SummaryIntroduction.The aim of the study was to find out the determinants of the quality of life in primary health care patients with type 2 diabetes.
<p><strong>Objective</strong>. The aim of our study was to investigate the predictors of morbidity (age, gender, smoking habits, obesity and the presence of chronic diseases) and COVID-19 outcomes.</p><p><strong>Subjects and Methods</strong>. The research was an observational descriptive study, conducted at The Family Medicine Education Center, The Primary Health Care Center, Banja Luka, in the period from 26th June to 31st December 2020. During the research period, seven family medicine teams followed their patients with COVID-19, and recorded possible predictors for morbidity and their influence on the disease outcome.</p><p><strong>Results</strong>. The study included 934 patients, 46.90% of whom were male. The majority of subjects were non-smokers and overweight. Diabetes was found in 5.57% patients, hypertension in 29.44%, chronic respiratory diseases in 5.25%, cancer in 4.39% patients. In the observed sample, 29.23% subjects contracted pneumonia, 18.52% were hospitalized, while 19 (2.03%) patients with severe clinical features had a fatal outcome. Multivariable regression analysis showed a high risk of pneumonia in male patients [OR=2.45, 95% CI (1.73-3.46)], elderly [OR= 1.07, 95% CI (1.06-1.09)] and obese patients with Body Mass Index ≥30.0 kg/m2 [OR=2.55, 95% CI (1.73-3.77)]. Male gender [OR=2.19, 95% CI (1.11-4.31)], older age [OR=1.08, 95% CI (1.05-1.11)] and hypertension [OR=2.51, 95% CI (1.06-5.91)] were the most important predictors for the development of severe clinical features in COVID 19. The statistically significant predictors of mortality were male gender [OR=7.16, 95% CI (1.56-32.86)] and older age [OR=1.12, 95% CI (1.06-1.18].</p><p><strong> Conclusion</strong>. Being familiar with the predictors of morbidity and poor outcome in COVID-19 is helpful for carrying out preventive measures, early diagnosis and treatment of risk groups of patients.</p>
<p><strong>Aim<br /></strong> To examine the prevalence of undiagnosed depression among primary care elderly patients in the entity of the Republic of Srpska (Bosnia and Herzegovina) as well as the sociodemographic and clinical risk factors associated with depression. <strong>Methods<br /></strong> A cross-sectional study was conducted between April and June 2019 in nine towns of the Republic of Srpska. The study sample included 1,198 primary care patients older than 65 years of age. Research instruments included a sociodemographic questionnaire and Geriatric Depression Scale-Short Form (GDS-SF). <br /><strong>Results<br /></strong> Positive screening test (GDS-SF score &gt; 5), which indicates depression was found in 484 (40.4%) participants. Multivariate regression analysis showed that lower education levels [OR = 1.565, 95% CI (1.13-2.17)], divorced and widowed [OR = 1.366, 95% CI (1.16-1.62)], poor financial situation [OR = 1.690 , 95% CI (1.25-2.29)], non-home residents [OR = 2.200, 95% CI (1.41-3.44)], non-hobby patients [OR = 2.115, 95% CI (1.54-2.91) ], non-friends [OR = 3.881, 95% CI (2.70-5.57)], patients suffering from chronic pain [OR = 2.414, 95% CI (1.72-3.39)], patients with daily life limitation activities [OR = 1.415, 95% CI (1.03-1.95)], patients with three or more chronic diseases [OR = 1.593, 95% CI (1.12-2.27)], patients using five or more drugs [OR = 1.425. 95% CI (1.00-2.03)], and patients with history of previous depression [OR = 2.858, 95% CI (1.94-4.21)] were at higher risk for depression. <br /><strong>Conclusion<br /></strong> The prevalence of undiagnosed depression in the elderly in Republic of Srpska is high. Future strategies are needed to strengthen screening of geriatric depression in primary health care.</p>
Introduction. The number of people over 65 is increasing in the world, and falls are rather common among them. The objective of this research was to examine the impact of depression, dementia, the number of chronic diseases and the number of used medications in the risk of falls in the elderly. Material and Methods. We carried out a prospective study during the period from March 20 to May 20, 2016. The patients were interviewed, and data were also obtained from medical records. The data collection included a socio-demographic questionnaire, the Tinetti Gait and Balance Instrument, Beck Depression Inventory and the Folstein Mini-Mental State test to assess cognitive functions. Results. The study included 208 patients older than 65 years, 81 men, 127 women. The Tinetti Gait and Balance tool revealed that onethird (63) of patients were at a high risk of falls, 35 patients at a moderate risk, and 110 patients presented with a low risk of falls. The results of our study showed a statistically significant association between dementia (p = 0.000) and depression (p = 0.000) as the risks of falling. Patients with some chronic diseases and patients continuously taking various drugs were also at higher risk of falls. Conclusion. Timely detection and treatment of depression and dementia may contribute to reducing the risk of falls in the elderly. Patients´ medication lists should be reviewed to decrease the number of medications or modify the dose. Family physicians play a major role in preventing falls in the elderly.
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