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Aim: To examine the relationship between patient–provider communication, psychosocial patient self‐efficacy, resources and support for self‐management and socio‐demographics within individualized care of older adults with diabetes. Design: A quantitative study with a cross‐sectional survey design. Methods: Data were collected from September 2019 to January 2021 using: Individualized Care Scale, The Communication Assessment Tool, The Diabetes Empowerment Scale and The Resources and Support for Self‐Management Scale. Patients with either Type 1 or Type 2 diabetes mellitus that were 65 years old and over (N = 145) participated in the study. Results: The most positive aspects of patient–provider communication were respect and creating a comfortable environment for the patient. A significant relationship was observed between patients' perceptions and support of individualized care and diabetes‐related measures. Effective communication was the main factor associated with support for individualizing care, and together with education level, empowerment and access to resources, explained 23% of the variance. [ABSTRACT FROM AUTHOR]

Objective A case-control study was conducted to assess seasonal influenza vaccine effectiveness (SIVE) during the 2015-2016 influenza season. Methods A study was performed in three departments in Lithuania between 1 December 2015 and 1 May 2016. Data on demographic and clinical characteristics including influenza vaccination status were collected from the patients recommended to receive the seasonal influenza vaccine. Influenza virus infection was confirmed by multiplex reverse transcription polymerase chain reaction (RT-PCR) . Results Ninety-one (56.4%) of the 163 included subjects were =65 years old. Fifteen (9.2%) subjects were vaccinated against influenza at least 2 weeks before the onset of influenza symptoms, 12 of them were =65 years old. Of the 72 (44.2%) influenza virus positive cases, 65 (39.9%) were confirmed with influenza A (including 50 cases of influenza A(H1N1)pdm09), eight (4.9%) were confirmed with influenza B and one was a co-infection. Unadjusted SIVE against any influenza, influenza type A and influenza A(H1N1)pdm09 was 57% (95% CI -41% to 87%), 52% (95% CI -57% to 85%) and 70% (95% CI -43% to 94%) respectively. Conclusion Although SIVE estimates were not statistically significant the point estimates suggest moderate effectiveness against influenza type A. [ABSTRACT FROM AUTHOR]

Background: Age-related macular degeneration (ARMD), a progressive retinal disease, is responsible for an impaired central vision in about 180 million people worldwide. Current options for ARMD prevention and treatment are limited due to an incomplete understanding of disease etiopathogenesis. We aimed to test the hypothesis that the single nucleotide polymorphism rs5888 of SCARB1 gene reflecting lipid and antioxidant micronutrient metabolism pathways is associated with ARMD susceptibility and to evaluate if there is any relation between SCARB1 rs5888 and the macular lesion area. Materials and methods: The prospective case-control study included patients with ARMD (n = 215) and the reference group (n = 238) drawn from a random sample of the Lithuanian population (n = 1436). The genotyping test of SCARB1 rs5888 was carried out using the real-time polymerase chain reaction method. Results: Regression analysis adjusted by gender and age demonstrated that SCARB1 rs5888 TT genotype significantly decreased the odds for ARMD development (OR: 0.61, 95%; CI: 0.380-0.981, p = 0.04). A smoking habit and leading an outdoor life are associated with larger macular lesion areas in ARMD patients (0.54 (0.00-39.06) vs. 3.09 (0.02-19.30) and 0.27 (0.00-34.57) vs. 0.75 (0.00-39.06), respectively). In late stage ARMD subjects with CT genotype, the macular lesion area was larger than in TT carriers (7.64 (0.49-39.06) mm² vs. 5.02 (0.03-37.06) mm², p = 0.006). Conclusions: SCARB1 rs5888 and environmental oxidative stress have a prominent role in ARMD susceptibility, early ARMD progression to advanced stage disease and even in the outcome of the disease--an area of macular lesion. [ABSTRACT FROM AUTHOR]

Light changes in mental function after operation occur in patients of all ages, but more frequent they are observed in older patients. The incidence of early postoperative cognitive dysfunction varies depending on surgical procedure and may be as high as 20-90% in aged patients, and occurs most often in patients undergoing cardiovascular surgery. Early postoperative cognitive dysfunction is a predictor of late postoperative cognitive dysfunction. Delirium develops in at least 50% of older surgical patients and even more frequently after cardiac surgeries (72%). Postoperative delirium, like delirium manifesting with co-existing disease, and late postoperative cognitive dysfunction are strong predictors of functional and cognitive decline in one-year period after discharge and are associated with higher morbidity and mortality, longer hospital stay, and a higher rate of institutionalization. The reasons of postoperative cognitive dysfunction and delirium are not well understood. An assessment of cognitive function should be completed as a routine in older patients, and effective prevention requires the identification of risk factors for delirium: advanced age, preexisting dementia and depression, visual and hearing impairment, Parkinson disease, emergency operation, anticholinergic drugs, and others. After operation, elderly patients must be carefully monitored for probable postoperative delirium. It is important to deepen health care professionals' knowledge of postoperative cognitive complications in older surgical patients.

Unlabelled: The aim of this study was to assess cognitive functions of the elderly in an acute care department and long-term care institutions., Material and Methods: A total of 151 hospitalized patients and 111 residents in long-term care facilities participated in the study; in total, 262 respondents. The general items of the inter RAI Questionnaires (Acute Care and Long-Term Care Facilities) were used to evaluate and compare cognitive functions. Hospitalized patients were examined on admission (during 24 hours) evaluating the patient's status before hospitalization (three days before admission to hospital) and 24 hours before planned discharge. The residents in long-term care institutions were examined once., Results: The assessment of skills for daily decision-making showed that more patients made decisions independently at discharge (68.6%) comparing with admission day (53.0%). Impaired decision-making was more common on admission than at discharge, while the residents in long-term care institutions were more dependent than the hospitalized elderly. Procedural memory problems were more frequent among the residents in long-term care institutions (67.6%) than among the hospitalized elderly both on admission (34.7%) and discharge (21.9%) (P<0.001). The patients were able to express themselves clearly and understood others well at discharge more frequently (81.0% and 82.5%, respectively) than on admission (72.7% and 75.3%, respectively), while only 14.4% of the residents in long-term care institutions were able to express themselves clearly and understood others well (P<0.001)., Conclusions: The residents in long-term care institutions had worse cognitive functions than the hospitalized patients. Cognitive functions of the hospitalized elderly were significantly more impaired on admission as compared to discharge, possibly due to impaired somatic and functional status on admission.

Although Lithuanian population is aging and the number of older persons is increasing, the expectancy of autonomous life is one of the shortest in Europe. An increasing number of the elderly results not only in aging society, but in increasing morbidity as well. Reality of life is encouraging health care systems to take into account the needs of older patients and to seek for comprehensive assessment, which is not limited by physical assessment only but includes evaluation of functional state, cognition, socioeconomic status, home environment, identification of geriatric syndromes and vulnerability factors, and assessment of frailty. The term "frailty" is used to describe the status of the elderly person who can usually perform the main practical and social daily tasks, but due to loss of various functions, changes, or disorders cannot restore quickly the strength. Concomitant diseases, disorders, disability, and frailty were considered as synonyms, but the researchers have recently agreed that these terms are not the same. The social part of supportive environment is composed of people (family, friends, professional caregivers) who provide help. The physical part includes technologies that make living easier and more autonomous. Gerontechnologies in vulnerable and frail elderly people can compensate impaired orientation and memory, widen the possibility to communicate, exchange information, and move. With the help of gerontechnologies, safe home environment and monitoring of health state can be ensured. In the article, algorithm for maintenance of autonomy in older persons made by the authors is presented.

Unlabelled: The aim of this study was to identify and evaluate the prevalence of urinary incontinence and risk factors that influenced it among inpatients treated in the departments of internal medicine., Material and Methods: A total of 151 inpatients were questioned using a standardized geriatric questionnaire (InterRAI-Acute Care). Inpatients aged 65 years and more and who gave written informed consent were enrolled into the study. The mean age of the inpatients was 78+/-0.6 years. There were 58.9% of women and 41.06% of men., Results: Urinary incontinence was significantly influenced by the age of the inpatients. Inpatients with urinary incontinence were 3 years older on the average as compared to those without urinary continence (P<0.025). Women were more frequently affected than men (74.2% vs. 48.4%). A significant association between urinary and fecal incontinence and memory problems, movement disorders, delirium, dependence in daily activities, falls was established. The odds of having double incontinence were increased by dementia (OR=20.9; 95%, CI 2.3-186) and residual effects of a stroke (OR=3.5; 95%, CI 1.2-9.6). The prevalence of urinary incontinence decreased from 63.6% before hospitalization to 39.7% after hospitalization. According to standard medical documentation, urinary incontinence was diagnosed in 3.3% of cases, while using the interRAI-AC questionnaire, it was documented in 63.6% of cases., Conclusions: The prevalence of urinary incontinence increases in the elderly; therefore, it has to be investigated and treated. Memory problems, delirium, dependence in daily activities, movement disorders, and falls are directly related to the risk of urinary, fecal, and double incontinence among elderly inpatients. Double incontinence was significantly influenced by dementia (20.9 times) and residual effects of a stroke (3.5 times). Underdiagnosis of urinary and fecal incontinence in inpatients burdens the possibility of providing aid for elderly patients with this disorder.

Unlabelled: The aim of this study was to assess nutritional status of aged surgical patients, to determine the prevalence of malnutrition and factors associated with it., Material and Methods: A total of 156 patients aged 45 years and more, treated at the Departments of Surgery and Urology of Kaunas 2nd Clinical Hospital, were enrolled in the study. Elderly group (aged 65 years and more) consisted of 99 patients, and middle-aged group (45 to 64 years old) of 57 patients. The following anthropometric measurements were performed: weight, height, mid-arm circumference; hemoglobin, serum albumin level, and total lymphocyte count were determined. Standard assessment scales included Instrumental Activities of Daily Living, Geriatric Depression Scale, and Mini Mental State Exam. Statistical analysis was performed with the help of SPSS 12.0., Results: Malnutrition was diagnosed in 53.5% of older patients and in 15.8% of middle-aged patients (P<0.05). Obesity was diagnosed in 32.3% of elderly patients and in 40.4% of middle-aged patients (P<0.05). Among men, obese patients made up 20%, among women - 54.4% (P<0.05). Malnutrition was more prevalent among elderly patients who underwent urgent operations than in patients who underwent planned operations (69.6% and 34.1%, respectively; P<0.05) and among elderly patients with impaired cognitive functions than among those without impaired cognitive functions (in 100% of patients with medium impaired cognitive function, in 59.3% of patients with mild impaired cognitive function, and in 44.4% of patients with unimpaired cognitive function, P<0.05). Malnourished elderly patients had lower functional level than the remaining (IADL score of 3.97 and 4.75 for men, 5.38 and 6.89 for women, respectively; P<0.05). The prevalence of malnutrition did not differ significantly in the groups of older patients with depression, probable depression and not depressed patients - 75.0%, 57.7%, and 46.7%, respectively (P>0.05)., Conclusions: Malnutrition was diagnosed more frequently in elderly surgical patients than in middle-aged patients. Obesity was more common in women than in men. The prevalence of obesity was not associated with age. Malnutrition in elderly surgical patients was associated with poor functional status, impaired cognitive function, and urgent operation.

Mini Nutritional Assessment has been specifically designed to assess the nutritional status of elderly patients and preoperative nutritional evaluation. It can be used for nutritional evaluation in patients receiving treatment for advanced prostate cancer. We assessed 80 patients 65 year age and over. Forty patients were with prostate cancer and 40 patients with benign prostatic hyperplasia. The Mini Nutritional Assessment is a clinical score consisting of four items: anthropometric assessment, global evaluation, dietetic assessment and subjective assessment. The Mini Nutritional Assessment stratifies patients in the three categories: well--nourished patients (24 < or = MNA < or = 30), at risk of malnutrition (17 < or = MNA < 23.5) and undernutrition (MNA < 17). Patients suffering from prostate cancer were more likely to be overweight and they had rapid lost of weight. The Mini Nutritional Assessment was found to be well-suited for nutritional evaluation in patients receiving treatment for advanced prostate cancer. Mini Nutritional Assessment requires no complex analysis and can be easily used in hospitals and should be routinely performed.