Journal of the Indian Academy of Geriatrics

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Sarcopenia is a geriatric disease characterized by a marked loss of muscle mass and strength. This has led to it being recognized for the role it plays in elderly morbidity and mortality. It is a multifactorial disease with many mechanisms to how it comes about. So far, increasing physical activity has proven to be the best therapeutic agent. Exercise is capable of increasing flow of nutrition to muscle, reversing mitochondrial damage, increasing muscle mass, and strength. Furthermore, resistance training has been shown to be superior to aerobic training when it comes to increasing muscle mass and strength. Additionally, exercise plays a role in both prevention and treatment of sarcopenia, especially in a background of adequate nutrition. With increasing age, the effect of exercise is also subjected to issues such as anabolic resistance that can make increasing muscle mass and strength more challenging. However, physical activity and exercise remain the most important components of improving muscular strength.

Background: As the COVID-19 pandemic continues with its high mortality in older adults, there is a need to find better outcome predictors in such patients. The use of frailty as outcome predictors in the acute-care settings may help in providing more care to the high-risk patients. The aim of this pilot study was to assess the use of frailty measurement in the emergency department as an in-hospital and short-term outcome predictor in older patients admitted with severe acute respiratory illness (SARI). Subjects and Methods: The study was conducted in the emergency department of a tertiary care hospital in India from May 1, 2020 to July 31, 2020. All older patients presenting with SARI were assessed using the Clinical Frailty Scale at presentation by the emergency medicine residents who were trained by a geriatrician. Patients were followed up telephonically till January 31, 2021. Results: A total of 100 patients were recruited (mean age-71.5 years, males-61%, and 75 years or older-40%). Of these patients, 44% were found to be frail. Overall, 50% were SARS-CoV-2 positive. Frail patients had higher in-hospital (47.7% vs. 41.1%) and short-term mortality (67.6% vs. 54.7%); however, the difference was not statistically significant. Duration of hospitalization was also not significantly different between the two groups. Conclusions: Frailty among older SARI patients (with or without COVID-19 infection) was associated with higher in-hospital and long-term mortality, although the results were not statistically significant. Larger multicentric studies are needed to further explore this.

Background: Vaccine against coronavirus disease 2019 (COVID-19) was rolled out in India to prevent the infection caused by severe acute respiratory syndrome coronavirus 2. We aimed at investigating the adverse events following immunization (AEFI) associated with the first dose of Covishield (ChAdOx1 nCoV-19) vaccine in the elderly population (60 and above). Methodology: An observational study, conducted among 463 vaccinated individuals at multiple community health centers in Jaipur, of AEFIs associated with the first dose of Covishield vaccine. We investigated these AEFIs through telephonic interviews, using pharmacovigilance per forma provided from the Indian Pharmacopoeia Commission, Ghaziabad. Results: Four hundred and sixty-three people responded to the telephone survey. About 7.7% (36/463) of the respondents experienced AEFIs. Of these, commonly reported systemic AEFI were fever (47.2%), fatigue (38.8%), dizziness (5.5%), and diarrhea (2.7%), and local AEFI were injection site soreness (27.7%) and itching with rash (2.7%) AEFI reported in the age group (60–70) was higher (8.7%, 26/297) than those above 70 (6.2%, 10/166). Females (9.9%, 20/202) were associated with higher AEFI than males (6.1%, 16/261). More than one-third (43.8%, 203/463, P = 0.001) were hesitant before vaccination. Respondents in the age group of 60–70 years (55.2%, 164/297) were more hesitant than those above 70 (23.4%, 39/166). There is no association between gender and AEFI status and age group and respondent's AEFI. Conclusion: Only 7.7% of the respondents experienced AEFIs associated with ChAdOx1 nCoV-19, though all were mild and self-limiting. There were no serious events requiring hospitalization, and most AEFIs improved within few days. Vaccine hesitancy among 43.8% of the respondents could be attributed to the unscientific information on social media.

Purple urine bag syndrome is a rare disease commonly associated with urinary tract infection. Generally, it is seen in geriatric patients who are chronically debilitated with long-term indwelling urinary catheters. Management of the disease must involve diagnosis of urinary tract infection and treatment of the same with antibiotics and treatment of associated constipation.

Online since 4^th August 2020