increase in dementia incidence among the elderly is directly related to aging, which is associated with changes in bodily functions and other health-related risk factors. Alzheimer's dementia is the most prevalent form of dementia, and individuals in the late stages are predominantly dependent on other family members. Therefore, it is important for families, as the closest support group, to recognize common symptoms early. Objective: To provide a family-friendly guide to the ten common symptoms of Alzheimer's dementia. Methods: This is a descriptive survey-based research that included 354 families comprising elderly people (≥60 years) residing in Jakarta. The instrument aimed at identifying ten common Alzheimer's dementia symptoms in Indonesia. Descriptive statistical analysis based on frequency tables was used. Results: The participant's major characteristics were age ≥66 years (52.3%), female sex (70.3%) and primary school education (87.3%). The predominant symptoms experienced by 42.4% of the elderly included forgetting recent events and asking questions and narrating a particular detail repeatedly. The remaining 35.6% demonstrated signs of forgetting where an item was placed and frequently suspecting others of theft and concealment of personal items. Conclusion: The symptoms of frequently forgetting new events and the location of personal belongings are of particular concern for families, as they have a propensity to progress and interfere with daily activities. Therefore, the families of affected individuals are expected to identify this symptom early on and present the affected individual for screening or examination at a health care facility.

RESUMO. O aumento da incidência de demência entre os idosos está diretamente relacionado ao envelhecimento, que está associado a alterações nas funções corporais e outros fatores de risco relacionados à saúde. A demência de Alzheimer é a forma mais prevalente de demência e os indivíduos nos estágios avançados são predominantemente dependentes de outros membros da família. Portanto, é importante que as famílias, como grupo de apoio mais próximo, reconheçam os sintomas comuns precocemente. Objetivo: fornecer um guia familiar para os dez sintomas comuns da demência de Alzheimer. Métodos: Trata-se de uma pesquisa descritiva de base survey que incluiu 354 famílias compostas por idosos (≥60 anos) residentes em Jacarta. O instrumento teve como objetivo identificar dez sintomas comuns de demência de Alzheimer na Indonésia. Foi utilizada análise estatística descritiva baseada em tabelas de frequência. Resultados: As principais características do participante foram idade ≥ 66 anos (52,3%), sexo feminino (70,3%) e escolaridade primária (87,3%). Os sintomas predominantes vivenciados por 42,4% dos idosos incluem o esquecimento de acontecimentos recentes, fazer perguntas e narrar um determinado detalhe repetidamente. Os 35,6% restantes demonstraram sinais de esquecimento de onde um item foi colocado e frequentemente suspeitam de furto e ocultação de itens pessoais. Conclusão: Os sintomas de esquecimento frequente de novos eventos e da localização de objetos pessoais são de particular preocupação para as famílias, visto que apresentam tendência para progredir e interferir nas atividades diárias. Portanto, espera-se que as famílias dos indivíduos afetados identifiquem esse sintoma logo no início e apresentem o indivíduo afetado para triagem ou exame em uma unidade de saúde.

Management of immobilization and its complication for elderly.

Increased life expectancy have an effect on the rising percentage of elderly population in Indonesia and health problem associated with the elderly, particularly immobilization. Immobilization may cause various complications, especially when it has been overlooked without any appropriate and proper medical care in keeping with the procedures. High incidence of immobilization in elderly and the life-threatening complication call for an agreement on management of immobilization and its complication. Management of immobilization needs interdisciplinary team-work cooperation, the patients and their family. The management may be commenced through a complete geriatric review, formulating functional goals and constructing therapeutic plan. Various medical conditions and external factors that may act as risk factors of immobilization as well as drugs intake that may exaggerate the immobilization should be evaluated and optimally managed. Any complication due to immobilization and other concomitant disease/condition should be recognized and managed comprehensively in order to reduce morbidity and mortality. Management of immobilization and its complications include pharmacological and non-pharmacological treatment, i.e. various mobility exercises, utilization of ambulatory device and supporting appliance for assisting patients in stand-up position, as well as the management of urinary voiding and defecation.

C-reactive protein levels and decrease of albumin levels in hospitalized elderly patients with community-acquired pneumonia.

AIM: To obtain: (1) the correlation between initial CRP level on admission with the decrease of albumin level during hospitalization, (2) the mean difference in initial CRP level between the groups of patients with and without decrease of albumin level during hospitalization, and (3) the risk difference of decreasing albumin level in patients with high CRP levels on the admission compared to whom with low CRP level on the admission, in hospitalized elderly patients with CAP. METHODS: A prospective cohort study were conducted on 23 hospitalized elderly patients with CAP. Subjects with diseases and conditions that could interfere with CRP and albumin level besides pneumonia infection were excluded. The patient's CRP level was measured upon the initiation of the study, while the patient's albumin level was measured on the first and fifth day of hospitalization to observe changes that took place during 5 days of hospitalization. Pearson's correlation test, independent t-test, and chi-square test were used to answer the objectives of the study. RESULTS: We found that there were negative correlation between the initial CRP level and the percentage of albumin level decrease during 5 days of hospitalization (r=-0.442, p= 0.035) and significance difference in the mean initial CRP level between patients with and without decreasing albumin level (mean difference 99.69 mg/L, 95%CI 13.25 to 186.13 mg/L; P 0.026). The risk difference of decreasing albumin level during hospitalization between patients with high and low initial CRP levels did not attained statistical significance (RR 2.12. 95%CI 0.26 to 29.07; p=0.621). CONCLUSION: In hospitalized elderly patients with community-acquired pneumonia with high initial CRP levels tend to experience a decrease in albumin level during hospitalization.

Writing for scientific medical manuscript: a guide for preparing manuscript submitted to biomedical journals.

Publishing a manuscript of study results in a medical or biomedical journal is not as easy as we imagine. There are some components that should be noticed in publishing a medical scientific journal. Although every journal has different manuscript format, in general, a manuscript contain some components, which consist of: introduction, methods, results, and discussion. Before submitting the manuscript, be sure that it has been consistent with instructions to authors of the desired journal. Submitted manuscript should be enclosed by a cover letter, a statement about any sponsor or other potential relationship that may cause conflict of interest, a statement that the manuscript has been read and agreed by the author(s), and any information about a corresponding author. Writing skills is very important to obtain a good manuscript of study result, in order to achieve greater possibility for publication. Writing skills can be learned through various books or electronic sources such as internet which discuss about writing techniques.