The purpose of this study was to investigate whether elderly clients in an acute care setting perceived themselves as being treated with dignity and respect, and whether clients with a higher socioeconomic status are more likely than clients with a lower socioeconomic status to be treated with dignity and respect. Sixty-two elderly clients who had been in hospital at least five days, were alert and oriented during their hospitalization, and could speak English were selected for the study. Using a convenience sampling technique, the clients were selected from medical and surgical units of two major teaching hospitals. They were interviewed within three days after discharge to respond to items on a questionnaire selected from the Medicus Quality Assurance Tool. The results of the study show that elderly clients may not perceive that they are consistently treated with dignity and respect. Older clients (75+ years) are less likely than younger older clients (65-74) to be treated with dignity and respect, and elderly clients with a lower socioeconomic status and women, are less likely to be treated with dignity and respect. / Applied Science, Faculty of / Nursing, School of / Graduate

The purpose of the current study was to explore the relationship between cognitive status and depression in a sample of geriatric patients. Participants included 282 geriatric patients ranging in age from 65 to 96 years who were classified according to diagnosis as: DAT, VaD, MCI, and Norm. All were referred for neurocognitive testing from the Geriatric Assessment Program (GAP) at the University of North Texas Health Science Center (UNTHSC) in Fort Worth, Texas. This study sought to identify factor structures for two versions of the GDS using a geriatric sample of cognitively impaired and intact patients. It then compared these factors to each other to determine whether the GDS-15 is truly a shorter version of the GDS-30. These were then compared to a previously determined factor structure. This study explored whether the four-factors of the GDS-30 are able to differentiate cognitive diagnostic groups. Further, this study sought to identify whether the severity of cognitive decline impacted GDS factor score for each of the cognitively impaired groups. Results revealed a two-factor model of the GDS - 15 and a four-factor model with the GDS - 30. The GDS-15 factors did not differ from the first two factors of the GDS-30. Comparison between the GDS-30 factor structure and that reported by Hall and Davis (in press) revealed no significant differences despite the inclusion of a normal, non-demented group in the current study. Comparisons of subscale scores revealed that DAT patients tended to score lower than the other groups on all but the cognitive impairment subscale. Severity level analyses indicated that as severity of deficits increases, awareness of deficits decreases. This study found that although the GDS-30 is a good screening tool for depression in geriatric patients, it is not particularly useful in differentiating cognitive status group. Also, the GDS-15 was not found to be a good substitute for the GDS-30.

No description available.

Orientador: Paulo José Fortes Villas Boas / Resumo: Introdução: Atualmente a expectativa de vida mundial está aumentando significativamente. Avaliar a população assistida em centros de convivência permitirá ampliar a discussão acerca das atividades realizadas e propostas nesses locais, com ênfase na qualidade de vida dos idosos. Objetivo: Avaliar os idosos do Centro de Convivência do Idoso “Aconchego” em Botucatu quanto às síndromes geriátricas, capacidade funcional e uso de medicamentos. Métodos: Estudo observacional transversal, realizado entre o mês de janeiro de 2018 e abril de 2019, no Centro de Convivência do Idoso Aconchego, em Botucatu (SP). Foi realizada avaliação geriátrica amola quanto aos domínios capacidade funcional (escala de Katz, Pfeffer, escala de Lawton), cognição (Mini Exame do Estado Mental - MEEM), humor (escala de depressão geriátricade Yesavage), deficit sensorial dos idosos (teste da voz sussurrada e déficit visual), nutrição (índice de massa corpo- ral), fragilidade (índice Study of osteoporotic fracture e índice fenotípico de Linda Fried), continência urinária e questão social e familiar. Os idosos portadores de demência foram classificados quanto a gravidade pelo Clinical Dementia Ratio (CDR). Foi realizada análise descritiva, testes de associação (QuiQuadrado, T-stu- dent), sendo estatisticamente significativo quando o nível alfa foi < 0,05. Resultados: A amostra avaliada foi de 76 idosos, que tiveram a média de idade de 80,6 + 8,0 anos, sendo que 72,4% (55) eram do sexo feminino. 94,2% apresentava... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: The current world life expectancy is increasing significantly. Assessing the population assisted in social centers will allow a broader discussion about the activities carried out and proposed in these places, with emphasis on the quality of life of the elderly. Objective: To evaluate the elderly of the Center for the Cohabitation of the Elderly "Aconchego" in Botucatu regarding geriatric syndromes, functional capacity and medication use. Methods: Cross-sectional observational study, conducted between January 2018 and April 2019, at the Aconchego Shelter Center in Botucatu (SP). A geriatric evaluation was carried out in relation to functional capacity domains (Katz scale, Pfeffer, Lawton scale), cognition (Mental State Mini Examination), humor (Yesavage geriatric depression scale), sensorial deficit of the elderly (Index of osteoporotic fracture and Linda Fried's phenotype index), urinary continence, and social and family issues. Elderly people with dementia were classified as severity by the Clinical Dementia Ratio (CDR). A descriptive analysis, association tests (Chi-Square, T-student) was performed, being statistically significant when the alpha level was <0.05. Results: The sample evaluated was 76 elderly, who had a mean age of 80.6 + 8.0 years, and 72.4% (55) were female. 94.2% had cognitive impairment by MMSE, and 47.4% had a previous diagnosis of dementia. 55.3% were classified as overweight / obese. 41.7% of the elderly were classified as mild dementia a... (Complete abstract click electronic access below) / Mestre

Introdução: O envelhecimento populacional acelerado reafirma a necessidade da prestação de cuidados de longa duração e a instituição de longa permanência para idosos (ILPI) é uma das modalidades disponíveis. Pela demanda de cuidado, os enfermeiros estão inseridos na maioria dessas residências. Objetivo: compreender a vivência de enfermeiros no cuidado ao idoso que reside em instituição de longa permanência. Método: trata-se de pesquisa qualitativa, com abordagem fenomenológica, realizada com 11 enfermeiros que trabalham em ILPI. Os dados foram coletados por meio de entrevistas individuais, gravadas em áudio, com as seguintes questões norteadoras: Fale sobre sua vivência no cuidado ao idoso que reside em instituição de longa permanência e O que você espera com a sua atuação em ILPI? Os conteúdos foram transcritos e analisados individualmente, segundo o referencial da fenomenologia social de Alfred Schütz. Resultados: a partir da análise dos discursos foi possível identificar sete categorias concretas do vivido: dificuldades no trabalho, desvalorização profissional, vínculo, valorização do trabalho, oferecer assistência de boa qualidade, ser reconhecido e valorizar o idoso. A vivência do enfermeiro nesse mundo vida é permeada pela escassez de recursos financeiros, materiais e humanos, alta rotatividade de profissionais e qualificação insuficiente para o trabalho, gerando sentimento de insegurança. Também é marcado pela falta de autonomia, baixos salários, preconceitos e desrespeito nas relações interpessoais. Apesar das dificuldades vivenciadas, a formação de vínculos afetivos significativos com os idosos leva o enfermeiro a refletir sobre o processo de envelhecimento e promover uma assistência mais humanizada. A partir da percepção do valor social do trabalho, projeta melhorar a qualidade da assistência oferecida, por meio de qualificação adequada dos profissionais que atuam em ILPI, adequação do quantitativo de recursos humanos e a eliminação da sobrecarga de trabalho. Dessa forma, busca reconhecimento profissional, financeiro e social. Por fim, da vivência desse contexto emerge, no grupo social estudado, a consciência sobre a importância e a premência da mudança do valor do idoso em nossa sociedade. Espera-se que isso aconteça por meio de intervenções educacionais, com enfoque na redução do preconceito, na difusão do envelhecimento saudável e pela ampliação e efetividade de políticas públicas que priorizem a população idosa. Considerações finais: o presente estudo possibilitou a compreensão da ação de cuidar de idosos residentes em ILPI, sob a perspectiva de enfermeiros, evidenciando a vivência desse grupo social, marcada pela dificuldade no trabalho, pela aproximação afetiva com os idosos e pelas expectativas de transformar a realidade do cuidado ao idoso, vislumbrando um envelhecimento digno a todos. / Introduction: Accelerated populational aging reaffirms the need for long-term care, and long-term care institutions for the elderly (LTCI) is one of the available modalities. Given the care demands, nurses are inserted in the majority of these residences. Objective: to understand nurses experience in the care for elderly living in a long-term institution. Method: this is a qualitative research of phenomenological approach, conducted with 11 nurses working in LTCI. Data were collected through individual audio-recorded interviews with the following guiding questions: Talk about your experience in the care of the elderly living in a long-term institution and What do you expect from your performance at the LTCI?. The contents were transcribed and analyzed individually according to Alfred Schützs social phenomenology framework. Results: from the analysis of discourses, it was possible to identify seven concrete categories of the experience: work difficulties, professional devaluation, bonding, valorization of work, provision of good quality care, being recognized and valuing the elderly. Nurses experience in this world is permeated by the scarcity of financial, material and human resources, high turnover of professionals and insufficient qualification for the work, generating a feeling of insecurity. It is also marked by lack of autonomy, low salaries, prejudices and disrespect in interpersonal relationships. Despite the difficulties experienced, the formation of significant affective bonding with the elderly leads nurses to reflect on the aging process and promote a more humanized care. Based on the perception of the social value of work, nurses plan to improve the quality of care provided by means of adequate qualification of professionals working in LTCI, adequate human resources quantitatively, and the elimination of work overload. This way, they seek professional, financial and social recognition. Finally, from the experience in this context, in the studied social group emerges the awareness about the importance and urgency of changing the elderlys value in our society. This is expected to happen through educational interventions focused on reducing prejudice, disseminating healthy aging, and by the expansion and effectiveness of public policies that prioritize the elderly population. Final considerations: the present study enabled an understanding about the action of caring for elderly people living in LTCI from the nurses perspective. It showed the experience of this social group is marked by work difficulties, affective approximation to the elderly and expectations of transforming the reality of care for the elderly, with the view of aging with dignity for all.

Elderly people, or those over 65 years of age, are known to comprise 10% of the United States population today and are projected to reach nearly 12% by the year 2000. Further, 5% of this population is reported to be institutionalized resulting in approximately 1.1 million chronic care patients or 0.5% of the population. The use of drugs in this population comprises approximately 25% of the prescription drug market in the United States which is directly related to the greater occurrence of pathological problems associated with the aging process. While it is evident that the beneficial outcome of drug therapies is partially related to the increased longevity observed in these elderly people, this population is also well-known to be the most prone to adverse drug reactions. Factors complicating drug use in the elderly include high usage, chronic therapy, long-term hospitalization, inappropriate and multiple prescribing of drugs, inadequate monitoring of adverse drug effects, susceptibility to physical deterioration and senility. Therefore, the objective of this project is to test the hypothesis that the quality and cost of drug therapy in SNF patients can be significantly improved by implementing measures to improve the utilization of drugs.

INTRODUCTION : La majorité des cancers survient chez la personne âgée. Cette population est hétérogène du fait de la prévalence de comorbidités, d’incapacités et de syndromes gériatriques contribuant à la fragilité. Ces éléments rendent complexe le choix de la stratégie thérapeutique à adopter. L’évaluation gériatrique approfondie (EGA) est recommandée pour évaluer la fragilité de ces patients. L’objectif général était d’identifier parmi les patients âgés de 70 ans et plus atteints de cancer, ceux qui présentaient un haut risque de morbi-mortalité afin de limiter les thérapeutiques agressives et proposer une prise en charge adaptée. Les objectifs spécifiques étaient : 1/d’identifier les facteurs oncologiques et paramètres de l’EGA conjointement associés au décès à 1 an, 2/d’identifier des profils de santé et de les valider sur la morbi-mortalité, 3/ d’évaluer la concordance entre 4 classifications de fragilité et de comparer leurs performances pronostiques. METHODES : ces travaux ont été réalisés à partir de la cohorte dynamique prospective ELCAPA (Elderly CAncer PAtient) qui inclut consécutivement tous les patients âgés de 70 ans et plus, avec un diagnostic de cancer solide ou hématologique et adressés en consultation d’oncogériatrie, dans 2 centres hospitalo-universitaires parisiens. Entre 2007 et 2012, 1 021 patients ont été inclus. Les critères de jugements étaient la mortalité globale à 1 an, les hospitalisations non programmées à 6 mois et la décision finale de traitement (curative, palliative). Nous avons analysé les facteurs associés au décès à 1 an de 993 patients à l’aide de modèles de Cox. Nous avons ensuite réalisé une analyse en classes latentes (ACL) sur cas-complets (n=821), avec analyses de sensibilité incluant les données manquantes (n= 1 021), puis selon le statut métastatique et validé cette typologie sur 375 nouveaux patients inclus dans la cohorte. La dernière étude a été réalisée sur 763 patients avec données complètes pour 4 classifications étudiées à l’aide de modèles de Cox (décès) et régression logistique (hospitalisations).RESULTATS: L’âge moyen était de 80,2 ans, 51,2% étaient des hommes, 21,4% avaient un cancer colorectal et 45% des métastases. Le nombre de comorbidités sévères (P≤0,05), la dénutrition (P<0,001), l’âge >80 ans (P≤0,05), le site tumoral et statut métastatique (P<0,001) étaient associés au décès à 1 an indépendamment de la perte d’autonomie (ADL ou PS) et de l’altération de la mobilité (GUG) (P<0,001). L’ACL nous a permis d’identifier 4 profils: ceux relativement en bonne santé [LC1, 28,3%], dénutris [LC2, 35,8%], avec troubles cognitifs et humeur [LC3, 15,1%] et globalement altérés [LC4, 20,8%]. Les comparaisons 2 à 2 ajustées montraient que les patients LC2, LC3 et LC4 avaient un risque de décès, d’hospitalisations et de décision palliative plus élevé que les LC1. Les patients LC4 avaient un risque de décès et de décision de traitement palliatif plus élevé que les patients LC2 et LC3. Aucune différence entre les LC2, LC3 et LC4 n’était observée pour les hospitalisations. La distribution des patients variait selon les 4 classifications, i.e., la typologie en classes latentes, la classification de Balducci, et les classifications SIOG 1 et 2 (P<0,001). La concordance entre ces 4 classifications était globalement faible à modérée. Pour le décès, la discrimination était bonne pour les 4 modèles (C≥0,70) avec des performances légèrement supérieures pour la classification SIOG 1. Pour les hospitalisations, les performances de ces 4 classifications étaient bonnes et similaires (C≥0,70). Aucune classification n’a montré de meilleures performances pour l’ensemble des cancers les plus fréquents. CONCLUSIONS : Nous avons montré l’utilité de l’EGA notamment de certains paramètres pour identifier parmi les patients âgés atteints de cancer, ceux qui sont « fragiles ». Des études sont nécessaires pour évaluer l’impact de l’EGA sur la morbi-mortalité et la qualité de vie de ces patients. / INTRODUCTION: The majority of cancers are diagnosed in the elderly. This population is heterogeneous due to the prevalence of comorbidities, disability and geriatric syndromes that contribute to frailty. These elements make the decision complex as well as the choice of the optimal therapeutic strategy. Geriatric assessment (GA) is recommended to assess frailty in older patients with cancer. The aim of this thesis was to identify among patients aged ≥70 years who had solid or hematologic malignancies, those with a higher risk of morbidity and mortality, to limit aggressive treatments, and improve their management. Specific objectives were : 1/ to identify both cancer-related factors and CGA findings associated with 1-year mortality, 2/ to identify health profiles based and validate these profiles on morbimortality, and 3/ to compare agreement among four frailty classifications based on GA findings and to compare their performance in predicting 1-year overall mortality and 6-month unscheduled admissions.METHODS: These various works were carried out from the prospective ELCAPA (ELderly CAncer PAtient) cohort study that includes consecutive patients aged 70 years or older who had newly diagnosed solid or hematologic malignancies and were referred to two geriatric oncology clinics in teaching hospitals in the Paris urban area, France. Between 2007 and 2012, 1021 patients were included. The primary outcomes included 1-year overall mortality, 6-month unscheduled hospitalizations, and the final planned treatment decision (curative, palliative). We assessed factors associated with 1-year overall mortality among 993 patients using Cox models. Then, we performed a complete-cases latent class analysis (LCA, n=821) with the following sensitive analyses: among patients with missing data (n=1 021), according to metastatic status, and then validating our typology in a different patient sample of the ELCAPA cohort (n=375). Finally, the last study included 763 patients with complete data for the 4 studied classifications using Cox models (mortality) and logistic regression models (hospitalizations).RESULTS: Mean age was 80.2 years, 51.2% were male, 21.4% had a colorectal cancer and 45% a metastatic disease. A higher number of severe comorbidities (P<0.05), malnutrition (P<0.001), age >80 years (P<0.05), tumor site and metastatic status (P<0.001) were associated with death independently from impaired ECOG-PS (P<0.001), ADL (P<0.001), and GUG (P<0.001). LCA displayed 4 health profiles: those relatively healthy [LC1, 28.3%], malnourished [LC2, 35.8%], with cognitive and/or mood impairments [LC3, 15.1%], and gloablly impaired [LC4, 20 8%]. In adjusted pairwise comparisons, compared to LC1, the three other LCs were associated with higher risks of palliative treatment, death, and unplanned admission. LC4 was associated with 1-year mortality and palliative treatment compared to LC2 and LC3. For unplanned admissions, no differences were demonstrated across these three LCs. Patient distribution differed significantly across the four classifications, i.e., Latent class Typology, Balducci, SIOG1 and SIOG2 (P<0.001). Agreement between these four classifications was globally poor to moderate. For mortality, discrimination was good for the 4 models (C-index ≥0.70) with slightly better performance for SIOG 1-model. For hospitalizations, performance was good and close between the four models (C-index ≥0.70). None of the four classifications performed best for all the three tumor sites.CONCLUSIONS: We showed the usefulness of GA and especially some GA-parameters to identify among older patients, those who are frail. Intervention studies are needed to assess the impact of GA on morbi-mortality and quality of life of those patients.

In  Anbetracht  der  steigenden  Zahl  an  älteren  und  multimorbiden  Patienten  in  Deutschland und  den  westlichen  Nationen  stellt  die  Geriatrie  eine  der  größten  gesundheitspolitischen, ökonomischen  und  sozialen  Herausforderungen  unserer  Gesellschaft  dar.  Die  Implementie‐ rung  der  Geriatrie  in  die  universitäre  Lehre  von  Studierenden  der  Medizin  ist  daher  essentiell.  Dabei  ist  die  Handhabung  geeigneter  geriatrischer  Screeningverfahren  im  klinischen Alltag  ein  wichtiger  Bestandteil,  um  Abläufe  zu  vereinfachen,  Diagnostik  und  Therapie  zu  individualisieren und Kosten zu reduzieren.   Das  geriatrische  Assessment  in  Form  des  STEP‐Assessments  (Standardisiertes  evidenzbasiertes  präventives  Assessment  älterer  Menschen  in  der  medizinischen  Primäreversorgung)  ist ein  solches  Screeningverfahren,  welches  im  Rahmen  des  Blockpraktikums  Allgemeinmedizin an  der  Universität  Leipzig  von  Medizinstudierenden  durchgeführt  wird.  Es  erfasst  ein breites Spektrum an Bedürfnissen in vielen unterschiedlichen Lebensbereichen  geriatrischer Patienten  und  scheint  daher  besonders  für  die  Sensibilisierung  von  Studierenden  der  Medizin  für die  Komplexität  der  Geriatrie  geeignet  zu  sein.  Zur  Verbesserung  der Auswertungsquantität und ‐genauigkeit  des  geriatrischen  Assessments  wurde  eine  Checkliste  als  strukturierende Interpretationshilfe  installiert.  In  dieser  Studie  wird  der  Effekt  dieser  Checkliste  im  Vergleich zweier Kohorten von Studierenden untersucht. Als weitere Indikatoren für die mögliche Verbesserung  der  Auswertungsquantität  und ‐genauigkeit  wurde  die  Benotung  des  Blockpraktikums, sowie für die Zufriedenheit der Studierenden mit dem  Blockpraktikum eine Evaluation herangezogen.  Bei  statistisch  belegter  Vergleichbarkeit  der  Patientenkohorten,  fanden  wir  bei  nahrzu  allen  STEP‐Themen  mehr  Dokumentation  durch  die  Studierenden,  denen  die  Checkliste  als  Interpretationshilfe  vorlag.  Durch  diese  checklistenassoziierte  Steigerung  der  Dokumentationsquantität  und  ‐genauigkeit  ließ  sich  eine  signifikante  Verbesserung  der  Noten  der  Studierenden  mit  Checkliste  gegenüber  derer  ohne  Checkliste  verbuchen.  Die  Analyse  der Evaluation zeigte jedoch, dass die Studierenden mit Checkliste mit dem Blockpraktikum nicht signifikant zufriedener waren.  In  der  Gegenüberstellung  der  Auswertungen  des  geriatrischen  Assessments  durch  die  Studierenden  mit  der  aktuellen  Fachliteratur  und  Leitlinien  stellte  sich  stellenweise  eine  Diskrepanz  dar.  Die  von  den  Studierenden  empfohlenen  Diagnostik‐  oder  Therapieansätze  waren zwar stets medizinisch korrekt, entsprachen jedoch nicht immer den empfohlenen klinischen Leitlinien.  Es  stellt  sich  die  Frage,  ob  dies  bei  noch  nicht  abgeschlossenem  Studium  von  den Studierenden  erwartet  werden  kann,  oder  ob  indikationsgerechte  und  zielführende  Vorschläge ausreichend sind.   Die  Ergebnisse  dieser  Untersuchung  zeigen,  dass  ein  Screeninginstrument  mit  der  Komplexität  eines  STEP‐Assessments  erst  in  Kombination  mit  einer  strukturierenden  Interpretations‐ hilfe  in  Form  einer  Checkliste  von  den  Studierenden  sachgerecht  gehandhabt  werden  kann.  Es  konnte  eine  Steigerung  der  Auswertungsgenauigkeit  sowie ‐quantität  gesehen  werden, was  zu  der  Vermutung  führt,  dass  dies  ebenfalls  zu  einer  Erhöhung  des  Lernerfolges  bei  den Studierenden  gereichte.  Eine  Verbesserung  der  Art  der  Implementierung  der  Checkliste  und deren  gesonderte Evaluation  wären wünschenswert,  um  die  Zufriedenheit  der  Studierenden mit der Checkliste messbar zu machen.  Ein Rückschluss dieser Ergebnisse auf bereits spezialisierte  Allgemeinmediziner  oder  Geriater  liegt  nahe  und  sollte  in  einer  weiteren  Studie  eingehend untersucht werden.

Background Disability rates increase with age. In 2012, Peruvian older adults ( 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown. Objective This study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty. Methods Secondary analysis of a national representative population based survey that utilizes information from Peru’s 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru’s available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported. Results Data from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (p<0.05). Conclusions This study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population. / Wellcome Trust / Revisión por pares

Title: Ageing of the population and specific aspects of prescribing of hypnotics in older adults (II.) Student: Karolína Puldová, Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Czech Republic Supervisor: Assoc. Prof. Daniela Fialová, PharmD, Ph.D., Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové and Department of Geriatrics and Gerontology, 1st Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic Introduction: World population is ageing and rational geriatric pharmacotherapy receives increasing attention. In seniors, rational pharmacotherapy is complicated by many risk factors, especially by physiological and pathological changes accompanying ageing, polymorbidity, polypharmacy, higher risk of adverse drug events, drug interactions and other risk factors. Particularly psychotropics belong to drug classes where rational prescribing in seniors often requires respecting of different rules. This diploma thesis focuses on specific aspects of irrational prescribing of hypnosedatives in ambulatory geriatric patients, particularly in the area of use of nongeriatric doses and nongeriatric lenght of therapy. Methodology: Data collection for this diploma thesis has been conducted between 2019-2020 years in the...