Search

Geriatrics before 1980s was a non-existent academic discipline across the globe. The (1st) World Assembly on Ageing in Vienna in 1982 may be considered as the starting point when social scientists, biologists and ultimately the health care professionals took note of the burgeoning ageing population and developed interest in this field of science. In the health sector, rapid development and growth of organ specific sub-specialties in subsequent years led to a paradigm shift in the way medicine was practiced at institutional as well as individual level. An older patient, who was visualized as a constellation of multiple organ specific disease states; failed to receive the quality health care as there was no evidence based protocol to address complex multi-morbidity and functional decline. While professionals were struggling to understand what is old age care beyond the sum total of care for each organ several issues became clear slowly but definitely. Assessment that is comprehensive yet meaningful, a very ill patient with no apparent illness, muscles that just disappear, failing mind, quick surgery for broken bones, lack of control over bladder and bowel are some of the challenges that made health systems and physicians to believe Geriatrics can be an umbrella under which an older patient with complex health and social issues can be provided quality health care at an affordable cost with a different way of looking at symptoms and signs, beyond organs and systems. Frailty, sarcopenia, cognitive decline, geriatric syndromes are yet to be included in the ICD system of disease nomenclature and coding. On the other hand, mundane issues of long term care and end of life care have emerged as big challenges for the family, community and the health system. Training medical and paramedical health professionals in care of older patients over and above their basic professional training and organization of health systems in old age care at different levels are challenges that have been faced and addressed in these years. Some of the critical questions remain; namely; how much of expertise the geriatricians should have in managing communicable diseases; how to organize intensive care for critically ill patients, the decision making in intensity of resuscitation and mechanical ventilation, and how to communicate with the older patients and their family members etc. The COVID 19 pandemic and the public health measures to limit its spread caused enormous misery to the ageing population; but paced substantial focus on care and well being of this vulnerable population. From infirmary care to health care of the older population has been a long journey; but healthy ageing is the ultimate goal of life and an end point of the discipline of Geriatrics. In December 2020, the United Nations and World Health Organization declared the 2021 -2030 as the Decade of Healthy Ageing. It is imperative on practicing and future geriatricians to achieve this goal. [ABSTRACT FROM AUTHOR]

The elevated level of cerebrospinal fluid (CSF) Tau and phosphorylated Tau181 (p-Tau181) proteins are well established hallmarks of Alzheimer’s disease (AD). Elevated level of p-Tau181 can differentiate AD from other neurodegenerative disease. However, the expression level of these proteins in serum of AD patient is not well set up. This study sought to evaluate the level of Tau and p-Tau181 in serum of AD, and mild cognitive impairment (MCI) patients for an alternative approach to establish protein-based markers by convenient way. Blood samples were collected from 39 AD patients, 37 MCI patients and 37 elderly individuals as controls. The levels of Tau and p-Tau181 in the serum of the different groups were measured by label free real time Surface Plasmon Resonance technology by using specific antibodies, and were further confirmed by the conventional western blot method. An appropriate statistical analysis, including Receiver Operating Characteristic (ROC), was performed. The concentrations of serum Tau and p-Tau181 were significantly higher (p<0.00001) in AD (Tau; 47.49±9.00ng/μL, p-Tau181; 0.161±0.04 ng/μL) compared to MCI (Tau; 39.26±7.78 ng/μL, p-Tau181; 0.135±0.02 ng/μL) and were further higher compared to elderly controls (Tau; 34.92±6.58 ng/μL, p-Tau181; 0.122±0.01 ng/ μL). A significant (p<0.0001) downhill correlation was found between Tau as well as p-Tau181 levels with HMSE and MoCA score. This study for the first time reports the concentration of Tau and p-Tau181 in serum of AD and MCI patients. The cutoff values of Tau and p-Tau181 of AD and MCI patients with sensitivity and specificity reveal that serum level of these proteins can be used as a predictive marker for AD and MCI. [ABSTRACT FROM AUTHOR]

Copyright of Academic Emergency Medicine is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and Objectives: Ageing is a progressive process which is associated with a decline in structure and function, impaired maintenance and repair systems, increased susceptibility to disease and death. Comprehensive information on health and functionality in extreme ageing is generally scant in Indian population as well as in world's literature. So, in this study we hypothesize to assess the factors known to influence healthy ageing in late life. Objective is to identify determinants which predict survival of the oldest old patients admitted for acute illness in Geriatric Medicine Ward in a tertiary care hospital in the short term and at one month. Materials and Methods: In this prospective cohort study patients aged 85 year or above getting admitted for acute illness in Geriatric Medicine Ward of AIIMS hospital residing in Delhi NCR during the period of October 2018-March 2020 were recruited. A convenient sample size of 70 was taken based on previous year admission. Patients who withdrew consent, died within 24 hour of hospitalization, with history of admission within previous one month and not traceable at end of one month of discharge were excluded. Data was collected on demographic details, presenting clinical features, Comprehensive geriatric assessment, APACHE III score and biomarkers (Sestrin1, Sestrin2, Sirtuin1, Sirtuin2, Sirtuin3, Sirtuin 6, p53 and gsk 3 beta). Outcome was recorded as discharge after improvement, discharged to long term care and death. Surviving cases were advised to report to Geriatric Medicine Ward for follow assessment at the end of 4 weeks (from the day of discharge) by telephone. Result: Awaited [ABSTRACT FROM AUTHOR]