2025, Ilkowski, Jan, Wieczorowska-Tobis, Katarzyna, Guzik, Przemyslaw

Activities of Daily Living (ADL) are fundamental tasks for individuals to manage their basic needs. Our study aims to examine ADL at admission (adADL) and the Pre-COVID-19 to Admission ADL Difference (ADL-change) as potential predictors of in-hospital mortality. This is a retrospective analysis of clinical data (including the Katz index for ADL) from 141 older patients aged at least 65 years hospitalized in a COVID-19-dedicated unit (not requiring ICU) from September 2021 until January 2022 in Poznań, Poland. Thirty patients (21.3% of all) died during hospitalization. Non-survivors were older than survivors, exhibited lower oxygen saturation, more severe inflammation, higher D-dimer concentrations, and were more commonly prescribed antibiotics. The AUC for in-hospital mortality was for adADL: 0.7417 (95% CI: 0.6478–0.8357; p < 0.0001) and for ADL-change: 0.6869 (95% CI: 0.579–0.7928; p = 0.0018). The corresponding cut-offs were 0 for adADL and 3 for ADL-change. Cox proportional hazard models yielded hazard ratios of 3.57 (95% CI 1.57–8.10; p = 0.0024) for adADL and 3.78 (95% CI 1.49–9.54; p = 0.005) for ADL-change. ADL assessment offers valuable insights into in-hospital mortality among older COVID-19 patients. Monitoring ADL in these patients indicates high-risk individuals for in-hospital death. Integrating ADL into routine clinical practice might enhance care for older patients.

2025, Kimatova, Kerbez, Yermukhanova, Lyudmila, Talarska, Dorota, Dworacka, Marzena, Sultanova, Gulnar, Sarsenbayeva, Gulzat, Bazargaliyev, Yerlan, Aitmaganbet, Perizat, Suwalska, Aleksandra, Wieczorowska-Tobis, Katarzyna, Philp, Ian, Tobis, Slawomir

BackgroundStudies about the needs of older individuals in Central Asia are very sparse. Thus, this study aimed to evaluate the needs of older adults in Kazakhstan with the EASYCare Standard 2010 (EC) questionnaire.MethodsThe study involved 524 participants aged 65 and older from various regions in Kazakhstan. Data were collected by trained research staff, and the participants’ needs were examined using median split with the three summarizing indexes of the EC system (Independence score, Risk of breakdown in care, and Risk of falls).ResultsSubjects with primary education had approximately double odds of scoring above the median compared to those with higher education in Independence score (p &lt; 0.01) and Risk of breakdown in care (p &lt; 0.01). Individuals with primary education also had 60% higher odds of scoring above the Risk of falls scale threshold, indicating a risk in this category (p &lt; 0.05). For the Risk of falls scores, financial situation was also significant; individuals having not enough to make ends meet had 75% higher odds than the remaining ones (p &lt; 0.01).ConclusionOur analysis highlights the importance of tailored interventions to address the unmet needs of the Kazakh population, particularly among those with lower education and those with financial concerns. The study also underscores the need for sustainable, comprehensive eldercare policies in Kazakhstan that account for the growing older population.

2025, Szewczyczak, Marlena, Talarska, Dorota, Strugała, Magdalena, Talarska-Kulczyk, Patrycja, Kawecka, Kamila, Wieczorowska-Tobis, Katarzyna, Tobis, Sławomir

Background: Social demographic changes contribute to increased life expectancy and disability. The ability to maintain independence depends on receiving appropriate support. This study aimed to analyze the needs of individuals over 75 years of age living in a home environment. Methods: A cross-sectional study assessed support needs from the perspectives of the patient, caregiver, and researcher. The following research tools were used: Camberwell Assessment of Need for the Elderly (CANE), Mini-Mental State Examination (MMSE), Barthel Index, and Geriatric Depression Scale (GDS). Results: The average total number of needs reported by the patients was 5.0 ± 2.9, by caregivers 6.63 ± 2.98, and by researchers 5.76 ± 3.43. The most frequently reported unmet needs were related to Accommodation, Company, and Eyesight/Hearing/Communication. A higher number of met needs (p = 0.006) and total needs (p = 0.011) was observed in individuals aged 85 and older and in seniors who had a caregiver (p < 0.001). Lower functional ability was an indicator of a higher number of met needs (p < 0.001). Cognitive function did not affect the number of reported needs. A correlation was found between the number of needs and depressive symptoms. The total number of needs reported by patients was significantly lower than the number reported by healthcare personnel and caregivers. Conclusions: The CANE questionnaire enabled the identification of individual care needs in the elderly. Although unmet needs were in areas that could be easily addressed, elderly individuals did not receive adequate support. Researchers and caregivers identified more met and unmet needs than the elderly individuals themselves.

2024, Goździewicz, Łukasz, Tobis, Sławomir, Chojnicki, Michał, Wieczorowska-Tobis, Katarzyna, Neumann-Podczaska, Agnieszka

The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = −0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs.

2024, Kaluźniak-Szymanowska, Aleksandra, Talarska, Dorota, Tobis, Sławomir, Styszyński, Arkadiusz, Cofta, Szczepan, Wieczorowska-Tobis, Katarzyna, Deskur-Śmielecka, Ewa

PurposeChanges in nutritional status are important extrapulmonary manifestations of the chronic obstructive pulmonary disease (COPD). The study aimed to assess the prevalence of different body composition phenotypes in older patients with COPD and to investigate the relationship between these phenotypes and the severity of the disease, as well as physical performance of the subjects.Patients and methodsThe study included 124 subjects aged ≥60 with COPD. In all of them body composition analysis and muscle strength measurement were performed. Additionally, data from patients’ medical records were analyzed. Study sample was divided into four groups based on the phenotypic body composition: normal phenotype (N), sarcopenia, obesity and sarcopenic obesity (SO).ResultsIncidence of sarcopenia was significantly higher in patients with severe or very severe COPD based on GOLD in comparison with subjects with mild or moderate obstruction (p = 0.043). Participants with sarcopenia, obesity and SO had lower results of the 6-min walk test than subjects with N (225.77 m, 275.33 m, 350.67 m, 403.56 m, respectively). Moreover, sarcopenia and SO had lower results than obesity (p = 0.001, p = 0.041, respectively).ConclusionSarcopenia is common in patients with advanced COPD. Sarcopenia and SO are associated with poorer physical performance. All older people with COPD should routinely have their body composition assessed, instead of simply measuring of body weight or body mass index (BMI).

2025, Ilkowski, Jan, Guzik, Przemysław, Kaluźniak-Szymanowska, Aleksandra, Rzymski, Piotr, Chudek, Jerzy, Wieczorowska-Tobis, Katarzyna

Background: Malnutrition is an often-overlooked yet potentially crucial factor influencing COVID-19 outcomes. Poor nutritional status weakens immune function, increases infection susceptibility, and worsens prognoses in hospitalized patients. However, its specific role in COVID-19 mortality remains insufficiently characterized. The aim of the study was to assess the impact of malnutrition, as determined by the Nutritional Risk Score (NRS-2002), on in-hospital mortality. Methods: This retrospective, single-center study analyzed 222 patients hospitalized with COVID-19 during the Delta variant predominance. Thirty-one patients died during hospitalization. Malnutrition (NRS ≥ 3) emerged as a strong predictor of in-hospital mortality in univariate Cox proportional hazard models, both before and after adjustment for potential confounders. Adjusted analyses used 10 different sets of three out of five mortality-related variables. Results: Hazard ratios for malnutrition ranged from 3.19 to 5.88 (p < 0.01 for all models), highlighting its substantial impact on mortality risk. The high Nagelkerke’s R2 values (0.66–0.77) indicate that the models explained a significant proportion of mortality variance. Nutritional status plays a critical role in COVID-19 survival among hospitalized patients. Conclusions: Given its simplicity and effectiveness, integrating the NRS-2002 into routine clinical assessments may help identify high-risk patients early. Future research should explore whether early nutritional interventions can mitigate the mortality risks associated with malnutrition in severe COVID-19 cases or patients with other infectious diseases or acute inflammation.