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Assessment of functional capacity and the risk of falls in the elderly with mild and moderate stage dementia
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2016) Skubal, Anna; Sudoł, Izabela; Ciąpała, Gabriela; Ćwirlej-Sozańska, Agnieszka; Wiśniowska-Szurlej, Agnieszka; Wilmowska-Pietruszyńska, Anna
Introduction: Dementia is a common problem among the elderly. Cognitive impairments may cause difficulty in performing basic activities of daily living. The deterioration of physical and / or mental capacity can lead to the necessity of institutional care over patients. Aim: To assess functional capacity and the risk of falls in the elderly with mild and moderate dementia. Material and Methods: The study group included 146 people aged 60-90 residing in the Residential Home as well as Care and Treatment Centre in the south-eastern Poland. Cognitive and functional capacity, balance, and the risk of falls were assessed using the following scales and clinical tests: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Activities of Daily Living (ADL), Time Up & Go test, Tinetti test, Berg Balance Scale. Results: It has been demonstrated that individuals with dementia were characterized by reduced capacity in performing basic activities of daily living. More than half of the patients with mild and moderate dementia presented 5-times higher risk of falls than those without dementia. Moderate risk of falls was observed in 76.1% of patients with moderate dementia. Conclusions: Cognitive impairments decrease the capacity to perform basic activities of daily living. The higher the stage of dementia, the worse the balance and the greater the risk of falling. It is necessary to develop simple rehabilitation programs allowing to maintain the highest possible level of functional capacity in the elderly patients with dementia under institutional care.
Assessment of mobility, body balance and risk of fractures in the elderly
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2016) Ćwirlej-Sozańska, Agnieszka; Wilmowska-Pietruszyńska, Anna; Wiśniowska, Agnieszka; Guzik, Agnieszka; Drużbicki, Mariusz; Sozański, Bernard
Introduction. In recent years, we have seen significant changes in the highly dynamic process of ageing amongst the population of Europe, leading to increasing life expectancy. Prolonging the life of the elderly, in which full independence and functional performance are maintained, is a challenge facing modern medicine. It is necessary to take actions to improve health and quality of life during old age. Purpose. The aim of this research is to assess the differences in mobility level and static/dynamic balance, as well as the risk of bone fractures between people aged 50 and 65 years and the elderly aged between 66 and 80 years. An analysis of the suitability of selected clinical tests is conducted to assess the above mentioned parameters. Material and methods. The study included a group of 200 randomly selected people living in Rzeszow, a city in southeastern Poland, who were aged between 50 and 80 years. All the results of the research, which ultimately involved 138 people – 103 women and 35 men – have been analysed. To assess the mobility and static/dynamic balance, the following clinical tests were used: Timed Up and Go, Functional Reach, Tandem Stance, Tandem Walk and Tandem 180° Pivot. For the assessment of fracture risk, the Fracture Risk Assessment Tool (FRAX) calculator was used, while the data were collected on the basis of direct interviews. Results. It was found that, with age, the frequency of dynamic balance, mobility disorders and the risk of bone fractures significantly increase. In a group of people aged 66 to 80 years, a decrease in the efficiency level of mobility and balance was observed in 30% of respondents on average, depending on the kind of functional test used (20-60%), in relation to people whose age did not exceed 65 years. Conclusions. It is necessary to take preventive actions, especially amongst a group of people aged over 65 years, in order to improve functional efficiency and balance, thereby reducing the risk of fractures.