Research Article
BibTex RIS Cite

Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals

Year 2024, , 118 - 124, 31.12.2024

Hilal Gürbüz Türkmen , Neslihan Kayahan , Mehmet İlkin Naharci , Burcu Doğan , Oktay Sarı

https://doi.org/10.22391/fppc.1556884

Abstract

Introduction: Skin lesions observed concomitantly with increasing functional dependency and/or cognitive impairment can lead to significant additional challenges. In this study, we aimed to assess the relationship between functional dependency, cognitive status, and skin lesions in elderly individuals
Methods: Individuals presenting to the geriatric outpatient clinic of a tertiary reference center were included in a cross-sectional study. The level of dependency was determined using the Katz Index of Independence in Activities of Daily Living (ADL) and the Lawton-Brody Instrumental Activities of Daily Living (IADL) scale, classifying individuals as "totally dependent," "partially dependent," or "independent." Cognitive status was assessed using the Standardized Mini-Mental State Examination (MMSE), with scores of 24 and above considered "normal."
Results: Of the 228 individuals included in the study, 63.60% were male, with a mean age of 76.20 (±7.10) years. The three most commonly observed skin findings in the study group were scar (43.90%), xerosis (40.40%), and dermatophytosis (36.40%). It was revealed that the occurrence of xerosis, infection-related lesions, eczema, diabetic foot ulcers, decubitus ulcers, and pruritus was statistically significantly lower in individuals with "totally independent" ADL, "totally independent" IADL, and/or "normal" cognitive function assessed by MMSE.
Conclusion: There is a significant relationship between functional and cognitive status and the occurrence of skin lesions in elderly individuals. Certain skin lesions such as xerosis, infection-related lesions, eczema, diabetic foot ulcers, decubitus ulcers, and pruritus may be particularly common in elderly individuals who are functionally dependent and/or have impaired cognitive functions and should be taken into consideration in clinical practice.

Keywords

Elderly individual functional dependency cognitive impairment skin lesions

Ethical Statement

For this research, the Ethics Committee approval was obtained from the Health Sciences Ethics Committee of our University School of Medicine (17/10/2022 dated 09 numbered), and then the research permit approval was obtained from the hospital's chief medical officer. An "informed consent" form was given to the volunteers who participated in the study, and their personal consent was obtained.

References

  • 1. Elderly with Statistics, Turkish Statistical Institute. Avaliable at: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2023-53710
  • 2. Ozkaya AG. Aksoy G, Skin Diseases in the Elderly: A Practical Approach (in Turkish). 2022;(107):15.
  • 3. Kalayci BN, Yakaryilmaz FD. Evaluation of dermatological disease and malnutrition status in elderly at nursing home: a cross sectional study.Turk Clin J Derma, 2022; 32(1): 16-21.
  • 4. F. Savaş S. Comprhensive geriatric assesment. EJM 2010;49(3):19-30.
  • 5. Zhang H, Zhang D, Tang K, Sun Q. The relationship between Alzheimer's disease and skin disease: a review. Clin Cosmet Investig Dermatol. 2021;14:1551-60. https://doi.org/10.2147/CCID.S322530
  • 6. Pilkington SM, Bulfone-Paus S, Griffiths CE, Watson RE. Inflammaging and the Skin. J Invest Dermatol. 2021;141(4S):1087-95. https://doi.org/10.1016/j.jid.2020.11.006
  • 7. Kligman A, Psychological aspects of skin disorders in the elderly. Cutis. 1989;43(5):498-501.
  • 8. Borchert K, Bliss DZ, Savik K, Radosevich DM. The incontinence-associated dermatitis and its severity instrument: development and validation. J Wound Ostomy Continence Nurs. 2010;37(5):527-35. https://doi.org/10.1097/WON.0b013e3181edac3e
  • 9. Gill TM, Guo Z, Allore HG. The epidemiology of bathing disability in older persons. J Am Geriatr Soc. 2006;54(10):1524-30. https://doi.org/10.1111/j.1532-5415.2006.00890.x
  • 10. Clos AL, Kayed R, Lasagna-Reeves CA, Association of skin with the pathogenesis and treatment of neurodegenerative amyloidosis. Front Neurol. 2012;3:5 https://doi.org/10.3389/fneur.2012.00005
  • 11. Ikoma A, Ebata T, Fukuda R, et al. Prevalence of pruritus in the elderly with dementia: a multicenter survey of Japanese patients. Acta Derm Venereol. 2020;100(14):adv00210. https://doi.org/10.2340/00015555-3572
  • 12. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist.1970;10(1):20-30. https://doi.org/10.1093/geront/10.1_part_1.20
  • 13. Lawton MP, Brody EM, Assessment of older people: self-maintaining and instrumental activities of daily living.Gerontologist 1969 ;9(3):179-86.
  • 14. Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Ann Geriatr Med Res.2020;24(1):35-40. https://doi.org/10.4235/agmr.19.0051
  • 15. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98
  • 16. Gungen C. Validity and reliability of Standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish society. Turk J Psych. (in Turkish). 2002;13(4):273-81.
  • 17. Ruiz-Medina P, Bravo M, Gil-Montoya JA, Montero J. Discrimination of functional capacity for oral hygiene in elderly Spanish people by the Barthel General Index.Community Dent Oral Epidemiol. 2005t;33(5):363-9. https://doi.org/10.1111/j.1600-0528.2005.00222.x
  • 18. Behunin T, Mantey J, Cassone M, Mody L. Functional dependence as a contributing factor for patient hand contamination by multidrug-resistant organisms in acute care.Infect Control Hosp Epidemiol 2024;10:1-6. https://doi.org/10.1017/ice.2024.70
  • 19. Lindgren M, Unosson M, Fredrikson M, Ek AC. Immobility–a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study.Scand J Caring Sci. 2004;18(1):57-64. https://doi.org/10.1046/j.0283-9318.2003.00250.x
  • 20. Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018 Dec 11;18(1):305. https://doi.org/10.1186/s12877-018-0997-7
  • 21. Duim E, Felipe H, Yeda A, Rita C, Maria L. Prevalência e características das feridas em pessoas idosas residentes na comunidade. Rev. esc. enferm. 2015; 49(Esp):50-56. https://doi.org/10.1590/S0080-623420150000700008
  • 22. Kottner J, Lichterfeld A, Blume‐Peytavi U. Maintaining skin integrity in the aged: a systematic review. Br J Dermatol. 2013 Sep;169(3):528-42.. https://doi.org/10.1111/bjd.12469
  • 23. Sugiyama A, Fujita Y, Kobayashi T, et al. Effect of protein malnutrition on the skin epidermis of hairless mice. J Vet Med Sci. 2011;73(6):831-5. https://doi.org/10.1292/jvms.10-0399
  • 24. Luo Y, He P, Guo C, Chen G, Li N, Zheng X. Association between sensory impairment and dementia in older adults: evidence from China.J Am Geriatr Soc. 2018;66(3):480-6. https://doi.org/10.1111/jgs.15202
  • 25. Catak B, KILINC A, BADILLIOGLU O, Sütlü S, Sofuoglu AE, Aslan D. Profile of elderly patients receiving home health care services in Burdur and health services provided at home. TJPH. (in Turkish) 2012;(10)1:2 - 13
  • 26. Hazer O, Ateşoğlu L. The effect of health literacy on successful aging in the elderly: An example from Ankara. Interdisciplinary Approach to Geriatrics and Gerontology: Turkey Clinics (in Turkish); 2019; 48-56
  • 27. T. MG., "Yaşlı Hastalarına Bakım Veren Kadınların Deneyimleri Işığında “Evde Bakım Hizmetinin” Değerlendirilmesi," no. 26, pp. 157-86, 2017.
  • 28. Özgül E, Akpınar Söylemez B. The Effect of Gender of Caregivers of Dementia Individuals on Caregiver Self-Efficacy. GUJH. (in Turkish) 2022;11(3):1107-13. https://doi.org/10.37989/gumussagbil.943585
  • 29. Şahin S, Boyacıoğlu H, Taşar PT, Kozan E, Sarıkaya OF, Akçiçek F. Functional dependency rates in the population over 65 years of age living in Bornova district. EMJ (in Turkish). 2016; 55(2): 65-70.
  • 30. Saltan A, Mert Boğa S, Kalındemirtaş Küçük M. The Investigation of Physical Health/Function and Sleep in Older Adults HC., 2018;2(9):31-37

Yaşlı bireylerde deri lezyonları ile fonksiyonel bağımlılık ve bilişsel durum arasındaki ilişkinin değerlendirilmesi

Year 2024, , 118 - 124, 31.12.2024

Hilal Gürbüz Türkmen , Neslihan Kayahan , Mehmet İlkin Naharci , Burcu Doğan , Oktay Sarı

https://doi.org/10.22391/fppc.1556884

Abstract

Giriş: Artan işlevsel bağımlılık ve/veya bilişsel bozuklukla birlikte görülen cilt lezyonları önemli ek zorluklara yol açabilir. Bu çalışmada, yaşlı bireylerde işlevsel bağımlılık, bilişsel durum ve cilt lezyonları arasındaki ilişkiyi değerlendirmeyi amaçladık
Yöntem: Üçüncü basamak bir referans merkezinin geriatrik polikliniğine başvuran bireyler kesitsel olarak çalışmaya dahil edildi. Bağımlılık düzeyi, Katz Günlük Yaşam Aktivitelerinde Bağımsızlık Endeksi (GYA) ve Lawton-Brody Günlük Yaşamın Enstrümantal Aktiviteleri (IADL) ölçeği kullanılarak belirlendi ve bireyler "tamamen bağımlı", "kısmen bağımlı" veya "bağımsız" olarak sınıflandırıldı. Bilişsel durum, 24 ve üzeri puanların "normal" kabul edildiği Standardize Mini-Mental Durum İncelemesi (MMSE) kullanılarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen 228 bireyin %63,60'ı erkekti ve ortalama yaşları 76,20 (±7,10) yıldı. Çalışma grubunda en sık görülen üç cilt bulgusu yara izi (%43,90), kseroz (%40,40) ve dermatofitoz (%36,40) idi. Kserozis, enfeksiyonla ilişkili lezyonlar, egzama, diyabetik ayak ülserleri, bası yaraları ve pruritusun görülme sıklığının, "tamamen bağımsız" ADL, "tamamen bağımsız" IADL ve/veya MMSE ile değerlendirilen "normal" bilişsel işlevi olan bireylerde istatistiksel olarak anlamlı derecede daha düşük olduğu ortaya çıkmıştır.
Sonuç: Yaşlı bireylerde fonksiyonel ve bilişsel durum ile cilt lezyonlarının görülmesi arasında anlamlı bir ilişki vardır. Kserozis, enfeksiyonla ilişkili lezyonlar, egzama, diyabetik ayak ülserleri, bası yaraları ve pruritus gibi belirli cilt lezyonları, fonksiyonel olarak bağımlı ve/veya bozulmuş bilişsel işlevi olan yaşlı bireylerde özellikle yaygın olabilir ve klinik uygulamada dikkate alınmalıdır.

Keywords

Yaşlı birey fonksiyonel bağımlılık bilişsel bozukluk cilt lezyonları

Ethical Statement

For this research, the Ethics Committee approval was obtained from the Health Sciences Ethics Committee of our University School of Medicine (17/10/2022 dated 09 numbered), and then the research permit approval was obtained from the hospital's chief medical officer. An "informed consent" form was given to the volunteers who participated in the study, and their personal consent was obtained.

References

  • 1. Elderly with Statistics, Turkish Statistical Institute. Avaliable at: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2023-53710
  • 2. Ozkaya AG. Aksoy G, Skin Diseases in the Elderly: A Practical Approach (in Turkish). 2022;(107):15.
  • 3. Kalayci BN, Yakaryilmaz FD. Evaluation of dermatological disease and malnutrition status in elderly at nursing home: a cross sectional study.Turk Clin J Derma, 2022; 32(1): 16-21.
  • 4. F. Savaş S. Comprhensive geriatric assesment. EJM 2010;49(3):19-30.
  • 5. Zhang H, Zhang D, Tang K, Sun Q. The relationship between Alzheimer's disease and skin disease: a review. Clin Cosmet Investig Dermatol. 2021;14:1551-60. https://doi.org/10.2147/CCID.S322530
  • 6. Pilkington SM, Bulfone-Paus S, Griffiths CE, Watson RE. Inflammaging and the Skin. J Invest Dermatol. 2021;141(4S):1087-95. https://doi.org/10.1016/j.jid.2020.11.006
  • 7. Kligman A, Psychological aspects of skin disorders in the elderly. Cutis. 1989;43(5):498-501.
  • 8. Borchert K, Bliss DZ, Savik K, Radosevich DM. The incontinence-associated dermatitis and its severity instrument: development and validation. J Wound Ostomy Continence Nurs. 2010;37(5):527-35. https://doi.org/10.1097/WON.0b013e3181edac3e
  • 9. Gill TM, Guo Z, Allore HG. The epidemiology of bathing disability in older persons. J Am Geriatr Soc. 2006;54(10):1524-30. https://doi.org/10.1111/j.1532-5415.2006.00890.x
  • 10. Clos AL, Kayed R, Lasagna-Reeves CA, Association of skin with the pathogenesis and treatment of neurodegenerative amyloidosis. Front Neurol. 2012;3:5 https://doi.org/10.3389/fneur.2012.00005
  • 11. Ikoma A, Ebata T, Fukuda R, et al. Prevalence of pruritus in the elderly with dementia: a multicenter survey of Japanese patients. Acta Derm Venereol. 2020;100(14):adv00210. https://doi.org/10.2340/00015555-3572
  • 12. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist.1970;10(1):20-30. https://doi.org/10.1093/geront/10.1_part_1.20
  • 13. Lawton MP, Brody EM, Assessment of older people: self-maintaining and instrumental activities of daily living.Gerontologist 1969 ;9(3):179-86.
  • 14. Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Ann Geriatr Med Res.2020;24(1):35-40. https://doi.org/10.4235/agmr.19.0051
  • 15. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98
  • 16. Gungen C. Validity and reliability of Standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish society. Turk J Psych. (in Turkish). 2002;13(4):273-81.
  • 17. Ruiz-Medina P, Bravo M, Gil-Montoya JA, Montero J. Discrimination of functional capacity for oral hygiene in elderly Spanish people by the Barthel General Index.Community Dent Oral Epidemiol. 2005t;33(5):363-9. https://doi.org/10.1111/j.1600-0528.2005.00222.x
  • 18. Behunin T, Mantey J, Cassone M, Mody L. Functional dependence as a contributing factor for patient hand contamination by multidrug-resistant organisms in acute care.Infect Control Hosp Epidemiol 2024;10:1-6. https://doi.org/10.1017/ice.2024.70
  • 19. Lindgren M, Unosson M, Fredrikson M, Ek AC. Immobility–a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study.Scand J Caring Sci. 2004;18(1):57-64. https://doi.org/10.1046/j.0283-9318.2003.00250.x
  • 20. Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018 Dec 11;18(1):305. https://doi.org/10.1186/s12877-018-0997-7
  • 21. Duim E, Felipe H, Yeda A, Rita C, Maria L. Prevalência e características das feridas em pessoas idosas residentes na comunidade. Rev. esc. enferm. 2015; 49(Esp):50-56. https://doi.org/10.1590/S0080-623420150000700008
  • 22. Kottner J, Lichterfeld A, Blume‐Peytavi U. Maintaining skin integrity in the aged: a systematic review. Br J Dermatol. 2013 Sep;169(3):528-42.. https://doi.org/10.1111/bjd.12469
  • 23. Sugiyama A, Fujita Y, Kobayashi T, et al. Effect of protein malnutrition on the skin epidermis of hairless mice. J Vet Med Sci. 2011;73(6):831-5. https://doi.org/10.1292/jvms.10-0399
  • 24. Luo Y, He P, Guo C, Chen G, Li N, Zheng X. Association between sensory impairment and dementia in older adults: evidence from China.J Am Geriatr Soc. 2018;66(3):480-6. https://doi.org/10.1111/jgs.15202
  • 25. Catak B, KILINC A, BADILLIOGLU O, Sütlü S, Sofuoglu AE, Aslan D. Profile of elderly patients receiving home health care services in Burdur and health services provided at home. TJPH. (in Turkish) 2012;(10)1:2 - 13
  • 26. Hazer O, Ateşoğlu L. The effect of health literacy on successful aging in the elderly: An example from Ankara. Interdisciplinary Approach to Geriatrics and Gerontology: Turkey Clinics (in Turkish); 2019; 48-56
  • 27. T. MG., "Yaşlı Hastalarına Bakım Veren Kadınların Deneyimleri Işığında “Evde Bakım Hizmetinin” Değerlendirilmesi," no. 26, pp. 157-86, 2017.
  • 28. Özgül E, Akpınar Söylemez B. The Effect of Gender of Caregivers of Dementia Individuals on Caregiver Self-Efficacy. GUJH. (in Turkish) 2022;11(3):1107-13. https://doi.org/10.37989/gumussagbil.943585
  • 29. Şahin S, Boyacıoğlu H, Taşar PT, Kozan E, Sarıkaya OF, Akçiçek F. Functional dependency rates in the population over 65 years of age living in Bornova district. EMJ (in Turkish). 2016; 55(2): 65-70.
  • 30. Saltan A, Mert Boğa S, Kalındemirtaş Küçük M. The Investigation of Physical Health/Function and Sleep in Older Adults HC., 2018;2(9):31-37
There are 30 citations in total.

Details

Primary Language English
Subjects Geriatrics and Gerontology
Journal Section Original Research
Authors

Hilal Gürbüz Türkmen 0009-0001-6589-0994

Neslihan Kayahan 0000-0002-6802-7926

Mehmet İlkin Naharci 0000-0003-2730-7144

Burcu Doğan 0000-0002-3817-7560

Oktay Sarı 0000-0002-4042-1454

Publication Date December 31, 2024
Submission Date September 27, 2024
Acceptance Date November 20, 2024
Published in Issue Year 2024

Cite

APA Gürbüz Türkmen, H., Kayahan, N., Naharci, M. İ., Doğan, B., et al. (2024). Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals. Family Practice and Palliative Care, 9(4), 118-124. https://doi.org/10.22391/fppc.1556884
AMA Gürbüz Türkmen H, Kayahan N, Naharci Mİ, Doğan B, Sarı O. Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals. Fam Pract Palliat Care. December 2024;9(4):118-124. doi:10.22391/fppc.1556884
Chicago Gürbüz Türkmen, Hilal, Neslihan Kayahan, Mehmet İlkin Naharci, Burcu Doğan, and Oktay Sarı. “Assessment of the Relationship Between Functional Dependency and Cognitive Status With Skin Lesions in Elderly Individuals”. Family Practice and Palliative Care 9, no. 4 (December 2024): 118-24. https://doi.org/10.22391/fppc.1556884.
EndNote Gürbüz Türkmen H, Kayahan N, Naharci Mİ, Doğan B, Sarı O (December 1, 2024) Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals. Family Practice and Palliative Care 9 4 118–124.
IEEE H. Gürbüz Türkmen, N. Kayahan, M. İ. Naharci, B. Doğan, and O. Sarı, “Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals”, Fam Pract Palliat Care, vol. 9, no. 4, pp. 118–124, 2024, doi: 10.22391/fppc.1556884.
ISNAD Gürbüz Türkmen, Hilal et al. “Assessment of the Relationship Between Functional Dependency and Cognitive Status With Skin Lesions in Elderly Individuals”. Family Practice and Palliative Care 9/4 (December 2024), 118-124. https://doi.org/10.22391/fppc.1556884.
JAMA Gürbüz Türkmen H, Kayahan N, Naharci Mİ, Doğan B, Sarı O. Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals. Fam Pract Palliat Care. 2024;9:118–124.
MLA Gürbüz Türkmen, Hilal et al. “Assessment of the Relationship Between Functional Dependency and Cognitive Status With Skin Lesions in Elderly Individuals”. Family Practice and Palliative Care, vol. 9, no. 4, 2024, pp. 118-24, doi:10.22391/fppc.1556884.
Vancouver Gürbüz Türkmen H, Kayahan N, Naharci Mİ, Doğan B, Sarı O. Assessment of the relationship between functional dependency and cognitive status with skin lesions in elderly individuals. Fam Pract Palliat Care. 2024;9(4):118-24.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505