Medication-related problems are common among home care patients who take many medications and have complex medical histories and health problems. The goals of home health care services are to help individuals to improve function and live with greater independence; to promote the client’s optimal level of well-being; and to assist the patient to remain at home, avoiding hospitalization or admission to long-term care institutions. Home care is an arrangement of care given by gifted experts to patients in their homes under the heading of a doctor. Home medicinal services administrations incorporate nursing care; physical, word related, and discourse dialect treatment; and therapeutic social administrations. Doctors may allude patients for home social insurance administrations, or the administrations might be asked for by relatives or patients. The scope of home social insurance benefits a patient can get at home is boundless. Contingent upon the individual patient’s circumstance, care can extend from nursing care to specific therapeutic administrations, for example, research facility workups. Normal analyses among home social insurance patients incorporate circulatory infection, coronary illness, damage and harming, musculoskeletal and connective tissue sickness and respiratory malady.
The expression “Home-based care” or basically home care might be characterized as a wide exhibit of various kinds of care gave in the home by a wide scope of gatherings. The continuum of various sorts of home-based care conveyed in the home shifts as far as various measurements, including sharpness, kind of care gave, and level of physician contribution. Home-based care incorporates both formal and casual individual care services, Medicare gifted home health, physician house calls, and even “emergency clinic at-home” services. Prescription related issues are essential among home care patients who take various drugs and have complex medical annals and medical issues. The destinations of home social protection organizations are to help individuals with improving limit and live with progressively noticeable opportunity; to propel the client’s optimal element of thriving; and to assist the patient with staying at home, keeping up a vital good way from hospitalization or admission to long haul care establishments. Home care is a game plan of care given by capable specialists to patients in their homes under the heading of a doctor. Home restorative services organizations join nursing care; physical, word related, and talk language treatment; and medical social organizations. Doctors may suggest patients for home therapeutic services organizations, or the organizations may be requested by relatives or patients. The extent of home human services benefits a patient can get at home is endless. Contingent upon the individual patient’s condition, care can reach out from nursing care to explicit medical organizations, for instance, research center workups. Essential investigations among home therapeutic services patients consolidate circulatory disease, coronary ailment, harm and hurting, musculoskeletal and connective tissue disease and respiratory disease.
Indonesia is the fourth most populous country in the world. An increase number in the proportion of elders is accompanied by an increase of degenerative diseases and disabilities, including Alzheimer’s disease (AD). Prevalence of dementia in Indonesia is 1.2 million cases in 2015 and will keep increasing up to 3,980,000 in 2050. This study discusses data on the prevalence of dementia’s risk factors in Indonesia, calculates population-attributable risks (PAR) to identify the number of dementia cases that could be prevented, and determines which intervention strategies will have the most significant effect in reducing Alzheimer’s Disease (AD) cases. Prevalence of potentially modifiable risk factors for AD such as low education, hypertension, diabetes, obesity, and mental disorders are still high. Moreover, the prevalences keep increasing for the last five years. Low education has the highest estimated PAR, which could significantly lower new AD cases if it is being improved. Ten and thirty percent of risk factor reduction can decrease AD cases by 18,000 and 66,000 cases. In addition, reducing physical inactivity by 10% and 30% can reduce 19,000 and 55,000 cases of AD respectively; lowering 10% prevalence of midlife hypertension and diabetes can reduce 2400 and 1600 cases of AD. Decreasing 10% of all risk factors is estimated to reduce 22,000 of new AD cases. By reducing these modifiable risk factors, especially by improving access to education, the incidence of AD could be greatly reduced. This review is expected to give suggestion to the government in determining the priority scale of controlling risk factors for reducing the social and economic burden caused by AD.
Incidence of Cognitive Decline and Association with Changes in Sociodemographic, Lifestyle, and Health Indicators in Individuals aged 50 years and older: Prospective Cohort
Objectives: To identify the incidence of cognitive decline (CD) in an urban community-dwelling population aged 50 years and older in a 4-year follow-up period and its prospective association with sociodemographic factors, lifestyle and health conditions as well as with changes in these factors. Methods: This is a prospective cohort with a representative sample of people aged 50 years and older (n = 206) from Cambé, PR, where baseline data collection occurred in the year 2011 and the follow-up occurred in 2015. The incidence of CD was the outcome of this study, and its evaluation occurred through the Mini-Mental State Examination. Results: The incidence of CD was 13.1% over the 4 years of follow-up, and adjusted Poisson regression models (sex, age and age range) showed that this condition was prospectively associated with depression (adjusted relative risk (RR) = 3, 50, 95% CI = 1.65-7.43). When analyzing the effect of sociodemographic factor changes on CD, it was verified that the risk of CD was 2.86 times higher among the group that stopped having a companion in the 4 years of follow-up when compared to the group that maintained a companion in that same period, independent of confounding factors. Conclusion: The data suggest that the CD process begins before the age of 60 y and that aggravation is associated with potentially modifiable factors that can be approached by health services from the perspective of promotion, prevention and care.
The Neuro Engraftment and Neuroregenerative effects of Hydrogen Sulphide Donor, Intracerebral MSCs, Ginko Biloba and Kefir in Attenuating Neuropathological hallmarks of Lipopolysaccharide induced Alzheimer’s disease Rat models
Background: Memory disorders have been characterized by being a devastating long term incurable diseases with a huge social impact in addition to a diminished efficient available medical treatments. Deep Brain stimulation via using neuroprotective inducers for treatment of brain structure degenerative diseases such as Alzheimer’s disease (AD) can be considered as being a promising successful therapy due to its various targets and underlying mechanisms for improving brain dysfunction. Objectives: The main aim of this study is to suggest therapeutic protocol having the potentials for restoring normal neurons diverse population and modifying neuropathological deposited hallmarks including both positive and negative lesions. Materials and Methods: Rats were divided into nine groups: (G1) control ;(G2) rats received LPS as a method of inducing nongenetically manipulated AD;(G3)AD rats received NaHS;(G4) AD rats received MSCs intracerebrally;(G5) AD rats received MSCs+NaHS;(G6)AD rats received kefir+GB;(G7)AD rats received MSCs+kefir+GB;(G8)AD rats received NaHS+kefir+GB; (G9) AD rats received MSCs+NaHS+kefir+GB. Results: AD induction resulted in down-regulation of CBS expression and GSH brain tissue level accompanied with overexpression in amyloid-β protein, MAPK, tau protein, ACAT expression and MDA brain tissue level in addition to elevated caspase-3 serum level. Conclusion: The implantation of amyloid reliving therapy that do have a wide clinical impact if initiated at benign plaques stage before irreversible brain damage occurs. The following effects have been observed following the administration of suggested medical protocol where a decrease in AD pathological deposited hallmarks has been observed with maintaining inflammatory brain factors by functioning as a potent neuroregenerative.
Alzheimer´s Disease and Age-related Macular Degeneration could simultaneously be treated or prevented with a single therapeutic intervention
Alzheimer ´s diseases becomes the most common type of dementia in the world. There is more of 5.4 million AD patients in America, more than 6 million patients in China, and 35.6 million patients worldwide. AD and other dementias worldwide will increase to 67.5 million by 2030 and 115.4 million by 2050. In the aging population, two of the most common neurodegenerative diseases, AD and AMD, could simultaneously treated or prevented with single therapeutic intervention.
This study aimed to analyze the disorders of depression and suicidal ideation in a population of institutionalized elderly in the city of Recife – PE. To measure the phenomena under study two standardized scales were adopted, the BECK SCALE FOR Suicide Ideation (BSI) and the Geriatric Depression Scale (GDS / GDS). The collected data were entered into a database, and statistical procedures performed using the Statistical Package for Social Sciences (SPSS) version 13.0 for Windows. After analysis of the data was possible to show that with the EDG, 48% of the interviewed elderly population is with some degree of depression. It was observed higher scores on the BSI scale for women. Among the elderly depression affects more the age less than 80 years, suicidal ideation was little evident in the population studied, being more related to female.
Prevalence of Polypharmacy and Association to Pharmacotherapy Complexity in Older HIV-Positive Patients. The Sevihlla Study
Background: Increased life expectancy of older HIV-positive patients has been associated to a parallel increase in age-related comorbidities. Objectives: To ascertain the prevalence of polypharmacy and its association to pharmacotherapy complexity, as measured by the Medication Regimen Complexity Index, in older HIV-positive patients; to calculate the median value of pharmacotherapy complexity; to identify polypharmacy and multimorbidity patterns; and to address adherence to antiretroviral and concomitant drugs. Methods: A cross-sectional, observational study was conducted in patients over 50 years of age receiving active antiretroviral drugs during 2014 at outpatient pharmacy services of a tertiary hospital in Spain. Data collected from the electronic medical record included demographic, clinical and comorbidity related endpoints. The primary endpoint was the proportion of patients with polypharmacy and major polypharmacy. Polypharmacy was defined as treatment with six or more drugs (including antiretroviral). Major polypharmacy (more than 11 drugs) was also considered. Patients was categorized according to their polypharmacy pattern. Three patterns were applied based on age of participants: cardiovascular, depression-anxiety, and chronic obstructive pulmonary (COPD) disease patterns. A patient was classified into a pattern when at least three drugs of the treatment were in the same pattern. Antiretroviral treatment adherence was measured using the SMAQ questionnaire and hospital dispensing records. Adherence to concomitant medication was measured using the Morisky-Green questionnaire and electronic pharmacy dispensing records. Pharmacotherapy complexity index, as assessed by MRCI, was also considered. Patients were classified as low MRCI (less than 14 points) or high MRCI (more than 14 points). Results: The study sample consisted of 223 patients (86.5% men), with a median age of 53.0 years. More than 80.0% of the patients were viro-inmunological controlled. Prevalence of polypharmacy was 56.1%. The median value of pharmacotherapy complexity was 11.0. The main contribution to this value was from the concomitant medication. The polypharmacy pattern mainly calculated…
Whey Protein Supplementation as a Strategy to Preserve Muscle Mass and Increase Protein Synthesis in the Elderly: a Review of Literature
INTRODUCTION: Aging often coincides with loss of muscle mass, strength and function, known as sarcopenia. Sarcopenia, a geriatric syndrome closely linked to physical frailty, has a substantial impact on the quality of life. Inadequate dietary intake, especially protein intake, has been associated with decreased lean body mass. Dietary protein affects muscle mass by the stimulation of muscle protein synthesis after absorption of amino acids into muscle cells AIMS: Verify the effectiveness of whey protein supplementation in increasing protein synthesis and muscle mass in elderly. METHODS: This is a systematic review conduced in the pubmed database, which sought clinical trials published between 2012 and 2016, with the combination of descriptors: Whey protein, muscle mass, protein synthesis, sarcopenia. RESULTS: We found 30 articles and after exclusion of non-relevant issues and duplicate articles were included 11 articles in this study. Of the selected material, 3 studies did not find positive effects with supplementation, this null response could have occurred because of dose and/or timing of supplementation, 1 study found the same effect with leucine supplementation and 7 studies found positive effects with whey protein supplementation for the protein synthesis and the increase of lean body mass in the elderly. CONCLUSIONS: Therefore, we can conclude that supplementation of whey protein shows positive results for increased protein synthesis and muscle mass in the elderly. However, the results differ between the sexes, quantity and timing of consumption, which after the need of new studies for the best understanding of the subject. It seems that the elderly respond best to higher amounts of supplement and the periods more distant from the practice of resistive exercise. In addition, after reviewing the articles it appears that men present better results than women do. The results give us another option to maintain the independence and quality of the elderly.
Background: The principles of motor learning (PML) emerged from studies of limb motor skills in healthy, young adults. The applicability of these principles to speech motor learning, and to older adults, is uncertain. Aims: The purpose of this study was to examine one PML, feedback frequency, and its effect on retention and generalization of a novel speech and comparable tracing task. Methods: Sixty older adults completed a speech motor learning task requiring the production of a novel phrase at speaking rates 2 times and 3 times slower than habitual rate. Participants also completed a limb motor learning task requiring the tracing of a sine wave 2x and 3x slower than habitual rate. Participants were randomly assigned to receive feedback every trial, every 5th trial, or every 10th trial. Mean absolute error was measured to examine immediate generalization, delayed generalization, and 2-day retention. Findings: Results suggested that feedback frequency did not have an effect on the retention and generalization of the speech or manual task, supporting the small but growing literature highlighting the constraints of generalizing the PML to other modalities and populations. Funding: This research was supported by the National Institute on Deafness and Other Communication Disorders Grants T32 DC000033, P30DC04661, and the University of Washington Royalty Research Fund (A70442) awarded to Dr. Kristie Spencer. The authors gratefully acknowledge Sara Savaglio, Christopher Woollcott, and all participants for their contributions to this study. The content is solely the responsibility of the authors and only represents their views.