https://digitallibrary.bldedu.ac.in/xmlui/handle/123456789/5760 2026-05-20T09:29:08Z https://digitallibrary.bldedu.ac.in/xmlui/handle/123456789/5762 Title: Clinical Profile Of Anemia And Its Impact On Functional Capacity And Cognition In Elderly” Submitted In Partial Fulfillment Of M.D Degree Examination Geriatrics Authors: Vigneshwaran, S. Abstract: This study is a case control analysis, with fifty elderly anemic cases that meet the WHO definition of anemia and fifty non-anemic controls, matched for age and sex. This comparative study aims to determine how anemia hastens the onset of cognitive decline and functional disability in the elderly. Furthermore, it assesses the comprehensive clinical profile of fifty elderly cases of anemia, which will aid in determining the prevalence of common anemia types, dietary patterns, drug history, clinical manifestations, and the most common aetiology leading to occurrence of anemia. Standardised scales such as the Katz ADL and Lawton IADL were used to evaluate the functional capacity of the cases and controls. Cognition assessment was done using MOCA scale. Data for clinical profile was collected by thorough history taking, clinical examination and lab investigations. Female preponderance was seen in our study and mean age of the study population was 69.8 years. Iron deficiency anemia was the most common type of anemia and the most common etiology leading to occurrence of anemia was due to poor bioavailability secondary to various causes. Katz ADL assessment among the cases and controls revealed a significant odds ratio (OR = 15.8) which implies the odds of anemic elderly getting their daily activities impaired were found sixteen fold higher than non-anemic elderly. The Lawton IADL performed on study population revealed a considerable odds ratio (OR = 10.62) which implies that the anemic elderly are eleven times more prone to get dependent on others for their instrumental activities of day to day life. MOCA assessment performed among the cases and controls reveals that odds of anemic elderly undergoing cognition decline is tenfold higher than the non-anemic elderly (OR = 9.75). Considering this note, anemia not only impairs the older individuals physically but it also impacts their mental capacity which will make older people more dependent on caretakers to do everyday tasks. Due to their greater dependence on others, elderly people in developing nations like India, where there is a shortage of skilled caregivers, face a costly dilemma that increases their vulnerability to elder abuse in multiple ways. Therefore, the government should take action to raise awareness about the need of early diagnosis and treatment of anemia in the elderly in order to prevent functional impairment and cognitive decline and preserve their quality of life. 2021-01-01T00:00:00Z https://digitallibrary.bldedu.ac.in/xmlui/handle/123456789/5761 Title: Assessment of nutritional status and its impact on outcome in elderly admitted with respiratory diseases in critical care unit Authors: Sandeep Kumar Abstract: Need for the study Abstract As the ageing population is growing world-wide, so is the risk of malnutrition in elderly population1. There is a high prevalence of malnutrition in elderly population, and the prevalence increases manifold in hospitalized elderly patients2. The reason for high prevalence of malnutrition are many and includes-multi- morbidity, atypical disease presentation, delay in seeking medical consultation due to various psycho-socio-economic factors and also includes the fear of hospital admission in elderly age group. Disease and illness in itself is a risk factor of malnutrition and eating fewer than two meals a day adds to this problem. The frail elderly adult may be requiring assistance for self-care and for his activities of daily living. He may be suffering from tooth loss or mouth pain, chewing difficulty, economic hardships to buy food stuff, reduced social contact or may be facing involuntary weigh loss. Patients with COPD are mostly severely undernourished for proteins. The main mechanism is hyper-metabolism, which is responsible for increased oxygen consumption by the malnourished respiratory muscles. One of the most important cause of the atrophy and decreased strength of respiratory muscles decreased exercise performance, decreased quality of life and increased risk of hospital acquired or community-acquired Pneumonia is malnutrition3. Mini Nutritional Assessment-short form (MNA-SF®) is an easy and reliable screening tool for physician, dietician, medical students or nurses to quickly evaluate the nutritional status of elderly adults. A low MNA-SF® score (0-7) represents malnutrition; a high score (12-14) represents normal nutrition status and an intermediate score (8-11) represents risk of malnutrition. MNA-SF® is an ideal tool for the evaluation of older adults with high specificity, sensitivity, negative and positive predictive values and a high validity. Materials and method The present study is a hospital-based cross-sectional study conducted on 100 elderly patients admitted with various respiratory diseases in the critical care unit (ICU) of Shri B M Patil Medical College and Research Centre, Vijayapura, after obtaining due approval from the institutional ethical committee. Results The study population of this study consists of 53% males and 47% females with mean age of 69.11± 7.82 years. Majority (74%) of patients fall in the age group of 60-74 years (young-old) and 65% were on mixed diet with 52% elderly patients reported a normal dietary intake. In our study, 17% of patients were screened by MNA-SF® to be malnourished, 40% were found to be to risk of malnutrition, and 43% were normally nourished. 58% of the patients stayed below ten days in the hospital, and only 18% stayed for more than 20 days. 32% of the study population required mechanical ventilation, 28% were on non-invasive ventilation, and 26% elderly patients were given Oxygen via mask. Considering the haematological and biochemical parameters, 72% elderly had haemoglobin less than 13 g/dL, total leukocytes counts were more than 11,000 per cu mm in 38%, mean corpuscular volume was less than 80 fL in 30% and more than 100 fL 13%. Serum Creatinine was more than 1.3 mg/dL in 34% of patients. In our study, mortality was seen in 10% of patients and 71% patients were discharged with follow-up advice. 8% of patients who died had breathlessness as the presenting complaint, 7% had three co-morbidities, 4% died due to lower respiratory tract infection as their diagnosis and 6% of them had mid-arm circumference less than 22.5 cm which was statistically significant. 6% elderly patients died due to malnutrition based on MNA-SF® finding, which is a statistically significant finding of this study. Conclusion Malnourished patients face heightened risks of mortality and morbidity, which can exacerbate existing conditions like chronic lung disease, sepsis, trauma, and cardiovascular dysfunction. Addressing malnutrition through systematic nutritional screening is crucial as it allows healthcare providers to identify patients at risk early on. This approach not only highlights the problem but also integrates nutritional correction as a fundamental part of patient therapy. Importantly, many of the adverse effects of malnutrition can be partially reversed with appropriate re- feeding strategies. More research is needed in this domain in the future and time will see that ―clinical nutrition‖ will be considered as ―fundamental human right‖ in the future, by the governments. 2021-01-01T00:00:00Z