title: Dermatological disease in the older age group: a cross-sectional study in aged care facilities.
abstract: OBJECTIVE
  To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease.
  
  
  METHODS
  2 large aged care facilities in Auckland, New Zealand, each providing low and high level care.
  
  
  METHODS
  All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited-66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years).
  
  
  METHODS
  Primary--presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary--functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score).
  
  
  RESULTS
  81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment.
  
  
  CONCLUSIONS
  A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer). Those with less significant physical impairment were found to be at greater risk of inflammatory dermatoses.
authors.affiliation: Department of Dermatology, Middlemore Hospital, Auckland, New Zealand.
authors.forename: Maneka S
authors.initials: MS
authors.lastname: Deo
authors.affiliation: Faculty of Medical and Health Sciences, School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: Ngaire
authors.identifier: http://orcid.org/0000-0002-5992-3681
authors.initials: N
authors.lastname: Kerse
authors.affiliation: Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand and Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand.
authors.forename: Alain C
authors.initials: AC
authors.lastname: Vandal
authors.affiliation: Department of Dermatology, Middlemore Hospital, Auckland, New Zealand Department of Medicine, The University of Auckland, Auckland, New Zealand.
authors.forename: Paul
authors.initials: P
authors.lastname: Jarrett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012871:Skin Diseases / Q000453:epidemiology* / Q000209:etiology
keywords: EPIDEMIOLOGY; HEALTH ECONOMICS; PUBLIC HEALTH