PRESENT POST: consultant physician, professor in pension
Prague (1980) – Postgraduate Medical Schools and Institutes in– Internal Medicine 1st degree
Prague (1985) Postgraduate Medical Schools and Institutes in– Internal Medicine 2nd degree
Prague (1989) Geriatric Medicine
Sion (Switzerland – 1999/2000) European Academy for Medicine of Ageing – EAMA, IUKB Foundation Sion,
Prague (2002) – Diabetology
Older diabetics – multi-morbidity, problem of therapy, functional abilities and Limitations
Introduction: The elderly are extremely heterogeneous group of people. Health status in old age is a consequence of many factors, including chronic diseases of ageing and many other prevalent reasons that cannot be defined as classic „diseases“ because they do not rise from a single pathologic cause. For the quality of the senior‘s life and keeping their self-sufficiency, presence of the disease itself (or more
diseases) is not the cornerstone, it is just keeping their self-sufficiency. The clinical picture of the disease in multi-morbid elderly persons is often represented by nonspecific and universal symptoms (stereotypical neurological and psychiatric signs). The aim of geriatric medicine is to optimize residual functions despite the decline in total functional capacity with increasing multi-morbidity and used polypharmacy.
Aim of the study: The retrospective study of dates was aimed at conducting an analysis of multi-morbidity, number of used drugs, obesity, late complications, self-sufficiency and social status in older diabetics.
File specification: During the year 2016 the authors treated 1,572 diabetic outpatients
altogether, aged ≥ 65 y. Out of this number of the diabetics there were 743 men and 829 women of an average age (74.5 ±7 y.). All the patients had been longterm treated in the outpatient dept. for diabetes (DIASTOP). They had been nonselectively enrolled from the catchment area of Brno city where 25,000 inhabitants live.
Results: Subgroup of “young old” (65-74y.) included 843 persons (44.5%); 623 out of them were multi-morbid (74%). Subgroup of “old old” (75-84y.) 516 persons (32.8%); 420 of them were multi-morbid (81.4%). The third subgroup included people “oldest old” (≥ 85y.) 213 seniors (13.5%); 173 of them were multi-morbid (81.2%).
The average numbers of daily used drugs according to the above mentioned age subgroups were 4.6 ±2.3; 5.3 ±2.5 and 5.6 ±2.7. Polypharmacy (≥5 drugs) was present in 44.5%; 53.5% and 51.6%. Extreme polypharmacy (≥10 drugs) was present in 4.9%; 7% and 7% (according to the individual age subgroups). Diabetic late complications, number of used drugs, obesity, self-sufficiency and social status (loneliness) according to the age categories were analyzed too.
Conclusion: Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. We consider issues such as the relationship between multi-morbidity and polypharmacy today as a very crucial issue, especially with regard to the current demographic prognosis of the global population aging.