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ISSN 1405-8790 (Print)

2007, Number 1

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Rev Mex Med Fis Rehab 2007; 19 (1)

Evaluation of the impairments presented by the elderly admitted in a general hospital

Carvalho REM, Lianza S

Language: English
References: 42
Page: 8-15
PDF size: 90.25 Kb.


ABSTRACT

The normal and physiological aging process is not considered as incapacitating, but a significant part of the elderly population does develop malfunctions or impairments. At present, the chronic and incapacitating diseases that are often presented by the elderly comprise a great challenge for health structures, once they are technologically adapted to handling and solving acute cases. Thus, there is a need to acknowledge the geriatric population and its impairments, aiming at treating the geriatric patient on a more specific and global way. Normal aging is followed by gradual and progressive physiological changes, and by an increase in the prevalence of acute and chronic diseases. That process is associated to an increase in the functional impairments incidence, even if it is not considered a disease, but a physiological process. Acute hospitalization creates an increase in impairments, especially among the elderly population, due to several factors, such as changes in routine, changes in the vigil sleep, increase in medication consumption with several side effects, besides the fact that during hospitalizations there are habits which, when reinforced, lead to a greater impairment, such as circumstances like the patient being hospitalized for a longer time, and the hospital employees performing their tasks. Also, painful scenarios not appropriately controlled cause impairments isolatedly or in association with cognitive reduction and motor function scenarios. Depression is also a factor that increases the number of impairments by acting in increasing the pain sensation and in reducing the motor and cognitive function. This study aims at determining the presence of motor, cognitive, painful and mixed impairments in the elderly inpatient population in the Main Hospital at Santa Casa de Misericórdia de São Paulo within the Medicine, Surgery, Gynecology, and Orthopedics Departments, and evaluating the factors related to the presence of impairments, among them: gender, age, hospitalization time, dependence level previous to the hospitalization, number of chronic diseases, depression, and leisure activities. The survey herein consists of an observational study of transversal active search, in which we studied all the patients with 60 years old or higher at the moment of the evaluation, hospitalized in the Main Hospital at Santa Casa de São Paulo, in the Medicine, Gynecology, Lung and Heart Units Surgery, and Orthopedics and Traumatology Departments, who could communicate themselves or had the data selective to the survey within their medical records, during a period corresponding to the first three weeks in October, 2004. The data collection for the survey herein was performed by means of an application form comprising items regarding the motor impairment (muscle strength loss, articular movement ranges changes, muscle tonus changes, presence of osteomuscular deformities), cognitive impairment (Mini Examination of the Mental Status and Geriatric Depression Scale), and painful impairment (Descriptive Verbal Scale); and the survey of associated factors (gender, age, hospitalization time, dependence level previous to the hospitalization, number of chronic diseases, use of medications, depression). Impairments were found in 54 % of the patients studied (34 sick individuals. The most frequent impairment was pain, observed in 52 % of the patients (32 patients), followed by motor impairments, with 49% (31 patients), and by cognitive impairments, found in 30 % of the patients (19 patients). There is a significant presence of impairments in the sample population studied, and the painful ones are the most frequent. The presence of incapacities might be related to the hospitalization period, but there was no association to gender, number of comorbidities, age, use of medications, leisure activities. Painful impairments presented association to depressive symptoms.


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