Insomnia symptoms and their correlates among the elderly in geriatric homes in Alexandria,Egypt

The prevalence of sleep complaints increases steadily with age. Studies investigating insomnia among elderly people living in geriatric homes, especially among Egyptians, are scarce. This study aimed to determine the prevalence of insomnia symptoms among the elderly living in geriatric homes in Alexandria and their correlates. A cross-sectional survey of a representative sample of elderly population of geriatric homes in Alexandria was implemented. A total of 177 persons aged 60 years or older participated. Difficulty initiating sleep was reported by 65% of the participants. Approximately half of them had difficulty maintaining their sleep (50.8%) or had non-restful sleep (51.4%). Short sleep was reported by 43.5% of the participants, while early morning awakening was reported by 28.2%. Advanced age (≥75 years) was significantly associated with increased risk for early morning awakening, non-restful sleep and short sleep. Women had approximately a fourfold risk of non-restful sleep as opposed to men. Short stay in geriatric homes (<1 year) was associated with 2.5-fold increased risk of non-restful sleep. Unmarried status was strongly and positively related to difficulty to maintain sleep and non-restful sleep. Depressive status was significantly associated with an increased risk of difficulty to maintain sleep and decreased risk of early morning awakening. Conclusively, the present study showed that insomnia symptoms are highly prevalent among the elderly living in geriatric homes. It also revealed that although age, gender, and other socio-demographic factors are correlated with insomnia symptoms, other factors are highly important. Health care providers should take these factors in consideration when dealing with elderly patients who complain of insomnia.     

Prevalence of insomnia and its associated factors in elderly long-term care residents

Insomnia is a significant problem that may jeopardize elderly residents' quality of life in long-term care settings. However, there are only a few studies dealing with sleeping disturbances among nursing home residents. The goal of this study was to determine the prevalence of insomnia and its associated factors in nursing home residents. A cross-sectional study (n=2332) was conducted among seniors living in long-term care facilities. The findings indicate that 144 (6.2%) participants had an insomnia disorder according to DSM-IV criteria, 17% displayed at least one symptom of insomnia, and more that half of the subjects were benzodiazepine users. According to multivariate analysis, psychological distress (adjusted odds ratio=1.51) and disruptive behaviors (adjusted odds ratio=2.10) were the only factors associated with an insomnia disorder among this population. In conclusion, insomnia is a fairly important problem, as a symptom or a syndrome, among elderly people and deserves attention from caregivers. Alternative interventions to benzodiazepine drugs, which are suited to long-term care residents while tailored to these specific care settings, should be developed.     

Montreal Cognitive Assessment Arabic version: Reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo

Aim:   Mild cognitive impairment (MCI) is a clinical label which includes elderly subjects with memory impairment and with no significant daily functional disability. MCI is an important target for Alzheimer's dementia prevention studies. Data on the prevalence and incidence of MCI varies greatly according to cultural difference. The first aim of this study was to assess the reliability and validity of Montreal Cognitive Assessment (MoCA) Arabic version in MCI detection. The second was to determine the prevalence of MCI among apparently healthy elderly people attending geriatric clubs in Cairo.
Methods:   In stage I reliability & validity of MoCA Arabic version were assessed in reference to Cambridge Cognitive Examination (CAMCOG). In stage II prevalence of MCI was estimated using Arabic MoCA among apparently healthy elderly attending geriatric clubs. These geriatric clubs were randomly selected from different regions in Cairo governorate.
Results:   Test–retest reliability data of the Arabic MoCA were collected approximately 35.0 ± 17.6 days apart. The mean change in Arabic MoCA scores from the first to second evaluation was 0.9 ± 2.5 points, and correlation between the two evaluations was high (correlation coefficient = 0.92, P  < 0.001). The internal consistency of the Arabic MoCA was good, yielding a Cronbach's α on the standardized items of 0.83. In diagnosing mild cognitive impairment, the Arabic MoCA showed 92.3% sensitivity and 85.7% specificity. The prevalence of MCI among elderly subjects attending geriatric clubs in Cairo is 34.2% and 44.3% of healthy men and women, respectively.
Conclusion:   Older age, female sex and less education are the independent risk factors for MCI among apparently healthy elderly subjects attending geriatric clubs in Cairo.     

Insomnia and depressive symptoms in patients with Parkinson's disease. Relationship to health-related quality of life. An interview study of patients living at home

The objectives of this study were to describe the prevalence of insomnia and depressive symptoms in patients with Parkinson's disease (PD) and to relate those symptoms to health-related quality of life. A total of 102 patients living at home, most of them moderately to severely disabled, were interviewed. Of them 43 patients were women with a mean age of 70 (range 58-79). The mean age for the men was 71 (range 56-80). Time since diagnosis was <2 years for 57%, 2-10 years for 31% and >10 years for 12%. The geriatric depression scale (GDS) and Livingston's insomnia scale were used. The results were related to quality of life as measured with the SF-36 health survey. The prevalence of insomnia was 80%. Moderate depressive symptoms were found in 47% and severe depressive symptoms in 5%. Patients with insomnia or with depressive symptoms had a significantly impaired quality of life on all eight scales of the SF-36. In a stepwise regression analysis the presence of pain and ache and depressive symptoms were significantly related to insomnia. The variables most related to depressive symptoms were Hoehn and Yahr group and insomnia. Hoehn and Yahr groups (more disability) were significantly related to insomnia and depressive symptoms. Thus, insomnia and depressive symptoms are prevalent in PD and influence quality of life and should, therefore, be considered when evaluating patients with PD.     

Study of constipation in a geriatric hospital, day hospital, old people's home and at home

A study of constipation and related factors was carried out in 439 geriatric hospital patients, 183 people living in two old people's homes, and 78 patients visiting a geriatric day hospital. In addition, a cross-sectional survey of constipation and related factors was undertaken in 138 people older than 74 years and 74 people aged 41 to 50 years living at home. Constipation and the use of laxatives were most frequent in the geriatric hospital (79% and 76% respectively), followed by the old people's homes (59% and 60%), the day hospital (29% and 31%), elderly living at home (38% and 20%) and middle-aged living at home (12% and 5%). The results suggest an increased risk of constipation for the persons walking less than 0.5 km daily [relative risk (RR) = 1.7], walking with help (RR = 3.4), chairbound (RR = 6.9) and bedbound (RR = 15.9). The relative risk of constipation increased for the persons living in the old people's homes (RR = 1.7) and the geriatric hospital (RR = 2.2), and also with advancing age (between 75 and 84 years, RR = 2.9; over 84 years, RR = 4.9). The prevalence of constipation was directly correlated to fecal and urinary incontinence.     

Sleep disturbances and their correlates in elderly Japanese American men residing in Hawaii

BACKGROUND: Elderly people frequently report the presence of chronically disturbed sleep. However, most data are derived from predominantly Caucasian populations. The current study is an investigation of the prevalence and correlates of sleep disturbances in a cohort of elderly Japanese American men residing in Hawaii. The importance of this population lies in its representation of an ethnic group living in a culture different from their ancestry. METHODS: This study is a cross-sectional cohort analysis of data pertaining to sleep disturbances and their potential correlates from 3,845 elderly Japanese American men residing in Hawaii (mean age. 78 years; range, 71-93 years) who participated in the fourth survey of the Honolulu Heart Program (1991-1994), which is the baseline exam for the Honolulu-Asia Aging Study. Information collected included an extensive survey of medication use, medical history, and assessments of physical and mental function, quality of life, and sleep. RESULTS: The prevalence of insomnia (DIMS) was 32.6%, a rate similar to that reported in predominantly Caucasian populations. Depression, benzodiazepine use, and several chronic health problems were the most important factors associated with DIMS. In contrast, excessive daytime sleepiness (EDS) had a prevalence of 8.9%, a rate lower than that found in elderly Caucasian populations but close to that reported among native Japanese. Important factors related to EDS were symptoms of nocturnal respiratory disturbance, depression, perception of adverse quality of life, Parkinson's disease, and digitalis use. CONCLUSIONS: Elderly Japanese men are less likely than elderly Caucasian men to report excessive daytime sleepiness. However, their insomnia rates are similar.     

Prevalence and risk factors for insomnia in community-dwelling elderly in northern Taiwan

Background/PurposeTo determine the prevalence and risk factors for insomnia among community-dwelling elderly in northern Taiwan.Materials and methodsA cross-sectional survey was conducted among 1358 elderly people (601 men, 44.3%; and 757 women, 55.7%) who had received a senior-citizen health examination between March 2009 and November 2009. Responses to a clinical questionnaire on insomnia (Chinese version of the Athens insomnia scale), mental health (brief symptom rating scale), and 14 physical symptoms were measured.ResultsInsomnia syndrome was found in 41% of individuals; it was more common in women than in men (63.3.0% vs. 36.7%). Multivariate models showed that aging [≥80 years old, odds ratio (OR) = 0.67, 95% confidence interval (CI): 0.46–0.93], living with family (OR = 0.51, 95% CI: 0.35–0.76), and perceived good health status (OR = 0.58 and 0.71, p<0.05) were associated with a decreased risk of insomnia. Meanwhile, female gender (OR = 1.70, 95% CI: 1.37–2.12), receipt of medication for chronic diseases (OR = 1.64, 95% CI: 1.29–2.08), high brief symptom rating scale score (1.45, 95% CI: 1.32–1.86), perceived poor health status (OR = 1.92 and 1.80, p<0.05), and total physical symptoms (OR = 1.34, 95% CI: 1.08–1.70) were associated with an increased risk of insomnia.ConclusionThe results indicate that the aging process itself is not responsible for the increased prevalence of insomnia often reported in older people. Instead, physical symptoms, receipt of medication for chronic diseases, mental health status, living status, and perceived level of well-being affected the risk of insomnia.     

Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: III. Phuto in Vietnam

Background: The objective of the present study is to compare the findings of comprehensive geriatric assessment between community‐dwelling elderly aged 60 years and older living in Vietnam and in Japan. Methods: A cross‐sectional, interview‐ and examination‐based study was undertaken of community‐dwelling elderly people living in under‐developed Ngoc Quan village, semideveloped Viet‐tri city in Phuto province, both in Vietnam and in Sonobe town in Kyoto, Japan. One hundred and ninety‐nine and 188 community‐dwelling elderly aged 60 years or older in two developmentally different areas in Vietnam and 411 community‐dwelling elderly aged 65 years or older in Japan, were examined using a common comprehensive geriatric assessment tool. Interviews pertaining to activities of daily living (ADL), medical and social history, quality of life (QOL) and the 15‐item Geriatric Depression Scale as well as anthropometrical and blood chemical examinations were included in the assessment. Using anova and χ² test, findings from the three groups were compared. Results: In a comparison of comprehensive geriatric assessment findings among community‐dwelling elderly in under‐developed Ngoc Quan village, in semideveloped Viet‐tri city in Vietnam and in highly developed Kyoto in Japan, all activities of daily living scores except those relating to social role, all quality of life scores, body mass index, serum lipid levels and hemoglobin concentrations were lowest in Ngoc Quan and highest in Kyoto. Mean blood pressure measurements, prevalence of hypertension and prevalence of impaired glucose tolerance were higher in Vietnam than in Japan. The prevalence of depression was lower in the elderly in Viet‐tri in Vietnam than those in Ngoc Quan in Vietnam or in Kyoto in Japan. Conclusion: It is supposed that economic and social development might bring higher comprehensive geriatric assessment scores, better‐nutritional states and more appropriate controls for risk factors in community‐dwelling elderly in a economically developmental dose responsive manner.     

Aspects of quality of life in persons with pre-lingual deafness using sign language: subjective wellbeing,ill-health symptoms,depression and insomnia

This study investigated health-related quality of life, expressed as subjective wellbeing and the prevalence of depressive symptoms and insomnia, among elderly pre-lingually deaf persons using sign language. Comparisons were made with elderly hearing people. Forty-five pre-lingually deaf persons, 65 years or older, took part (a response rate of 46%). Subjective wellbeing was assessed with the Gothenburg Quality of Life (GQL) instrument. Depressive symptoms were rated with the 15-item version of the geriatric depression scale (GDS), and insomnia was measured with Livingston's sleep scale. Ratings of subjective wellbeing among elderly pre-lingually deaf people were generally high. One third of the deaf persons demonstrated depressive symptoms and nearly two thirds suffered from insomnia. There was substantial correlation between insomnia, depressive symptoms and lower subjective wellbeing. The results strengthened the assumption that depressive symptoms and sleep disturbance are more frequent among elderly pre-lingually deaf people using sign language than among hearing people. On the other hand, and contrary to our expectations, this did not imply significantly lower perceived subjective wellbeing compared with hearing elderly people. Results must be interpreted with caution due to limitations in the study.     

Polypharmacy prevalence among older adults based on the survey of health,ageing and retirement in Europe

Polypharmacy, a common condition among the elderly, is associated with adverse outcomes, including increased healthcare costs, due to higher mortality, falls and hospitalizations rates, adverse drug reactions, drug–drug reactions and medication nonadherence. This study aims to evaluate the prevalence and factors related to polypharmacy in older adults across 17 European countries, plus Israel.In this cross-sectional analysis, we used data from participants aged 65 or more years from Wave 6 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) database. Polypharmacy was defined as the concurrent use of five or more medications. Age, gender, education, physical inactivity, number of limitations with activities of daily living, network satisfaction, quality of life, depression, number of chronic diseases and difficulty taking medication variables were found to be associated with polypharmacy.Our results showed a prevalence of polypharmacy ranging from 26.3 to 39.9%. Switzerland, Croatia and Slovenia were the countries with the lowest prevalence, whereas Portugal, Israel and the Czech Republic were the countries where the prevalence of polypharmacy was the highest. Age, gender, number of limitations with activities of daily living, number of chronic diseases, quality of life, depression, physical inactivity, network satisfaction, difficulty in taking medications, years of education and shortage of money were significant variables associated with polypharmacy.Polypharmacy is a highly prevalent condition in the elderly population. Identification of variables associated with polypharmacy, such as those identified in this study, is important to identify and monitor elderly groups, which are most vulnerable to polypharmacy.     

Prevalence of Long-Term Care Acquired Infections in Nursing and Residential Homes in the Emilia-Romagna Region

Abstract Background: Hardly any data on the occurrence of infection in Italian nursing homes have been published; yet Italy has the second oldest population in the world. The objective of the study was to assess the frequency of infections in a sample of Italian nursing homes. Materials and Methods: A 1-day prevalence survey was conducted in three local health authorities (LHAs) of the Emilia-Romagna region in Italy, aimed at describing the prevalence of patients with long-term care facilityassociated infections and their associated factors among residents of nursing and residential facilities. All nursing homes (NHs) and a stratified random sample of residential homes (RHs) in the three LHAs were included in the study, for a total of 1,926 elderly people in 49 facilities. The following data were recorded: infections, medical condition, activities of daily living (ADL), use of antibiotics. The main outcome of the study was infection prevalence. Results: The prevalence of patients with long-term care facility-associated infection was 8.4/100 residents overall (CI 95% 7.9–9.0), 14.6/100 in NHs and 7.5/100 in RHs (CI 95% 6.8–8.1). The prevalence of infection significantly varied with LHA and facility. It was associated with level of dependency and exposure to invasive procedures, such as urinary catheterization and parenteral procedures. Six percent of residents received a systemic antimicrobial on the day of the study, and in 22% of cases there was no evidence of suspected or diagnosed infections. Conclusion: The prevalence study identified a high prevalence of infected patients in nursing homes in Italy, consistent with observation in other geographic areas.     

Factors associated with the prevalence of sarcopenia and frailty syndrome in elderly university workers

BackgroundFrailty and sarcopenia are highly prevalent, as a part of geriatric syndrome, among elderly individuals. However, little is known about how these syndromes can affect elderly individuals who continue to work.ObjectiveTo estimate the prevalence of sarcopenia and frailty, and their individual and occupational factors among elderly individuals.MethodsThis cross-sectional study included elderly individuals working in a public university in Brazil, who were classified according to their sarcopenia and frailty profiles. They answered a structured questionnaire comprising potential explanatory variables: individual sociodemographic factors, work related factors, and health behaviors. Additionally, they performed a physical performance test. Multinomial logistic regression was used to estimate odds ratios and respective 95% confidence intervals (95% CIs). All analyses were conducted using the Stata 13.0 software, considering a significance of 5%.ResultsRespectively, 55.8% and 6.3% of the elderly participants were classified in the Sarcopenia and Severe Sarcopenia groups. Frailty prevalence was 9.4%, with 62.5% classified as Pre-frail. Sarcopenia prevalence was significantly higher among men, and among those living with a partner, with a university degree, exhibiting poor lower limb function, and with multiple work demands. Frailty prevalence was significantly higher among women, and among those living without a partner, having a low educational level, with less work experience, working in an unhealthy/dangerous environment, and whose job was predominantly physical.ConclusionThis study identified different potential trigger factors for the development of sarcopenia and frailty. These findings confirm that individual and work factors could explain the incidence of sarcopenia and frailty syndrome.     

Accidents of the elderly living in Kocaeli Region (Turkey)

The accidents seen in the elderly have a remarkable impact on their family life and the society they live in. In this study, we have aimed to assess the prevalence, types and characteristics of the accidents seen among the elderly. We performed a cross-sectional study. The data was collected from 486 old people living in Kocaeli Region, in 2003. Demographic features, numbers and the variety of accidents were recorded after interviews. The data were also obtained from a questionnaire given after a physical examination. The ratio of accidents was found to be 9.5% (46 cases) in the study group; of those 71.7% were indoor and 28.3% outdoor accidents. The causes of the accidents were falls (69.6%), cuts (13.0%) and stings (10.9%). The distribution of the indoor accidents was 72.7% for falls, 12.1% for cuts, 9.1% for stings and 6.1% for other injuries. The distribution of the outdoor accidents was 61.5% for falls, 15.4% for cuts, 15.4% for stings and 7.7% for burns. Fall-induced injuries seem to be a major problem among the elderly. The results of our study indicate that the occurrence of indoor accidents is an important health problem in the geriatric population.     

Insomnia in the elderly—A hospital-based study from North India

Background/PurposeInsomnia affects the elderly population significantly. The Indian elderly population is growing rapidly and the epidemiology of insomnia needs to be studied in detail in this group.MethodsAn observational study was carried out using a standard questionnaire on 304 male and 200 female Indian elderly patients presenting to the geriatric clinic of the Sir Sunderlal Hospital of the Institute of Medical Sciences, Banaras Hindu University, to study the prevalence and nature of insomnia in this population. The mean age of the study group was 66.47 (±6.855) years. The distribution of insomnia in the various groups (based on sex, occupation, residence, habit-forming substance use, depression) was compared using the Chi-square test with SPSS version 16.0.ResultsInsomnia was present in 32% of the study population. A statistically significant association was found between increasing age and insomnia (p = 0.035) but no significant sex differences were appreciable (p = 0.173). Early insomnia was found to be the most common pattern of insomnia identified (39% of total affected). Most of the cases were of chronic insomnia (89.45%) and associated with some comorbidity (100%). Cardiovascular diseases were the most common comorbidity (27.3% of patients with insomnia). Further, positive and statistically significant correlation was found between insomnia and the place of living (p = 0.034), habit-forming substance use (p = 0.045) and depression (p < 0.001).ConclusionThe nature and attributes of insomnia in the Indian elderly are identified by this study. The scope for cause-finding studies is highlighted and points regarding adequate intervention are suggested.     

The ankle-brachial index is not related to mortality in elderly subjects living in nursing homes

Low ankle-brachial index (ABI) levels are associated with increased risk of all-cause and cardiovascular mortality in middle-aged and older adults. We evaluated the association between low ABI and all-cause and cardiovascular mortality in elderly patients living in nursing homes. In 632 subjects (mean age 82.1 +/-7.4 years, 137 men) living in 3 municipal nursing homes, ABI, prevalent cardiovascular diseases, and conventional risk factors were evaluated at baseline in 1998. After a 3-year follow-up the relation between a low ABI and mortality outcomes was evaluated by using multivariable Cox proportional hazards analysis. A low ABI (<0.90) was observed in 177 participants (28%). After 3 years, 304 subjects (48.1%) died; death occurred in 53.6% of those with low ABI and in 45.9% of those with normal ABI. No significant relation between low ABI and all-cause (hazard ratio [HR] 1.1, 95% confidence interval [CI] 0.7-2.0) or cardiovascular mortality (HR 1.3, 95% CI 0.8-2.1) was observed. Among elderly patients living in nursing homes, there is a high prevalence of low ABI, which is not related to all-cause and cardiovascular mortality.     

Gastroesophageal reflux disease: prevalence and associated factors

BACKGROUND: O gastroesophageal reflux is a high prevalent disease with prevalence rates ranging from 21 to 56% in different countries. OBJECTIVE: To study the epidemiology and the prevalence of gastroesophageal reflux disease among adult population (20 years and old) at the city of Pelotas, southern Brazil. METHODOLOGY: A population-based cross-sectional study was conducted. Household interviews were done between October 1999 and January 2000. Association between gastroesophageal reflux disease and age, sex, skin color, years of formal education, income per capita, marital status, psychological variables (insomnia, stressful psychosocial events in the last year, psychological distress), body mass index, smoking and weekly consumption of alcoholic beverages was assessed through logistic regression. RESULTS: Three thousands and nine-hundred thirty four (3,934) individuals were interviewed. A prevalence of 31,3% (CI 95% 29.9%-32.8%). After allowing for confounding gastroesophageal reflux disease was significantly associated with female sex, living without partner, low level of formal education, insomnia, psychological distress, reported stressful psychosocial events in the last year, obesity and overweight. CONCLUSION: Gastroesophageal reflux disease is a high prevalent disease and its main associated factors are sex, anthropometric variables and psychological characteristics.     

Prevalence of functional disability among elderly patients with cancer

This study is part of a larger multicenter prospective study conducted in Italy to assess the efficacy of the comprehensive geriatric assessment (CGA) among elderly patients with cancer (i.e. aged 65 years or older). The prevalence of functional limitations, and its association with selected characteristics, was investigated among 303 elderly patients consecutively admitted at the Department of Medical Oncology, IRCCS Centro di Riferimento Oncologico, Aviano (Northeast Italy), between 1995 and 1998. These patients had a median age of 72 years (range, 65-94), and were affected by haematological (n=182) or solid tumours (n=121). At baseline, their physical function was assessed, in addition to performance status (PS), by means of the activity of daily living (ADL) and the instrumental activities of daily living (IADL) scales. Overall, 17% of the patients had a limitation for ADL, and 59% for IADL, the prevalence of functional disabilities increased with age. Specifically, 8% of patients had continence limitations and 13% had limitations in taking the prescribed drugs. By multivariate analysis, a poor PS turned out to be a strong independent determinant of both ADL and IADL disabilities.     

Sleep Disturbance and Total Sleep Time in Persons Living with HIV: A Cross-Sectional Study

Short and long sleep durations have been associated with inflammation and chronic diseases. To study the association between sleep duration/quality and HIV disease severity, a cross-sectional study was conducted in patients living with HIV (PLWHs) using self-administered questionnaires assessing total sleep time, insomnia (ICSD-3 criteria), and poor sleep quality (PSQI?>?5). Multivariable logistic regression identified the factors associated with sleep disorders and with HIV features. 640 Parisian ambulatory PLWHs were included. The prevalence of insomnia was 50 and 68% of patients had a PSQI?>?5. Patients with CD4 count?<?500 cells/mm³ were more likely to be long sleepers (>?8 h/day) (OR 1.49; 95% CI [1.10–1.99]: p?<?0.01), and less likely to be short sleepers (<?6 h/day) (OR 0.69; 95% CI[0.50–0.96]; p?=?0.04) or to experience insomnia (OR 0.59; 95% CI[0.40–0.86]; p?<?0.01). HIV features were not associated with a PSQI?>?5. Thus, insomnia and impaired sleep quality were highly prevalent in well-controlled PLWHs and the severity of HIV infection was associated with long sleep times.     

HIGH PREVALENCE OF Strongyloides stercoralis INFECTION AMONG THE ELDERLY IN BRAZIL

SUMMARY

Little is known about the frequency of intestinal parasites in the elderly due to a lack of attention given to the occurrence of these infections among older adults. This study compares the frequency of Strongyloides stercoralis and other enteroparasites between elderly living in nursing homes (n = 100) and those noninstitutionalized (n = 100) from Uberlândia, state of Minas Gerais, southeastern Brazil, associated with data of epidemiological and socio-demographic conditions. Through coproparasitological examination of both groups, enteroparasites were detected in 15 of 200 individuals examined (7.5%; CI: 5.1- 9.9). S. stercoralis was the most frequent parasite 10/200 (5%; CI: 4.2-5.8), being significantly higher in males and in individuals with autonomy for daily living activities. There were no statistical differences in the prevalence of parasites between the two groups compared. In conclusion, S. stercoralis infection was highly prevalent in elderly patients and it does not depend on whether the individual was institutionalized or not.     

Prevalence of remediable disability due to low vision among institutionalised elderly people

BACKGROUND: Prevalence of remediable visual disability among institutionalised elderly people, resulting from inappropriate use or non-use of low-vision aids, is reported to be high, but largely rests on anecdotal evidence. OBJECTIVE: To estimate the prevalence of binocular low vision and underlying eye diseases among institutionalised elderly people in a Dutch urban population and the size of remediable visual disability as the result of inappropriately corrected low vision. METHODS: The design was a cross-sectional survey of 284 subjects with low vision (corrected binocular vision <0.4) in nursing homes and homes for the elderly in the Netherlands. RESULTS: 284 of 610 eligible residents were examined. The prevalence of binocular low vision was 31.3%. Among elderly residents with low vision, prevalence of cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy was 77.9, 37.7, 5.2 and 5.2%, respectively. In 32 residents (41.6%), (non)-use of low-vision aids was considered inappropriate. In 50 residents (64.9%), visual disability was considered at least partially remediable, either through better use of low-vision aids, or through cataract extraction. Residents who were not optimally corrected for low vision were significantly more functionally impaired compared with their peers who were optimally corrected. CONCLUSION: Low vision is likely to be highly prevalent among institutionalised elderly. A significant amount of the associated visual disability may be remediable.