Objective: The objective of the study was to determine the effect of COVID-19 lockdown on the health care and psychosocial aspects of the elderly in Kerala. Methodology: The study was a community-based cross-sectional study designed as an online survey, and the study setting was the entire state of Kerala. Target participants (more than 60 years old) were selected with nongovernment organizations working in geriatric welfare. The tool used for the survey was a semi-structured online questionnaire. To assess the magnitude of psychological distress, Geriatric Anxiety Scale-? Version 2.0 was used. Results: Five hundred and thirty-six elderly people were included in the study, of which 273 (50.9%) were males and 263 (49.1%) were females. Four hundred and forty-two people (82.5%) were on regular medications before the lockdown, of which 28 (6.3%) missed the same during lockdown. Routine laboratory testing went down from 404 (75.4%) to 294 (54.9%) and medical follow-up from 348 (64.9%) to 180 (33.6%) during the lockdown period. Two hundred and three elderly (37.9%) in the study population showed significant anxiety symptoms. Conclusions: Lockdown has adversely affected the health care and non-COVID medical services of the elderly. Fear of COVID infection and the presence of possible COVID infection symptoms were associated with psychological distress and anxiety. Proper psychosocial interventions are necessary to mitigate the effects of lockdown on health care and psychosocial aspects of the elderly.

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Background: The presence of neuropsychiatric symptoms (NPS) in older adults with no cognitive impairment confers a high risk of future cognitive decline. Mild behavioral impairment (MBI) is a syndrome characterized by the new onset of NPS after 50 years, which is sustained and impactful. We report the distribution of various domains of MBI in subjects with mild cognitive impairment (MCI) and subjective cognitive impairment (SCI) and the association between different blood markers in individuals with MBI. Materials and Methods: This cross-sectional study was conducted in the Memory clinic of the Department of Geriatric Medicine in a tertiary health center. The study duration was 1½ years. Subjects with MCI and SCI were screened for the presence of NPS and MBI. Patients with dementia, impaired activities of daily living, and psychiatric illnesses were excluded. The mild behavioral impairment checklist ascertained the presence of various domains. Levels of various blood markers were assessed. Results: In this study, 124 participants were included. The mean age of the population was 69.21 ± 6.64, 71.77% were male, and 28.23% were female. Fifty-one participants were diagnosed to have MBI. Among the MBI domains, impulse dyscontrol was most commonly involved (68.63%) followed by decreased motivation (60.78%). Low Vitamin D (85.71%; P = 0.005) and high serum triglyceride (50%; P = 0.044) were associated with MBI. Conclusion: NPS, especially impulse dyscontrol and decreased motivation, in participants without dementia, were common in the memory clinic setting. Vitamin D deficiency and high triglyceride levels were significantly associated with MBI.

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Background: The Model Rural Health Research Unit at Kallur, Tirunelveli, established by the Department of Health Research, Government of India, is linked to Tirunelveli Medical College. It is mentored by the ICMR-National Institute of Epidemiology, Chennai. The key objective was to develop area-specific models to undertake field health research depending on the disease profile, topography, morbidity patterns, and better health-care services. As a part of the ongoing activity, we constructed a cohort of 36,289 people and analyzed the self-reported information on morbidities experienced by the registered population from different aspects. In this communication, we report some of the findings extracted from the data sets as descriptive epidemiology on the self-reported magnitude of illness and their utilization of health services in the rural cohort of a primary health center among the geriatric population 60 years or more. Methods: A demographic health database of 11,006 households (HH) with 36,289 individuals was constructed in the study area under the Primary Health Centre, Nadu Kallur, Tirunelveli. This database consists of self-reported morbidity data collected at baseline, pertaining to the cohort members with age 60 years or more and analyzed it. Results: The study area's total geriatric population with 60 years of age or more was 4891 (13.5%). In this cohort, the gender ratio was 824 males for every 1000 females, with an average of 0.4 geriatric persons per HH, and 37% of them were illiterates. About 38% of the study population were either widowed or separated. Nearly 65% of the people in the cohort lived in the same house for more than 10 years. Around 10% were pensioners, and almost 36% had to work for their daily living. Only 27% had health insurance or were covered by a health scheme. About 52% (2564) of the individuals reported about their one or more ailments. The total number of different types of ailments reported was 3704. Among them, 402 (11%) were not treated. For the remaining (3302 ailments) one or more treatments were taken, i.e., in all 4705 instances, treatment was taken either consulting a physician or self-treatment. Hypertension (25%) and diabetes mellitus (21%) were the major cause of morbidity among the elderly in this cohort. Conclusion: The above rural baseline survey portrays the commonly reported morbidities and their treatment-seeking behavior of a cohort of elderly people living in the area under Government Primary Health Centre, Nadu Kallur, South India. The findings indicate that the commonly reported morbidity and their treatment-seeking behavior remain unchanged even after rapid strides in India's health-care delivery. This study's data strengthen the need to increase the services for the geriatric population to improve their quality of life.

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Coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 primarily affects the lung resulting in acute lung injury, which may progress to acute respiratory distress syndrome and rarely multiorgan dysfunction syndrome. Elderly are the worst affected among all age groups. Falls are one of the most common problems faced by the elderly. Since the outbreak of this pandemic, most hospital resources have been redirected to the care of COVID-19 patients, resulting in the postponement of many orthopedic elective surgeries. In this case report, we discussed managing a traumatic fall in the elderly who tested positive for COVID-19.

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Introduction: With the exponential increase in India's elderly population, the medical students of today need to be well prepared for the demographic changes of tomorrow. Training and attitude of future physicians in elderly care should develop concurrently with the rise in qualifying medical graduates. Objectives: The aim of this study is to determine the knowledge and attitudes of medical students entering internships, toward older people at a teaching hospital in Thrissur, Kerala. Methodology: Medical students of a medical college in Kerala, who were to enter the residency program were enrolled in the study. Sixty-nine students, who voluntarily participated, were asked to complete two questionnaires, the Revised Facts on Aging Quiz, a 25-item multiple-choice test on aging, and the University of California at Los Angeles (UCLA) Geriatric Attitudes Scale, a 14-item questionnaire consisting of a mixture of positively and negatively worded questions answered on a five-point Likert scale. The data obtained were assessed using SPSS version 21. Results: The results indicate that although the medical students entering residency showed a moderately positive attitude (UCLA score 49.67 ± 5.02) toward older people, almost one-third (n = 20, 29%) of these 69 students had poor knowledge (25%–50% score), and the rest (n = 49, 71%) had minimal knowledge (51%–75% scores) on aging. Conclusion: These findings suggest that training in geriatrics is inadequate for MBBS students. More geriatric based content needs to be incorporated into the undergraduate curriculum to address the changing population demographics.

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Introduction: Increasing geriatric population imposes a significant burden on health-care resources. Compromised immunity and decreased organ reserves make them vulnerable for morbidity and mortality from various diseases. We aim to study the clinical profile of elderly patients hospitalized with systemic inflammatory response syndrome (SIRS) and identify factors predicting inhospital mortality. Materials and Methods: One hundred and two elderly patients (>60 years) fulfilling two or more SIRS criteria admitted between March 2019 and January 2020 in a tertiary care hospital of North India are prospectively studied. Results: The mean age of patients is 69.7 years. Hypertension (32.35%), chronic obstructive pulmonary disease (27.45%), and diabetes mellitus (20.58%) are common comorbidities. 65.6% of patients have SIRS with one or more organ dysfunction, and 29.4% have septic shock. Fever (73.52%) and cough (56.86%) are the most common presenting symptoms. The respiratory system is affected in 78 (76.47%) patients, followed by renal involvement in 66 (64.70%) patients. Thirty-nine (38.23%) patients need intensive care unit (ICU) care, 25 (24.50%) patients require mechanical ventilation, and 30 (29.11%) patients require inotropic support. Overall mortality is 35.3%. Factors associated with inhospital mortality need ICU care, organ dysfunction, septic shock, and need for mechanical ventilation and vasopressors. Conclusion: Geriatric patients hospitalized with SIRS have a high prevalence of multiple organ dysfunction, septic shock, ICU occupancy, and need for advanced life support along with increased overall and ICU mortality rate. This signifies the need for specialized geriatric ICUs and focused policymaking and allocation of health-care resources for geriatric care.

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Background: Frailty is a common clinical syndrome in the elderly with increased risk for poor health outcomes manifesting as falls, disabilities, hospitalization, and death. In this study, we measured the prevalence of frailty based on two commonly used tools, i.e., Fried frailty phenotype (FFP) and Edmonton frailty scale (EFS). Furthermore, the agreement between these tools was determined. Materials and Methods: In this cross-sectional study, 296 patients with age 60 years or more visiting geriatric outpatient department at a tertiary care center in Western India were assessed for frailty using FFP and EFS. The study groups' association is evaluated with the Fisher's test, Student's “t-test”, and Pearson's chi-squared test. Results: A total of 296 patients were assessed with the mean age group of 68.47 ± 5.92 years. There were 151 (51.1%) males and 145 (48.9%) females with the majority of patients from the age group of 60–70 years (68.8%). Total 68 patients (22.9%; males: 55.8%, females: 44.2%) and 50 patients (17%; males and females 50% each) were frail as per FFP and EFS, respectively. There was a statistically significant agreement between FFP and EFS (k = 0.602, P < 0.05). Conclusion: There is a significant agreement between frailty prevalence measured by FFP and EFS. In elderly population, measurement of frailty using these simple tools can be effective in screening and subsequent early interventions to reduce ageing-related mortality and morbidities.

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Introduction: Digitalization of the world and the Internet of things have completely transformed social life and health care. Technologies such as artificial intelligence (AI), wearable and implantable devices, mobile applications, and the Internet have revolutionized health-care delivery. With the betterment of health care and control of infectious diseases, longevity has increased, resulting in the bane of chronic noncommunicable illnesses and comorbidities in the aging population. This study aims to review the existing literature on technology applications in health care and the scope for promoting healthy aging. Methods: An online search was done on electronic databases such as PubMed and Google in July 2019 using a combination of keywords mobile, Android, cellphone, artificial intelligence, machine learning, natural language processing, diabetes, blood sugar, hypertension, blood pressure, dyslipidemia, cognitive impairment, and falls. About 80,964 citations were found. On applying the filter title, 997 articles were obtained. In the title and abstract review, 15 unique articles were selected, by eliminating similar, duplicate, and nonrelevant articles. In addition, using cross-reference and Google search, ten articles were found. Discussion: Various applications of the technology in the management of noncommunicable diseases (NCDs) such as diabetes, hypertension, and obesity and geriatric syndromes such as falls and cognitive impairment have been classified into three sections: prevention and prediction; diagnosis and detection; and medication and management. The names of a few applications have been cited as examples. Conclusion: The new age technology has shown promise at various health-care intervention levels in a futuristic hope of taking medicine to the next level - Precision Medicine. The present work will allow physicians involved in older patients with NCDs and geriatric comorbidities to help them have an independent, comfortable, and functional aging.

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Geriatric patients have different oral healthcare needs than young individuals; they need special infrastructure and training to deal with. During this ongoing pandemic, the geriatric patients' oral healthcare needs take a back seat because of the lockdown and because of the frail health status of the individuals. There is a need to find ways to deal with geriatric patients' unique oral healthcare needs during these testing times and tailored to individual needs.

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