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Volume 8
Journal of Palliative Care & Medicine
ISSN: 2165-7386
Geriatrics 2018
July 30-31, 2018
Page 36
conference
series
.com
July 30-31, 2018 | Barcelona, Spain
8
th
International Conference on
Geriatrics Gerontology & Palliative Nursing
Nina Gorshunova, J Palliat Care Med 2018, Volume 8
DOI: 10.4172/2165-7386-C2-016
Criteria of physical and cognitive frailty of older persons as determinants of their high need for
palliative care
T
he progression of involutive changes in older people is accompanied by the development of polyfunctional deficiency leading to
the appearance of physical and cognitive frailty, limitations of life activity (reduced self-service abilities, independent movement).
To determine the older people needs inmedico-social care, a comprehensive geriatric evaluation of 417 people older than 80 years was
performed, with the expression of osteopenia and sarcopenia, decreased muscle strength and walking pace, attention and memory.
The assessment of physical frailty is performed by the dynamometry, muscle and bone mass by bioimpedance analysis, cognitive
functions on the Montreal scale (MoCA), psychological disorders - on the geriatric depression scale. The possibility of self-service is
determined using the Barthel and Katz scales, preserving the skills of instrumental daily activity on the Lawton-Brody scale. It has
been established that in patients over 80 years the severity of muscle mass, its strength, bone reduction, limitations of self-service and
movement depend on the age and degree of functional insufficiency. Markers of cognitive frailty: Reduction of visual, constructive
skills and memory with an increase of depression is significant in 45% of patients. It is revealed that about 70% of them need
in social assistance, 52% in rehabilitation, 44% in psychological support and 35% in palliative care. Older people with physical
pre-frailty to prevent the development of self-care restrictions and self-movement should recommend a diet rich in high-grade
proteins, regular isometric exercise under the control of heart rate and blood pressure. Patients with predementia cognitive
disorders can be recommended training programs aimed at activating attention, memory and perception. Immobile patients
are shown therapeutic exercises, timely prophylaxis of bedsores. Palliative care programs are developed by general practitioners
and implemented under their supervision by nurses. The importance of developing clinical recommendations for differentiated
provision of palliative care is highly significant.
Biography
Nina Gorshunova is a Doctor of Medicine, Professor, Head of the Polyclinic Therapy & General Practice Department of Kursk State Medical University, Russia. She
is a Head of local scientific center of Global Aging Research Network supported by the International Association of Gerontology and Geriatrics. She is a Member of
Governing Board in Scientific Gerontological society of the RussianAcademy of Sciences, the member of the InternationalAdvisory Board of academic journalAdvances of
Gerontology. The main scientific trends are: Gerontology and geriatrics in general practice, cardiovascular problems of elderly people, age-related disorders of hemostasis;
mediсo-social rehabilitation; organization and methodical problems of the general medical practice, educational technologies for prevention of premature ageing. She is an
author of more than 600 scientific publications. In 2012, she was awarded by gold medal of European scientific industrial chamber for original investigations in gerontology.
gorsh@kursknet.ruNina Gorshunova
Kursk State Medical University, Russia