Coincidence of arthrosis and depression in elderly patients - therapeutic implications.

BACKGROUND: More then half of elderly adults over 60 years old suffer from arthrosis. Pain and mobility reduction associated with this disease, reduce elderly peoples independence and are the reason of their physical disability. The aim of this study was to estimate coincidence of arthrosis and depression in population of outpatients of Geriatric Clinic and to asses the influence of each disease on functional ability, pain and selfhealth evaluation. Furthermore we tried to evaluate a relationship between age, sex, education, financial position, self-evaluation of health condition with presence of arthrosis. METHODS: The study group consisted of 70 elderly adults over 60 years old - Geriatric Department of Medical University in Bialystok outpatients. In all subject the social and demographic data and clinical diagnosis were evaluated using a self-constructed questionnaire. Furthermore the following tests were used: Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE) and Personal Activities of Daily Living Scale PADL). RESULTS: Depression was observed more frequently in patients with arthrosis associated with pain. Symptoms of depressions were found in 92% group with arthritis. The present work confirmed high statistical significancy between depression and chronical pain of joits (p=0,000). Relationship between difficulties in performing everyday activities, mobility and arthrosis was also found. CONCLUSIONS: 1.Taking into consideration data that emotional disorders in studied group of elderly adults are associated with arthrosis, and publications about positive effect of antidepressive treatment on pain susceptibility in rheumatological diseases, we should pay more attention to diagnosis and treatment (in reasonable cases) of depression in elderly patients in compex therapy of arthrosis. 2.The proper recognition of coincident diseases directs treatment and enables comprehensive approach to medical care. It results in better health condition, quality of life and independence of elderly people.

[Health-related quality of life in the elderly after coronary artery bypass grafting]. / Zdrowotne wykladniki jakosci zycia osób starszych po zabiegach pomostowania tetnic wiencowych.

Despite of higher operative risk in the elderly, coronary artery bypass grafting (CABG) is more often performed in this age group to achieve the remission of the disease and to improve the quality of life. The aim of the study was to assess some subjective and objective health indices in the elderly two years after CABG (I group) in comparison to analogous group of older patients just waiting for CABG (II group). 109 patients aged 65 years and older, consecutively discharged from the Cardiac Surgery Department 2 years ago, were analyzed as well as 60 patients currently waiting for such surgery. Both groups of patients did not differ with demographic features. The health related quality of life was measured with the EASYCare questionnaire and similar one of own construction supplemented with some items of the WHOQol-BREF scale. Two years after CABG, 100 patients were available for the study (six persons died and three persons refused). Response rate was 92%. Significant reduction of symptoms of the coronary artery disease were shown. The chest pain was declared in 18% in I group vs 70% in II group; palpitation in 23% in I group vs 38% in II group and effort angina in 38% in I group vs 65% in II group. The positive evaluation of the health status was declared significantly more often in the patients of I group in comparison to patients in II group. CABG caused positive change concerning health-related quality of life in the elderly two years after surgery.

[Hypertension in the advanced old aged: prevalence and treatment in comparative urban and rural survey]. / Nadcisnienie tetnicze w póznej starosci: czestosc wystepowania, problemy terapii--porównawcze badania srodowiska miejskiego i wiejskiego.

UNLABELLED: Hypertension is a serious medical, social and economical problem. It is accepted that high blood pressure is one of the major risk factors of all kinds of cardiovascular diseases. The aim of the study was to estimate the prevalence of hypertension and evaluate the difficulties with antihypertensive treatment in the rural and urban community dwelling elderly in advanced old age. The survey was carried out, as a screening, in systematically sampled 463 people 75 years old and over, coming from area served by primary health units (230 in urban area--Bialystok and 233 in rural area--Sokólka). Estimation of blood pressure (single measure) and medical anamnesis concerning earlier diagnoses and pharmacological treatment was made in proband's home by general practitioner or community nurse. The diagnosis of hypertension was established according to the WHO-ISN criteria. RESULTS: In general 49.1% of the elderly in urban and 70.4% in rural area had elevated systolic or/and diastolic blood pressure independently on antihypertensive medication; significantly more frequent in female than in male. 32% of the elderly in urban and 22% in rural area had normal blood pressure without antihypertensive treatment ("healthy"), whereas respectively 19% and 7% had normal blood pressure with antihypertensive treatment. 21% of persons in Bialystok city and 38% in Sokólka had elevated high arterial pressure and hadn't any antihypertensive treatment. The results of the study confirm the high prevalence of hypertension in elderly population, higher in rural than urban area. Therapy of hypertension in studied group was ineffective in most of the hypertensive patients, mainly in neglected rural area. The differences between urban and rural samples can be partly explained by socio-demografic characteristic of the two studied population.