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The aim of this study was to assess the analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds.Twenty adult patients, who underwent surgical treatment of third-degree burn wounds under general anesthesia, were included. Two of the patients underwent surgery twice. During surgery, patients received 50-100 μg fentanyl every 20-30 min and, after surgery, patients received 100 mg ketoprofen twice daily. Additionally, ten patients (group 1) received 50 μg sufentanil added to the burn wound dressings soaked in octenidine and phenoxyethanol while 10 patients (group 2) received 25 μg sufentanil added to the same dressings. The rescue analgesic, which was administered when pain intensified, was 5 mg subcutaneous morphine. Plasma sufentanil concentrations were assayed at 1, 2, 3, and 6 h after surgery completion and when pain was reported, along with pain intensity evaluation.Sufentanil was not detected in the serum of any patients. Rescue morphine was given during the postoperative period (24 h) in one patient in group 1 (who underwent surgery twice) and three patients in group 2. The mean sufentanil concentration in dressings was higher in group 1 (0.13 ± 0.03) than group 2 (0.06 ± 0.03 μg/mL; p0.001). The group 1 patient who received rescue morphine had a sufentanil concentration of 0.10 μg/mL, which was the lowest concentration in group 1. Group 2 patients who received rescue morphine had sufentanil concentrations of at least two-fold lower (0.03-0.05 μg/mL). No adverse effects were observed.Sufentanil in dressings after burn wound surgery provides effective and safe analgesia and the sufentanil concentration in dressings should be ≥0.10 μg/mL in a solution of octenidine and phenoxyethanol.

Background Long-term care units’ residents do not constitute a homogeneous population. Providing effective care, tailored to individual needs, is crucial in this context. It can be facilitated by suitable tools and methods, which include needs assessment along with the physical, psychological and social aspects of care. We thus applied a cluster approach to identify their putative groupings to enable the provision of tailored care. Methods The needs of 242 residents of care homes in four Polish cities (Poznan, Wroclaw, Bialystok and Lublin), aged 75–102 years (184 females), with the Mini-Mental State Examination (MMSE) score ≥ 15 points, were assessed with the CANE (Camberwell Assessment of Need for the Elderly) questionnaire. Their independence in activities of daily living was evaluated by the Barthel Index (BI), and symptoms of depression by the Geriatric Depression Scale (GDS). The results of MMSE, BI and GDS were selected as variables for K-means cluster analysis. Results Cluster 1 (C1), n = 83, included subjects without dementia according to MMSE (23.7 ± 4.4), with no dependency (BI = 85.8 ± 14.4) and no symptoms of depression (GDS = 3.3 ± 2.0). All subjects of cluster 2 (C2), n = 87, had symptoms of depression (GDS = 8.9 ± 2.1), and their MMSE (21.0 ± 4.0) and BI (79.8 ± 15.1) were lower than those in C1 (p = 0.006 and p = 0.046, respectively). Subjects of cluster 3 (C3), n = 72, had the lowest MMSE (18.3 ± 3.1) and BI (30.6 ± 18,8, p p p p p p = 0.015). There were also differences in the patterns of needs between the clusters. Conclusions Clustering seems to be a promising approach for use in long-term care, allowing for more appropriate and optimized care delivery. External validation studies are necessary for generalized recommendations regarding care optimization in various regional perspectives.

Background: Gender-related differences in fat distribution may affect blood pressure (BP) control in hypertensive subjects. The aim of the study was to assess how body mass (BM), BMI, and waist circumference (WC) influence the effectiveness of antihypertension therapy in hypertensive men and women in daily clinical practice. Patients and Methods: The observational study involved 12,289 adult hypertensive Caucasians (6,163 women) declaring regular use of antihypertensive drugs. BP control was scored based on the mean values of 2 attended office BP measurements. WC thresholds for visceral obesity were adopted from definitions of the International Diabetes Federation (≥94/80 cm for men/women) and National Cholesterol Education Program Adult Treatment Panel III (≥102/88 cm for men/women). Stepwise backward multivariable logistic regression was used to analyse correlates of the effectiveness of hypertension therapy. Results: The predictive value of BMI ≥30 (for uncontrolled hypertension) was stronger than that of visceral obesity, regardless of the criteria used. In men, BP control rapidly deteriorated with BMI (odds ratio [OR] up to 8.58 [95% CI: 5.74–12.83]) and WC (OR up to 5.09 [3.84–6.74]), while in women, the association was more flattened (OR up to 3.63 [2.78–4.74] and 1.93 [1.59–2.35], respectively). However, the highest risk of uncontrolled BP occurred in women with BM ≥110 kg (OR = 10.47 [5.05–21.71]) and men with BM ≥125 kg (OR = 9.66 [5.86–15.94]). Conclusions: (1) Obesity and visceral obesity limit the effectiveness of antihypertension therapy more in men than in women. (2) This phenomenon should be taken into account in the prescription of adequate doses of antihypertensive drugs.

Introduction. Pre- and post-graduate education, provided for many years, has quite significantly changed the perception of the role of opioids in the treatment of patients with pain, mainly chronic pain. However, research on the knowledge of students on opioids has not been conducted, which makes it difficult to implement desired changes in educational programmes. The aim of the paper was to evaluate the knowledge of medical students on selected opioid drugs: tramadol, buprenorphine and oxycodone, based on a survey filled in after one-week classes in palliative medicine and pain management. Respondents and methods. The study included 140 fourth-year students of medicine at the University of Medical Sciences in Poznan who completed one-week classes in palliative medicine and pain management. Their knowledge on opioid analgesics was checked using an anonymous survey that included 7 statements. Results. Students demonstrated better knowledge in statements regarding theoretical aspects of the use of specific opioids and their mechanisms of action. The percentage of correct answers in the group of statements concerning the availability of specific opioid analgesics was much lower, which confirms that they have less knowledge in this area. Conclusions. Paying attention to the characteristics of specific opioids should improve the individual selection, effectiveness and safety of treatment. Better knowledge on pain management among students, doctors and the general public may dispel their concerns about using opioid analgesics as well as increase the effectiveness of pain management and improve the quality of life of patients with cancer and chronic pain in palliative care.

Purpose The medical students’ attitude toward pain in people with advanced dementia, while constituting an important factor in care, has rarely been assessed to date. The aim of our study was thus to perform such assessment in medical students in Kazakhstan, to enable an improvement of the existing curriculum (like we previously did in Poland). Materials and Methods We analyzed the knowledge about pain using a short anonymous questionnaire, which was completed by 112 students of the Medical University of Aktobe, Kazakhstan. Results On average, students listed symptoms of 1.4 ± 1.2 (out of 6 analyzed) pain areas (median 2.0). The symptoms related to changes in mental status were suggested the most often (57 students: 50.9%). The students who indicated these symptoms also listed a higher number of symptoms from the remaining domains (1,1 ± 1.0 [median 1.0] vs 0.6 ± 0.8 [median 0.0]; p

Background Frailty and adverse drug effects are linked in the fact that polypharmacy is correlated with the severity of frailty; however, a causal relation has not been proven in older people with clinically manifest frailty. Methods A literature search was performed in Medline to detect prospective randomized controlled trials (RCTs) testing the effects of pharmacological interventions or medication optimization in older frail adults on comprehensive frailty scores or partial aspects of frailty that were published from January 1998 to October 2019. Results Twenty-five studies were identified, 4 on comprehensive frailty scores and 21 on aspects of frailty. Two trials on comprehensive frailty scores showed positive results on frailty although the contribution of medication review in a multidimensional approach was unclear. In the studies on aspects related to frailty, ten individual drug interventions showed improvement in physical performance, muscle strength or body composition utilizing alfacalcidol, teriparatide, piroxicam, testosterone, recombinant human chorionic gonadotropin, or capromorelin. There were no studies examining negative effects of drugs on frailty. Conclusion So far, data on a causal relationship between drugs and frailty are inconclusive or related to single-drug interventions on partial aspects of frailty. There is a clear need for RCTs on this topic that should be based on a comprehensive, internationally consistent and thus reproducible concept of frailty assessment.

The SARS-CoV-2 tendency to affect the older individuals more severely, raises the need for a concise summary isolating this age population. Analysis of clinical features in light of most recently published data allows for improved understanding, and better clinical judgement. A thorough search was performed to collect all articles published from 1st of January to 1st of June 2020, using the keywords COVID-19 and SARS-CoV-2 followed by the generic terms elderly, older adults or older individuals. The quality assessment of studies and findings was performed by an adaptation of the STROBE statement and CERQual approach. Excluding duplicates, a total of 1598 articles were screened, of which 20 studies were included in the final analysis, pertaining to 4965 older COVID-19 patients (≥60 years old). Variety in symptoms was observed, with fever, cough, dyspnea, fatigue, or sputum production being the most common. Prominent changes in laboratory findings consistently indicated lymphopenia and inflammation and in some cases organ damage. Radiological examination reveals ground glass opacities with occasional consolidations, bilaterally, with a possible peripheral tendency. An evident fraction of the elderly population (25.7%) developed renal injury or impairment as a complication. Roughly 71.4% of the older adults require supplementary oxygen, while invasive mechanical ventilation was required in almost a third of the reported hospitalized older individuals. In this review, death occurred in 20.0% of total patients with a recorded outcome (907/4531). Variability in confidence of findings is documented. Variety in symptom presentation is to be expected, and abnormalities in laboratory findings are present. Risk for mortality is evident, and attention to the need for supplementary oxygen and possible mechanical ventilation is advised. Further data is required isolating this age population. Presented literature may allow for the construction of better predictive models of COVID-19 in older populations.

Magdalena Sacha,1 Jerzy Sacha,2,3 Katarzyna Wieczorowska-Tobis1 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland; 3Department of Cardiology, University Hospital in Opole, Opole, PolandCorrespondence: Jerzy Sacha Email sacha@op.plPurpose: Frailty is a geriatric syndrome that is usually considered as a set of physical deficits (unidimensional concept); however, it can also concern the psychological and social domains of human functioning (multidimensional concept). The FRAIL scale is a diagnostic tool which ascertains only physical frailty, whereas the Tilburg Frailty Indicator (TFI) is a diagnostic instrument for multidimensional frailty. The study investigates if non-robust physical status and multidimensional frailty affect the same individuals and whether simultaneous employment of the FRAIL scale and TFI identifies specific subgroups of elderly people which require different interventions.Patients and Methods: In this cross-sectional study, 1024 community dwelling elderly individuals at the age of 65 years or older (mean age 72.6 ± 6.3 years; range 65– 93 years) were evaluated with the FRAIL scale and TFI.Results: According to the FRAIL scale, 52.9% of the subjects were physically non-robust, but according to TFI, 54.6% presented multidimensional frailty. These two diagnostic tools were concordant in their outcomes in 77.1% (ie, 42.3% of individuals were physically and multidimensionally frail but 34.8% were robust according to both two instruments); however, in 22.9% the outcomes were discordant. Consequently, by simultaneous employment of the FRAIL scale and TFI, four distinct functional categories have been distinguished: (i) non-robust physical status with multidimensional frailty, (ii) exclusive non-robust physical status, (iii) exclusive multidimensional frailty, and (iv) full robust status.Conclusion: By applying simple physical and multidimensional frailty diagnostic tools, subgroups of elderly people may be identified that require specific management strategies to improve their functional status.Keywords: physical frailty, multidimensional frailty, psychological frailty, social frailty, aging, functional status

Older adults are particularly susceptible to COVID-19 in terms of both disease severity and risk of death. To compare clinical differences between older COVID-19 hospitalized survivors and non-survivors, we investigated variables influencing mortality in all older adults with COVID-19 hospitalized in Poznań, Poland, through the end of June 2020 (n = 322). In-hospital, post-discharge, and overall 180-day mortality were analyzed. Functional capacity prior to COVID-19 diagnosis was also documented. The mean age of subjects was 77.5 ± 10.0 years, among them, 191 were females. Ninety-five (29.5%) died during their hospitalization and an additional 30 (9.3%) during the post-discharge period (up to 180 days from the hospital admission). In our study, male sex, severe cognitive impairment, underlying heart disease, anemia, and elevated plasma levels of IL-6 were independently associated with greater mortality during hospitalization. During the overall 180-day observation period (from the hospital admission), similar characteristics, excluding male sex and additionally functional impairment, were associated with increased mortality. During the post-discharge period, severe functional impairment remained the only determinant. Therefore, functional capacity prior to diagnosis should be considered when formulating comprehensive prognoses as well as care plans for older patients infected with SARS-CoV-2.

Vitamin B12, folate, iron deficiency (IDA), chronic kidney disease (CKD), and anemia of inflammation (AI) are among the main causes of anemia in the elderly. WHO criteria of nutritional deficiencies neglect aging-related changes in absorption, metabolism, and utilization of nutrients. Age-specific criteria for the diagnosis of functional nutritional deficiency related to anemia are necessary. We examined the nationally representative sample of Polish seniors. Complete blood count, serum iron, ferritin, vitamin B12, folate, and renal parameters were assessed in 3452 (1632 women, 1820 men) participants aged above 64. Cut-off points for nutritional deficiencies were determined based on the WHO criteria (method-A), lower 2.5 percentile of the studied population (method-B), and receiver operating characteristic (ROC) analysis (method-C). Method-A leads to an overestimation of the prevalence of vitamin B12 and folate deficiency, while method-B to their underestimation with over 50% of unexplained anemia. Based on method-C, anemia was classified as nutritional in 55.9%. In 22.3% of cases, reasons for anemia remained unexplained, the other 21.8% were related to CKD or AI. Mild cases were less common in IDA, and more common in non-deficiency anemia. Serum folate had an insignificant impact on anemia. It is necessary to adopt the age-specific criteria for nutrient deficiency in an old population.

Background Numerous medications used in older adults require dose modification or should be avoided in individuals with impaired kidney function. Purpose To assess medical students' and physicians' knowledge of drug prescribing recommendations in older patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m2. Patients and Methods A survey comprising a list of 64 drugs conducted in 183 medical students (Students), and 138 post-graduate trainees in internal medicine (Physicians). The respondents were asked to classify each drug into one of three categories: 1) no renal precautions; 2) dose should be reduced; and 3) medication should be avoided. Results A range of 16.9-68.3% students and 14.5-81.2% physicians correctly classified drugs in the category "No renal precautions." Drugs requiring dose reduction were correctly classified by 6-67.2% students, and 24.6-85.5% physicians. For drugs that should be avoided in subjects with eGFR < 30 mL/min/1.73m2, the range was 6-44.8% in the Students, and 8.7-76.1% in the Physicians. The Physicians did better than the Students by classifying five drugs that do not require renal precautions, 12 drugs requiring dose reduction, and six medications that should be avoided. The Students had a higher percentage of correct answers for seven drugs in the category "no renal precautions," and one drug requiring dose reduction. Conclusion Medical students and post-graduate trainees in internal medicine have poor knowledge of drug prescribing recommendations in older patients with renal impairment.

Background: Pain in older subjects with cognitive impairement is frequently undertreated. Purpose: The aim of the study was to characterize pain treatment among 199 elderly nursing home residents (NHR), aged 65 years and above. Patients and methods: In all studied subjects, cognitive functions were assessed. Based on the results, participants were divided into two groups: group 1 - cognitively intact subjects in whom the pain was evaluated based on Numerical Rating Scale (NRS), and group 2 - subjects with cognitive impairment, in whom Abbey Pain Scale (APS) was used to assess pain. Thereafter, subjects with inappropriately treated pain (ie, ineffectively treated or untreated) were analyzed in detail as group 1a (NRS >0) and group 2a (Abbey >2). Results: The prevalence of pain in group 1 and 2 did not differ (65% and 70% respectively). However, inappropriately treated pain occurred more frequently in group 2 (2a=85% vs 1a=64%; p

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.

This chapter, which provides a review of medication in patients with dementia, identifies various issues with relevance to patients with dementia and assorted ways to deal with them. In addition to supplying an overview of the cognitive side effects of specific drugs, there is a helpful table and two boxes with checklists on conducting a patient medication review and a clinical medication review, which may be especially helpful to less experienced physicians in the field.

Background A pan-European approach to evaluate policy impact on health behaviour requires the employment of a consensus set of established and relevant indicators. Methods As part of the Joint Programming Initiative on a Healthy Diet for a Healthy Life, the Policy Evaluation Network PEN identified key indicators of health behaviours and their determinants. These key indicators are already, or have the potential to be, adopted by large European Union surveillance systems for the assessment of policy impact. The iterative selection process included consultations in two rounds via email prior to a 2-days expert workshop. The experts collated a list of dietary behaviour, physical activity and sedentary behaviour indicators for European policy monitoring in young and adult populations based on existing frameworks and literature reviews. The expert panel was composed of researchers, policy makers and representatives of major European surveillance systems and related initiatives, as well as, representatives of organisations providing monitoring data, such as the European Commission and Eurostat. Results The process provided two lists of key indicators including 37 diet ‘policy’ indicators and 35 indicators for dietary behaviour and their ‘determinants’; as well as 32 physical activity ‘policy’ indicators and 35 indicators for physical activity, sedentary behaviour and their ‘determinants’. Conclusion A total of 139 key indicators related to the individual, the setting and the population level, and suitable for the assessment of dietary behaviour, physical activity and sedentary behaviour were prioritised by policy makers and researchers with the ultimate aim to embed policy evaluation measures in existing surveillance systems across the European Union. In a next step, data sources and suitable instruments will be identified to assess these key indicators.

Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R2 = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R2 ranging between 0.07&ndash, 0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R2 = 0.33) and 11 factors (R2 = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social), the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.

Sławomir Tobis,1 Katarzyna Wieczorowska-Tobis,2 Dorota Talarska,3 Mariola Pawlaczyk,1 Aleksandra Suwalska4 1Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland; 2Laboratory of Geriatrics, Department of Palliative Care, Poznan University of Medical Sciences, Poznan, Poland; 3Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland; 4Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland Introduction: No comprehensive needs assessment is performed routinely in Poland. Purpose: The goal of the study was to investigate the patterns of needs in older individuals living in long-term care institutions (LTCIs) using the Camberwell Assessment of Need for the Elderly (CANE) questionnaire, based on a previously published study protocol.Participants and methods: The study included 306 LTCI residents (age: ≥75years) with the a Mini-Mental State Examination (MMSE) score of at least 10 points. The dependence in basic activities of daily living was measured using the Barthel index (BI). A screening for depression was performed using the Geriatric Depression Scale (GDS) in subjects with an MMSE score of ≥15 points. Thereafter, CANE was used to analyze needs receiving adequate support (met needs) and those without appropriate interventions (unmet needs).Results: The mean age of studied individuals was 83.2±6.0years. They had 10.4±3.2 met needs and 0.8±1.2 unmet needs. Unmet needs were reported most commonly in the following areas: company (15.9%), psychological distress (14.0%), intimate relationship (11.4%), eyesight/hearing/communication (11.4%), and daytime activities (11.0%). The OR of having a large number of met needs (ie, above the median) was almost eight times higher in residents with a BI score of 0–49 points versus those with ≥ 80 points. The group between (with 50–79 points) had this parameter almost four times higher. The OR of having a large number of unmet needs depended neither on BI nor on GDS and was more than four times higher in the group of 10–19 MMSE points (ie, with symptoms of moderate dementia) versus subjects with 24–30 MMSE points (ie, without symptoms of dementia).Conclusion: We defined the target group with high probability of unmet needs and the areas in which resources and efforts should be concentrated. We believe that the results can be used to optimize care in LTCIs. Keywords: met needs, unmet needs, determinants, aged 75 and older, long-term care, optimization, CANE

Tomasz Nowak,1 Agnieszka Neumann-Podczaska,2 Ewa Deskur-Śmielecka,1 Arkadiusz Styszyński,1 Katarzyna Wieczorowska-Tobis1 1Laboratory of Geriatrics, Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań, Poland; 2Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznań, Poland Introduction: In patients with dementia, observational scales are recommended for use in the assessment of pain. Unfortunately, their application is rare, and as a consequence pain is frequently underdiagnosed and undertreated in these types of subjects. Thus, the aim of the study was to assess analgesic treatment in nursing home residents with cognitive impairment and to delineate the relationship between pain and behavioral and psychological symptoms of dementia.Patients and methods: The research was conducted in 2 nursing home facilities in Wielkopolska, Poland. The analyzed group consisted of 96 residents (78 female) with moderate and severe cognitive impairment in whom pain was assessed with the Abbey Pain Scale (APS) and agitation with the Cohen–Mansfield Agitation Inventory (CMAI). Thereafter, medical files related to drug prescriptions were analyzed.Results: Analgesics were consumed by 33 individuals (34%); 24 (25%) received regular pain treatment and 7 individuals (7%) - as when needed pain treatment. A relationship was found between the APS and CMAI (r=0.45, p

Objectives To investigate the influence of overweight and obesity on general performance and mortality in seniors. Design Cross-sectional multidisciplinary study on ageing of the Polish population. Setting Community-dwelling individuals aged 65 years or older, selected using three-stage stratified, proportional draw. Participants 4944 Polish Caucasian seniors, aged 65 years or older recruited between October 2007 and October 2010. Measurements All study subjects underwent measurement of body mass index (BMI), waist circumference (WC), and arm circumference (AC). The physical and cognitive performance was evaluated using the Katz Activities of Daily Living (ADL) score and Mini-Mental State Examination (MMSE), respectively. Morbidity data were obtained from a medical questionnaire. Mortality data were obtained from the Population Register of Poland between October 2015 and October 2018. Results Increasing age was associated with a decreased prevalence of obesity (all p Conclusions Overweight and obesity in Caucasian seniors are not associated with deterioration of physical and cognitive function or with increased mortality.

The number and proportion of older adults are increasing globally, and it is predicted that in 2020, there will be 723 million people worldwide aged 66 and older. In recent decades, numerous studies showed that healthy eating is positively associated with better nutritional status and quality of life, and the decreased incidence of noncommunicable diseases. As older adults become health conscious, the demand for foods and beverages rich in nutrients and bioactive compounds has increased. The increased demand for healthy food stimulated a recent rapid increase in designing, producing, and marketing functional foods to prevent or correct nutrient deficiencies and to improve the nutritional status of older adults. These functional products contain and/or are enriched with dietary fiber; omega-3 polyunsaturated fatty acids; phytoestrogens; polyphenols; carotenoids such as alpha- and beta-carotene; lutein and zeaxanthin; pre-, pro-, and synbiotics; and plant sterols and stanols. A limited number of publications have thoroughly addressed the effect of functional foods on the nutritional status of older adults. The goal of this review was to review existing recent research on the role of functional foods in healthy and active aging.

Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients as well as Likert scale-based telephonic survey were performed for a comprehensive evaluation of the project’s significance. Results: To date, 49 consultations have been conducted. Remote consultations performed by medical and pharmacy students working collaboratively were beneficial for both students, participants. Conclusions and Practice Implications: This experimental education project provided students with authentic challenges while simultaneously delivering care to the older adults who are susceptible to disruption of care associated with the pandemic. Further development and expanded implementation of such approaches may be a post-pandemic practice to provide more accessible care for senior patients while incorporating interprofessional education.

Purpose] The aim of the study was to analyze the impact of inpatient rehabilitation on the functional status of the elderly. [Subjects and Methods] A total of 100 patients (>65 years of age) in a rehabilitation ward were enrolled in this study. Age, absence of depression and signs of dementia in screening tests constituted the inclusion criteria. A comprehensive geriatric assessment was performed of all of the subjects twice, at the beginning and end of hospitalization (Assessments I and II, respectively), and included fall risk assessment (Timed Up and Go Test, TUG), evaluation of physical function (Short Physical Performance Battery Test, SPPB), the handgrip strength test, as well as patients' self-reports of pain intensity, well-being and functional status. [Results] At the end of inpatient rehabilitation, significant improvement was observed in reduction the TUG time, physical function, and handgrip strength, as well as in subjective parameters such as self-reported pain intensity, well-being, and functional status. [Conclusion] Our results show the high efficacy of inpatient rehabilitation as a means of improving functional independence. Hospital rehabilitation should be recommended for elderly people, not only in cases of absolute indications for hospital admission, but also periodically for patients at risk of physical disability.

Introduction SARC-F is a quick questionnaire recommended as a screening tool for sarcopenia. The aim of the study was to translate, adapt, and validate the Polish version of the SARC-F for community-dwelling older adults in Poland. Materials and methods We included 160 Polish volunteers aged ≥ 60 years (44% of men). The Polish version of SARC-F was adapted following standardized forward-backward translation procedure. SARC-F was validated against the six sets of diagnostic criteria as the reference standards [developed independently by European Working Group on Sarcopenia in Older People1 (EWGSOP1), European Working Group on Sarcopenia in Older People2 (EWGSOP2), Foundation for the National Institutes of Health (FNIH) Sarcopenia Project, Asia Working Group for Sarcopenia (AWGS), the International Working Group for Sarcopenia (IWGS), and Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD)]. Results SARC-F score ≥ 4 points was observed in 18.8% of the study population. Cronbach’s alpha was 0.70. The sensitivity of SARC-F varied from 33.3% to 50.0% depending on the diagnostics criteria used, while the specificity was about 85%. Positive predictive value (PPV) was low (about 30%) for five out of six sets of the diagnostic criteria used (EWGSOP2, IWGS, AWGS, FNIH, and SCWD), while the negative predictive value (NPV) was generally high (>88%). The area under the ROC curves (AUC) was 0.652–0.728. SARC-F had the largest AUC against FNIH criteria (0.728), indicating a moderate diagnostic accuracy. Similar results were found for EWGSOP2 and IWGS criteria. The AUC values were below 0.7 for AWGS, SCWD, and EWGSOP1 criteria. Conclusion Based on the results, the Polish version of SARC-F shows excellent reliability and good internal consistency. High specificity and high NPV make SARC-F a useful tool to rule-out sarcopenia with high accuracy in community-dwelling older adults, independently of the diagnostic criteria used.

The older population is one of the most vulnerable to experience adverse outcomes of COVID-19. Exploring different clinical features that may act as detrimental to this population&rsquo, s survival is pivotal for recognizing the highest risk individuals for poor outcome. We thus aimed to characterize the clinical differences between 60-day survivors and non-survivors, as well as analyze variables influencing survival in the first older adults hospitalized in Poznan, Poland, with COVID-19. Symptoms, comorbidities, complications, laboratory results, and functional capacity regarding the first 50 older patients (&ge, 60 years) hospitalized due to COVID-19 were retrospectively studied. Functional status before admission (dependent/independent) was determined based on medical history. The 60-day survivors (n = 30/50) and non-survivors (n = 20/50) were compared across clinical parameters. The patients had a mean age of 74.8 &plusmn, 9.4 years. Overall, 20/50 patients died during hospitalization, with no further fatal outcomes reported during the 60-day period. The non-survivors were on average older (78.3 &plusmn, 9.7 years), more commonly experienced concurrent heart disease (75%), and displayed functional dependence (65%) (p &lt, 0.05). When assessing the variables influencing survival (age, heart disease, and functional dependence), using a multivariate proportional hazards regression, functional dependence (requiring assistance in core activities of daily living) was the main factor affecting 60-day survival (HR, 3.34, 95% CI: 1.29&ndash, 8.63, p = 0.01). In our study, functional dependence was the most important prognostic factor associated with mortality. Elderly with COVID-19 who required assistance in core activities of daily living prior to hospitalization had a three times increased risk to experience mortality, as compared to those with complete independence. Exploring geriatric approaches, such as assessment of functional capacity, may assist in constructing comprehensive survival prognosis in the elderly COVID-19 population.

Collaboration between physicians and pharmacists is essential for proper and effective medical care. Medicine is a multifaceted discipline where success is judged by the final results of the patient’s wellbeing. Incorporating an interdisciplinary education in a medical career enhances the cooperation between future medical professionals. In this comprehensive review, we present current steps which have already been implemented in order to apply interdisciplinary care as well as interprofessional cooperation possibilities during the COVID-19 pandemic.

Background Numerous medications should be avoided, or require dose adjustment in subjects with impaired kidney function. We aimed to assess the prevalence of potentially inappropriate use of renal risk drugs in a nation-wide, community-dwelling Polish older adult population. Methods We analysed regular intake of 38 medications that should be avoided, requiring dose modification, increase the risk of pre-renal kidney injury, or may cause potassium retention in subjects with moderately to severely impaired renal function in the PolSenior data base (N = 4514, mean age 76 ± 11 yrs). Kidney function was assessed with short Modification of Diet in Renal Disease formula estimated glomerular filtration rate (sMDRD) and Cockcroft-Gault creatinine clearance (CC). Results There were 855 (19%) individuals with sMDRD

IntroductionThere are four screening sarcopenia questionnaires (SARC-F, SARC-CalF, MSRA-5, MSRA-7). To unambiguously determine which of them is the most effective tool in community-dwelling older adults, we performed a diagnostic accuracy study. The aim of the analysis was to assess the diagnostic values of SARC-F, SARC-CalF, MSRA-5, MSRA-7 and compare their psychometric properties against six criterion standards (EWGSOP1, EWGSOP2, FNIH, AWGS, IWGS, SCWD criteria).Materials and methodsWe included 100 community-dwelling volunteers aged ≥ 65yrs. The sensitivity/specificity analyses were performed. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were calculated to compare the overall diagnostic accuracy of the four questionnaires. Ideal screening tools should have reasonably high sensitivity and specificity, and an AUC value above 0.7.ResultsWith respect to the six criterion standards used, the sensitivity of SARC-F, SARC-CalF, MSRA-5, and MSRA-7 ranged 35.0-90.0%, 20.0-75.0%, 64.7-90.0%, 76.5-91.7%, respectively, whereas the specificity ranged 86.9-91.1%, 80.0-90.0%, 45.8-48.8%, 28.9-31.0% respectively. The AUCs of SARC-F, SARC-CalF, MSRA-5, and MSRA-7 ranged from 0.655-0.882, 0.711-0.874, 0.618-0.782 and 0.588-0.711 respectively. Only SARC-CalF had AUC >0.7 and ConclusionBased on our analysis, the standard sarcopenia screening questionnaires deliver contradictory results in many practically occurring cases. It appears that SARC-CalF is an optimal choice for screening sarcopenia in community-dwelling older adults.

In the original publication of this article, the members of the FORTA group were provided in such a way that they could not be indexed as collaborators on PubMed. The article should have included an Acknowledgement section as shown below.

ObjectiveThe identification of determinants of dietary intake is an important prerequisite for the development of interventions to improve diet. The present systematic literature review aimed to compile the current knowledge on individual functional determinants of dietary intake in community-dwelling older adults.DesignA systematic search was performed in PubMed, Scopus, Web of Science and the Cochrane Library. Titles, abstracts and full texts were screened according to predefined inclusion and exclusion criteria. Studies were included when focusing on dietary intake as an outcome and on chemosensory, oral, cognitive or physical function as a determinant.SettingCommunity.SubjectsOlder adults at least 65 years old without acute or specific chronic diseases.ResultsFrom initially 14 585 potentially relevant papers, thirty-six were included. For chemosensory, cognitive and physical function only a few papers were found, which reported inconsistent results regarding the relationship to dietary intake. In contrast, oral function was extensively studied (n31). Different surrogates of oral function like dental status, number of teeth, bite force or chewing problems were associated with food as well as nutrient intakes including fibre. As all except six studies had a cross-sectional design, no causal relationships could be derived.ConclusionsAmong functional determinants of dietary intake oral factors are well documented in older adults, whereas the role of other functional determinants remains unclear and needs further systematic research.

This paper describes the evaluation of human-robot-interaction (HRI) related to the future use of a humanoid robotic system as a tool supporting the care for an independently living elderly person with MCI. The core motivation was to summarize user experience that was gained during the tests of socially assistive robot in domestic trials. To what extend older users acceptance and use of the autonomous robot is the central research topic covered in this paper. To evaluate this problem user validation was performed together with 5 older people in their own homes during 10 weeks of trials. Detailed results covering user acceptance, their attitude towards the robot, perception of the robot and scores regarding the naturalness, animacy and intelligence of the tested system were measured using The Godspeed and the Almere questionnaire. The results show high acceptance of the robot in the context of perceived enjoyment, perceived ease of use, trust and social influence. What shows that elderly users may be open to the facilitating technologies.

Objectives The aim of the study was to evaluate the Camberwell Assessment of Need for the Elderly questionnaire (CANE) in assessing the needs of elderly individuals living in long-term care institutions (LTCI) in Poland. Setting and Participants The needs of 173 residents were assessed. The inclusion criteria were age (at least 75 years of age) and the lack of severe cognitive impairment (Mini Mental Scale Examination score of at least 15 points). Measurements In all participants, met and unmet needs were assessed by themselves and by the nursing staff involved in care activities. Results The number of met needs assessed by the staff was higher than in the users’ opinions (p

Introduction Poland according to demographic forecasts will be the fastest aging country in Europe. We observe a growing demand for geriatric care and treatment that should be performed holistically. Objectives The aim of this study was to analyse the phenomenon of disability in the oldest age group and the needs related with it, depending on the place of residence of elderly people. Method The study involved 170 people over 75 years of age, 100 were from nursing homes (NH), and 70 from family home environment. Results The average age of respondents was 81.6 years, and 56.5% (n = 113) of the group were women. From the respondent's point of view there were no significant differences in the assessment of needs that were met, unmet, and in total number of needs, whereas from the researcher's point of view greater number of both met needs (P Conclusions In order to improve the care provided for elderly people it seems necessary to promote knowledge of the wider needs of older patients among the employees of different forms of geriatric care.

Background The wide variation in performance among the elderly leads to the search for a suitable instrument to identify the necessary support. The aim of this study was to examine the scope of independent functioning of the elderly and to indicate the necessary support using basic instruments, Comprehensive Geriatric Assessment (CGA) and EASY-Care Standard 2010. Methods For statistical analysis were qualified 101 questionnaires of patients from oncological surgery clinic. Results The study group was dominated by women (79.2%). The average age for the entire group was 74.7 ± 7.5 years. In terms of basic life activities (Barthel Index), 75.2% of the elderly performed most of their activities independently. The Lawton IADL (Instrumental Activity of Daily Living Scale) median was 25 points. Moderate depression (Geriatric Depression Scale) reported 37.6% of the group. The influence of age, education, mode of movement and efficiency in basic and instrumental life activities and depression (Geriatric Depression Scale) was demonstrated in the results in three scales of the EASY-Care Standard 2010 questionnaire: Independence score, Risk of break down in care and Risk of falls. There was no difference in terms of gender and the nature of the residence. Conclusion The study group of the elderly was characterised by a good level of efficiency in basic and instrumental activities of daily living. Questionnaire EASY-Care Standard 2010 enables to identify functional limitations of the elderly that may form the basis for planning individual support.

Introduction Demographic aging of the Polish population is becoming a challenge for health and social policy, similarly to other European countries. It is also seen as one of the most important causes for developing formal long-term care. Objective The aim of this study was to analyse the complex needs of residents of nursing homes over 75 years old in different Polish cities from different perspectives and to explore the unmet need associations of health-related factors. Material and methods The sample consisted of 300 randomly selected people over 75 years old from different nursing homes in three metropolises: Wroclaw, Poznan and Lublin. The detailed needs were assessed using the CANE questionnaire and psychophysical condition was based on MMSE, GDS and BI. Results Comparison of needs examined from three different perspectives showed that nursing home residents reported significantly fewer problems than nursing home staff and rater and significantly more unmet needs than staff. The most common areas where unmet needs were reported were company/friends and psychological distress. Moreover, the more severe the depression and the worse the cognitive functions were, the more unmet needs were reported by nursing home residents. Conclusions In order to improve the care provided for elderly people, it seems necessary to promote knowledge concerning wider needs of elderly patients among the employees of different geriatric care facilites. Interventions to reduce senior׳s unmet needs should be targeted at organisational and medical assessment issues. Future studies with longitudinal follow-ups are required.

Objective The aim of the study was to assess dental status of Polish seniors having and wearing dentures in relation to demographic, socioeconomic and lifestyle factors. Background Tooth loss is associated with deterioration of general health status. The epidemiological data on dental status in Poland, including Polish seniors, are fragmented. Materials and methods The study cohort consisted of 4524 randomly selected participants, aged 65 years and over, representative for Polish seniors. Demographic, socioeconomic, lifestyle factors and dental status were collected using standardised questionnaires. Results The prevalence of partial and complete edentulism in the Polish senior population was estimated at 45.7% and 47.1%, respectively. Fourteen point four per cent (14.4%) of complete edentulous participants and 31.1% with partial edentulism (1-19 natural teeth) did not have dentures, and one-twelfth of respondents having dentures were not wearing them. The independent correlates of complete edentulism were: female sex, advanced age, rural dwelling, lower education level, physical work in the past, smoking and diabetes. Male sex, age 90+, rural dwelling, type of work, dependence in activities of daily living and partial edentulism were independent correlates of not having dentures and denture disuse. Lower than average personal income was only significant for not having dentures. Conclusions Complete edentulism is frequent among older Poles and affects almost 50% of them. It is associated with female sex, age, rural dwelling, poor economic status, smoking and diabetes. Rural dwelling and dependence of daily living are significant correlates of not having dentures and denture disuse.

This text referring directly to the diagnosis and treatment of hypertension in elderly patients is a translation of a fragment of REMEDIA NT 65+ GP published in the “Lekarz POZ” (GP Practitioner) journal 4/2018.

ObjectiveNumerous studies have reported an association between vitamin D (25-hydroxyvitamin D; 25(OH)D) deficiency and low economic status, lower educational level, drugs exposure, smoking and reduced physical activity. Our study analysed the association between sociodemographic factors and 25(OH)D status in Polish (Caucasian) seniors.DesignCross-sectional study (part of the PolSenior study). Serum 25(OH)D concentration was measured by a solid-phase ELISA method; a standardized questionnaire evaluated educational level, economic status, alcohol consumption, current or past cigarette smoking, physical activity, activities of daily living (ADL) and instrumental activities of daily living.SettingCommunity-dwelling randomly selected individuals aged 65 years or older, selected using three-stage stratified, proportional draw.SubjectsSeniors (n 3472; 1658 women and 1814 men).ResultsMean serum 25(OH)D concentration was 20·5 (sd 9·6) ng/ml. Values below the recommended level (30 ng/ml) were detected in 82·8 % of men and 90·4 % of women. Regression analysis revealed that the difference between sexes was associated with decreased walking activity in women, probably resulting in less sunlight exposure. There was a positive association between any disability in ADL and the presence of vitamin D deficiency/insufficiency. In the sex-adjusted analysis, older age, alcohol abstinence and lack of cycling and long-distance walking were explanatory variables for vitamin D deficiency.ConclusionsVitamin D deficiency/insufficiency is frequent in the older Polish population and associated with functional disability and impaired mobility of seniors.

Background Falls affect approx. 30% of elderly population per year. They cause major injuries and reduce independence of the older adults’ functioning. The main objective of the study was to evaluate the degree of independence and find the fall risk factors in the study group. Methods The study included 506 – older adults. The study group included patients from GP clinics and members of two senior centers. The study duration was 12 months. Our study tools included EASY- Care Standard 2010 questionnaire, Abbreviated Mental Test Score (AMTS), Index Barthel, Instrumental Activities of Daily Living Scale (IADL), Geriatric Depression Scale (GDS), Timed Up and Go (TUG). Results The study included 357 (70.6%) female and 149 (29.4%) male subjects. The mean age of the study group patients was 75.7 years ± 8.0. Most of the older adult subjects were independent in both basic (Index Barthel) and instrumental (IADL) activities. Gait fluency evaluated in TUG scale found slow and unsteady gait in 33.7% of the subjects. 27.5% of the subjects used mobility aids when walking. In the Risk of falls scale, 131 subjects (25.89%) were at risk of falls. According to logistic regression the main risk of fall determinants (p

Background and objective: The number of studies related to medical students&rsquo, attitude toward pain is limited. The aim of our study was, thus, to assess the medical students&rsquo, knowledge of pain assessment and treatment in advanced stages of dementia in order to improve the existing curriculum in this area. Material and methods: We analyzed the medical students&rsquo, knowledge about pain in advanced dementia based on a short questionnaire. The research was anonymous. The questionnaire was completed by 147 students. Results: The students most often suggested that pain in patients with advanced dementia could be manifested via body language and facial expression (107 students&mdash, 72.8% and 100 students&mdash, 68.0%, respectively). Vocalization was the third most frequently reported pain manifestation (84&ndash, 57.1%). Other groups of pain symptoms (changes in activity patterns, changes in interpersonal interactions, and mental status changes) were indicated less often (p &lt, 0.0001). Only five students (3.4%) listed the DOLOPLUS behavioral pain scale as an assessment tool for patients with advanced dementia, and 16 (10.9%) indicated observational scale elements or a necessity to observe the patient. Still, 110 students (74.5%) correctly characterized pain treatment in patients with advanced dementia. Conclusions: To the best of our knowledge, our study is pioneering in defining the deficits of medical students&rsquo, knowledge on pain assessment and treatment in patients with advanced dementia. We highlighted knowledge gaps in the area of pain assessment which might make medical students incapable of proper pain treatment. Following the International Association for the Study of Pain considerations regarding the need for excellence in pain education, these results can contribute to the improvement of existing medical curricula in Poznan University of Medical Sciences to include pain management in dementia in a more &rdquo, patient-centered&rdquo, way in order to increase future staff&rsquo, s competency and to assure a better quality of care.

Objectives. Cut-off points (COPs) for appendicular lean mass (ALM) index, essential to define low muscle mass (LMM) in the elderly, have never been officially defined for Poland. The aim of the study was to establish them. Additionally, the significance of body mass index (BMI) for correctly defining the COPs in a young, healthy reference group was assessed.Methods. The study was composed of reference group (n=1113) and the elderly group (n=200). In all subjects, body composition was assessed by bioimpedance analysis, and ALM index was calculated. Next, COPs (kg/m2) were set up for the whole reference group and for particular subgroups with different BMIs separately. They were used to diagnose sarcopenia in the elderly.Results. COP for all young females was 5.37 (COP-F), while it was equal to 5.52 (COP-F2) when only those with a recommended BMI (18.50–24.99 kg/m2) were taken into consideration. For males, it was 7.32 and 7.29, respectively. Only 7% of elderly females had LMM based on COP-F and 15% had LMM based on COP-F2P<0.05; for males, the percentages were 18% and 16%, respectively.Conclusions. COPs for LMM for Poland are 5.52 kg/m2(females) and 7.29 kg/m2(males). The reference group BMI is an important factor in establishing COPs for low muscle mass.

Background. The question arises how recent developments in robotics can contribute to the care for older people. The study is part of the EU-funded ENRICHME project.Objectives of Study. The aim of the study was to investigate opinions of occupational therapy students (OTS), as future professional caregivers, on the use of robots in care for older people.Methods. It included 26 OTS from Poznan University of Medical Sciences. To collect data, the Users’ Needs, Requirements, and Abilities Questionnaire (UNRAQ) was developed.Findings. OTS perceived the robot as “a useful device” and “an assistant” rather than “a companion” (p<0.01). In their opinion, the most important functions of the robot were related to health aspects (emergency alarms, health parameters monitoring, physical activity and memory training, and reminders about medication, drinks, etc.), scored positively by 23–26 OTS. Functions such as mood detection, encouraging to contact with friends, and monitoring of food consumption were accepted by 16-17 OTS. Two statements concerning social functions (accompanying in everyday activities and decreasing the sense of loneliness) were rated positively by less the than half of the participants.Limitations and Recommendations for Further Research. A module concerning technology use, including robotics, should constitute an important part of the curricula of both academic and continuous education of OTS.

Introduction : Pain is the most common complaint of elderly people. In Poland, no large studies on the prevalence of chronic pain in the elderly were conducted until recently. Material and methods : The study was a part of the PolSenior project, a cross-sectional multidisciplinary study on ageing of the Polish population, and included a randomly selected group of 716 people aged 55–59 years, and 4979 people over 65 years. The survey was conducted through a standardized questionnaire. An evaluation of pain occurrence, location, intensity and coexistence of pains in relation to gender, age and use of health care was performed. Results : Chronic pain affected 42.0% of respondents aged 65 years and over (48.6% of women and 35.8% of men) as compared to 35.2% of the pre-elderly. The most common pain locations were the lumbar region (51.6%) and knees (41.0%). The average number of pain sites was 3.1 ±2.3. Average intensity of pain was 6.2 points on the VAS scale in people over 65 years and 6.0 points in the pre-elderly (NS). Average pain intensity increased significantly from 5.7 points in patients reporting pain in one place to 7.2 points in those reporting six pain sites. Elderly respondents with pain compared to those without pain more frequently reported physician visits performed at least once a month (54.6% vs. 48.4%, p < 0.001). Conclusions : Polish elderly most frequently complained of low back and lower limb pain. In respondents reporting many sites of pain, an increase in the intensity of pain was observed. Elderly patients with chronic pain often use medical care.

Abstract: Both descriptive and longitudinal studies of aging are nowadays a subject of growing interest in different countries worldwide. However, in Poland and other Central–Eastern European countries, such comprehensive, nationally representative, multidimensional studies were never performed in the past in elderly population. The present paper describes the PolSenior project including its objectives, sample selection and structure, methods, fieldwork procedures and study flow. The aim of the project was to examine medical, psychological and socioeconomic aspects of aging in Poland. The research sample included 5695 respondents (2899 males and 2796 females) split into six equally sized age groups of elderly individuals (65–69 years, 70–74 years, 75–79 years, 80–84 years, 85–89 years, 90 + years) and one group of subjects just about to enter old age (55-59 years). Subjects were recruited using three stage stratified, proportional draw. The response rate was 42% and ranged from 32% to 61% between provinces. The study consisted of three visits performed by trained nurses including questionnaire survey, comprehensive geriatric assessment and blood and urine sampling. The questionnaire consisted of medical and specific socioeconomic questions. The comprehensive geriatric assessment included blood pressure and anthropometric measurements, as well as selected scales and tests routinely used in the examination of elderly subjects. Blood and urine samples were collected from 4737 and 4526 individuals, respectively. More than 50 biochemical parameters were measured, and DNA was isolated and banked. In a selected group of 1018 subjects, a medical examination by a physician was performed. The self-rated health was lower in females than in males in age groups 70–84, but similar in individuals of both sexes aged 65-69 and  85 years. Besides providing data on health and functioning of elderly population, the PolSenior project aims to analyze interrelationships between different elements of health and social status, and between genetics and health status in advanced age. The results of the PolSenior project will facilitate prioritizing the state's public health and social policies in elderly population. Such a program provides also an excellent starting point for longitudinal studies and a basis for comparative analysis between Poland and other European countries or regions.

Background In the elderly, chronic low-grade inflammation (inflammaging) is a risk factor for the development of aging-related diseases and frailty. Using data from several thousand Eastern Europeans aged 65 years and older, we investigated whether the serum levels of two proinflammatory factors, interleukin-6 (IL-6) and C-reactive protein (CRP), were associated with physical and cognitive performance, and could predict mortality in successfully aging elderly. Results IL-6 and CRP levels systematically increased in an age-dependent manner in the entire study group (IL-6: n = 3496 individuals, p

The aim of the study was to assess the effect of a polyunsaturated omega-3 fatty acids (PUFA) supplementation on the parameters of body composition, muscle strength and physical performance in elderly people with decreased muscle mass (DMM). Fifty three elderly people with an ALM index (the ratio of appendicular lean mass to squared height) either below (−2SD: low muscle mass-LMM) or between (−1SD and −2SD: the risk of LMM-rLMM) the ALM index for the young Polish reference population were randomly assigned to PUFA-treated groups (LMM-PUFA, rLMM-PUFA) or control groups (LMM-control, rLMM-control). PUFA-treated groups received capsules containing 1.3 g of PUFA and 10 mg of vitamin E, while the control groups received 11 mg of vitamin E daily for 12 weeks. Body composition (BIA analysis), muscle strength (hand grip measured with dynamometer) and physical performance (Timed Up and Go test-TUG) were assessed before and after supplementation. No statistically significant differences were observed either in muscle mass or in the hand grip and TUG in any group. The post-pre difference (mean ± SD) in ALM index was as follows (kg/m2): LMM-PUFA: 0.00 ± 0.30, rLMM-PUFA: 0.00 ± 0.22, LMM-control: 0.03 ± 0.36, rLMM-control: –0.03 ± 0.20. In our study, a 12 week supplementation of PUFA did not affect the evaluated parameters in elderly individuals with DMM.

Multiple drugs used in palliative care, including most opioids or their active metabolites may accumulate in patients with abnormal renal function, leading to serious adverse effects. The incidence and severity of renal impairment in palliative care inpatients has not been evaluated. The aim of the study was to investigate the incidence and severity of renal impairment in palliative care inpatients.A retrospective analysis of medical records of patients admitted to the palliative care ward was performed. Estimated glomerular filtration rate (eGFR) was derived using the Cockcroft-Gault (C-G) and abbreviated Modification of Diet in Renal Disease (aMDRD) equations.Serum creatinine levels (SCr) were determined in 332 subjects aged 66.4±11.80 years (194 women; mean body mass index [BMI] 22.7±5.21 kg/m(2)). Mean SCr was 107.7±112.31 μmol/L. Elevated SCr (115 μmol/L) was found in 20.2% of patients. Mean eGFR calculated with C-G and aMDRD equations was 66.6±38.52 mL/min and 78.7±43.55 mL/min/1.73 m(2), respectively. Between 35.2% and 51.8% of patients had eGFR60 mL/min/1.73 m(2) (depending on the equation used). More than 10% of patients had eGFR30 mL/min/1.73 m(2). In patients with normal SCr, between 18.9% and 39.2% had eGFR60 mL/min/1.73 m(2).Renal impairment is common in palliative care inpatients, including considerable number of subjects with moderately to severely reduced kidney function.