Marta Podhorecka

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.

OBJECTIVES Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. METHODS A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). RESULTS ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). CONCLUSIONS MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Activation of the elderly with dementia syndrome

Dementia is a set of symptoms caused by a chronic and progressive brain disease. The disease leads to the disorders of higher brain functions such as memory, orientation, thinking, understanding, counting, ability to learn, language and assessment. Dementia causes decrease in intellectual functions and hinders basic everyday life activities. The most known disease connected with dementia is the Alzheimer’s disease. Its treatment consists of pharmacotherapy and other nonpharmacological methods, which play an important part in the improvement of patient’s functioning. Activation of the elderly person with dementia is not easy and depends greatly on our attitude. The purpose of this article is to present different therapeutic methods activating the patient in a daytime. Apart from physiotherapy, the methods include occupational therapy and memory training.

Clinical evaluation of postural posture of patients with previous stroke subjected to early rehabilitation

Introduction: Impairment disorders are often found in patients with stroke and impairment of motor and cognitive functions. This is a very serious complication because, by imposing a motor impairment, it aggravates the condition of disability and makes it difficult to conduct physical rehabilitation. The resulting neurological deficits due to stroke determine functional disorders. The possibility of locomotion is usually compromised, therefore the risk of falls increases significantly. The aim of the work is to present Postural Assesment Scale for Strock PASS with the postural stroke assessment scale, the impact of early rehabilitation of patients staying in the neurology ward. Material and methods: Postural examination was carried out among 17 people, of which 8 were women, and 9 were male. The study was divided into two stages. The first stage occurred immediately after the stroke and the second one before the patient was discharged from the ward. Research was carried out at the Biegański Specialist Hospital in Grudziądz in the Department of Neurology and Clinical Neuroimmunology and Impact Department. Conclusions: The results of the postural studies carried out in people with previous stroke subjected to early physiotherapy have a beneficial effect of the conducted therapy. There are positive changes between the first and the final examination of the patients. Słowa kluczowe: Udar mózgu, rehabilitacja, ocena posturalna, koncepcja Bobath,

The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence – a pilot study

Objective The aim of the study was to assess the myostatin concentration and an improvement in the severity of urinary incontinence (UI) after pelvic floor muscle training (PFMT) in a group of elderly women with stress UI. Methods A total of 74 participants were included in the analysis: 40 participants in the experimental group (EG) and 34 participants in the control group (CG). The EG underwent PFMT, whereas no therapeutic intervention was applied to the CG. Myostatin concentration and UI severity (Revised Urinary Incontinence Scale [RUIS]) were assessed in all women before and after the treatment. Results By comparing the results before and after the treatment, we have been able to demonstrate a statistically significant decrease in myostatin concentration (P<0.0001) and an improvement in the severity of UI (RUIS) (P<0.0001) in the EG. No statistically significant differences in all measured variables were reported before and after the treatment in the CG. A lower myostatin concentration (P=0.0084) and an improvement in the severity of UI (RUIS) (P=0.0008) were observed after the treatment in the EG compared to that in the CG. Conclusion Effective PFMT causes downregulation of myostatin concentration and an improvement in the severity of UI in elderly women with stress UI. Further trials on a larger EG and an assessment of long-term treatment outcomes are required.

Sleep quality disorders among the people of old and presenile age

Podhorecka Marta, Cytarska Magdalena, Gebka Dominika, Perkowski Radoslaw, Jaroch Alina, Siedlecka–Glowczewska Emilia, Sokolowski Remigiusz, Radzinska Michalina, Zukow Walery, Kedziora-Kornatowska Kornelia. Sleep quality disorders among the people of old and presenile age. Journal of Education, Health and Sport. 2017;7(12):322-338. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1133977 http://ojs.ukw.edu.pl/index.php/johs/article/view/5181 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.12.2017. Revised: 15.12.2017. Accepted: 28.12.2017. Sleep quality disorders among the people of old and presenile age Zaburzenia jakości snu wśrod osob w wieku starczym i przedstarczym Marta Podhorecka1, Magdalena Cytarska1, Dominika Gebka1, Radoslaw Perkowski1, Alina Jaroch2, Emilia Siedlecka–Glowczewska1, Remigiusz Sokolowski1, Michalina Radzinska1, Walery Zukow3, Kornelia Kedziora-Kornatowska1 Faculty of Health Sciences, Department and Clinic of Geriatrics, Nicolaus Copernicus University, Torun, Poland, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland Faculty of Health Sciences, Department and Institute of Nutrition and Dietetics, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland Department of Spatial Management and Tourism, Faculty of Earth Sciences, Nicolaus Copernicus University in Torun, Torun, Poland Streszczenie: Wedlug najnowszych badan na zaburzenia snu cierpi ponad polowa osob w populacji geriatrycznej. Obnizona jakośc snu wplywa negatywnie na biopsychspoleczne funkcjonowanie jednostki. Celem badan bylo określenie wielości problemu wystepowania zaburzen jakości snu u osob starszych. Badania do pracy zostaly przeprowadzano za pomocą anonimowej ankiety, ktora skladala sie z dwoch kwestionariuszy: Kwestionariusza Jakości Snu Pittsburgh (PSQI) oraz ankiety wlasnej konstrukcji. W badaniach wzielo udzial 100 osob a ankieta byla skierowana do osob po 50 roku zycia.. Badania pokazaly, ze ponad jedna piąta badanych ocenia swoj sen na raczej zly oraz wykazano istotne korelacje miedzy wydluzeniem czasu potrzebnego do zaśniecia a budzeniem sie w nocy lub nad ranem czy brakiem energii. Slowa kluczowe: sen, osoby starsze, geriatria Summary: According to the newest research over the half of geriatric population suffers from sleep disorders. Lowered quality of sleep has got a negative influence on biopsychosocial functioning of an individual. The aim of the study was to define the magnitude of the problem of sleep quality disorders occurrence in the elderly. The research for the study was carried out by means of anonymous survey which consists of two questionnaires: The Pittsburgh Sleep Quality Index (PSQI) and a survey constructed for the sake of the study. 100 people took part in the study and the survey was aimed at people over the age of 50. The research showed that over one fifth of the subjects assess their sleep as rather bad and significant correlations between lengthening the time needed to fall asleep and waking up at night or before dawn and the lack of energy. Key words: sleep, the elderly, geriatrics

Falls in the elderly – risk assessment and procedding

The aging of society was an incentive to the development of many fields of medicine including geriatric physiotherapy. Rehabilitation in geriatrics involves a range of issues connected with the involutional and/or disease related changes in the organism of an elderly person. To highlight the most important ones, so called ‘great geriatric problems’ were distinguished. One of them are falls. The risk of falls rises significantly after the age of 65. Among people older than 65 the chances of falls are 40% higher than among younger people. The article aims at showing the issues connected with the role of physiotherapy in falls prophylaxis in the elderly. The problem of falls in the elderly is mainly connected with the consequences of falls. Falls may lead to injuries, disability and even death. Falls prophylaxis should start with complex geriatric assessment. To assess the risk of falls a physiotherapist may use special scales: the stand up and go and the Tinetti test. After thorough analysis of the state of health of the elderly person appropriate prophylaxis measures may be chosen: removal of the environmental threats, appropriate selection of shoes as well as the assisting equipment, acute and chronic diseases treatment, pharmacotherapy modification, physiotherapy. Anti-fall rehabilitation usually focuses on balance training, expanding the range of motion, gait re-education and analgesic measures. In some medical centres special anti-fall programs are being developed, where physical activities and appropriate assisting equipment play the most important role. Modern physiotherapy methods enable individual anti-fall prophylaxis adjustment to the elderly person’s needs. The use of rehabilitation to diminish the risk of falls in the elderly is more and more common.

Urination disorders occurring in the elderly – point of view of a physiotherapist

International Continence Society defines urinary incontinence as involuntary urine leakage in subjective assessment. It is essential that urinary incontinence is regarded to as a symptom not as a separate disease. Until recently, majority of the elderly society considered disorders connected with urinary continence a taboo topic. Higher awareness level and easier access to knowledge enable even the elderly patients to start therapy in the area of these afflictions more willingly. According to the world standards of urination disorders, in the first stage of treatment noninvasive treatment should be used and when it fails, surgical treatment is to be applied. It is especially crucial in geriatrics patients whose polymorbidity poses contraindications or higher risk to general anesthesia procedures. The following article presents the point of view of a physiotherapist and possibilities of using a wide range of noninvasive methods in the therapy of urination disorders. Classification of urination disorders is presented, as well as possible comorbidities relevant during urological physiotherapy