2016/1

  • Position of indapamide in the treatment of hypertension in the elderly – a clinical case with commentary
    Marcin Barylski
    Hypertension is a disease which incidence is increasing with age. Diagnosis and treatment of hypertension in elderly patients require individualized procedure. Effectiveness of antihypertensive therapy leads to a reduction in morbidity and mortality like in the younger groups of patients. Choosing the correct treatment should take into account both the indications and contraindications for a class of drugs, as well as the needs of patients. The article presents the clinical case of an 82-year-old female with stage 2 hypertension and discusses the place of indapamide in the treatment of hypertension in the elderly.
    Keywords: hypertension, older age, indapamide

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  • Nonpharmacological attempts to improve cognition in elderly patients illustrated with neurobiofeedback
    Leszek Bidzan
    Deterioration of cognitive functions is a common occurrence in elderly people. Various methods attempting at reducing cognitive impairment and, at the same time, stopping the progression of the disorders have been subjects to studies for many years. Despite numerous trials with a variety of medications, no unequivocal evidence has been obtained regarding any of the drugs. Apart from pharmacological treatment, attempts have been made to establish an efficient nonpharmacological method. One of such methods is EEG-biofeedback, also named neurobiofeedback. Efficacy of this method on some domains of cognitive functioning and executive functions has been suggested. However, the very influence on memory functions is often questioned. The greatest agreement regarding neurofeedback is that it is effective in subjects with insignificant cognitive impairment.
    Keywords: neurobiofeedback, cognition

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  • Selected problems of antihypertensive treatment in the elderly
    Anna Chudiak, Katarzyna Lomper, Beata Jankowska-Polańska
    Due to physiological changes in the body and the presence of comorbidities, the treatment of hypertension in the elderly is a challenge for the whole of the therapeutic team. In addition, old age is closely associated with the occurrence of the frailty syndrome. It applies to about 15-20% of patients after 65 years. The team fragility, impaired cognitive functions negatively affect adherence to treatment recommendations which in turn reduces the effectiveness of antihypertensive therapy. Effective antihypertensive therapy reduces the risk of complications, thereby reducing the risk of strokes, and deaths from cardiovascular diseases. Antihypertensive treatment in geriatric patients requires an individual procedure. Using antihypertensive medications among elderly patients should be aware of the increased risk of falls, polypragmasy and orthostatic hypotension.
    Keywords: hypertension, antihypertensive treatment, old age

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  • Health or beauty?
    Body image and health attitudes among elderly women
    Alicja Głębocka
    Background. Aging and related changes in appearance are responsible for shaping negative beliefs and emotions towards one’s own body among women. Aim. The aim of the study was to examine body image (body satisfaction, characteristics of cognitive and emotional processes, social and cultural influences, behaviors in respect to bodies, and attitudes toward plastic surgery) and health attitudes relationship among elderly women compared to young and mid-aged women. Material and methods. Two hundred sixty four participants, aged 20-86 years, completed: Body Satisfaction Scale, Body Image Questionnaire, Scale of Attitudes toward Plastic Surgery, and Pro-health Attitudes Scale. Results. The results indicated some similarities of body image indicators between elderly and younger women, but some differences were reviled as well in the level of body satisfaction, criticism of environment, stereotypes of beauty and ugliness, and the attitudes toward plastic surgery. Age wasn’t the most important predictor of body image, health attitudes and attitudes toward plastic surgery. More important factors determining the variables were body weight, desirable body weight, and media exposures. Conclusions. The relation between beauty and health was confirmed: the body satisfaction correlated positively to the physical activity, and the belief that healthy life style support well-being and health were strongly connected with the negative attitudes toward plastic surgery, which were evaluated by elderly woman as dangerous for health.
    Keywords: body image, body satisfaction, health, plastic surgery, media

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  • Elderly-onset rheumatoid arthritis: diagnosis, course and treatment options
    Paweł W. Królik
    Background. According to the classical definition of rheumatoid arthritis (RA) is a chronic immune disease with typical symmetric arthritis and plurality of extra-articular lesions leading to disability and early death [1]. It is very important early and aggressive anti- inflammatory treatment, the systematic control of disease activity and the assessment of tolerability. The goal of treatment is to achieve remission or low disease activity for each patient. In the elderly should prevent the development of disability, including through the treatment of pain and depression and aware of the increased risk of adverse drug reactions [2]. Case report. Below are two cases of elderly patients in whom disease onset was clearly different from the traditionally conceived course of RA. The key to diagnosis turned out to determine the level of anti-cyclic citrullinated peptide antibodies (aCCP) whose detection in the elderly is similar to younger age groups.
    Keywords: rheumatoid arthritis, old people

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  • The sense of coherence and dealing with an illness experienced cerebral stroke
    Krystyna Kurowska, Małgorzata Lasota
    Background. There is a relevant relation between the sense of coherence and health. Having high level of SOC eases dealing with difficult and stressful situations. A cerebral stroke appears suddenly. It leads to life activity limitation, it involves hospitalization and thus it is so significant to find and choose the right strategy of dealing with stress that an illness is accompanied by. Aim. The definition of SOC level and the ways of dealing with stress preferred by patients with cerebral stroke diagnosed, as a determiner of a positive functioning in everyday life and the maintenance of an optimal state of health. Material and methods. 85 patients with cerebral stroke diagnosis were examined at the Neurological Clinic in The University Hospital of Dr. A. Jurasz in Bydgoszcz. The sense of coherence was defined with the help of Living Orientation questionnaire (SOC-29) and dealing with stress was measured with the help of the Endler and Parker’s CISS questionnaire, adapted into Polish by Szczepanik, Strelau and Wrześniewski. Results. The ill comprise people of an average SOC level. When found in stressful situations they usually focus on putting effort aiming at solving the problem by cognitive transformation or attempts to change the situation. Conclusions. The results can help to prepare better the patient with a total hip, replacement to live with the disease. They also help to plan better the patients’ treatment. They also allow to start the activity which aims to help in disease acceptation.
    Keywords: sense of coherence (SOC), coping styles, cerebral stroke

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  • EASY-Care questionnaire in the assessment of needs of elderly subjects
    Dorota Talarska, Dorota Ryszewska-Łabędzka, Sławomir Tobis
    Intense ageing of world’s societies induces necessity of search for optimal solutions aimed at maintaining personal fitness as long as possible. A holistic assessment of needs of elderly is indispensable, in the perspective of both health and social care. One of the tools possible to use is the EASY-Care Standard 2010 Questionnaire. The paper discusses this tool and describes its past use.
    Keywords: needs, care, EASY-Care questionnaire

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  • Anorexia of aging – epidemiology, causes and health consequences
    Edyta Wernio, Jolanta Anna Dardzińska, Sylwia Małgorzewicz
    Anorexia of aging, defined as a loss of appetite and/or reduced food intake. Approximately 20-25% of elderly people in Europe suffer from anorexia. Physiologic alterations, comorbidities, polypharmacy, psychological and social problems are the major factors responsible for the reduction of appetite. Loss of appetite leads to an inappropriate calories and nutrients intake. The anorexia of aging is associated with protein-energy malnutrition, increase the risk of sarcopenia, frailty, morbidity and mortality as well. Because anorexia is connected with serious health consequences, the appetite of older people should be systematically tested.
    Keywords: elderly, anorexia of aging, malnutrition, sarcopenia, frailty

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