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YAŞLILARIN SAĞLIK DURUMLARI İLE KIRILGANLIK DÜZEYLERİNİN DEĞERLENDİRİLMESİ VE YAŞAM KALİTESİ İLE İLİŞKİSİNİN İNCELENMESİ

Year 2023, Volume: 17 Issue: 2 - Turkish Journal of Family Medicine and Primary Care, 324 - 332, 20.06.2023

Sabahat Arabacı Sibel Tunç Karaman Okcan Basat

https://doi.org/10.21763/tjfmpc.1222425

Abstract

Giriş: Bu çalışmada yaşlı bireylerin genel sağlık durumları ile kırılganlık düzeylerinin değerlendirilmesi ve yaşam kalitesi ile ilişkisinin incelenmesi amaçlandı. Bu sayede kapsamlı geriatrik değerlendirme (KGD) ihtiyacı olan kişilerin belirlenip ilgili merkezlere yönlendirilmesi planlandı.
Yöntem: Bu kesitsel çalışma üçüncü basamak bir hastanenin aile hekimliği polikliniğine Ekim-Aralık 2021 tarihleri arasında başvuran 65 yaş ve üzeri kişilerden dahil etme kriterlerini karşılayanlar ile gerçekleştirildi. Verileri elde etmede Hasta Bilgi Formu, G8-Geriatrik Tarama Ölçeği (G8-GTÖ), Edmonton Kırılganlık Ölçeği (EKÖ) ve Yaşlılarda Yaşam Kalitesi Ölçeği-Kısa Form (YYK-KF) kullanıldı. Anlamlılık p<0.05 düzeyinde değerlendirildi.
Bulgular: Çalışmaya dahil edilen 145 kişinin yaş ortalaması 72,74±7,01 (min:65-maks:97) yıl idi. Ölçeklerden alınan ortalama puanlar G8-GTÖ için 13,44±2,43 iken; EKÖ için 6,11±3,13 ve YYK-KF için 47,06±5,63 idi. Katılımcıların %43,4’ü (n=63) EKÖ’ye göre herhangi bir düzeyde kırılgan idi, %59,3’ünün (n=86) G8-GTÖ puanı ≤14 idi. G8-GTÖ ile EKÖ puanları arasında ters yönlü, YYK-KF puanı arasında pozitif yönlü, YYK-KF ile EKÖ puanları arasında ise ters yönlü anlamlı ilişki bulundu (hepsi için p:0,001). Son 1 yılda düşme ve hastanede yatış öyküsü olanların G8-GTÖ ve YYK-KF puanları daha düşük iken EKÖ puanları ise daha yüksekti (G8-GTÖ için; p:0,001 ve p:0,001, YYK-KF için; p:0,014 ve p:0,030, EKÖ için; p:0,001 ve p:0,001). Kronik hastalığı olanların EKÖ puanları daha yüksekti (p:0,043).
Sonuç: Çalışmamıza göre; yaşlı bireylerin %43,4’ü herhangi bir düzeyde kırılgan olup, genel sağlık durumları ve yaşam kaliteleri orta düzeyde idi. Yarısından fazlasında KGD ihtiyacı vardı. Genel sağlık durumu iyileştikçe kırılganlık azalmakta, yaşam kalitesi ise iyileşmekte idi. Düşme ve hastaneye yatış öyküsü yaşlı bireyleri olumsuz etkileyen ve KGD ihtiyacını artıran faktörlerdi. Yaşlı bireylerle ilk temas noktası olan aile hekimleri tarafından tüm yaşlı bireylerin KGD ihtiyacı belirlenmeli ve gerekli girişimler planlanmalıdır.

Keywords

Kırılganlık Kapsamlı Geriatrik Değerlendirme Yaşam Kalitesi Yaşlılık.

References

  • 1. WHO Ageing and health https://www.who.int/news-room/fact-sheets/detail/ageing-and-health Erişim tarihi 20.12.2022
  • 2. Ağar A. Yaşlılarda ortaya çıkan fizyolojik değişiklikler. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi 2020;3(3):347-54.
  • 3. WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva, Switzerland. Geneva: World Health Organization; 2017 (WHO/FWC/ALC/17.2). Licence: CC BY-NC-SA 3.0 IGO.
  • 4. Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep 2013; 24(9):10-17.
  • 5. Alkan ŞB, Rakıcıoğlu N. Kırılgan yaşlılarda beslenme nutrition in frail elderly patients. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi 2019;10(2):184-88
  • 6. Özdemir S, Öztürk ZA, Türkbeyler İH, Şirin F, Göl M. Geriatrik hastalarda farklı ölçekler kullanılarak kırılganlık prevalansının belirlenmesi. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 2017;12(3):1-5.
  • 7. Tuncel B, Tuz C, Akturan S, Kartçı SA. Aile hekimlerinin ‘kırılganlık’bilgi düzeylerinin değerlendirilmesi; Kesitsel bir çalışma. The Journal of Turkish Family Physician 2020;11(4):171-78. 8. Bellera CA, Rainfray M, Mathoulin-Pelissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012;23(8):2166-72.
  • 9. Çavuşoğlu Ç, Demirkol ME. Yaşlılarda bağımlılık. Bağımlılık Dergisi 2018;19(3):59-69.
  • 10. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing 2006;35(5):526-29.
  • 11. Aygör Eskiizmirli H, Fadıloğlu Ç, Şahin S, Aykar Şenuzun F, Akçiçek F. Validation of Edmonton Frail Scale into elderly Turkish population. Arch Gerontol Geriatr 2018;76: 133-37.
  • 12. Bowling A, Hankins M, Windle G, Bilotta C, Grant R. A short measure of quality of life in older age: The performance of the brief Older People's Quality of Life Questionnaire (OPQOL-brief). Arch Gerontol Geriatr 2013;56(1):181-87.
  • 13. Çalışkan H, Ayçiçek GS, Özsürekçi C, Tuna Doğrul R, Balcı C, Sümer F, et al. Turkish validation of a new scale from older people’s perspectives: Older People’s Quality of Life-Brief (OPQOL-brief). Arch Gerontol Geriatr 2019;83:91-95. 14. Hamaker ME, Mitrovic M, Stauder R. The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy. Ann Hematol 2014;93(6):1031-40.
  • 15. Hamaya T, Hatakeyama S, Momota M, Narita T, Iwamura H, Kojima Y, et al. Association between the baseline frailty and quality of life in patients with prostate cancer (FRAQ-PC study). Int J Clin Oncol 2021;26(1):199-206.
  • 16. Van Walree IC, Scheepers E, van Huis-Tanja L, Emmelot-Vonk MH, Bellera C, Soubeyran P, et al. A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer. J Geriatr Oncol 2019;10(6): 847-58.
  • 17. Smets IH, Kempen GI, Janssen-Heijnen ML, Deckx L, Buntinx FJ, van den Akker M. Four screening instruments for frailty in older patients with and without cancer: A diagnostic study. BMC Geriatr. 2014;14(1):14-26.
  • 18. Choi YS, Kim MJ, Lee GY, Seo YM, Seo AR, Kim B, et al. The association between frailty and disability among the elderly in rural areas of Korea. Int J Environ Res Public Health 2019 Jul 11;16 (14):2481.
  • 19. Düzgün G, Üstündağ S, Karadakovan A. Assessment of frailty in the elderly. Florence Nightingale J Nurs 2021 Feb 1;29(1):2-8.
  • 20. 20.Jankowska-Polańska B, Uchmanowicz B, Kujawska-Danecka H, Nowicka-Sauer K, Chudiak A, Dudek K, et al. Assessment of frailty syndrome using Edmonton Frailty Scale in Polish elderly sample. The Aging Male 2019;22(3):177-86.
  • 21. Yang L, Jiang Y, Xu S, Bao L, Parker D, Xu X, et al. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: A cross-sectional study. Contemp Nurse 2018 Dec;54(6):630-39.
  • 22. Harttgen K, Kowal P, Strulik H, Chatterji S, Vollmer S. Patterns of frailty in older adults: comparing results from higher and lower income countries using the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Study on Global AGEing and Adult Health (SAGE). PLoS One 2013;8(10):e75847.
  • 23. Cheng MH, Chang SF. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis. J Nurs Scholarsh 2017;49(5):529-536.
  • 24. Aydıner Boylu A, Terzioğlu G. Ailelerin yaşam kalitelerini etkileyen bazı objektif ve subjektif göstergelerin incelenmesi. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 2008;26(2):1-27.
  • 25. Bilotta C, Bowling A, Nicolini P, Casè A, Pina G, Rossi SV, et al. Older People's Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health Qual Life Outcomes 2011 Sep 5;9:72.

EVALUATION OF HEALTH STATUS AND FRAGİLİTY LEVELS OF THE ELDERLY AND INVESTIGATION OF THEIR RELATIONSHIP WITH QUALITY OF LIFE

Year 2023, Volume: 17 Issue: 2 - Turkish Journal of Family Medicine and Primary Care, 324 - 332, 20.06.2023

Sabahat Arabacı Sibel Tunç Karaman Okcan Basat

https://doi.org/10.21763/tjfmpc.1222425

Abstract

Introduction: This study aimed to evaluate the general health status and fragility levels of elderly individuals and to examine their relationship with quality of life. In this way, it was planned to identify people in need of comprehensive geriatric evaluation (CGE) and refer them to the relevant centers.
Methods: This cross-sectional study was conducted with individuals aged 65 and over who applied to the family medicine outpatient clinic of a tertiary hospital between October and December 2021, and met the inclusion criteria. Data were collected through the Patient Information Form, G8-Geriatric Screening Tool (G8-GST), Edmonton Frailty Scale (EFS), and Older People Quality of Life-Brief (OPQOL-Brief) were used. Significance was evaluated at the p< 0.05 level.
Results: The mean age of 145 participants was 72.74±7.01 (min:65-max:97) years. The mean scores obtained from the scales were 13.44±2.43 for G8-GST; 6.11±3.13 for EFS, and 47.06±5.63 for OPQOL-Brief. Of them, 43.4% (n=63) had any degree of frailty according to the EFS, 59.3% (n=86) had a G8-GST score of ≤14. There was an inverse significant relationship between G8-GST and EFS scores, a positive correlation between OPQOL-Brief scores, and an inverse significant relationship between OPQOL-Brief scores and EFS scores (p:0.001 for all). Those who had a history of falling and hospitalization in the last 1 year had lower G8-GST and OPQOL-Brief scores, while their EFS scores were higher (for G8-GST; p:0.001 and p:0.001, for OPQOL-Brief; p:0.014 and p: 0.030 for EFS; p:0.001 and p:0.001). Those with chronic diseases had higher EFS scores (p:0.043).
Conclusion: According to our study, 43.4% of elderly individuals were frail at any level, and their general health status and quality of life were moderate. More than half of them needed CGE. As the general health status improved, frailty decreased and quality of life improved. The history of falling and hospitalization were factors that negatively affected elderly individuals and increased the need for CGE. Family physicians, who are the first contact point with elderly individuals, should determine the needs of all elderly individuals and necessary interventions should be planned.

Keywords

Comprehensive geriatric evaluation Elderly Fragility Quality of life

References

  • 1. WHO Ageing and health https://www.who.int/news-room/fact-sheets/detail/ageing-and-health Erişim tarihi 20.12.2022
  • 2. Ağar A. Yaşlılarda ortaya çıkan fizyolojik değişiklikler. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi 2020;3(3):347-54.
  • 3. WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva, Switzerland. Geneva: World Health Organization; 2017 (WHO/FWC/ALC/17.2). Licence: CC BY-NC-SA 3.0 IGO.
  • 4. Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep 2013; 24(9):10-17.
  • 5. Alkan ŞB, Rakıcıoğlu N. Kırılgan yaşlılarda beslenme nutrition in frail elderly patients. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi 2019;10(2):184-88
  • 6. Özdemir S, Öztürk ZA, Türkbeyler İH, Şirin F, Göl M. Geriatrik hastalarda farklı ölçekler kullanılarak kırılganlık prevalansının belirlenmesi. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 2017;12(3):1-5.
  • 7. Tuncel B, Tuz C, Akturan S, Kartçı SA. Aile hekimlerinin ‘kırılganlık’bilgi düzeylerinin değerlendirilmesi; Kesitsel bir çalışma. The Journal of Turkish Family Physician 2020;11(4):171-78. 8. Bellera CA, Rainfray M, Mathoulin-Pelissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012;23(8):2166-72.
  • 9. Çavuşoğlu Ç, Demirkol ME. Yaşlılarda bağımlılık. Bağımlılık Dergisi 2018;19(3):59-69.
  • 10. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing 2006;35(5):526-29.
  • 11. Aygör Eskiizmirli H, Fadıloğlu Ç, Şahin S, Aykar Şenuzun F, Akçiçek F. Validation of Edmonton Frail Scale into elderly Turkish population. Arch Gerontol Geriatr 2018;76: 133-37.
  • 12. Bowling A, Hankins M, Windle G, Bilotta C, Grant R. A short measure of quality of life in older age: The performance of the brief Older People's Quality of Life Questionnaire (OPQOL-brief). Arch Gerontol Geriatr 2013;56(1):181-87.
  • 13. Çalışkan H, Ayçiçek GS, Özsürekçi C, Tuna Doğrul R, Balcı C, Sümer F, et al. Turkish validation of a new scale from older people’s perspectives: Older People’s Quality of Life-Brief (OPQOL-brief). Arch Gerontol Geriatr 2019;83:91-95. 14. Hamaker ME, Mitrovic M, Stauder R. The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy. Ann Hematol 2014;93(6):1031-40.
  • 15. Hamaya T, Hatakeyama S, Momota M, Narita T, Iwamura H, Kojima Y, et al. Association between the baseline frailty and quality of life in patients with prostate cancer (FRAQ-PC study). Int J Clin Oncol 2021;26(1):199-206.
  • 16. Van Walree IC, Scheepers E, van Huis-Tanja L, Emmelot-Vonk MH, Bellera C, Soubeyran P, et al. A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer. J Geriatr Oncol 2019;10(6): 847-58.
  • 17. Smets IH, Kempen GI, Janssen-Heijnen ML, Deckx L, Buntinx FJ, van den Akker M. Four screening instruments for frailty in older patients with and without cancer: A diagnostic study. BMC Geriatr. 2014;14(1):14-26.
  • 18. Choi YS, Kim MJ, Lee GY, Seo YM, Seo AR, Kim B, et al. The association between frailty and disability among the elderly in rural areas of Korea. Int J Environ Res Public Health 2019 Jul 11;16 (14):2481.
  • 19. Düzgün G, Üstündağ S, Karadakovan A. Assessment of frailty in the elderly. Florence Nightingale J Nurs 2021 Feb 1;29(1):2-8.
  • 20. 20.Jankowska-Polańska B, Uchmanowicz B, Kujawska-Danecka H, Nowicka-Sauer K, Chudiak A, Dudek K, et al. Assessment of frailty syndrome using Edmonton Frailty Scale in Polish elderly sample. The Aging Male 2019;22(3):177-86.
  • 21. Yang L, Jiang Y, Xu S, Bao L, Parker D, Xu X, et al. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: A cross-sectional study. Contemp Nurse 2018 Dec;54(6):630-39.
  • 22. Harttgen K, Kowal P, Strulik H, Chatterji S, Vollmer S. Patterns of frailty in older adults: comparing results from higher and lower income countries using the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Study on Global AGEing and Adult Health (SAGE). PLoS One 2013;8(10):e75847.
  • 23. Cheng MH, Chang SF. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis. J Nurs Scholarsh 2017;49(5):529-536.
  • 24. Aydıner Boylu A, Terzioğlu G. Ailelerin yaşam kalitelerini etkileyen bazı objektif ve subjektif göstergelerin incelenmesi. Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 2008;26(2):1-27.
  • 25. Bilotta C, Bowling A, Nicolini P, Casè A, Pina G, Rossi SV, et al. Older People's Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health Qual Life Outcomes 2011 Sep 5;9:72.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Orijinal Articles
Authors

Sabahat Arabacı 0000-0001-7154-2294

Sibel Tunç Karaman 0000-0003-1833-8758

Okcan Basat 0000-0002-5222-9136

Publication Date June 20, 2023
Submission Date December 21, 2022
Published in Issue Year 2023 Volume: 17 Issue: 2 - Turkish Journal of Family Medicine and Primary Care

Cite

Vancouver Arabacı S, Tunç Karaman S, Basat O. YAŞLILARIN SAĞLIK DURUMLARI İLE KIRILGANLIK DÜZEYLERİNİN DEĞERLENDİRİLMESİ VE YAŞAM KALİTESİ İLE İLİŞKİSİNİN İNCELENMESİ. TJFMPC. 2023;17(2):324-32.
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English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.