Objective: To determine the factors associated with the outcome of older patients admitted in Geriatric Intensive Care Unit. Materials and Methods: This cross-sectional, observational study was conducted in the Geriatric Intensive Care Unit of the Department of Geriatric Medicine, Madras Medical College, Chennai. one hundred and seventy two patients, aged 60 and above, admitted in the Geriatric ICU during the period of 6 months, from January 2017 to June 2017, were selected to participate in this study. Data regarding age, sex, number of comorbidities, major organ system involved, duration of stay and procedures underwent in the ICU were collected and analyzed. Results: Out of the 172 samples, 92 were males, and 80 were females. The mean age of the study population was 70.1 ± 8.3 years. We found no association between age and survival (p=0.581), gender and survival (p=0.298). 30.2% of the samples who expired had four comorbidities. We found a statistically significant association between the number of comorbidities and outcome (p<0.008). Around 44 patients (25.6%) had respiratory problems, and it was the commonest cause of admission to ICU in this study. We found no association between major system involved and outcome (p=0.089). Sixty of the study participants (34.9%) needed mechanical ventilatory support. We found a statistical significance between procedure underwent and outcome (p<0.001). 57.5% of the study participants stayed in the GICU up to 1 week. We found a statistical significance between the duration of stay and outcome (p=0.022). In this study, 71.5% of the study participants survived, 3.5% of them went against medical advice, and 25% of them expired. Conclusion: In this study, the outcome of older patients admitted in Geriatric Intensive Care Unit depended on the number of preexisting comorbidities, length of stay and procedure underwent during the ICU stay but not the chronological age. In this study, only one in four died after undergoing treatment in the Geriatric Intensive care unit. Geriatric intensive care services can improve the outcome of older patients admitted with a critical illness.

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Background: Despite the huge clinical impact of sarcopenia, there is very little to no data from Indian subcontinent regarding sarcopenia in older adults. We conducted this study to assess the frequency of sarcopenia in Indian older outpatients and its characteristics and associations with various geriatric syndromes and quality of life in Indian older adults. Methods: 100 participants above the age of 65 years were recruited from the outpatient department of Geriatric Medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance was measured by DXA scan (Dual Energy X-ray Absorptiometry), hand-held dynamometer and 4 m gait speed respectively. Sarcopenia was identified using an Asian working group for sarcopenia (AWGS) criteria. Many geriatric syndromes such as osteoporosis, dementia, depression and malnutrition were assessed using DXA scan (Dual Energy X-ray Absorptiometry), HMSE (Hindi Mental State Questionnaire). GDS-5 (Geriatric Depression scale - 5 item questionnaire) and MNA (Mini Nutritional Assessment) respectively. Quality of life was assessed using the OPQOL-brief questionnaire. Results: The prevalence of sarcopenia in our study population was 53% (49.3% in males, 61.3% in females). Hypothyroidism, neurological disease and osteoporosis were the only comorbidities found to be positively associated with sarcopenia. Among geriatric syndromes, nutrition and cognition were negatively associated with sarcopenia. Sarcopenia was also negatively related to the quality of life. Multivariate stepwise logistic regression analysis showed that osteoporosis (OR: 5.43; 95% CI: 1.57-18.81: p-value: <0.01) was significantly associated with sarcopenia. Conclusion: Sarcopenia was common among Indian older outpatients with increased risk of geriatric syndromes and poor quality of life, therefore, a regular sarcopenia assessment may be considered in elderly patients.

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Mild cognitive impairment is an intermediate stage between the expected cognitive decline of normal ageing and the more serious decline of dementia. Dementia is typically diagnosed when acquired cognitive impairment has become severe enough to compromise social and/or occupational functioning. The elderly are at much greater risk for cognitive impairment. Unfortunately, most cases of cognitive impairment without apparent dementia go undetected and thereby untreated in primary care. Clinical diagnosis supported by appropriate use of diagnostic tests and biomarker is essential to improve the quality of life in these patients, In this article, we discussed the role of clinical laboratories in the diagnosis of cognitive impairment and dementia in the geriatric population.

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With improving healthcare facilities, the geriatric population in India is on the rise. Anaesthesia in the geriatric age group poses many challenges to the peri-operative physician because of the decreased functional reserve and various comorbidities associated with advanced age. In addition to that, there is greater risk of post-operative cognitive dysfunction and delirium. Anaesthesia in patients above 100 years is a sub-speciality in itself, with several special considerations. We, hereby present the case of a 102-year-old female patient with severe aortic stenosis posted for left-sided dynamic hip screw fixation on an emergency basis under low dose, unilateral spinal anaesthesia, supplemented with slow and graded epidural anaesthesia.

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Background: Skin diseases can be one of the factors affecting the quality of life of the growing elderly population. In treating various dermatoses in the elderly, structural and physiological changes of the skin due to ageing need to be considered. Phototherapy has been proven to be a valuable modality for many skin diseases in adults. However, there is currently no study evaluating the use of phototherapy to treat skin diseases in geriatric population in Indonesia. Objective: To learn the efficacy and safety of narrowband ultraviolet B (NB-UVB) phototherapy in geriatric patients. Methods: A retrospective study using data from medical records of patients aged 60 years and above that received NB-UVB phototherapy in Dermatovenereology Clinic at the Dr Cipto Mangunkusumo National General Hospital in 2014–2018. Results: From 34 included patients, 21 (61.7%) patients had psoriasis, 9 (26.5%) had vitiligo, and 5 (14.7%) patients had other dermatoses. Psoriasis Area Severity Index (PASI) 76% was achieved by 52.4% psoriasis patients with a median of 22 sessions and cumulative dose of 26.6 J/cm². Initial repigmentation was seen in 100% of vitiligo patients starting from a median of 6 sessions and a cumulative dose of 1.5 J/cm². The side effect of erythema presented in 10 (47.6%) patients, with an event rate of 1.48% per session. Severe erythema was experienced by one vitiligo patient requiring a delay in phototherapy session. Conclusion: Phototherapy is a safe and effective modality for the geriatric population with various skin diseases, using doses and frequency similar to those of adult patients.

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Introduction: Ageing is a natural phenomenon that is accompanied by a cascade of unwanted and unintended circumstances or problems that are always undesirable but not still avoidable. Polypharmacy or irrational use of medicines is one of the many issues that may affect any age group but mostly affects the geriatric population. Since ageing is usually associated with several co-morbities. elderly are exposed to polypharmacy to greater extent, Lack of knowledge about the outcomes of polypharmacy adds to the suffering of elderly due to adverse drug reactions caused by drug interactions. Aim: The primary objective of the present study is to assess the prevalence of polypharmacy along with its association with psychiatric problems and how they influence polypharmacy. Methods: A literature review of electronic databases utilizing the search terms polypharmacy, polypharmacy in elderly, polypharmacy and ageing, multiple medications, inappropriate medication and prescribing cascade etc. for the period from 2010 to 2018 was done. The search was supplemented with online site searches of relevant medical, health and pharmaceutical journals. Also, literature comprising of original articles, and case studies were studied to identify articles which correspond to various definitions, causes, types of polypharmacy etc. The priority of search was geriatric pharmacy. Thus, the studies or the articles matching the geriatric age group were considered, and adequate data was extracted. A specific protocol regarding the sectioning of search like relevant data & irrelevant data was then incorporated to collect the most suitable and the authentic material for the review. Results: The aged population practice polypharmacy more in comparison to other age groups. Psychiatric illnesses further, enhances the polypharmacy. Conclusion: The findings suggested that polypharmacy is associated with the worsening of the health of the elderly due to its positive association with mental health problems.

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Frailty refers to a loss of physiologic function that makes a person susceptible to disability from minor stresses. The frailty syndrome is a collection of symptoms primarily due to the aging-related loss and dysfunction of skeletal muscle and bone, that place older adults at increased levels of risk for disability, dependency, falls, injury, hospitalization, need for long term care, and mortality. Frailty is thought distinguishable from disability and comorbidity. Frailty always implies multisystem dysfunction. Severity of frailty range subclinical to a clinical stage to impending death. It is Important to recognize and treat the frailty syndrome before occurrence of any adverse outcomes. Fried's Phenotype screening tool identifies a person as being frail.

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