@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2017;9(2):97-103

Background
The growing population of elderly people has attracted the attention of policy makers, as they predict an increasing rise in social health care and an increase in the population of younger generations [1]. … [2-13]. Increasing the age of veterans with an average age of 54 years has accelerated the beginning of aging process. Therefore, conducting research projects for this foundation in order to be aware of their health status will be a contributor [14].
Previous Studies
The study by McCall et al. found that American with spinal cord injury had better mental health status than Canadians and English, and Canadians had more complications of disability compared to the other two countries, that the reasons are not clear [12]. The less a person has spinal cord injury, the less depression and anxiety he will have [13].
Aim(s)
The purpose of this study was to comprehensively review the health status of spinal cord of elderly veterans over the age of 60 years.
Research type
This is a descriptive cross-sectional study.
Research society, place and time
This research was conducted in 2011 among all elderly spinal cord injured veterans aged over 60 years old from provinces throughout the country who participated in a health resort.
Sampling method and number
For this study, 53 samples were entered into the study by census method.
Used devices&materials
The following questionnaires were used to collect data: 1- Mini Nutritional Assessment (MNA): This questionnaire is appropriate for initial studies of nutrition along with investigation of albumin level in the blood. The validity and reliability of original version of this tool is confirmed by Gigoos et al. [15] and its Persian version has been confirmed by Yahya Pasdar et al. [16]. 2-Norton Substance Ulcer Risk Questionnaire: This tool is used to evaluate the risk of bedsore wounds with five items on incontinence issues (urine and stool), mobility, independent activity, mental status, and general condition. Validity and reliability of the original version of the questionnaire have been verified [17]. 3- Mini-Mental State Examination (MMSE): The MMSE test is most commonly used in the elderly to examine cognitive impairment. Validity and reliability of the original version of this tool has been verified by Buban et al. [18] and its Persian version has been reviewed and translated by Sidian et al. [19]. 4. Geriatric Depression Scale (GDS): It is about mental health status. The validity and reliability of the original version of this tool is confirmed by Yasavaj et al. [20] and its Persian version has been confirmed by Malakooti et al. [21]. 5- Lawton Instrumental Activities of Daily Living (IADL): The Lawton tool examines the complex daily activities with the help of tools. The validity and reliability of the original version of this tool has been confirmed by Lawton et al. [22] and its Persian version has been confirmed by Hasanimehraban et al. [23]. 6- Barthel Scale of Determining Level of Need and Dependence: Barthel's tool is used to determine the level of need and dependence of the elderly in everyday life. Determining the validity and reliability of the original version of this tool has also been carried out by Sullivan and Schmidts [24]. Data analysis was performed using descriptive and inferential statistics and SPSS 14 software. The Chi-square test was used to determine the relationship between the variables of the research, and the Mann-Whitney test was used to determine the relationship between age and cognitive disorder status.
Findings by Text
Totally, 53 elderly spinal cord veterans (40.8%) from the entire elderly spinal cord community (130) participated in the study. Of these, one (1.9%) was female and single, and the rest were male and married. All the spinal cord veterans were subject to employment law for 70% disability. In mini nutritional assessment (MNA), 24 (45.3%) had proper nutrition, 27 (50.9%) had a malnutrition risk and 2 (8.3%) had malnutrition. In the study of the risk of bed sore, 74 (88.7%) of the studied population had the risk of developing bedsore. In cognitive and assessment of cognitive impairment, 47(88.8%) had no cognitive impairment or mild cognitive impairment. 6(11.3%) of the subject had intermediate cognitive impairment and none of them had severe cognitive impairment. In studying the depression in the elderly, 21(39.6%), 18(34.0%), 9(17.0%) and 5(9.4%) had no depression, mild depression, moderate depression and severe depression respectively. With regards to daily activities with the help of instrument (IADL), 35 (66.0%), 17 (32.1%), and 1 (1.9%) were independent, needed, and completely dependent respectively. In determining the level of need and dependence of the elderly in everyday life, 2(3.8%), 13 (24.5%), 28(52.8%), 6(11.3%), and 4(3.8%) were completely dependent, severely dependent, moderately dependent, mildly dependent, and minimally dependent respectively (Table 1). There was a significant relationship between nutrition status and depression variables (p<0.001), daily activities with the help of tools (p=0.04), and the level of need and dependency in everyday life (p=0.038). Also, there was a significant correlation between age in spinal cord veterans and cognitive impairment (p=0.004), that is as the age was increasing, the mean score of cognition was significantly decreasing.
Main comparison to the similar studies
… [25].In more than half of the spinal cord veterans, there was a risk of malnutrition. Nutrition is one of the influencing factors in postponing or controlling chronic diseases such as coronary artery disease, some types of cancers, stroke, and type 2 diabetes [26]. … [27, 28]. In a study by Goghtay and Nezhati on 120 elderly people in Kashan using a Standard Tool for Comprehensive Health Assessment [29], it was found that these people are respectively at risk of malnutrition, depression, and cognitive impairment. In this study, the risk of sole bed in elderly spinal cord veterans was high due to spinal cord injury and immobility which was predictable. Although a similar study has not been carried out in this field, it was higher compared to the study by Goghtai and Nejati [29]. … [30]. Of the common mental illnesses in the elderly is a depression that may not have its usual symptoms, and symptoms may be due to loss of appetite, sleep disorders, sadness, frustration, and lack of adequate energy for daily activities [31] …[32]. One of the tools used to measure depression in an elderly person is the GDS tool [33]. Reducing environmental stresses in the living of the elderly, holding recreational and educational camps, adapting the living environment and meeting their needs can contribute to reduce the amount of depression … [34].
Suggestions
It is suggested that in future studies, complete information about the history of diseases, important risk factors such as cigarettes and narcotics, the level of familiarity of family members with the elderly spinal cord veteran’s needs and the assessment of life quality be considered.
Limitations
The nature of the spinal cord injury of these loved veterans who are wheelchair users, and secondary complications due to lack of mobility, and the scattered presence of spinal cord disabled people in different cities requiring adequate vehicles and costs, prevented all elderly spinal cord veterans from participating in study. Other limitations of this study were the lack of record of previous history of diseases.
Conclusions
Most elderly spinal cord veterans over 60 years of age, with no cognitive disorder, have the signs of depression and are at risk of malnutrition and sole bed. They are dependent in all day-to-day affairs and they are independent in instrumental activities of daily living (IADL).
Acknowledgments
All the elderly spinal cord veterans who helped us in conducting the research, as well as the chairman of the Institute of Engineering and Medical Sciences of Veterans, Dr. Soroush, and the professors of the Department of Aging of the University of Social Welfare and Rehabilitation Sciences, in particular Dr. Sahaf, are appreciated.
Conflict of interest
Non-declared
Ethical Permissions
All samples while being described the complete process of research by the researcher, completed the consent form of participation in the research project before participating in the study.
Funding Sources
The funding of this project is from the personal income of the researcher and support of Deputy of Health of the Foundation of Martyr and the Veterans Affairs.

TABLES and CHARTS

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