Iranian Journal of

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Introduction: The height measurements in the elderly are associated with several problems. In this study we used a model to predict of the Iranian people aged height from age, shin length and forearm length. Methods: A total 165 aged people ≥60 years were randomly selected based on medical record number of about 800 eligible older people who lived in Kahrizak Charity Foundation. Standing height, shin length and forearm length were measured. Data from 99 participants were used to creat a predicting multivariate linear regression model for estimation of standing height of older men and women. The data of the rest 66 participants were used for models testing. Result: The following equations were created: Men height = 78.928+ (1.430× shin length) + (0.817×forearm length)-(0.176×age) The height of women = 71.694+ (1.414×shin length) + (1.084× forearm length)-(0.277× age) R2 were calculated as 0.63 for men and 0.52 for women. Error of estimation was +0.44 cm and it was - 0.16cm and +1.09cm for men and women respectively. Estimated heights were not significantly different from standing statures. Conclusion: height was predictable from shin length and for forearm lengths and also age with a relatively small error in the estimation among Iranian older people. The error of model is more in women than men.

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Objective(s): The purpose of the present study is to better understand relationships between mental health components (Psychological distress, Psychological wellbeing) and utilization of health services and community aged care services among the Iranian elderly living in Sydney metropolitan area. These findings will, in part, fill the gap in gerontological knowledge and also help to health policy makers, social fairness, increasing fairness to the Iranian elderly migrants, and also increasing their more access to the aged care services. Material & methods: In this cross sectional study 302 old people were selected via a random sample among 1209 Iranian aged people 65 years old and over migrated in Australia. In this study 302 old people 65 years old and over participated who lived in Sydney state’s of Australia for at least 6 months prior to the survey. This study has done in 2005-7. Multiple methods were utilized to collect data including telephone interviews, face to face interviews, or a written survey instrument by mail. The tools used were based on the “annual elderly health survey in 2000” through Australian ministry of health. The mental health instruments applied were psychological well being (Yeild), and psychological distress (K6). The service utilization tools included utilization of aged care services (basic and supportive), and use of health services. T test, ANOVA and liner regression applied to predict of mental health components by SPSS ver.15 soft wear. Results: demonstrated that the majority of respondents reported feeling so sad and nervous most of the time in the last four weeks. The bulk of respondents had moderate level of psychological distress. About one quarter of respondents had lower level of feeling of wellbeing in the last four weeks preceding this study. Use of health services and community basic aged care services are predicted by mental health status of Iranian elderly respondents. However, mental health status could not predict utilization of community supportive aged care services. Conclusion: Generally, use of interpreters and organized community services were predicted with mental health components among the Iranian elderly migrants.

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Introduction: Studying of physical and mental health of older adults is important for health care services to elderly. With increasing ageing population and chronic diseases among older people, the expenditure of ageing services will increase. Thus, it is necessary to clear a cut point chronological age for starting ageing career. The aim of this paper is to understand health differences between two cohorts (60-64 and 65-69) of older adults. Methods: This study is cross-sectional and descriptive-analytical study. Data collected by structured questionnaire. The study population was 60 -64 and 65-69 cohort groups of older adults who living in rural and urban areas of Tehran in 2011. The sample size was estimated 400 people those were chosen using cluster sampling. Findings: The findings of study showed significantly differences between two groups of older adults, 60-64 and 65-69, in terms of physical health that measured using activity of daily living(ADL) and limitation of physical function. In contrast, there were no significant differences between two age groups in psychological wellbeing and mental illness. Based on results, complementary health services can start from 65 years old and providing counseling services according to women and men differences.

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Introduction: Mental disorders are common in the elderly.The purpose of this study was to assess the general health status and its related factors among people ≥ 65 years in different districts of Tehran. Methods: This study has used data of the participants ≥ 65 years old in urban health equity and response tool (Urban-HEART) study. Finally the data of 1313 elderly were considered for this study. Variables included demographic characteristics (gender, age, education level, family size, marital status and employment status) and mental health using the Persian GHQ -28 questionnaire (domains: somatic, depression, insomnia and anxiety) and quality of life using the SF12. Results: The mean age of participants was 73.68 (5.91) (women=627 and men=686). GHQ-28 median of scores the participants were 24.00 (22.00)[20.00 (27.00) in women and 19.00 (19.00) in men (P<0.01)].Based on GHQ-28 cut-point 23, 50.2%of the participants had mental health problems, [61.2% women and 40.1% men (P<0.01)].The residents of third municipality districts had the best mental health (26.3% of men and 38.5% of women had mental health problems) and the aged of 20th municipality district had the worst health status (65.7% of males and 84.2% of women had mental health problems).In multivariable logistic regression model, for each year of increment age, 2.9% chance of mental health problems increased (P<0.01). With increasing level of education, mental health status was improved (P trend < 0.01). The relationship between family size and mental health was not significant (P =0.06). Conclusion: Mental health status of the elderly in Tehran was worse than the many other countries. The elderly lived in 20th municipal district, had the worst and the dwellers in the 3th district had the best mental health status.

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Background: Falling is one of the health problems among aged population. Elderly living in institutions are at greater risk of falling than those dwellings in the community, due to their health status and environmental conditions. This study was designed and conducted aimed to address the factors affecting falls in Kahrizak Charity Foundation (KCF). Methods: This is a prospective longitudinal study, which 194 of residents of KCF were participating in it with inclusion criteria were selected by Random Cluster sampling. They were enrolled after signing an informed consent. At baseline the data of demographic, lifestyle, past medical history and visual ability were collected by interviewing. The anthropometric measurements were performed as well. Cognitive status data were collected using abbreviated mental test (AMT) questionnaire and mini mental state examination (MMSE), balance status was assessed using the Tinetti mobility test (TMT) and its balance and gait sub- scores, depression was detected using the geriatric depression scale-15 (GDS-15). The participants were monitored for the falls occurrence its complications by daily call with caregivers and filling out the special forms for the recording of the falls occurrence by the head nurse. Data were analyzed using univariate and multivariable Cox-regression models. Results: The mean age of the participants was76.02 (8.82) years and the mean follow-up days was 754.40±189.26 days. 44 cases of falls were recorded during follow-up (over two years). The fall rate was 22.7 subjects per 100 participants per year. History of stroke, Parkinson's disease, visual loss, taking antidepressants, TMT score and TMT balance sub-score after adjustment (for age, sex, body mass index and survival time) were associated with falls. Conclusion: The falls among nursing home elderly residents were associated with a history of chronic diseases such as stroke and Parkinson's diseases, visual acuity, use of antidepressants and the TMT and its balance sub score.

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Background: Because of various health problems, the risk of the death in the elderly is higher than adults. The purpose of this study was to investigate the causes of the death, and comparing the cause of death that recorded on the death certificates and those were extracted from the medical records review. Methods: Variables included the demographic characteristics (age and sex), time of death and the cause of death were recorded in the death certifies and those were extracted from the medical records. Results: The mean of death age was 83.8 (8.50) years and in women and men were 84.2 and 81.5 years, respectively, (P < 0.01).The most prevalent cause of death was sudden cardiac death based on both death certificates recorded and review of medical records were 42.5% and 25.9% respectively. Sudden cardiac death in both methods was higher in women than men. Using the kappa, the highest degree of correspondence about the cause of death between two method was about gastrointestinal bleeding (K = 0.76) and then the cancers (K = 0.71) and respiratory infections (K =0.67). Total Kappa of two methods for causes of mortality was 0.50. The most cases of death were reported during 12:00 – 13:59 and 8:00 – 9:59am, time period (16.2 % and 14.1% respectively). Conclusion: the causes of deaths, which are recorded in the elderly nursing homes, do not have enough accuracy. Due to the high incidence of sudden cardiac death in elderly in nursing homes, resuscitation facilities and teams may be helping to reduce these types of death.

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Background: increasing the population of aged, Consequently Increasing rate of chronic disease and to decreasing quality of life level caused many problems in different communities. The important aim of this study was surveying the effect of an educational intervention by use of the educational components of precede model on quality of life in the elders. Methods: This semi-empirical research was performed on 54 aged people in two group-case and control- for the Aged in 2009. In this study two questionnaires the designed questionnaire based on PRECEDE model and the questionnaire on the quality of life standard of the World Health Organization (WHOQOL) were used and the quality of life of the aged people in two groups before and after one month from the educational interference was evaluated. Independent t-test paired T-test, one way ANOVA, was used for data analysis. Results: The average total score of the quality of life of the aged people of test group, showed a meaningful difference before and after educational interference with a p quality less than 0.05, but there wasn’t a meaningful difference between total scores of two groups. Though the relationship of attitude (predisposing factors), enabling factors (skills) and behavioral factors with quality of life of a p quality less than 0.05 was meaningful. But knowledge (predisposing factor) and reinforcing factors didn’t show a meaningful relationship with the quality of life. Conclusion: It seems that the health, education and health promotion programs are effective on quality of life in the aged people.

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Background: One of the common problems of the elderly, which increase of its prevalence with aging is the dementia and the cognitive impairment. We can help the involved patients to have a better quality of life with early diagnosis of the cognitive impairment. The aim of this study was an assessment of the validity and reliability of the Persian version of the abbreviated mental test (AMT) among the older people in a nursing home setting. Methods: 176 eligible elderly people aged ≥ 60 years living in KahrizakCharity Foundation (KCF), were selected randomly based on medical record number. Demographic information and past medical history of the participants were collected. Geriatric depression scale 15 (GDS-15), global deterioration scale (GDS) forms and also the Persian version of the abbreviated mental test (AMT) were administered. The participants were assigned to two groups the normal and impaired cognitive groups, based on DSM-IV diagnostic criteria. The GDS cut-points were used for assessment of validity, sensitivity and specificity of the Persian version of AMT. Results: The mean age of the participants was 77.30 (7.94) years. The Persian version of AMT had good discriminated validity in diagnosis of normal and impaired cognitive participants (7.35 ± 2.33 and 5.99 ± 2.29, P < 0.01 respectively) and at cut-point AMT< 8,(based on GDS cut-point) it had a sensitivity and specificity 92.15 % and 81.50% respectively. The sensitivity and specificity based on theism IVcriteriawere 64.9% and 64.0% at cut-off point equal to 7, respectively. The internal consistency of the Persian version of AMT was acceptable (Cronbach’salpha coefficient =0. 76). As well as the external reliability (intra-rater) of this instrument was good inter-class correlation coefficient (ICC) = 0.89) Conclusion: The Persian version of the AMT has appropriate validity and reliability in Iranian older people.

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Background: Oral health is an important issue in elders’ life in both food consumption style and their self-esteem. The aim of this study was to survey the oral health among aged people in Gorgan city. Methods: In a cross sectional study and through a standard questionnaire, the data of 869 aged people who were resident in the areas where were covered by 4th and 5th Health Station of Gorgan Health Center, has been analyzed. Participants (over 60 years old persons) entered in the study through a census method are asked about their oral health by trained persons. Data analyzed by descriptive statistics and Chi-Square test. Alpha level set at 0.05. Results: Complete toothless was 54.3 percent in male and 62.6 percent in female. Totally teeth preservation rate was 6.4 percent in male and 1.5 percent in female. The mean and standard deviation of tooth loss were 22.5±12.4 in male and 24.4±11.2 in female. The Complete toothless significantly was high in single people compared with married one. Completely toothless was low among aged people with less than or equal to four children and was low among aged people in the worst status of economic situation. Conclusion: Oral health among the study population was in a bad situation. For preservation of teeth till adult age, appropriate planning and interventions is necessary.

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Background: Dementia is a common health problem in the elderly. Studies have shown that levels of pulse wave velocity (PWV) could predict cognitive impairment. The objective of this study was assessment of the relationship between arterial stiffness levels and cognitive status among the older people. Methods: In this cross-sectional study, 60 individuals included 31 women and 29 men aged ≥ 60 years who were admitted to Khatam-Ol-Anbya hospital in Tehran and were eligible, were randomly selected according to admission code. Data such as demographic information, Global Deterioration Scale level, Geriatric Depression Scale -15 score, were collected by face to face interview. The arterial stiffness was measured using Sphygomocor system by calculation of carotid to femoral pulse wave velocity. Data analyzing was conducted using univariate and multivariable logestic regression models. Result: The mean age of the participants was 72.62 (7.62) and it was significantly higher in cognitive impairment than those who had normal cognition [73.40(7.36) vs. 70.27(8.00) respectively, P = 0.05]. The average years of the schooling in individuals with normal cognitive status was higher than the other groups (P < 0.01). Average pulse wave velocity in the participants was 11.81(4.11) meters per second. The PWV was significantly increased with the exacerbation of the cognitive impairment (7.24 m/s in normal group vs. 15.52 m/s in the severe cognitive impaired group, P < 0.01). Conclusion: The pulse wave velocity has an inverse relationship with cognitive status. It seems that arterial stiffness associates with lower levels of cognitive status independent to other cardiovascular risk factors.

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Background: Increasing number of elder people accompanied with an increasing number of subjects with chronic diseases among them. The aim of this study was to compare the results of physical condition of elder people in Grogan city, Golestan, Iran, in 2009 with the results in 2004.
Methods: Through a cross-sectional study using a standard questionnaire data on 884 elder people who were resident in 4^th and 5^th health station covered by Gorgan health center at 2009 were collected by trained persons as self-report. Participants entered in the study through a census method are asked about their physical condition. Using Qui-Square method, collected data has been analyzed. The results were compared with the outcomes of pervious study (unpublished) at 2004 which has been carried out among 315 elder people in the same study area. SAS 9.2 software has been used for data analyzing.
Results: Mean age of elders at 2009 was 67.20±6.67 years and at 2004 was 67.59±6.72 years. Frequency of Hypertension, hyperlipidemia, asthma, diabetes showed a statistically significant (p<0.05) increase in 2009 compared with 2004. On the other hand, the frequency of epilepsy, losing of teeth, inguinal hernia and heart burn decreased during these years, statistically significant again (p<0.05).
Conclusion: The results of the current study indicated that cardiovascular disease significantly increased in second phase of the study rather than first one. It is necessity to interventions to the control of these problems.

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Background: Older people are vulnerable in terms of health status. The elderly`s Khuzestan due to the very warm weather of this region are more at risk for health problems. This study is a report on the health status of the elderly in Khuzestan province in 2012.
Methods: This is a Cross-sectional study, with multi-level proportional cluster Random sampling among people aged ≤ 60 years of Khuzestan province. Nutritional status was assessed by Mini Nutritional Assessment (MNA), depressed mood screening was conducted with Geriatric Depression Scale-15 questionnaire, activities of daily living was evaluated using KATZ ADL and Lawton Instrumental ADL tools.
Results: In this study, 387 people participated. The prevalence of hypertension, diabetes mellitus, depressed mood, and anxiety in the participants, were 38.8%, 28.6%, 34.9 and 38.7, respectively. Hearing loss reported in 33.9% and vision impairment was in 62.2% of the participants. Memory impaired founded in 14.9% of the participants.  4.3% of the elderly suffered from malnutrition and 48.3% were at risk of malnutrition. Dysfunction in ADL were existed in 13.9% and 30.3% of the participants had some degrees of dysfunction in IADL.
Poly pharmacy (consumed more than 3 medications) was observed in 36.5% of older adults in this province. The most common health services need was medical services at home and then transport services.
Conclusion: Although the health status of the elderly in Khuzestan province  generally was not worse than the average of Iran, it needs that a special pay attention in some areas, such as hypertension, diabetes, nutritional status and lack of independence in activities of daily living in this age group.
 

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Background: Improved in health condition, reduced fertility rates, and increased life expectancy has increased number and proportion of elderly population. This study was reported the health status of older population in North Khorasan province.
Methods: This is a cross-sectional study that enrolled 99 subjects (40 men and 59 women) ≥ 60 years by a multi-levels proportionate cluster random sampling method.
Required information was gathered by means of a demographic questionnaire. Mini Nutritional Assessment (MNA), Geriatric Depression Scale-15 (GDS-15), Katz's basic activity of daily living, and Lawton's instrumental activity of daily living were administered. Measurements of anthropometric and blood pressure were performed based on standard methods
Results: The prevalence of diabetes and hypertension in elderly, were 17.7% and 57.6%, respectively. Depressed mood was observed in 36.4% of the participants 36.4% of the participants and 18.2 percent of them reported that their health condition was bad. In addition, 73.5% of the elderly had complained about any bodily pain. As well as, 22.6% of the participants used opium at least once during the last year.
Conclusion: It seems that the health status of the elderly in North Khorasan province is not suitable in many indicators, such as hypertension, malnutrition, drug abuse and complaints of pain and their health status was worse than the national average of Iran. A special attention requires to the health status of elderly in this province .

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Background: Although several tools for evaluating and screening of cognitive status have been introduced, most of them are not applicable in Iranian elderly population because of cultural differences and high illiteracy rate. This study is report of "Brief Cognitive Assessment Tool"(BCAT) was developed as a cognitive status-evaluating test and reported psychometric characteristics.
Methods: the BCAT tool includes memory assessment using three words recall test with a rating similar to Mini-Cog and the functional status including "ability to dress", "ability to use the phone," " ability to manage own medications", among both two sexes and financial management capabilities in men and ability to prepare food in women. Functional rating is different in educated and non-educated people. Diagnosis of dementia is considered, when memory impairment is accompanied by the dysfunction. Eighty-six residents of a nursing home (41 men and 45 women) among who had inclusion and no had exclusion criteria also consent to participate were randomly enrolled. Concurrent validity was shown as correlation coefficient between the BCAT categorization and score of mini meAntal state examination (MMSE). Criterion validity, sensitivity and specificity of BCAT were evaluated based on global deterioration scale (GDS). Reliability of two raters results within two weeks was indicated by Kappa coefficient.
Results: The sensitivity and specificity and accuracy rate of the BCAT based the GDS was 88.6%, 82.6%, and 84.9%, respectively. The correlation between the MMSE score and results of the BCAT classifying was significant. The Kappa coefficient between the results of two raters was 81.1%.
Conclusion: It seems that the BCAT has good psychometric properties to recognize cognitive impairment among Iranian older adults.

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Background: Osteoarthritis (OA) is the most common joint disorder and the most prevalent cause of joint pain across the spectrum of middle age to elderly. The purpose of this study was to determine the role of subjective norms and perceived behavioral control on self-care among elderly patients with osteoarthritis who are suffering from OA in Yazd city, Iran.
Methods: A cross-sectional study was conducted and 87 elderly who attained to health centers subjects through simple sampling methods. The data collection instrument was a questionnaire designed for the study which the first includes demographic variables, of subjective norms and perceived behavioral control Part II, and self-care behaviors categories of items Part III. The questionnaires completed by interview and data were analyzed by SPSS18 software using T-Test, ANOVA, correlation coefficient tests.
Results: The mean score of the subjective norms, perceived behavioral control and self-care were 81.85±11.40 (The top 110 scores), 90.19±6.19 (The top 120 scores) and 44.93±5.84 (The top 60 scores), respectively. The results showed that between subjective norms and perceived behavioral control and self-care with demographic variables except education and perceived behavioral control (P =0.001), the history of disease of self-care (P =0.001) and perceived behavioral control and economic status (P =0.002) were not a significant relationship, Also The results Pearson’s correlation test revealed that there was a significant correlation between self-care behaviors and perceived behavioral control (P =0.008, r=0.297).
Conclusion: As for strong association between behavioral control and self-care that we found in our study and high influence and extension of mass media, it recommends to emphasis on using these methods as educational assistance devices in interventional programs in these medias.

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Background: The aging of the population is a great challenge of the public health in this century. The health promotion of the elderly people requires a comprehensive and accurate understanding of their health status.
Methods: This cross-sectional study has assessed the health status of 191 old people ≥ 60 in Sistan and Balouchestan province that selected by a multi-level cluster random sampling. General health data was collected using SF-36 questionnaire, nutrition status was assessed using Mini Nutritional Assessment (MNA), depression status was detected by the geriatric depression scale-15 (GDS-15), functional status was assessed using the activity daily living (ADL) and instrumental activity daily living (IADL) questionnaires, as well as, the information about demographic, history of diseases, vaccination, participation in social activities, and the utilization of elderly care services were evaluated by an approved questionnaire. History of hypertension was asked from the participants. Moreover the blood pressures of them were twice measured.
Results: The mean age of the participants was 69.81 (8.32) years. The health status was reported excellent and bad by 4.2% and 9.4% of the participants, respectively. The prevalence of fall in recent year, memory disorder, hearing and visual impairment, and malnutrition were 35.3%, 15.6%, 30.3%, 56.6%, and 8.9%, respectively. The prevalence of dependency in "activity of daily living" and "instrumental activity of daily living" were 25.8% and 58.2%, respectively.
Conclusion: It seems that the prevalence of malnutrition, impaired ADL and IADL, and memory impairment in the older population of Sistan and Baluchestan are above the national and global averages.
 

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Background: Alborz Province is one of the provinces that accepted immigrants. Immigration has a profound effect on physical and mental health in elderly. This study was performed to assess the health status of Alborz province older population.
Methods: In this cross-sectional study, 235 subjects were enrolled (113 men and 122 women) aged ≥ 60 years using multi-level proportionated cluster random sampling that selected from 19 cities of this province. Data was collected by a demographic questionnaire, measuring anthropometric characteristics, and blood pressure and using "Mini Nutritional Assessment", ”Geriatric Depression Scale-15 ", “Katz’s Activity of daily living”, and "Lawton’s Instrumental activities of daily living”. Data was analyzed with spss21.
Results: The mean age of the participants was 68(6.00) years.  The prevalence of anxiety and depression among the participants was as 51.5% and 34%, respectively. At risk or malnutrition was observed in 27% of the participants and 54.5% had suffered dental problems and 49.8% also had problem in walking.
Conclusion: Overall, the health status of elderly people in the Alborz, perhaps slightly better than the national average, but the high prevalence of metabolic disorders also the high prevalence of depression and anxiety require serious intervention by policy makers to promote the health in elderly.