Clinical portrait of elderly outpatient

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Abstract

The increase in the cohort of elderly people throughout the world leads to a revision of the approach to medical care provision, taking into account body involutional changes.

The aim: to assess the incidence of multimorbidity, geriatric syndromes and their correlations in patients who are taking medical care at an outpatient basis.

Material and methods. Open, cross-sectional study included 371 patients (61.7% females) aged 60–93 years, observed by a general practitioner in medical consulting room for patients of older age groups with multiple chronic diseases. Clinical and laboratory parameters were analyzed, screening for senile asthenia was performed using “Age is not a hindrance” questionnaire.

Results. The average age of studied patients was 73 (68; 80) years, most of them were elderly (58.8%) and female (61.7%) persons, having more than three (70.89%) diseases. The most common disease was arterial hypertension (95%). Diabetes mellitus and obesity had 42 and 39% of them, respectively. Geriatric syndromes occurred in 80.86% of patients: decreased hearing and vision (71%), sleep disturbances (56%) and movement disorders (48%), urinary incontinence (27%) and falls during the year (20%). Factors associated with frailty were osteoarthritis (odds ratio (OR) 2.56; 95% confidence interval (CI): 1.33–4.89; p = 0.005), myocardial infarction in anamnesis (OR 3.43; 95% CI: 1.78–6.62; p = 0.001), chronic kidney disease (OR 1.91; 95% CI: 1.00–3.65; p = 0.050), female gender (OR 4.23; 95% CI: 1.73–10.31; p = 0.002). The cut-off value for the age at which the likelihood of senile asthenia developing increases was 75.5 years (95% CI: 0.68–0.85).

Conclusion. Among outpatients aged 60 years and older, elderly female patients and persons with complex pathology are predominating. Arterial hypertension, diabetes mellitus and obesity are leading diseases in the structure of multimorbidity, hearing and vision loss, sleep disturbances and mobility problems are existing among geriatric syndromes. Chronic kidney disease, history of myocardial infarction, and osteoarthritis are associated with senile asthenia, especially in females, as well as at the age of 75.5 years and older, when the probability of senile asthenia developing is highest.

About the authors

Vera N. Larina

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: larinav@mail.ru
ORCID iD: 0000-0001-7825-5597

MD, Dr. Sci. (Medicine), professor, head of the Department of polyclinic therapy of the Faculty of general medicine

Russian Federation, Moscow

Ekaterina V. Kudina

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: larinav@mail.ru
ORCID iD: 0000-0002-9547-078X

MD, PhD (Medicine), associate professor of the Department of polyclinic therapy of the Faculty of general medicine

Russian Federation, Moscow

Ekaterina S. Shcherbina

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: larinav@mail.ru
ORCID iD: 0000-0001-8619-8123

MD, resident of the Department of polyclinic therapy of the Faculty of general medicine

Russian Federation, Moscow

Marina P. Mikhailusova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: larinav@mail.ru
ORCID iD: 0000-0003-0271-6726

MD, PhD (Medicine), associate professor of the Department of polyclinic therapy of the Faculty of general medicine

Russian Federation, Moscow

Denis A. Orlov

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: larinav@mail.ru
ORCID iD: 0000-0002-0994-8880

MD, PhD (Medicine), assistant at the Department of polyclinic therapy of the Faculty of general medicine

Russian Federation, Moscow

Olga V. Kladovikova

Diagnostic Clinical Center No. 1 of the Department of Healthcare of Moscow

Email: larinav@mail.ru
ORCID iD: 0000-0001-7977-5850

MD, acting as a chief physician for organizational and methodological work

Russian Federation, Moscow

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