Purpose: The aims of this study were to explore prevalence of health-related problems and identify factors associated with health-related quality of life (HRQOL) among community-dwelling older adults (CDOAs) in rural Thailand. Methods: A total of 384 CDOAs with mean age of 71 years (SD = 7.6) were recruited. The Thai Ministry of Public Health’s comprehensive geriatric assessment (CGA) was used to measure the CDOAs’ health conditions in the primary care unit of community hospitals. HRQOL of the participants was assessed by using the EQ-5D questionnaire. Results: The results showed that the most common health-related problems were risk of glaucoma (89.6%) and hypertension (64.6%). The HRQOL were predicted by the incidence of falls (β = −0.076, P < .001), Timed Up and Go Test (β = −0.087, P < .001), and age (β = −0.667, P = .002). Discussion: This study highlighted the need to incorporate CGA in family practice, which included risk of falls assessment by measuring TUG test, fall prevention, and to provide resources for caring older adults at home which ultimately will improve CDOAs’ quality of life.

A 56-year-old Thai female was referred to Naresuan university hospital with anemia and pitting edema both legs. She had underlying diseases of hypertension, hypercholesterolemia and chronic renal failure with anemia. Before her referral, she was treated by an internist at a provincial hospital. With deterioration of creatinine level and anemic symptom, she was advised to see a nephrologist for the diagnosis of causative pathology and treatment. The reevaluation of chronic renal failure was done. The results of laboratory investigation were creatinine level of 2.42 mg/dl, blood urea nitrogen (BUN) 44 mg/dl and the urinalysis found microscopic hematuria. Further evaluations for hematuria ; vaginoscopy, cystoscopy and ultrasonography of genitourinary system, were performed consequently but all investigations were unremarkable. Then, renal biopsy was done with the result of anti-glomerular basement membrane glomerulonephritis. The hemodialysis and total plasma exchange were done several times to reduce the antibody of anti glomerular basement membrane level.During her admission, she complained of sudden blurred vision both eyes after the ninth total plasma exchange. She has no previous ocular problems nor physical trauma. The ocular examination showed visual acuity of counting fingers both eyes. Anterior segment was unremarkable for her age. The posterior segments showed retinal thickening around the posterior poles with clear intervening zones both eyes with some intraretinal hemorrhage which was compatible with Purtscher-like retinopathy by clinical. The pathogenesis of Purtscher-like retinopathy was investigated with negative results. The counseling was done and the treatment of observation was chosen by the patient and her family. Then she was discharged and followed up at out patient unit of ophthalmology department, Naresuan university hospital.   Conclusion: The Purtscher-like retinopathy is a rare ocular disease with  variable treatment strategies and outcomes. In complicated case without obvious causes, the pathogenesis of the disease should be investigated which directed to the proper treatment and better visual outcome.