الفهرس | Only 14 pages are availabe for public view |
Abstract Frailty is a rather new concept in geriatric research and practice. Over the last decades, there has been an exponential rise in the use of the term “frailty” in the literature. Frail older people are at high risk for developing adverse outcomes as disability, morbidity, mortality, hospitalization and institutionalization. Frailty confers loss of independence and impairs the quality of life and psychological well-being of older people. It also poses challenges on families, caregivers, and other structures of social care and support. Given the prominent role of CVD in the aggregate burden of morbidity and mortality in the elderly, it was not surprising that CVD, was strongly correlated with frailty. The Women’s Health Initiative Observational Study showed that community-dwelling older women with CVD and cardiovascular risk factors were at higher risk of developing incident frailty. Coronary artery disease and stroke were associated with the highest risk of developing incident frailty. Osteoporosis often accompanies advanced frailty and any fragility fracture in this population is likely to have a profound impact on quality of life and may lead to permanent disability and even premature death. The multidimensional aspects of osteoporosis require a multidisciplinary integrated approach, including environmental, lifestyle, dietary and pharmacological interventions . This study was conducted to compare frail & healthy elderly regarding Bone mineral density, carotid circulation and serum levels of Homocysteine, coronary risk factors and CRP. This study is a case-control study performed on 104 elderly 60 years and older, male and female. They were divided into two groups: group A (case group): 52 frail elderly diagnosed by Fried’s criteria as applied by Avila-Funes et al., 2008. group B (control group): 52 healthy elderly . Both groups were recruited from out patient clinics & inpatient wards at Ain Shams University hospital. The 104 elderly were subjected to comprehensive geriatric assessment including personal history, past medical history, cognitive assessment using mini mental state examination (MMSE), depression assessment using geriatric depression scale (GDS), functional assessment using the activities and instrumental activities of daily living (ADL & IADL), measurment of serum level of : CRP, homocystiene , lipid prfile (total cholesterol, triglycerides, LDL, HDL), carotid duplex to assess CIMT, bone DEXA scan to assess spinal & femoral BMD. This study showed that frailty has been associated with higher number of chronic diseases & with specific disease as DM, hypertension ischemic heart disease,stroke , thyroid disorders, hearing & visual impairment.Also spinal & femoral osteoprosis & osteopinea were greater among cases The study also showed that frail cases had more ADL & IADL depedance , increased prevelance of depression & cognitive impairment. Finally, it was found that patients had higher mean level of homocystiene,CRP & triglycerides in addition to low serum HDL & higher CIMT. Homocystiene is more sensitive in predicting frailty than CRP. |