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The Elderly as the Symbol of a Generation’s Experience through Covid-19 Pandemic 2 2 This article has no abstract. 1 2 2020/04/14 1399/1/26 2020/04/20 1399/2/1 Mohammad Sabzi Khoshnami Mohammad Sabzi Khoshnami Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Seyyed Mohammad Hossein Javadi Seyyed Mohammad Hossein Javadi Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran javadismh4@gmail.com Sara Noruzi Sara Noruzi Social Worker, Shahid Chamran Hospital, Lorestan University of Medical Sciences, Lorestan, Iran Iran Moslem Arian Moslem Arian Department of Counseling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Yamamoto M, Matsuyama S, Li X, Takeda M, Kawaguchi Y, Inoue JI, et al. Identification of nafamostat as a potent inhibitor of Middle East respiratory syndrome coronavirus S protein-mediated membrane fusion using the split-protein-based cell-cell fusion assay. Antimicrobial Agents and Chemotherapy. 2016; 60(11): 6532-9. ##Canrong WU, Yang Y, Yang LI, Zhang P, Wang Y, Wang Q. Furin, a potential therapeutic target for COVID-19. ChinArxiv [Internet]. 2020##Ministry of Health and Medical Education of the Islamic Republic of Iran [Internet]. 2020. Available from: https://behdasht.gov.ir/##Farzaneh S, Alizadeh S. A survey on effects of social risk factors on social health of elderlies of Babol. Quarterly of Socio-Cultural Development Studies. 2013; 2(1): 183-208. [Persian]##Khalili F, Sam Sh, Sharifirad GhR, Hassanzadeh A, Kazemi M. The relationship between perceived social support and social health of elderly. Journal of Health System Research. 2011; 7(6):1216-25. [Persian]##Jia Z, Tian W, Liu W, Cao Y, Yan J, Shun Z. Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake. BMC Public Health. 2010; 10(1): 1–11.##Lin MR, Huang W, Huang C, Hwang HF, Tsai LW, Chiu YN. The impact of the Chi-Chi earthquake on quality of life among elderly survivors in Taiwan–a before and after study. Quality of Life Research. 2002; 11(4): 379–388.##Hassan Rafiey, Momtaz YA, Alipour F, Khankeh H, Ahmadi S, Khoshnami MS, Khoshnami S. Are older people more vulnerable to long-term impacts of disasters?. Clinical Interventions in Aging. 2016; 11: 1791-5##Sajjadi H, Biglaryian A. Quality of life among elderly women in Kahrizak charity foundation, Tehran, Iran. Payesh. 2007; 6(2): 105-8. [Persian]##Javadi SMH, Arian M, Qorbani-Vanajemi M. The need for psychosocial interventions to manage the coronavirus crisis. Iranian Journal of Psychiatry and Behavioral Sciences. 2020; 14(1).## ##

Effect of Yoga on Memory in Elderly Women 2 2 Introduction: Cognitive impairment rate such as memory loss increases because of aging as a natural process. Based on the evidence, physical activity can lead to improved mental and cognitive function and also plays a preventive role against reducing cognitive function.  the purpose of this study was to investigate the effect of yoga exercises on memory of elderly women. Methods: This experimental study was a randomized, controlled clinical trial that was conducted in 2018. Two elderly day care centers in Yazd city ,in central  Iran were selected and randomly assigned to control and intervention groups. Then, according to the inclusion criteria, eligible people were selected from the centers and enrolled in the study. Participants were 58 elderly women who were assigned to control (n: 29) and intervention (n: 29) groups. Yoga exercises were held for 2 months (three 1-h sessions a week) for intervention group. The Wechsler Memory Scale was completed for both groups before and after the intervention. Data were analyzed by SPSS using descriptive and inferential statistics. Results: The mean score of memory in the intervention group before intervention was 77.7 ± 17.8 and after the intervention reached 86.4 ± 17.3, with a statistically significant difference (p < 0.05), but in control group, no significant difference was observed. In the intervention group, mental control, logical and visual memory subscales increased significantly (p < 0.05), but there was no significant difference in other subscales. There was no significant difference in any of the subscales in control group (p > 0.05). Conclusion: To improve the memory of the elderly, physical activity such as yoga exercise can be helpful. The elderly can routinely practice these exercises in elderly care centers.   3 8 2020/04/142019/01/25 1397/11/5 2020/04/202020/05/16 1399/2/27 Aliakbar Vaezi Aliakbar Vaezi 1. Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Arefeh Dehghani Tafti Arefeh Dehghani Tafti 2. Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Sanaz Behzadi Goodari Sanaz Behzadi Goodari 3. Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran sa.behzadi70@gmail.com Reza Bidaki Reza Bidaki 1. Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Memory Yoga Aged Potter P, Perry G. Basic nursing: theory and practice. 7th ed. Philadelphia: Mosby; 2007.## Chen J-F. Adenosine receptor control of cognition in normal and disease. International Review of Neurobiology. 2014; 119: 257-307.##Sexton CE, Walhovd KB, Storsve AB, Tamnes CK, Westlye LT, Johansen-Berg H, et al. Accelerated changes in white matter microstructure during aging: a longitudinal diffusion tensor imaging study. The Journal of Neuroscience. 2014; 34(46): 15425-36.## Pressley JC, Trott C, Tang M, Durkin M, Stern Y. Dementia in community-dwelling elderly patients: A comparison of survey data, medicare claims, cognitive screening, reported symptoms, and activity limitations. Journal of Clinical Epidemiology. 2003; 56(9): 896-905.## Farina N, Isaac MG, Clark AR, Rusted J, Tabet N. Vitamin E for Alzheimer's dementia and mild cognitive impairment. The Cochrane Database of Systematic Reviews. 2012; 11: 1-31.##Simon SS, Cordás TA, Bottino CM. Cognitive behavioral therapies in older adults with depression and cognitive deficits: a systematic review. International Journal of Geriatric Psychiatry. 2015; 30(3): 223-33.##Barnes DE, Yaffe K, Belfor N, Jagust WJ, DeCarli C, Reed BR, et al. Computer-based cognitive training for mild cognitive impairment: results from a pilot randomized, controlled trial. Alzheimer Disease and Associated Disorders. 2009; 23(3): 205-10.##Kelly ME, Loughrey D, Lawlor BA, Robertson IH, Walsh C, Brennan S. The impact of exercise on the cognitive functioning of healthy older adults: a systematic review and meta-analysis. Ageing Research Reviews. 2014; 16: 12-31.## Monteiro-Junior RS, da Silva Figueiredo LF, Maciel-Pinheiro PT, Abud ELR, Braga AEMM, Barca ML, et al. Acute effects of exergames on cognitive function of institutionalized older persons: a single-blinded, randomized and controlled pilot study. Aging Clinical and Experimental Research. 2017; 29(3): 387-94.##Villien F, Yu M, Barthélémy P, Jammes Y. Training to yoga respiration selectively increases respiratory sensation in healthy man. Respiratory Physiology & Neurobiology. 2005; 146(1): 85-96.##Khalsa SBS. Treatment of chronic insomnia with yoga: a preliminary study with sleep–wake diaries. Applied Psychophysiology and Biofeedback. 2004; 29(4): 269-78.## Parshad O. Role of yoga in stress management. The West Indian Medical Journal. 2004; 53(3): 191-4.## Eyre HA, Acevedo B, Yang H, Siddarth P, Van Dyk K, Ercoli L, et al. Changes in neural connectivity and memory following a yoga intervention for older adults: a pilot study. Journal of Alzheimer's Disease. 2016; 52(2): 673-84.##Kasai JYT, Busse AL, Magaldi RM, Soci MA, Rosa PDM, Curiati JAE, et al. Effects of Tai Chi Chuan on cognition of elderly women with mild cognitive impairment. Einstein (São Paulo). 2010; 8(1): 40-5.##Sharma V, Das S, Mondal S, Goswami U, Gandhi A. Effect of Sahaj Yoga on neuro-cognitive functions in patients suffering from major depression. Indian Journal of Physiology and Pharmacology. 2005; 50(4): 375-83.##Irandoust K, Taheri M, Seghatoleslami A. Comparing the effectiveness of water-based exercises and Yoga on memory and dynamic balance of elder people. Development and Motor Learning. 2015; 6(4): 463-73. [Persian]##Hsieh S-S, Chang Y-K, Hung T-M, Fang C-L. The effects of acute resistance exercise on young and older males' working memory. Psychology of Sport and Exercise. 2016; 22: 286-93.##Marandi SM, Rezayat F, Esfarjani F, Rezaei Z. The effect of "Tai Chi" exercise on depression, quality of sleep and some of physiological factors in elderly, living in Nursing Home. Scientific Journals Management system. 2013; 11(5): 51-61. [Persian]## Janizadeh E, Badami R, Torkan A. A comparison of the effectiveness of yoga and lavender on symptoms of depression in elderly women. Journal of Research in Behavioural Sciences. 2016; 14(4): 421-7. [Persian]##Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2003; 58(2): 176-80.##Kramer AF, Erickson KI, Colcombe SJ. Exercise, cognition, and the aging brain. Journal of Applied Physiology. 2006; 101(4): 1237-42.##Bullitt E, Rahman F, Smith J, Kim E, Zeng D, Katz L, et al. The effect of exercise on the cerebral vasculature of healthy aged subjects as visualized by MR angiography. American Journal of Neuroradiology. 2009; 30(10): 1857-63.##Stroth S, Hille K, Spitzer M, Reinhardt R. Aerobic endurance exercise benefits memory and affect in young adults. Neuropsychological Rehabilitation. 2009; 19(2): 223-43.##Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology. 2001; 58(3): 498-504.##Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance training and executive functions: a 12-month randomized controlled trial. Archives of Internal Medicine. 2010; 170(2): 170-8.##Erickson KL, Kramer AF. Aerobic exercise effects on cognitive and neural plasticity in older adults. British Journal of Sports Medicine. 2009; 43(1): 22-4.##Brenes GA, Sohl S, Wells RE, Befus D, Campos CL, Danhauer SC. The Effects of Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review. The American Journal of Geriatric Psychiatry. 2018; 27(2): 188-97.##Joolaei N, Bagherli J, Sanatkaran A. The effects of regular pilates exercise on long-term and short-term memory of the elderly. Journal of Aging Psychology. 2017; 3(2): 147-57. [Persian]##Brooks H, Landry K, Malas K, Rihal N, Umhoefer H. The Effects of Moderate Aerobic Activity on Short-Term and Long-Term Memory. Journal of Arts & Social Sciences. 2015;20(1):1-16.## ##

Effectiveness of a Theory of Planned Behavior-Based Intervention for Promoting Medication Adherence among Rural Elderly Hypertensive Patients in Iran 2 2 Introduction: Medication adherence is regarded as one of the most important factors in caring for hypertension. This study aimed to investigate the effect of intervention based on the theory of planned behavior (TPB) on medication adherence and its influencing factors on the elderly with hypertension in a rural area, Kerman province, Iran.                  Methods: This quasi-experimental study of the pre and post-control type was conducted on 109 elderly patients with hypertension. Data were collected using a multistage random sampling and a valid questionnaire based on the TPB. The intervention was an educational program based on TPB constructs using educational videos, pamphlets and booklets approved by the Ministry of Health. The collected data were analyzed by the SPSS 22 using parametric tests (Independent t-test, paired t-test, and regression analysis). Results: The average score of the attitudes , perceived behavioral control, as well as medication adherence behavior  constructs increased significantly after the intervention in the intervention group compared to the control group (p < 0.001). Multivariate regression analysis in intervention group after intervention showed that 76% of variations in intention were explained by the model. Attitude, subjective norms and perceived behavioral control were independent predictors of intention. The association between subjective norms and intention was of marginal significance (B = 0.89). Conclusion: The results of this research showed that an educational program based on TPB can affect medication adherence on elderly rural patients suffering from hypertension.   9 15 2020/04/142019/01/252019/06/9 1398/3/19 2020/04/202020/05/162020/04/27 1399/2/8 Ebrahim Jalali Javaran Ebrahim Jalali Javaran Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Iran Hamid Sharifi Hamid Sharifi HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Iran Marzieh Hasani Marzieh Hasani Department of Health Education and Promotion, School of Health, Kerman University of Medical Sciences, Kerman, Iran Iran Vahidreza Borhaninejad Vahidreza Borhaninejad Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran Iran Abedin Iranpour Abedin Iranpour HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Iran iranpourabedin89@gmail.com Hypertension Medication Adherence Theory of Planned Behavior Aged Patients Prakash R, Choudhary SK, Singh US. A study of morbidity pattern among geriatric population in an urban area of Udaipur, Rajasthan. Indian Journal of Community Medicine. 2004; 29(1): 35-40.##Woo EK, Han C, Jo SA, Park MK, Kim S, Kim E, et al. Morbidity and related factors among elderly people in South Korea: results from the Ansan Geriatric (AGE) cohort study. BMC Public Health. 2007; 7(1):1-9.##Sharkey JR, Branch LG, Zohoori N, Giuliani C, Busby-Whitehead J, Haines PS. Inadequate nutrient intakes among homebound elderly and their correlation with individual characteristics and health-related factors. The American Journal of Clinical Nutrition. 2002; 76(6): 1435-45.##Pessina AC, Boari L, De Dominicis E, Giusti C, Marchesi M, Marelli G, et al. Efficacy, tolerability and influence on" quality of life" of nifedipine GITS versus amlodipine in elderly patients with mild-moderate hypertension. Blood Pressure. 2001; 10(3): 176-83.##Ibrahim MM, Damasceno A. Hypertension in developing countries. The Lancet. 2012; 380(9841): 611-9.##Xu T, Wang Y, Li W, Chen WW, Zhu M, Hu B, et al. Survey of prevalence, awareness, treatment, and control of hypertension among Chinese governmental and institutional employees in Beijing. Clinical Cardiology. 2010; 33(6): 66-72.##Ma WJ, Tang JL, Zhang YH, Xu YJ, Lin JY, Li JS, et al. Hypertension prevalence, awareness, treatment, control, and associated factors in adults in southern China. American Journal of Hypertension. 2012; 25(5): 590-6.##Ghaffari S, Pourafkari L, Tajlil A, Sahebihagh MH, Mohammadpoorasl A, Tabrizi JS, et al. The prevalence, awareness and control rate of hypertension among elderly in northwest of Iran. Journal of Cardiovascular and Thoracic Research. 2016; 8(4): 176-82.##Kazemi T, Hajihosseini M, Mashreghimoghadam H, Azdaki N, Ziaee M. Prevalence and determinants of hypertension among Iranian adults, Birjand, Iran. 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Journal of Hypertension (Los Angel). 2018; 7(2): 1-6.##Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Boehm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension. 2013; 31(7): 1281-357.##Nielsen JØ, Shrestha AD, Neupane D, Kallestrup P. Non-adherence to anti-hypertensive medication in low-and middle-income countries: a systematic review and meta-analysis of 92443 subjects. Journal of Human Hypertension. 2017; 31(1): 14-21.##Balkrishnan R. Predictors of medication adherence in the elderly. Clinical Therapeutics. 1998; 20(4):764-71.##Gellad WF, Grenard JL, Marcum ZA. A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. The American Journal of Geriatric Pharmacotherapy. 2011; 9(1): 11-23.##Khothatso T, Moshoeshoe T, Saroni Z, Ross A. Knowledge of hypertensive patients about treatment in the Seboche hospital, 2013. Official Journal of the South African Academy of Family Practice/Primary Care. 2015: 58(1): 1-2.##Rich A, Brandes K, Mullan B, Hagger MS. Theory of planned behavior and adherence in chronic illness: a meta-analysis. Journal of Behavioral Medicine. 2015; 38(4): 673-88.##Ajzen I. From Intentions to Actions: A Theory of Planned Behavior. In: Kuhl J., Beckmann J, editors. Action Control. Berlin: Springer; 1985. p. 11-39.##Fishbein M, Ajzen I. Predicting and changing behavior: The reasoned action approach. New York: Psychology press; 2011.##Ajzen I. Attitudes, personality, and behavior. UK: McGraw-Hill Education; 2005.##Tabrizi JS, Karamouz M, Sadeghi-Bazargani H, Nikniaz A, Nikniaz L, Hasanzadeh R, et al. Health complex model as the start of a new primary healthcare reform in Iran: part b: the intervention protocol. Iranian Journal of Public Health. 2019; 48(1): 147-155.##Nunnally JC, Bernstein IC. Psychometric theory. New York : McGraw-Hill; 1994.##Ramanath K, Balaji D, Nagakishore CH, Kumar SM, Bhanuprakash M. A study on impact of clinical pharmacist interventions on medication adherence and quality of life in rural hypertensive patients. Journal of Young Pharmacists. 2012; 4(2): 95-100.##Hoseini Soorand A, Miri MR, Sharifzadeh G. Effect of curriculum based on theory of planned behavior, on components of theory in patients with hypertension. Journal of Birjand University of Medical Sciences. 2015; 22(3): 199-208. [Persian]##Fowler BA, Rodney M, Roberts S, Broadus L. Collaborative breast health intervention for African American women of lower socioeconomic status. Oncology Nursing Forum; 2005; 32(6): 1207-16.##Ajzen I. The theory of planned behavior. 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Sexual Behaviours among the Elderly Population in Osun State, Southwestern Nigeria 2 2 Introduction: The population of the elderly and older persons worldwide has increased over time as demographic transition thickens. In Nigeria, whereas, most interventional efforts are geared towards prioritizing and protecting youth sexuality, very little or no attention is being given to the sexuality of the elderly. The objective of this study therefore was to determine sexual behaviors among the elderly population in Osogbo, southwestern Nigeria. Methods: This was a community based descriptive cross-sectional study carried out in 2016 among 491 eligible elderly respondents drawn from a simple random sample of five clusters. Research instrument was interviewer administered semi-structured and pretested questionnaire. Bivariate analysis using chi-square test was used to examine association between categorical variables at 5% level of significance. Responses were analyzed using the SPSS software version 21.0. Results: Mean age in years of respondents was 66.9 ±7.3 SD, 106 (21.6%) were males, 78 (15.9%) have had sex within the last 12 months, 25.9% had high sexual risk behavior while 45 (9.2%) described themselves as still sexually active. Major predictors of having sexual intercourse within the past 12 months and self-reported of being sexually active include; living with spouse, having low educational status, currently taking alcohol, having a regular source of income and being a male, p < 0.05 in each case. Conclusion: The elderly age group is still sexually active to varying levels, thus stressing the importance of prioritizing elderly sexual health as part of a holistic and comprehensive geriatric care programmes. 16 23 2020/04/142019/01/252019/06/92019/11/5 1398/8/14 2020/04/202020/05/162020/04/272020/04/5 1399/1/17 Bolaji Egbewale Bolaji Egbewale Department of Community Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria Nigeria Wasiu Adebimpe Wasiu Adebimpe Department of Community Medicine, Faculty of Clinical Sciences, University of Medical Sciences, Ondo, Nigeria Nigeria lekanadebimpe@gmail.com Sexual Behavior Aged Predictors Nigeria Kalra G, Subramanyam A, Pinto C. Sexuality: desire, activity and intimacy in the elderly. Indian Journal of Psychiatry. 2011; 53(4): 300–6.##Lindau ST, Schumm P, Laumann E, Levinson W, O'Muircheartaigh C, Waite L. A study of sexuality and health among older adults in the USA. The New England Journal of Medical. 2007; 357: 762-74 ##Thomas HN, Hess R, Thurston RC. Correlates of sexual activity and satisfaction in midlife and older women. Annals of Family Medicine. 2015; 13(4): 336–42. ##Nash P, Willis P, Tales A, Cryer T. Sexual health and sexual activity in later life. Reviews in Clinical Gerontology. 2015; 25(1): 23-30.##Laumann EO, Paik A, Glasser DB, Kang JH, Wang T, Levinson B, et al. A cross-national study of subjective sexual well-being among older women and men: findings from the global study of sexual attitudes and behaviors. Archives of Sexual Behavior. 2006; 35(2): 145–61.##Lee DM, Nazroo J, O'Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Archives of Sexual Behavior. 2016; 45(1): 133–44.##Corona G, Lee DM, Forti G, O'Connor DB, Maggi M, O'Neill TW, et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). The Journal of Sexual Medicine. 2010; 7(4 Pt 1): 1362–80.##Population Council. Report of Nigeria’s National Population Commission on the 2006 Census. Population and Development Review, 2007; 33(1):206-210.##Arias-Castillo L, Ceballos-Osorio J, Ochoa JJ, Reyes-Ortiz CA. Correlates of sexuality in men and women aged 52-90 years attending a university medical health service in Colombia. The Journal of Sexual Medicine. 2009; 6(11): 3008-18.##Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. New England Journal of Medicine. 2007; 357(8): 762-74.##Beckman N, Waern M, Gustafson D, Skoog I. Secular trends in self-reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001. BMJ. 2008; 337: 1-7. ##Erens B, Mitchell KR, Gibson L, Datta J, Lewis R, Field N, et al. Health status, sexual activity and satisfaction among older people in Britain: A mixed methods study. Plos One. 2019; 14(3): 1-20. ##Kontula O, Haavio-Mannila E. The impact of aging on human sexual activity and sexual desire. Journal of Sex Research. 2009; 46(1):46–56.## ##

Relationship between Nutritional Status and Late-Life Depression in Esfarayen, Iran 2 2 Introduction: Since nutritional status has a great impact on physical and mental health, this study was conducted to determine the relationship between nutritional status and depression in elderly referring to urban health centers of Esfarayn, North Khorasan province, Iran) in 2017. Methods: This cross-sectional study was performed on 250 elderly referring to Esfarayen health centers. Data collecting tool was a standard questionnaire for investigating nutritional and depression status in the elderly. Data were analyzed using ANOVA, t-test, chi-square and correlation coefficient by SPSS18 software. Results: According to the results, 8.4% of elderly were malnourished and 30% were exposed to malnutrition. There was an inverse correlation between age, number of children and nutritional status, and there was a significant relationship between living alone, underlying diseases, body mass index and nutritional status (p < 0.05). Forthy four percent of the elderly had severe depression and 40% had mild depression. Significant relationship was found between variables such as age, gender, education, economic status, living alone, underlying diseases and depression (p < 0.05). There was a significant correlation between depression and nutritional status in the elderly (p <0.001, r = -0.615). Conclusion: Depression is prevalent among elderly, and their nutritional status is in moderate level. Regarding the correlation between these two variables, periodical psychiatric examinations, psychological interventions with the aim of treating depression as well as educational measures to improve the nutrition statues of the elderly is necessary. 24 30 2020/04/142019/01/252019/06/92019/11/52019/03/11 1397/12/20 2020/04/202020/05/162020/04/272020/04/52019/11/11 1398/8/20 Ahmad Sadeghi Ahmad Sadeghi Department of Public Health, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Iran Hasan Jafari Hasan Jafari Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Hossein Rouhani Hossein Rouhani Student Research committee, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Iran hoseinrohani3@gmail.com Fereshteh Eidy Fereshteh Eidy Student Research committee, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Iran Akram Zhiani Fard Akram Zhiani Fard Department of Public Health, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Iran Najmeh Davoodi Najmeh Davoodi Student Research committee, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran Iran Nutritional Status Depression Aged Eshaghi SR, Farajzadegan Z, babak A. Healty lifestyle assessment questionnaire in elderly: translation, reliability and validity. Payesh. 2010; 9(1): 91-9. [Persian]##Najafi B, Arzaghi M, Fakhrzadeh H, Sharifi F, Shoaei S, Alizadeh M, et al. Mental health status and related factors in aged population: Urban Health equti assessment and response tool (Urban-Heart) study in Tehran. Iranian Journal of Diabetes and Metabolism. 2013; 13(1): 62-73. [Persian]##Mirzaei M, Shams Ghahfarokhi M. Demography of elder population in Iran over the period 1956 To 2006. Salmand Iranian Journal of Ageing. 2007; 2 (3): 326-31. [Persian]##Habibi A, Nikpour S, Seiedoshohadaei M, Haghani H. Quality of life and status of physical functioning among elderly people in west region of Tehran: a cross-sectional survey. Iran Journal of Nursing. 2008; 21(53): 29-39. [Persian]##Sajadi H, Mohaqeqi kamal H, Vameghi M, Forozan A, Rafei H, Nosratabadi M. Systematic review of prevalence and risk factors associated with depression and its treatment in Iranian elderly. Salmand Iranian Journal of Ageing. 2013; 7(27):7-15. [Persian] ##Sarris J, ONeil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC Psychiatry. 2014; 14: 107.##Loprinzi PD, Mahoney S. Concurrent occurrence of multiple positive lifestyle behaviors and depression among adults in the United States. Journal of Affective Disorders. 2014; 165: 126-30.##Beydoun MA, Wang Y. Pathways linking socioeconomic status to obesity through depression and lifestyle factors among young US adults. Journal of Affective Disorders. 2010; 123(1-3): 52-63.##Arsalani N, Nobahar M, Ghorbani R, Kia NS, Etemadi M. Nutrition status and its relationship with depression in elderly people. Koomesh. 2017; 19(2): 401-11. [Persian]##Payahoo L, Khaje-bishak Y, Pourghassem Gargari B, Kabir-alavi M, Asghari Jafarabadi M. Nutritional status and its relation with depression in free-living elderly individuals. Medical Journal of Tabriz University of Medical Sciences and Health Services. 2013; 5(35): 20-5. [Persian]##Keshavarzi S, Ahmadi SM, Lankarani KB. The impact of depression and malnutrition on health-related quality of life among the elderly Iranians. Global Journal of Health Science. 2014; 7(3): 161-70.##Giri M, Chen T, Yu W, Lu Y. Prevalence and correlates of cognitive impairment and depression among elderly people in the World's fastest growing city, chongqing, peapoles repoblic of China. Clinical Interventions in Aging. 2016; 11: 1091-1098.##Van Bokhorst-de van der Schueren MA, Lonterman-Monasch S, de Vries OJ, Danner SA, Kramer MH, Muller M. Prevalence and determinants for malnutrition in geriatric outpatients. Clinical Nutrition. 2013; 32(6): 1007-11.##Nouri Saeidlou S, Kutlay Merdol T, Mikaili P, Bektas Y. Assessment of the nutritional status and affecting of elderly people living at six nursing home in URMIA, IRAN. International Journal of Academic Research 2011; 3(1): 463-72.##Forsman AK, Schierenbeck I, Wahlbeck K. Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis. Journal of Aging and Health. 2011; 23(3): 387-416##Ramezankhani A, Ghaffari M, Mirzaei A, Khodakarim S, Taheri Tanjani P, Haidaryan Zadeh Z. Dietary behaviors of elderly people referred to health centers of Ilam, Iran. Journal of Education and Community Health. 2016; 3(3): 45-50. [Persian]## Guyonnet S, secher M, Vellas B. Nutrition, frailty, cognitive frailty and prevention of disabilities with aging. Nestle Nutrition Institute Workshop Series. 2015; 82: 143-52.##Ji L, Meng H, Dong B. Factors associated with poor nutritional status among the oldest-old. Clinical Nutrition. 2012; 31(6): 922-6.##Vieira Ribeiro R, ineS da RoSa M, Clarisse Bozzetti M. Malnutrition and associated variables in an elderly population of Criciúma, SC. Revista da Associaçao Medica Brasileira. 2011; 57(1): 56-61.##Ramic E, Pranjic N, Batic-Mujanovic O, Karic E, Alibasic E, Alic A. The effect of loneliness on malnutrition in elderly population. Medical Archives. 2011; 65(2): 92-5.##Aliabadi M, Kimiagar M, Ghayoor Mobarhan M, IlityFaizabadi AK. Prevalence of malnutrition and factors related to it in the elderly subjects in Khorasan Razavi province, Iran, 2006. Iranian Journal of Nutrition Sciences & Food Technology. 2007; 2(3): 45-56. [Persian]##Tucker KL, Buranapin S. Nutrition and aging in developing countries. The Journal of Nutrition. 2001; 131(9): 2417-23.##Vanderwee K, Clays E, Bacquaert I, Gobert M, Folens B, Defloor T. Malnutrition and associated factors in elderly hospital patients: a Belgian cross-sectional, Multi-centre study. Clinical Nutrition. 2010; 29(4): 469-76.##Hajishafiee M, Saneei P, Esmaillzadeh A, Hassanzadeh Keshteli A, Roohafza HR, Afshar H, et al. Association between alternative healthy eating index (AHEI) and depression and anxiety in Iranian adults. Journal of Neyshabur University of Medical Sciences. 2016; 4(4):46-58. [Persian]##Hajek A, Brettschneider C, Ernst A, Lange C, Wiese B, Prokein J, et al. Complex coevolution of depression and health-related quality of life in old age. Quality of Life Research. 2015; 24(11): 2713-22.##Barua A, Kar N. Screening for depression in elderly Indian population. Indian Journal of Psychiatry. 2010; 52(2): 150-3.##Khodadadi N, Sheikholeslami F, Masouleh R, Yazdani M. Rate of depression in late-life in superannuated government employed center of Guilan University of medical sciences. Journal of Holistic Nursing and Midwifery. 2007; 17(1): 16-22. [Persian]##Kaplan, H.Sadok, Benjamin. Text Book of psychiatry. Philadelphia: Lippincott. 2005.##Manzouri L, Babak A, Merasi M. The depression status of the elderly and it's related factors in Isfahan in 2007. Salmand Iranian Journal of Ageing. 2010; 4(14): 27-33. [Persian]##Aliev G, Ashraf GM, Kaminsky YG, Sheikh IA, Sudakov SK, Yakhno NN, et al. Implication of the nutritional and nonnutritional factors in the context of preservation of cognitive performance in patients with dementia/depression and Alzheimer disease. American Journal of Alzheimers Disease Other Dementias. 2013; 28(7): 660-70.##Yaka E, Keskinoglu P, Ucku R, Yener GG, Tunca Z. Prevalence and risk factors of depression among community dwelling elderly. Archives of Gerontology and Geriatric. 2014; 59(1): 150-4.##Bastami F, Salahshoori A, Shirani F, Mohtashami A, Sharafkhani N. Risk Factors of Depression on the Elderly: A Review Study. Journal of Gerontology. 2016; 1 (2): 54-65. [Persian]##Van Bokhorst-de Van der Schuren MA, Lonterman Monasch S, de Vries OJ, Danner SA, Kramer MH, Muller M. Prevalence and determinants for Mulnutrition in geriatric outpatients. Clinical Nutrition. 2013; 32: 1007-11.##Kuczmarski MF, Cremer Sees A, Hotchkiss L, Cotugna N, Evans MK, Zonderman AB. Higher healthy eating index-2005 scores associated with reduced symptoms of depression in an urban population: findings from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study. Journal of the American Dietetic Association. 2010; 110(3):383-9.## ##

Coinfection of Toxoplasma Gondii and Intestinal Parasites among Elderly Immunocompromised Patients 2 2 Introduction: Patients with cancer and hemodialysis are prone to opportunistic infections. The present research aims to examine the frequency of Toxoplasmosis and intestinal parasites in these patients. Methods: In the present cross-sectional study, seventy stool and blood samples from immunocompromised patients (46 hemodialysis and 24 cancer patients) from Guilan Province were collected in 2017-2018. Different tests including direct smear examination and formalin-ether was conducted for the intestinal protozoan parasites. To detect coccidian parasites (e.g. Cryptosporidium spp.) Ziehl Neelsen staining was applied. The anti T.gondii antibodies were detected via ELISA method.  Results: Totally 6.52% and 4.16% cases of hemodialysis and cancer patients were positive for intestinal parasite infection respectively. Blastocystis hominis was only intestinal parasite that were detected in these patients. IgG anti-Toxoplasma antibody detected in 35 (76.8%) hemodialysis and 15 (62.5%) cancer patients. IgM antibody were found in 1 elderly hemodialysis patient. Mix infection (Toxoplasmosis and Blastocystis) was observed in 6.52% and 4.16% in hemodialysis and cancer patients respectively. Conclusion: It is recommended to evaluate these patients for intestinal parasitic infections during hemodialysis or chemotherapy sessions. Data showed the high percentage of elderly patients were susceptible to reactivation of chronic Toxoplasmosis. Therefore, in order to refer them for early therapy or other interventions, it is important that elderly hemodialysis and cancer patients with toxoplasma infection be diagnosed and identified.   31 35 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/16 1398/3/26 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/12 1399/1/24 Mohammad Reza Mahmoudi Mohammad Reza Mahmoudi Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran Iran mrmahmoodi2002@yahoo.com Behnaz Rahmati Behnaz Rahmati Department of Parasitology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran Iran Aged Immunocompromised Host Parasites Toxoplasmosis El Chakhtoura NG, Bonomo RA, Jump RL. Influence of aging and environment on presentation of infection in older adults. Infectious Disease Clinics. 2017; 31(4): 593-608.##United Nations. World population Ageing 2007. 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Revista do Instituto de Medicina Tropical de São Paulo. 2003; 45(4): 197-200.##Santos PH, Barros RD, Gomes KV, Nery AA, Casotti CA. Prevalence of intestinal parasitosis and associated factors among the elderly. Revista Brasileira de Geriatria e Gerontologia. 2017; 20(2): 244-53.##Mahmoudi MR, Kazemi B, Haghighi A, Karanis P. Detection of Acanthamoeba and Toxoplasma in river water samples by molecular methods in Iran. Iranian Journal of Parasitology. 2015; 10(2): 250-7.##Velimirovic B. Toxoplasmosis in immunosuppression and AIDS. Infection. 1984; 12(5): 315-7.##Gallino A, Maggiorini M, Kiowski W, Martin X, Wunderli W, Schneider J, et al. Toxoplasmosis in heart transplant recipients. European Journal of Clinical Microbiology and Infectious Diseases. 1996; 15(5): 389-93.##Wanke C, Tuazon CU, Kovacs A, Dina T, Davis DO, Barton N, et al. Toxoplasma encephalitis in patients with acquired immune deficiency syndrome: diagnosis and response to therapy. The American Journal of Tropical Medicine and Hygiene. 198; 36(3): 509-16.##Hamidi F, Etemadi J, Ghabouli Mehrabani N, Mahami Oskouei M, Motavalli R, Ardalan MR. Comparison of Toxoplasma gondii seropositivity in hemodialysis and peritoneal dialysis patients. Journal of Coastal Life Medicine. 2015; 3(8): 621-2.##Luft BJ, Remington JS. Clinical infectious diseases: an official publication of the infectious diseases society of America. Toxoplasmic Encephalitis in AIDS. 1992; 15(2): 211-22.##Ferreira MS, Borges AS. Some aspects of protozoan infections in immunocompromised patients: a review. Memorias do Instituto Oswaldo Cruz. 2002; 97(4): 443-57.##Cong W, Liu GH, Meng QF, Dong W, Qin SY, Zhang FK, et al. Toxoplasma gondii infection in cancer patients: prevalence, risk factors, genotypes and association with clinical diagnosis. Cancer Letters. 2015; 359(2): 307-13.##Foroutan M, Rostami A, Majidiani H, Riahi SM, Khazaei S, Badri M, et al. A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran. Epidemiology and Health. 2018; 40: 1-8.##Yan C, Liang LJ, Zheng KY, Zhu XQ. Impact of environmental factors on the emergence, transmission and distribution of Toxoplasma gondii. Parasites & Vectors. 2016; 19(1): 1-7.##Bora I, Dutta V, Lyngdoh WV, Khyriem AB, Durairaj E, Phukan AC. Study of intestinal parasites among the immunosuppressed patients attending a tertiary-care center in Northeast India. International Journal of Medical Science and Public Health. 2016; 5(5): 924-30.##Naves MM, Costa-Cruz JM. High prevalence of strongyloides stercoralis infection among the elderly in Brazil. Revista do Instituto de Medicina Tropical de São Paulo. 2013; 55(5): 309-13.##Kamani J, Mani AU, Egwu GO, Kumshe HA. Seroprevalence of human infection with Toxoplasma gondii and the associated risk factors, in Maiduguri, Borno state, Nigeria. Annals of Tropical Medicine & Parasitology. 2009; 103(4): 317-21.##Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. International Journal for Parasitology. 2000; 30(12-13): 1217-58.##Sharif M, Ajami A, Daryani A, Ziaei H, Khalilian A. Serological survey of toxoplasmosis in women referred to Medical Health Laboratory before marriage, northern Iran, 2003-2004. International Journal of Molecular Medicine and Advance Sciences. 2006; 2(2): 134-7.##Ocak S, Duran N, Eskiocak AF, Aytac H. Anti-Toxoplasma gondii antibodies in hemodialysis patients receiving long-term hemodialysis therapy in Turkey. Saudi Medical Journal. 2005; 26(9): 1378-82.##Nahnoush RK, Youssif EM, Hassanin OM. Detection of toxoplasmosis in hemodialysis Egyptian patients using serological and molecular techniques. Australian Journal of Basic and Applied Sciences. 2016; 10(6): 197-201.##Rezavand B, Poornaki AM, Mokhtari KR, Mohammad A, Andalibian A, Abdi J. Identification and determination of the prevalence of Toxoplasma gondii in patients with chronic renal failure by ELISA and PCR. Asian Pacific Journal of Tropical Disease. 2016; 6(5): 347-9.##Nissapatorn V, Leong TH, Lee R, Init I, Ibrahim J, Yen TS. Seroepidemiology of toxoplamosis in renal patients. Southeast Asian Journal of Tropical Medicine and Public Health. 2011; 42(2): 237-47.##Alvarado-Esquivel C, Liesenfeld O, Torres-Castorena A, Estrada-Martínez S, Urbina-Alvarez JD, Ramos-De la Rocha M, et al. Seroepidemiology of Toxoplasma gondii infection in patients with vision and hearing impairments, cancer, HIV, or undergoing hemodialysis in Durango, Mexico. Journal of Parasitology. 2010; 96(3): 505-8.##Zurainee MN, Abdullah KA, Fong MY, Hoh HB, Choon J, Rahmah N. Ocular presentations and Toxoplasma serology. Journal of Health and Translational Medicine. 2017; 5(2): 98-102.##Perry CE, Gale SD, Erickson L, Wilson E, Nielsen B, Kauwe J, et al. Seroprevalence and serointensity of latent Toxoplasma gondii in a sample of elderly adults with and without Alzheimer disease. Alzheimer Disease & Associated Disorders. 2016; 30(2): 123-6.##Alvarado-Esquivel C, Liesenfeld O, Burciaga-López BD, Ramos-Nevárez A, Estrada-Martínez S, Cerrillo-Soto SM, et al. Seroepidemiology of Toxoplasma gondii infection in elderly people in a northern Mexican city. Vector-Borne and Zoonotic Diseases. 2012; 12(7): 568-74.##Daryani A, Sarvi S, Aarabi M, Mizani A, Ahmadpour E, Shokri A, Rahimi MT, Sharif M. Seroprevalence of Toxoplasma gondii in the Iranian general population: a systematic review and meta-analysis. Acta Tropica. 2014; 137: 185-94.##Saeidinia A, Tavakoli I, Naghipour Mr, Rahmati B, Ghavami Lahiji H, Salkhori O, et al. Prevalence of Strongyloides stercoralis and other intestinal parasites among institutionalized mentally disabled individuals in Rasht, Northern Iran. Iranian Journal of Parasitology. 2016; 11(4): 527–33.##Salehi R, Haghighi A, Stensvold CR, Kheirandish F, Azargashb E, Raeghi S, Kohansal C, Bahrami F. Prevalence and subtype identification of Blastocystis isolated from humans in Ahvaz, Southwestern Iran. Gastroenterology and Hepatology from Bed to Bench. 2017; 10(3): 235–41.##35 Rebolla MF, Silva EM, Gomes JF, Falcão AX, Rebolla MVF, Franco RMB. High prevalence of blastocystis spp. infection in children and staff members attending public urban schools in São Paulo State, Brazil. Revista do Instituto de Medicina Tropical de Sao Paulo. 2016; 58: 1-8.##Duda A, Kosik-Bogacka D, Lanocha-Arendarczyk N, Kołodziejczyk L, Lanocha A. The prevalence of Blastocystis hominis and other protozoan parasites in soldiers returning from peacekeeping missions. The American Journal of Tropical Medicine and Hygiene. 2015; 92(4): 805-6.##Hurtado-Guerrero AF, Alencar FH, Hurtado-Guerrero JC. Occurrence of enteroparasites in the elderly population of Nova Olinda do Norte, Amazonas, Brazil. Acta Amazonica. 2005; 35(4): 487-90.##Mishra N, Tripathi SM. Intestinal Parasitosis among the elderly people in northern India. International Journal of Scientific Research. 2016; 5(10): 40-1.##Oliveira MC, Silva CV, Costa-Cruz JM. Intestinal parasites and commensals among individuals from a landless camping in the rural area of Uberlândia, Minas Gerais, Brazil. Revista do Instituto de Medicina Tropical de São Paulo. 2003; 45(3): 173-6.##Sayyari AA, Imanzadeh F, Bagheri Yazdi SA, Karami H, Yaghoobi M. Prevalence of intestinal parasitic infections in the Islamic Republic of Iran. Eastern Mediterranean Health Journal. 2005; 11(3): 377-83.##Girotto KG, Grama DF, Cunha MJ, Faria ES, Limongi JE, Pinto RD, Cury MC. Prevalence and risk factors for intestinal protozoa infection in elderly residents at Long Term Residency Institutions in Southeastern Brazil. 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In-Hospital Elderly Mortality in a Nigerian Tertiary Health Care Center 2 2 Introduction: The elderly represent a significant proportion of the populace and their mortality index is of public health significance. With dearth of vital registration, in-hospital based studies remains a desirable alternative. This study hopes to determine the epidemiologic pattern of elderly mortality with respect to sex, age, date and cause of death.  Methods: This is descriptive retrospective study of elderly deaths among hospitalized patients in a Nigerian Tertiary Care Center. The age, sex, date and causes of death were analyzed using SPSS 21 and results summarized in tables and figures. Results: Elderly death constitute 24.7% of all hospital deaths with a crude mortality of 25.3%. Males constitute majority of the cases and 81.6% of the deaths occur within the 7th and 8th decades. Non-communicable diseases, communicable diseases and injuries constitute 80%, 12.5% and 7.6% of the cases respectively. Major specific causes of death include cerebrovascular accident, chronic kidney disease, chronic liver disease, sepsis, diabetes mellitus, road traffic accident, prostate and colorectal cancers accounting for 28.8%, 8.7%, 5.7%, 5.3%, 4.9%, 3.8%, 3.4% and 3.0% of all cases respectively. Conclusion: Mortality rate among in-hospital elderly patients are relatively high. More male are affected than females with causes attributed, in descending order to non- communicable, communicable diseases and external injuries. Major specific causes of death include cerebrovascular accident, chronic liver disease, chronic kidney disease, diabetes mellitus, cancers, sepsis and road traffic injury. Understanding the disease pattern will go a long way guiding social policy and healthcare interventions on the elderly population. 36 42 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/162019/10/25 1398/8/3 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/122020/02/19 1398/11/30 obiora Jude uchendu obiora Jude uchendu Department of Histopathology, Morbid Anatomy, Delta State University, Abraka, Delta State, Nigeria Nigeria ojlinksent@yahoo.com Mortality Non-communicable Communicable Injury Aging Akanji BO, Ogunniyi A, Bayewu O. Healthcare for elderly persons, a country profile: Nigeria. Journal of the American Geriatrics Society. 2002; 50(7): 1289-92.##Boss GR, Seegmiller JE. Age-related physiological changes and their clinical significance. The Western Journal of Medicine. 1981; 135(6): 434–40.##Poulose N, Raju R. Aging and injury: alterations in cellular energetics and organ function. Aging and Disease. 2014; 5(2): 101-8.##Mathers CD, Ma Fat D, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bulletin of the World Health Organization. 2005; 83: 171–7.##Sanya EO, Abiodun AA, Kolo P, Olanrewaju TO, Adekeye K. Profile and causes of mortality among elderly patients seen in a tertiary care hospital in Nigeria. Annals of African Medicine. 2011; 10(4): 278-83.##Arodiwe EB, Nwokediuko SC, Ike SO, Ulasi II, Ijoma CK, Chiwuba KI. Medical causes of death among the elderly in a tertiary hospital internal medicine ward, South East Nigeria. The West Indian Medical Journal. 2017; 66(1): 50-5.##Lamont CT, Sampson S, Matthias R, Kane R. The outcome of hospitalization for acute illness in the elderly. Journal of the American Geriatrics Society. 1983; 31(5): 282-8##Shoko T, Shiraishi A, Kaji M, Otomo Y. Effects of pre-existing medical conditions on in-hospital mortality: Analysis of 20,257 trauma patients in Japan. Journal of the American College of Surgeons. 2010; 211(3): 338-46.## Avelino-Silva TJ, Szlejf C, Farfel J, Curiati JA, Jacob-Filho W. Predictors of in-hospital mortality among older patients. Clinics (Sao Paulo). 2009; 64(7): 613-8.##Bendavid E, Seligman B, Kubo J. (2011) Comparative analysis of old-age mortality estimations in Africa. PLoS ONE. 2011; 6(10): e26607. ##Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing population: the challenges ahead. Lancet. 2009; 374(9696): 1196-208.##United Nations. World Mortality Report 2015 –Highlights. New York: Department of Economic and Social Affairs, 2017. ##Uchendu OJ, Forae DJ. Diseases mortality patterns in elderly patients: A Nigerian teaching hospital experience in Irrua, Nigeria. Nigerian Medical Journal. 2013; 54 (4): 250-3.##World Health Organization. Global status report on non-communicable diseases 2010 [Internet]. 2011. Available from: https://apps.who.int/iris/bitstream/handle/10665/44579/9789240686458_eng.pdf?sequence=1##World Health Organization. Global status report on non-communicable diseases 2014: attaining the nine global non-communicable diseases targets; a shared responsibility [Internet]. 2014. Available from: https://apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf.##Feigin, VL, Norrving B, Mensah GA. Global burden of stroke. Circulation Research. 2017; 120(3): 439-449.##Alan Ö, Gürsel Ö, Ünsal M, Altın S, Kılçıksız S. Oncologic Approach in Geriatric Patients. Okmeydanı Tıp Dergisi. 2013; 29(2): 94–8.##Ijomone EA, Uchendu OJ, Nwachokor FN. A study of elderly deaths in Medicolegal autopsies performed in Warri, Nigeria. Journal of Dental and Medical Sciences. 2017; 16 (6): 61-4.##Onyemaechi NO, Nwankwo OE, Ezeadawi RA. Epidemiology of injuries seen in a Nigerian tertiary hospital. Nigerian Journal of Clinical Practice. 2018; 21(6): 752-7.##Tinetti ME. Preventing falls in elderly persons. The New England Journal of Medicine. 2003; 348: 42-9.##Stevens JA, Rudd Ra. Circumstance and contributing causes of fall deaths among persons aged 65 and older: United States, 2010. Journal of the American Geriatrics Society. 2014; 62(3): 470-5.##Uchendu OJ, Ijomone EA, Nwachokor NF. Suicide in Warri, Delta State, Nigeria: An autopsy study. Annals of tropical Pathology. 2019; 10; 16-9.## ##

Knowledge, Attitude and Behaviours regarding Medication Use in Elderly with Chronic Diseases in Turkey 2 2 Introduction: Physiological changes occurring with aging increase prevalence of chronic diseases in elderly individuals. This situation brings about difficulties in medication use in elderly individuals. This study was conducted to determine knowledge, attitude and behaviours regarding medication use in elderly with chronic diseases. Methods: Participants of this descriptive and cross-sectional study were 124 elderly individuals who were more than 65 years old, applied to Family Health Center in Yalova, Turkey between the dates of January- June 2018. Data were collected with data collection form including individual and disease information, medication use and knowledge, attitude and behaviours regarding medication use.  Results: Almost half of the elderly individuals (44.4%) expressed that they used medicine three times a day and 40.3% of them expressed that they used medicine six times and more a day. When the information about medication use of elderly individuals is evaluated, 75% of them stated that they did not receive any information on drug use and 82.3% of them did not know the side effects of drugs. When the attitudes of the individuals were evaluated, it was found that 6.5% of them liked to use medication, 67.7% of them had no dose, and 46% of them had stopped using medication without asking the physician. When the behaviors of elderly individuals were evaluated, 19.4% of them didn’t use their medicines regularly, 46% of them discontinued their medication without asking their doctors, 82.3% of them didn’t know side effect of the medicines, 81.5% of them used medicines without doctor’s advice, 79.8% of them didn’t read medicine usage instructions before using medicines, 12.9% of them kept their medicines in their bags and 55.6% of them kept them in a cabinet. Conclusion: Significant problems such as lack of information about drug use in elderly individuals and self-medication use have been identified. 43 50 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/162019/10/252019/04/25 1398/2/5 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/122020/02/192020/04/1 1399/1/13 Ilknur Ozkan Ilknur Ozkan Department of Nursing, Faculty of Health Sciences, Akdeniz University Kumluca, Antalya, Turkey Turkey Feride Taskin Yilmaz Feride Taskin Yilmaz Department of Nursing, Health High School of Susehri, Sivas Cumhuriyet University, Sivas, Turkey Turkey feride_taskin@hotmail.com Azime Karakoc Kumsar Azime Karakoc Kumsar Department of Nursing, Faculty of Health Sciences, Biruni University, Istanbul, Turkey Turkey Kamile Uyar Kamile Uyar Armutlu State Hospital, Yalova, Turkey Turkey Aged Medication Use Knowledge Attitude Behaviours Ertem Ö, Kasım İ, Özkara A, Koç EM, Kahveci R, Şencan İ. Inappropriate drug use in hospitalized elderly patients. 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The Effectiveness of a Chronic Disease Self-Management Program for Elderly People: a Systematic Review 2 2 Introduction: Elderly population is increasing in Pakistan. Majority of people aged 50 – 64, suffer from two or more chronic conditions. Care of elderly people is sub-optimal. Healthcare system has limited resources to provide healthcare support to elderly people. Thus, there is need to empower the elderly to self-manage their health conditions. Chronic Disease Self-Management Program (CDSMP) is the most widely accepted self-management patient education program. It is designed to help people to gain confidence and skills to better manage their chronic conditions. Evidence of the effectiveness of CDSMP specifically for elderly people aged 60 years and above is lacking. Therefore, the aim of this systematic review was to determine the effects of the program among chronically ill elderly people. Methods: MEDLINED, CINHAL, EMBASE, PSYINFO, JBI and ASSIA were searched between April and May, 2020 for studies that tested the effects of generic CDSMP. A total of 750 articles were identified, of which 5 were included in the core review (four randomized controlled trials and one quasi-experimental). Results: Eligible 5 studies yielded 2971 participants (mean aged 60.4 to 76.0 years). Elder people who participated in CDSMP improved their self-efficacy to manage disease in general and to manage symptoms. The effects on health status were mixed. Self-rated health and health distress showed significant improvement. Some health behaviours showed improvement, particularly exercise component showed significant improvement. For health services utilization, there was no improvement. Conclusion: The result of this review suggests that CDSMP is beneficial for elderly people who attended the structured CDSMP either through a trained care provider or layman. Experimental studies in low and middle income countries, with large sample sizes are suggested to further understand the impact of CDSMP. 51 63 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/162019/10/252019/04/252019/10/10 1398/7/18 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/122020/02/192020/04/12020/06/21 1399/4/1 Khairnnisa Mansoor Khairnnisa Mansoor School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan Pakistan khairunnisa.mansoor@aku.edu Hussain Maqbool Ahmed Khuwaja Hussain Maqbool Ahmed Khuwaja School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan Pakistan CDSMP Aged Health Status Self-Efficacy Health Behaviours Anette B, Sylvie R-D, Axel Z, Maurits B, Adrie D, Miriam L. Special issue on healthcare: Healthy ageing and the future of public healthcare systems. Belgium: European Commission; 2009.##Government of Pakistan. Provisional Summary Results of 6th Population and Housing Census [Internet]. Pakistan: Pakistan Bureau of Statistics; 2017. Available from: http://www.pbs.gov.pk/content/provisional-summary-results-6th-population-and-housing-census-2017-0##Lloyd-Sherlock P. Epidemiological change and health policy for older people in developing countries: some preliminary thoughts. Ageing Horizons. 2005; 2: 21-24.##World Health Organization. The world health report 2002: reducing risks, promoting healthy life [Internet]. World Health Organization; 2002. Available from: https://www.who.int/whr/2002/en/whr02_en.pdf?ua=1##World Health Organization. World report on ageing and health. World Health Organization [Internet]. World Health Organization; 2015. Available from: https://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf?sequence=1##Bennett JE, Stevens GA, Mathers CD, Bonita R, Rehm J, Kruk ME, et al. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. The Lancet. 2018; 392(10152): 1072-88.##World Health Organization. Noncommunicable diseases country profiles 2014 [Internet]. World Health Organization; 2014. . Available from: https://apps.who.int/iris/bitstream/handle/10665/128038/9789241507509_eng.pdf;jsessionid=5DC159DE6A62D4BFFC38663D07CADF87?sequence=1##Najam A, Bari F. Pakistan National Human Development Report. Unleashing the Potential of a Young Pakistan. Islamabad: UNDP. 2017.##Sabzwari SR, Azhar G. Ageing in Pakistan—a new challenge. Ageing International. 2011; 36(4): 423-7.##Baig L, Hasan Z, Iliyas M. Are the elderly in Pakistan getting their due share in health services? Results from a survey done in the peri-urban communities of Karachi. The Journal of the Pakistan Medical Association. 2000; 50(6): 192-6.##Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW, Bandura A, et al. Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care. 2001; 39(11): 1217-23.##Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-analysis: chronic disease self-management programs for older adults. Annals of Internal Medicine. 2005; 143(6): 427-38.##Porritt K, Gomersall J, Lockwood C. JBI's systematic reviews: study selection and critical appraisal. The American Journal of Nursing. 2014; 114(6): 47-52.##Webb C, Roe B. Reviewing research evidence for nursing practice: Systematic reviews. John Wiley & Sons; 2008.##Holopainen A, Hakulinen-Viitanen T, Tossavainen K. Systematic review–a method for nursing research. Nurse Researcher. 2008; 16(1): 72-83.##Leandro G. Meta-analysis in Medical Research: The handbook for the understanding and practice of meta-analysis: John Wiley & Sons; 2008.##Torgerson CJ. Publication bias: the achilles’heel of systematic reviews? British Journal of Educational Studies. 2006; 54(1): 89-102.##Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a self-management program on patients with chronic disease. Effective Clinical Practice: ECP. 2001; 4(6): 256-62.##Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of Clinical Epidemiology. 2009; 62(10): 1-34.##Joanna Briggs Institute. Meta-analysis of statistics: Assessment and review instrument (JBI MASTARI). Adelaide: Joanna Briggs Institute. 2006;20032007.##Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Bandura A, Ritter P, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical Care. 1999; 37(1): 5-14.##Fu D, Fu H, McGowan P, Shen Y-e, Zhu L, Yang H, et al. Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. Bulletin of the World Health organization. 2003; 81(3): 174-82.##Swerissen H, Belfrage J, Weeks A, Jordan L, Walker C, Furler J, et al. A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Education andCounseling. 2006; 64(1-3): 360-8.##Elzen H, Slaets JP, Snijders TA, Steverink N. Evaluation of the chronic disease self-management program (CDSMP) among chronically ill older people in the Netherlands. Social Science & Medicine. 2007; 64(9): 1832-41.##Chan WL, Hui E, Chan C, Cheung D, Wong S, Wong R, et al. Evaluation of chronic disease self-management programme (CDSMP) for older adults in Hong Kong. The Journal of Nutrition, Health & Aging. 2011; 15(3): 209-14.##Lorig K, Stewart A, Ritter P, Gonzalez V, Lynch J, Laurent D. 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Frailty Screening Tools: Frail Detection to Primary Assessment 2 2 Frailty is a vulnerable situation among older adults which can lead to unfavorable health outcomes such as falls, mortality, functional decline and institutionalization. The increasing number of elderly people and low rate of mortality has necessitated the need for high-quality medical services for this aging population, and this has led to a high cost of geriatric health care. There exist a huge number of screening tools to detect frailty and it is important for researchers and general practitioners (GPs) to select the appropriate and precise tool that would effectively lead to quality results. Frail individuals can be managed effectively when there is an early screening and intervention. Healthcare providers need tools that are simple and validated in order for screening and interventions to become effective. Self-reported frailty screening tools are very simple to use, not expensive and test results can be interpreted by non-health professionals. This work reviewed some of the commonly used frailty screening tools, and proposed a practical approach that would assist GPs in assessing frailty in older adults. 64 69 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/162019/10/252019/04/252019/10/102019/08/17 1398/5/26 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/122020/02/192020/04/12020/06/212019/10/1 1398/7/9 Jonathan Aseye Nutakor Jonathan Aseye Nutakor Department of Health Policy and Management, School of Management, Jiangsu University, China China jnutakor@gmail.com Alexander Kwame Gavu Alexander Kwame Gavu Quality Assurance Unit, University of Health and Allied Sciences, Ho-Volta Region, Ghana Ghana Frailty Aged Screening Tools Primary Health Care Geriatrics Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Mark Clarfield A. 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Clinical Adverse Events in Elderly Hospitalized Patients in a Medical Ward - a Prospective Study 2 2 Introduction: Studies to date describe between 3% to 50% of patients experiencing one or more clinical adverse event (CAE) during their hospital admission and many preventable. The aim of this prospective study was to determine the frequency of medical CAEs in a medical ward. Also the study aimed to compare data between patient age groups and determine the effect on length of hospital stay and mortality. Methods: This is a prospective study, consulting patients’ electronic clinical notes over 6 months . Every week, all patient electronic processes were reviewed, and CAEs noted. The episode was only noted if the episode was clearly labeled as a CAEs by the medical team in the patient´s notes. If confounding factors were present, this episode was excluded. Patients were grouped by age; compared in terms of demographics, comorbidities, diagnosis at admission and readmission rate. Primary outcomes included mean length of stay and mortality. Results: 62 episodes were studied, 14.8% of those admitted to hospital experienced a CAE. The most frequent adverse events included analytical alterations, anemia and blood loss, infection and altered state of consciousness. The most commonly implicated therapies were anticoagulants (23%) which lead to episodes of bleeding, anti-hypertensive and diuretics (17%) immunosuppressive therapy (16%) beta blockers (1%) and insulin (1%). Mean length of stay in hospital was 17 days in all groups, longer than the average length of stay of this medical ward which is 11 days. Mortality rate within one year of hospitalization was 30% in total, again significantly higher than the 10% mortality rate calculated for the same period on the ward. Conclusion: This study demonstrates that CAEs are still far too common, probably underestimated, cause serious harm to patients and strains healthcare services further.   70 72 2020/04/142019/01/252019/06/92019/11/52019/03/112019/06/162019/10/252019/04/252019/10/102019/08/172020/05/18 1399/2/29 2020/04/202020/05/162020/04/272020/04/52019/11/112020/04/122020/02/192020/04/12020/06/212019/10/12020/06/22 1399/4/2 Rita Vieira Alves Rita Vieira Alves Department of Medicine 7.2, Curry Cabral Hospital, Centro Hospitalar Lisboa Central, (CHLC), Lisbon, Portugal Portugal rita.vieira.alves@gmail.com Marilia Fernandes Marilia Fernandes Department of Medicine 7.2, Curry Cabral Hospital, Centro Hospitalar Lisboa Central, (CHLC), Lisbon, Portugal Portugal Inês Figueired Inês Figueired Department of Medicine 7.2, Curry Cabral Hospital, Centro Hospitalar Lisboa Central, (CHLC), Lisbon, Portugal Portugal Diogo Drummond Borges Diogo Drummond Borges Department of Medicine 7.2, Curry Cabral Hospital, Centro Hospitalar Lisboa Central, (CHLC), Lisbon, Portugal Portugal Margarida Antunes Margarida Antunes Department of Medicine 7.2, Curry Cabral Hospital, Centro Hospitalar Lisboa Central, (CHLC), Lisbon, Portugal Portugal Clinical Adverse Effect Inpatient Complication Side Effect Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. 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