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Piotrowicz K, Semeniv S, Kupis R, Ryś M, Perera I, Gryglewska B, Gąsowski J. Disease burden in older Ukrainian refugees of war: a synthetic reanalysis of public records data. THE LANCET. HEALTHY LONGEVITY 2022; 3:e667-e673. [PMID: 36122579 DOI: 10.1016/s2666-7568(22)00187-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Since the Russian invasion of Ukraine on Feb 24, 2022, more than 6 million Ukrainians, including hundreds of thousands of older people, have sought safety abroad. Older people generally have a higher burden of disease than younger people and the aim of our study was to estimate this burden in older Ukrainian refugees, given the potential financial and logistical impacts on the health-care systems of receiving countries. METHODS On May 20, 2022, we searched the official websites of the Polish Ministry of Digitisation for data on Ukrainian refugees who had applied between Feb 24, 2022, and May 19, 2022 for a Polish personal identification number (PESEL). We extracted the number of older people (ie, of pension age, which in Ukraine is 60 years or older for men, and 55 years or older for women). We calculated the percentage of older people among these PESEL applicants then extrapolated this percentage to two groups, for which population data had been extracted from UN, WHO, and Polish Border Guards websites: refugees who had crossed into Poland but had not applied for a PESEL and refugees who had fled to neighbouring countries other than Poland. Between April 4 and May 19, 2022, we searched the Ukrainian Ministry of Health official website for data on the prevalence and incidence of various diseases in the Ukrainian population of older people. We asked the Ukrainian Ministry of Health to confirm and expand on the website data, and thereby obtained annual data for 2010-17. The ministry did not supply tuberculosis statistics, so on May 21, 2022, we searched the Ukrainian Ministry of Health website and extracted the most recent tuberculosis data, which were for 2020. We then calculated the absolute prevalence and incidence of diseases in older refugees. FINDINGS As of May 19, 2022, 6·3 million Ukrainians had fled their country, including 3·5 million (56%) who had entered Poland. 1 114 418 people applied for a PESEL, including 109 985 older people (91 349 Ukrainian women aged 55 years or older and 18 636 Ukrainian men aged 60 or older). We estimated that the overall number of older Ukrainian refugees was 624 690. We estimated that these older refugees have a mean of 2·5 diseases each, the most frequent of which are cardiovascular diseases, followed by gastrointestinal, respiratory, musculoskeletal, and genitourinary diseases. We estimated that the expected absolute incidence is greatest for pulmonary disorders (71 689 diagnoses), followed by cardiovascular (49 327), ocular (24 100), musculoskeletal (20 367), and genitourinary (16 836) disorders. The estimated number of new diagnoses per year was 4578 for tuberculosis and 7827 for cancer. INTERPRETATION Our data indicate that the disease burden of older Ukrainian refugees is considerable. Although our estimates are only approximations, they provide a basis for predicting which areas of health care will most need to be reinforced to meet the challenge of the potential financial and logistical impacts on receiving countries. FUNDING There was no funding source for this study.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland; Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland
| | - Solomiia Semeniv
- Department of General, Oncological, Metabolic and Emergency Surgery, University Hospital, Krakow, Poland
| | - Robert Kupis
- Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland; Departament of Medical Education, Centre of Innovative Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Ryś
- Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland
| | - Ian Perera
- Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland; Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland; Department of Internal Medicine and Geriatrics, University Hospital, Krakow, Poland.
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Wierucki Ł, Kujawska-Danecka H, Mossakowska M, Grodzicki T, Błędowski P, Chudek J, Kostka T, Więcek A, Hajduk A, Bandosz P, Zagożdżon P, Wojtyniak B, Zdrojewski T. Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey. Arch Med Sci 2022; 18:92-102. [PMID: 35154530 PMCID: PMC8826695 DOI: 10.5114/aoms.2020.100898] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/07/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Population ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland. MATERIAL AND METHODS The project was conducted in the period 2018-2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests. RESULTS In the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection. CONCLUSIONS In recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland.
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Affiliation(s)
- Łukasz Wierucki
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Hanna Kujawska-Danecka
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Błędowski
- Institute of Social Economy, Warsaw School of Economics, Warsaw, Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Adam Hajduk
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Bandosz
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Paweł Zagożdżon
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdansk, Poland
| | - Bogdan Wojtyniak
- Department of Population Health Monitoring and Analysis, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
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Mikos M, Kucharska E, Lulek AM, Kłosiński M, Batko B. Evaluation of Risk Factors for Falls in Patients with Rheumatoid Arthritis. Med Sci Monit 2020; 26:e921862. [PMID: 32292180 PMCID: PMC7177037 DOI: 10.12659/msm.921862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background The aim of our study was to investigate the risk factors for falls in the rheumatoid arthritis (RA) patient population in Poland. This would be a major step towards the development of new fall prevention programs. Material/Methods There were 450 RA patients who met the criteria of the American College of Rheumatology who participated in this study. The average age of patient participants was 54.2 years; the average RA duration was 15.1 years. All patients filled out the study questionnaire regarding falls, medications, and diseases, and they filled out the Polish version of the Health Assessment Questionnaire (HAQ). Results Of the 400 patients, 203 patients (51%) experienced falls. Out of the 268 falls experienced by study patients, 113 falls (42%) were due to an environmental cause, the remainder 155 falls were caused by health conditions. The number of falls positively correlated with HAQ scores (r=0.42, P<0.01) and the duration of RA (r=0.39, P<0.05). For individuals who had fallen 3 or more times, there was a stronger positive correlation between the number of falls and the total HAQ score (r=0.61, P<0.01). The main risk factors for falls in the study group were dizziness (odds ratio [OR]=3.42), the use of hypotensive medication (OR=2.82), foot deformities (OR=4.09), and a high HAQ score (OR=2.59). Other factors such as drug use (e.g., glucocorticoids), pain, and duration of RA were measured using a visual analogue scale, and were found not to have increased the risk for falls and fractures (P>0.05). Conclusions Knowledge about risk factors can help identify high-risk patients to help decrease their risk of falling, thus preventing fall-related injuries.
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Affiliation(s)
- Marcin Mikos
- Department of Emergency Medical Services, Faculty of Medicine, The Andrzej Frycz Modrzewski Cracow University, Cracow, Poland
| | - Ewa Kucharska
- Department of Gerontology, Geriatrics and Social Work, Faculty of Education, The Ignatianum Academy, Cracow, Poland
| | - Anna Maria Lulek
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Michał Kłosiński
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland.,Department of Rheumatology, The J. Dietl Specialist Hospital Cracow, Cracow, Poland
| | - Bogdan Batko
- Department of Rheumatology, The J. Dietl Specialist Hospital Cracow, Cracow, Poland
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Zanetti M, Gortan Cappellari G, Ratti C, Ceschia G, Murena L, De Colle P, Barazzoni R. Poor nutritional status but not cognitive or functional impairment per se independently predict 1 year mortality in elderly patients with hip-fracture. Clin Nutr 2018; 38:1607-1612. [PMID: 30217470 DOI: 10.1016/j.clnu.2018.08.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/23/2018] [Accepted: 08/25/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Hip fractures are strongly associated with mortality in the elderly. Studies investigating predisposing factors have suggested a negative impact of poor nutritional, cognitive and functional status on patient survival, however their independent prognostic impact as well as their interactions remain undefined. This study aimed to determine whether poor nutritional status independently predicts 1 year post-fracture mortality after adjusting for cognitive and functional status and for other clinically relevant covariates. METHODS 1211 surgically treated hip fracture elderly (age ≥ 65) patients consecutively admitted to the Orthopaedic Surgery Unit of the "Azienda Sanitaria Universitaria Integrata Trieste" (ASUITs), Cattinara Hospital, Trieste, Italy and managed by a dedicated orthogeriatric team. Pre-admission nutritional status was evaluated by Mini Nutritional Assessment (MNA) questionnaire, cognitive status by Short Portable Mental Status Questionnaire (SPMSQ) and functional status by Activity of Daily Living (ADL) questionnaire. All other clinical data, including comorbidities, type of surgery, post-operative complications (delirium, deep vein thrombosis, cardiovascular complications, infections, need for blood transfusions) were obtained by hospital clinical records and by mortality registry. RESULTS Poor nutritional status (defined as MNA ≤23.5), increased cognitive and functional impairment were all associated with 3-, 6- and 12 month mortality (p < 0.001). Both cognitive and functional impairment were associated with poor nutritional status (p < 0.001). Logistic regression analysis demonstrated that the association between nutritional status and 3-, 6- and 12- month mortality was independent of age, gender, comorbidities, type of surgery and post-operative complications as well as of cognitive and functional impairment (p < 0.001). In contrast, the associations between mortality and cognitive and functional impairment were independent (p < 0.001) of demographic (age, gender) and clinical covariates but not of malnutrition. Kaplan-Meier analysis showed a lower mean survival time (p < 0.001) in patients with poor nutritional status compared with those well-nourished. CONCLUSIONS In hip fracture elderly patients, poor nutritional status strongly predicts 1 year mortality, independently of demographic, functional, cognitive and clinical risk factors. The negative prognostic impact of functional and cognitive impairment on mortality is mediated by their association with poor nutritional status.
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Affiliation(s)
- Michela Zanetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
| | | | - Chiara Ratti
- Orthopaedic Surgery Division, ASUITs, Trieste, Italy
| | | | - Luigi Murena
- Orthopaedic Surgery Division, ASUITs, Trieste, Italy
| | | | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
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Liang Y, Xu X, Yin M, Li Y, Zhang Y, Huang L, Ni J. A more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, China. BMC Geriatr 2018; 18:158. [PMID: 29976138 PMCID: PMC6034336 DOI: 10.1186/s12877-018-0852-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 06/27/2018] [Indexed: 12/19/2022] Open
Abstract
Background No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. We conducted a more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, a city in the central Guangdong Province of Southern China. Methods A total of 819 individuals aged ≥60 years were recruited from Dongguan home-based care system of via a two-stage selection process. We interviewed participants and assessed their ability level using the Ability Assessment for Older Adults, which defined by a combination of activity of daily living, sensory perception, mental status and social involvement. Conditional probability and Logistic regression approaches were used to assess the strength of association between each pair of conditions. Factors significantly associated with disability were identified via χ2 tests and multinomial ordinal logistic regression. Results Of the 819 included participants (mean age 87 ±4.7 years), 75.5% were female, 76.7% had any disability, and 62.3% had a mild disability. The occurrence of any deficits significantly increased the likelihood of the co-occurrence of other deficits (odds ratio [OR] > 1, P < 0.05), with the lowest prevalence odds ratio observed among individuals with sensory and communication deficiency (OR: 2.99; 95% confidence interval [CI]: 2.21–4.05). Multivariable ordinal logistic regression analysis indicated that physical activity (OR: 0.96; 95% CI: 0.93–0.99), sedentary behavior (OR: 1.25; 95% CI: 1.13–1.38), not watching television (OR: 1.7; 95% CI: 1.07–2.72) and age (OR: 1.09; 95% CI: 1.02–1.17) were significantly associated with disability. Conclusions Impairment of ADL, sensory perception, mental status or social involvement increased the likelihood of risk of the co-occurrence of other deficits. Comprehensive disability among older adults receiving home-based care is associated with age, sedentariness, physical activity and TV viewing. Electronic supplementary material The online version of this article (10.1186/s12877-018-0852-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yaping Liang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiaojia Xu
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingjuan Yin
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yulian Li
- Da Lang Community Health Service Center, Dongguan, China
| | - Yan Zhang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Lingfeng Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, China.
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Sulicka J, Pac A, Puzianowska-Kuźnicka M, Zdrojewski T, Chudek J, Tobiasz-Adamczyk B, Mossakowska M, Skalska A, Więcek A, Grodzicki T. Health status of older cancer survivors-results of the PolSenior study. J Cancer Surviv 2018; 12:326-333. [PMID: 29318512 PMCID: PMC5956036 DOI: 10.1007/s11764-017-0672-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 12/22/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study is to characterize health status of older cancer survivors using data from the population-based PolSenior study. METHODS We compared cancer survivors and non-cancer subjects according to comorbidities, functional status, mental health, and sociodemographic factors. RESULTS There were 286 (5.8%) cancer survivors in a population of 4943 adults aged 65 years and older. The mean age of cancer survivors was 79.4 ± 8.2 years and the median time since cancer diagnosis was 8.5 years (Q1-Q3: 4-16 years). After adjustment for age, sex, education, marital status, and number of comorbidities, compared with a non-cancer population, cancer survivors were more likely to experience falls (OR = 1.38; 95% CI: 1.04-1.83), and to report poor health (OR = 1.49; 95%CI: 1.83-2.06), but cancer survivorship was not associated with impairments in instrumental activities of daily living (IADLs). Age and university education, but neither the time from cancer diagnosis nor the number of comorbidities, were associated with impairments in cancer survivors. Three or more chronic diseases were found in over 50% of cancer survivors and in 38% of the non-cancer population (p < 0.001). CONCLUSIONS Cancer survivors over the age of 65 years have a higher prevalence of falls, are more likely to report poor health status, and have a higher number of chronic conditions than the non-cancer population, but they maintain independence in IADLs. Advanced age and elementary education are associated with increased occurrence of functional impairments in older cancer survivors IMPLICATIONS FOR CANCER SURVIVORS: Older cancer survivors may require preventive services to reduce the risk of functional decline.
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Affiliation(s)
- Joanna Sulicka
- Department of Rheumatology and Balneology, Jagiellonian University Medical College, 31-531, Krakow, Poland.
| | - Agnieszka Pac
- Department of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034, Krakow, Poland
| | - Monika Puzianowska-Kuźnicka
- Department of Human Epigenetics, Mossakowski Medical Research Centre, PAS, 02-106, Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, 01-813, Warsaw, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, 80-211, Gdansk, Poland
| | - Jerzy Chudek
- Department of Pathophysiology, Department of Internal Medicine and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752, Katowice, Poland
| | - Beata Tobiasz-Adamczyk
- Department of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-034, Krakow, Poland
| | | | - Anna Skalska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 31-531, Krakow, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice, 40-027, Katowice, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 31-531, Krakow, Poland
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