فصلنامه سالمند
پیاپی 5 (پاییز 1386)

Ageing and its consequences at the onset of the third millennium is becoming one of the major population-related issues in all countries.Methods & Materials: At present, Iran is undergoing a population transformation from a young age structure to an old age one. Although at the time being the elderly population (60 years and over) is rather small proportion of total population, but given increasing the elderly population growth compared to that of total population during the coming decades, it is necessary to make careful plans to deal with the problems of this age group. This study aims to assess the trend and changes in sex ratio, average annual growth rate, ageing index and dependency ratio of the elderly population by documentary method during the period 1956 through 2006 using Iran's Population and housing census data that collected by Statistical Centre of Iran. According to our findings, the estimates of some basic demographic indices such as the proportion, sex ratio, average annual growth rate, ageing index and dependency ratio for the Iranian elderly population at 2006 were 7.3%, 108, 2.5%, 29 and 43.4%, respectively. Considering the rapid decline in fertility during the last two decades, it is anticipated that ageing process will accelerate. This process is documented by observed trend of fertility and mortality rate and their possible changes in the future. Considering the facts, figures and findings of this study Iran is going to experience an increasing proportion of elder population by the beginning of the next solar century.

As individuals live longer, health promotion behaviors get even more important, particularly with regard to maintaining functional independence and improving quality of life. The purpose of this study was to explore the relationship between health promotion behaviors and level of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) among elderly people in west region of Tehran.Methods & Materials: This was a descriptive-correlational study. A multi-stage sample of 410 community residents who were over 60 years old were selected from west region of Tehran. Participants who consented to participate in the study were interviewed with a structured questionnaire. The questionnaire consisted of 2-part; Health Promotion Behavior Checklist and questions related to status of physical functioning, which includes activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Descriptive statistics and T-test were used to data analysis. The results of the study showed that there were significant relations between ADLs and ' exercise or walking', 'drinking milk, eating dairy and meat', 'eating vegetables and fruits', 'low salt diet' and 'low fat diet' (P<0.05). Furthermore there were significant relations between the IADLs and 'smoking cessation', 'alcohol abstinence', 'exercise or walking', 'drinking milk, eating dairy and meat', 'eating vegetables and fruits', 'low salt diet' and 'low fat diet' (P<0.05). Study showed, health promotion behaviors and level of ADL and IADL are related meaningfully. Health care professionals should enhance the physical functioning in elderly people by facilitating health promotion behaviors through formal health promotion programs which focus on regular diet, exercise, and regular physical check-ups which will maintain and increase a healthy and active life.

The aim of the current study is to determine the nutritional status of the elderly and their associated factors.Methods & Materials: Through a cross sectional study, elderlies nutritional state was evaluated by Mini Nutritional Assessment (MNA) questionnaire which was standardized for the Iranian population. It was filled for 248 randomly selected subjects (aged 60 and older) in Isfahan. Logistic regression analysis demonstrated the relationship between nutritional state and demographic factors. Forty percent of elderly people were in inappropriate nutritional status. Of the subjects, 65.7% had a Body Mass Index (BMI) over 25. Educational level, income and BMI had a significant relation with nutrition. Logistic regression models showed high income (OR=3A CI95%=L5-7.5), high BMI (OR=7 CI95%=L6-31) and high educational level (OR=OA CI95%=023-0.77) which all were the effective factors on nutritional status, independently. Obtaining high percentage of malnutrition prevalence among elderly, and the possibility of suitable interventions on the most effective factors, the importance of paying attention to the elderly lifestyle found to be more clear.

There are researches to point epidemiology of addiction to drugs, chemical and solvent abuse in elderlies. Drug and Solvent abuse is considered as one of these addictions. This study was point to chemical abuse among elderly population of Ahwaz an Iranian city during year of 2007.Methods & Materials: Research method is description-exploration with use to questionnaire, clinical interview and survey of medical and clinical reports among volunteer clients. Statistical community is all elderly population at one of citizen region in Ahwaz city (Iran). Seventy four dossiers were considered via random sampling; with 30 Elder volunteer clients been interviewed and replied to Elderly Drug Abuse Questionnaire (EDAQ).

Signification of hypothesis with X2 test was considered significant relation between age and addiction record variables to solvent abuse; this relation is very significant to second value of drug's derivations such as Morphine, Codeine, Tebaine and Heroine. Interview showed psychological dependent due to appeal them to solvent abuse. Kind of abuse among elderly was snuffing and abuse of medicine drugs which were been recommended to them by their physician.

Although study of solvent and chemical abuse's epidemiology pointed less average of this addiction in samples, should be considered important and notice in studies. Finally, researchers were suggested to avoid of this new drug abuse and so to control behavior and interaction of these addicted and their behavior development; it's better to control on distribution of solvent and glue materials and recommending of medicine drug via physicians visiting exderlies.

Hypertension is a third cause of mortality in the world and also has great cost of treatment for patients. Use of non pharmacologic methods similar as progressive muscle relaxation can reduce blood pressure and its complication such as myocardial infarction (MI). The study purpose determine conducted to the effect of progressive muscle relaxation on hypertensive patients with myocardial infarction.Methods & Materials: This research was quasi experimental study conducted on 40 patients who had MI with essential hypertension and were admitted to cardiac care unit (CCU) ward in Tehran Amiralam hospital during 2007. The patients were randomly divided into two groups (ex- perimental & control) and demographic information and vital sing of each patients were recorded before intervention. In experimental group progres- sive muscle relaxation technique conducted two sessions daily during 3 consecutive days and blood pressure were checked and record at the end of each session. In control group, without any intervention vital sing were checked and recorded after 20 minute. The early record vital sing and the data were analyzed with spss-software program. The age mean were 60.45±5.7 and 62.35±5.9 in experimental and control groups. The result showed in experimental group reduced mean systolic and diastolic blood pressure after the intervention which were significantly lower than control group (p<0.001) and also mean variation systolic and diastolic blood pressure pre and post application of technique also considered in control group (p<0.001). Progressive muscle relaxation (PMR) will cause reduce blood pressure in MI patients with essential hypertension. One may consider this technique (PMR) as subsidiary treat for hypertension.

Hearing loss is a major public health problem and has higher prevalence in elderly persons. Present study was conducted with the aim of characterizing age-related changes on audiometric thresholds and word discrimination ability of people with age range of 30 to 100 years.Methods & Materials: Hundred ninty persons (male 53.68% and female 46.32%) in seven aged decades were studied from May 2005 to Oct 2007 in Tehran. Individuals who referred for auditory evaluation had concern regarding presence of a kind of hearing problem. Pure tone audiometry, word discrimination score and immittance audiometry were performed for those people who has no previous history of auditory impairment and/or experiencing hearing hazardous agents. There was a significant reverse correlation between recording of acoustic reflexes with both age and hearing loss average. Loss of hearing sensitivity among seven aged decades was significant statistically. Hearing loss showed more decrement in men than women in all audiometric frequencies, and the difference between them was significant in higher frequencies. Decrease of word discrimination score with age growth was significant, and with 12.63% permanent tinnitus, 6.84% vertigo/dizziness and 4.21% history of hearing aid usage were reported in all individuals. Hearing sensitivity declines gradually and progressively with aging. Effects of hearing loss and some of it's associated disorders specially tinnitus and vertigo/ dizziness on degree of communication and quality of life in such individuals and higher prevalence in aged people reveals the necessity of scientific and executive programming for identification and treatment of auditory problems in such population.

In the elderly, total WBc decreases slightly. in response to sepsis the increase in WBc is so dramatic. There are some reports about effects of increasing the number of WBc as a predisposing factor of bacteremia and further association of neutrophili a and leukopenia with increased mortality rate in the elderly. The aim of this study was to determine relationship between age and peripheral WBc counts in young versus elderly patients with sepsis.Methods & Materials: A case-control study was designed on 65 admitted septic patients over 65 years of age as cases and 65 admitted septic patients less than65 years of age as controls according to Loghman Hakim and Booali Hospitals, during 2001- 2006. Mean WBc was 17061/54±1424/2 in the cases and 13567/7±9888 in the controls. There was not a significant difference between mean of WBe. There was a significant difference between mean of pulse rate, and oral temperature in two groups. (P<0.05). In elderly, there was a significant correlation between age with history of infection and age with history of hospitalization during last month and also a significant correlation between age with source of probable infection ((P<0.05), but there was no a significant correlation between death with WBc and death with source of probable infection. Bacteremia in elderly can be afebrile and with pulse rate less than otber patients. The history of infection and history of hospitalization during last month in elderly with sepsis are considered to be important in evaluation.

Influenza disease considered to be more sever and complicated in old age persons, because immune response diminish in this group. This disease is one of the main causes of mortality in elder people. The prevalence of influenza disease in elderly are living in nursing home is more in compare if they dwell in community. We studied the effect of influenza vaccine on the incidence and numbers of episodes of influenza like illness (ILI) and cost of cares in old population residing in Kahrizak Charity Foundation, during nine months period from December of 2004 Through September 2005.Methods & Materials: This Cohort study was executed in the Kahrizak Charity Foundation, which is located in southwest of Tehran. Outcomes of residents whom were administrated influenza vaccine (n=389) and control subjects whom werent administrated influenza vaccine (n=557), monitored clinically for onset of ILI and its relative drugs, radiology and laboratory costs. Range of participant's ages were 60-105 years. For intervention group one dose of inactivated, subunit trivalent influenza vaccine was administered. During December 2004 to September 2005, 10.9% of participants caught ILL There were statistically significant lower percents of ILI (7.2% in vaccinated group and 13.4% in unvaccinated control group). Lower of drugs, laboratory and total costs in vaccinated group in compare to unvaccinated group (Consequently 1174±4918, 48500±119362 and 90690±119962 in vaccinated group versus.2521±8710, 179494±408479 and 183015±43634 in unvaccinated control group. There wasnt significant difference in deaths between vaccinated group and unvaccinated control group (65 case in vaccinated group and 66 case in unvaccinated group and Odds ratio=1.04). No serious adverse reactions to vaccination were recorded. Thus, influenza vaccination is safe and effective in this population and should become a part of the routine care of old persons who are dwelling in nursing homes. This study implicates clinical efficacy and cost- benefit of influenza vaccination in nursing home residents in Iran. Annual influenza vaccination of old people requires the attention of all nursing home attendants, physicians, and public health organizations.