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Sample records for reported elder self-neglect

  1. Elder self-neglect: research and practice

    Directory of Open Access Journals (Sweden)

    Dong XQ

    2017-06-01

    Full Text Available XinQi Dong Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA Abstract: Elder self-neglect is a global public health and human rights issue that threatens older people’s health and safety. It commonly refers to refusal or failure to provide oneself with care and protection in areas of food, water, clothing, hygiene, medication, living environments, and safety precautions. While prevalent, the status of self-neglecting individuals remains largely unclear, in particular within community-dwelling populations. By reviewing the epidemiology of elder self-neglect (definition, prevalence, risk factors, and consequences to date, the present paper identifies key research gaps such as methodological inconsistency in case identification and measurement, and study designs that are inadequate to determine risk factors of self-neglect. More importantly, in light of the rapidly growing older population, relevant stakeholders (researchers, healthcare providers, social service providers, legal professionals, community organizations, and policymakers must be prepared for an expected increasing number of self-neglect cases and enlarging scope of the problem. Hence, in this article, I present an overview regarding the management issues of elderly self-neglect related to the detection, assessment, reporting and referral, and decision-making capacity. Based on the current literature, the paper is aimed to explore the present knowledge and challenges, and how they can pave the way for solutions to self-neglect research, practice, and policy. Keywords: elderly self-neglect, elder abuse, self-neglect future directions 

  2. Tocopherol in Elder Self-Neglect

    Science.gov (United States)

    Aung, K.; Burnett, J.; Dyer, C.; Smith, S. M.

    2009-01-01

    Although elder self-neglect is the most common form of elder mistreatment, its pathophysiology is not well understood. Alpha-tocopherol is a lipid soluble antioxidant required for the preservation of cell membranes. Since the association between tocopherol and cognitive impairment in older adults has been described, we explored the possibility of its role in elder self-neglect. OBJECTIVE: (1) To determine whether serum tocopherol levels are associated with elder self-neglect, and (2) to assess the association of serum tocopherol levels and cognitive function in elder self-neglect. METHODS: Serum tocopherol levels were measured in a cohort of 67 self-neglecting elders and 67 matched controls, recruited for the Consortium for Research in Elder Self-neglect of Texas. Pearson s correlation tests were performed to assess bivariate associations between serum tocopherol levels and cognitive function. RESULTS: Mean serum alpha-tocopherol levels were 10.8 +/- 4.7 ug/mL in self-neglect group and 13.0 +/- 4.9 ug/mL in control group (p = 0.006, unpaired student s t-test). None of the participants from either group had alpha-tocopherol level lower than the reference range. Mean serum gamma-tocopherol levels were 2.0 +/- 1.0 ug/mL in self-neglect group and 2.0 +/- 1.1 in control group (p=0.83). Proportion of the elders with gamma-tocopherol level lower than the reference range were 4.5% (3/66) in self-neglect group and 10.4% (7/67) in control group (p=0.32, Fisher s Exact Test). Among the self-neglecting elders, no association was found between serum alpha-tocopherol levels and the Mini-Mental State Examination (MMSE) or the Wolf-Klein Clock Drawing Test (CDT) scores (r =-0.42, p=0.75 for MMSE; r=0.08, p=0.54 for CDT). No association was found between serum gamma-tocopherol levels and the MMSE or the CDT (r=-0.12, p=0.35 for MMSE; r=0.05, p=0.68 for CDT). CONCLUSION: In our sample, neither alpha-tocopherol nor gamma-tocopherol appears to have a role in pathophysiology of elder

  3. Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

    Science.gov (United States)

    Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

    2017-10-01

    Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Homocysteine and Cognitive Performance in Elders with Self-Neglect

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    Burnett, J.; Smith, S.M.; Aung, K.; Dyer, C.

    2009-01-01

    Elevated plasma homocysteine has been associated with altered cognitive performance in older adults. Elders referred to Adult Protective Services (APS) for self-neglect have been reported to have elevated plasma homocysteine levels and to suffer from cognitive impairment. This study assesses the association, if any, between plasma homocysteine and cognitive performance among elders with self-neglect. Methods: Sixty-five community-living adults, 65 years of age and older, reported to Adult Protective Services for self-neglect and 55 matched controls (matched for age, ethnicity, gender and socio-economic status) consented and participated in this study. The research team conducted in-home comprehensive geriatric assessments which included the mini-mental state exam (MMSE), the 15-item geriatric depression scale (GDS), the Wolf-Klein Clock Drawing Tests (CDT) and a comprehensive nutritional biochemistry panel, which included plasma homocysteine. Student s t tests and Pearson correlations were conducted to assess for bivariate associations. Results: Elders with self-neglect had significantly higher plasma homocysteine levels (M=12.68umol/L, sd=4.4) compared to the controls (M=10.40umol/L, sd=3.61;t=3.21, df=127, p=.002). There were no statistically significant associations between cognitive performance and plasma homocysteine in the self-neglect group, however there was a significant correlation between plasma homocysteine and the CDT among the controls (r=-.296, p=.022). Conclusion: Mean plasma homocysteine levels were significantly higher in elders with self-neglect, however, they do not appear to be related to cognitive performance, indicating that cognitive impairment in elder self-neglect involve mechanisms other than hyperhomocysteinemia. These findings warrant further investigation

  5. Fat-Soluble Vitamin Status in Self-Neglecting Elderly

    Science.gov (United States)

    Kala, G.; Oliver, S. Mathews; Kelly, P. A.; Pickens, S.; Burnett, J.; Dyer, C. B.; Smith, S. M.

    2006-01-01

    Elder self-neglect is a form of elder mistreatment. The systematic characterization of self-neglecting individuals is the goal of the CREST project. Reported here is the evaluation of fat-soluble vitamin status. Self-neglect (SN) subjects were recruited and consented following referral from Adult Protective Services. Control (CN) subjects were matched for age, gender, race, and socioeconomic status, as possible. We report here on 47 SN subjects (age 77 plus or minus 7, mean plus or minus SD; body weight 76 kg plus or minus 26) and 40 CN subjects (77 y plus or minus 7, 79 kg plus or minus 20). Blood samples were analyzed for indices of fat-soluble vitamin status. Plasma retinol (p less than 0.01) was lower in SN subjects. Plasma tocopherol tended (p less than 0.06) to be lower in SN subjects, while gamma-tocopherol was unchanged. SN subjects tended to have lower serum 25-OH vitamin D (p less than 0.11), and to be vitamin D deficient (26% below 23 mmol/L). Hypercalcemia occurred more often in SN subjects (23% had values above 2.56 mmol/L), as did elevated parathyroid hormone concentrations (p less than 0.05). These data demonstrate that many nutrients are affected in the self-neglecting elderly, and that long-term deficits are evident by the nature of changes in fat soluble vitamins.

  6. Future research: a prospective longitudinal study of elder self-neglect.

    Science.gov (United States)

    Dyer, Carmel Bitondo; Franzini, Luisa; Watson, Mary; Sanchez, Luis; Prati, Laura; Mitchell, Stacy; Wallace, Robert; Pickens, Sabrina

    2008-11-01

    In almost every U.S. jurisdiction, elder self-neglect is the most common allegation addressed by Adult Protective Service (APS) agencies. Not only is self-neglect common, but this form of mistreatment is an independent risk factor for death. A lack of understanding of the precipitating factors and root causes and of the effect on social and medical systems persists in this field. Research in this area has been limited, because the needs of these vulnerable elderly people are complex and diverse. Moreover, these factors encompass interrelated medical, psychiatric, economic, social, and functional problems. In 2004, the National Institutes of Health Interdisciplinary Roadmap Initiative provided the means for preliminary exploration of elder self-neglect through the formation of the Consortium for Research in Elder Self-neglect of Texas (CREST). The goals of CREST include to conduct pilot studies, form interdisciplinary working groups, convene a national research conference, and appoint a national external advisory board. CREST orchestrated the work of 35 interdisciplinary investigators to achieve these goals. CREST researchers have begun to characterize the population of vulnerable elderly people who were reported to APS for neglecting themselves. The pilot studies provided a snapshot of 100 elderly people who had neglected themselves. A proposed next phase could involve a prospective longitudinal study of elderly people with severe self-neglect. This study of the clinical course, the death rate, the causes of death, the occurrence of acute and chronic medical or mental illness, and the costs to the healthcare and social systems would greatly inform the field of elder mistreatment.

  7. Elder Self-neglect and Suicidal Ideation in an U.S. Chinese Aging Population: Findings From the PINE Study.

    Science.gov (United States)

    Dong, XinQi; Xu, Ying; Ding, Ding

    2017-07-01

    Self-neglect and suicidal ideations are important public health issues among the aging population. This study aims to examine the association between self-neglect, its phenotypes, and suicidal ideation among U.S. Chinese older adults. Guided by a community-based participatory research approach, the Population Study of Chinese Elderly in Chicago (PINE) study is a population-based epidemiological study conducted from 2011 to 2013 among 3,159 Chinese older adults aged 60 years and older in the Greater Chicago area. Self-neglect was assessed by a 27-item instrument, describing five phenotypes with hoarding, poor personal hygiene, unsanitary condition, lack of utilities, and need of home repair. Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Logistic regression is utilized to analyze the association. Higher level of self-neglect was found significantly associated with increased risk of self-reported suicidal ideation within 2 weeks (odds ratio 2.97 [1.54-5.72]); 12 months (odds ratio 2.82 [1.77-4.51]); and lifetime (odds ratio 2.74 [1.89-3.95]). For phenotypes, the study found that poorer personal hygiene and severer level of unsanitary conditions were associated with increased risk of suicidal ideation at all three time periods. This study suggests that self-neglect and its phenotypes are significantly associated with suicidal ideation among Chinese older adults. Longitudinal studies are needed to explore the mechanisms through which self-neglect links with suicidal ideation. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. The First Intervention Study in Elder Self-Neglect: A Randomized Clinical Trial to Improve Vitamin D Levels

    Science.gov (United States)

    Burnett, Jason; Hochschild, Ann; Smith, Scott M.; Diamond, Pam; Stotts, Angela; Dyer, Carmel

    2011-01-01

    Despite high mortality rates, elder self-neglect is characterized by refusal of medical and social interventions. To date there have been no tested clinical interventions in elders who self-neglect. Previous research from the TEAM Institute has shown significantly low vitamin D levels in this population. This study aimed to determine the feasibility of a clinical intervention. Replacement of vitamin D was chosen because of its ease of administration and favorable safety profile. Methods: A randomized clinical trial using directly observed therapy of vitamin D was conducted using 50 elders, >65 years of age, with Adult Protective Services (APS) validated self-neglect. A staggered intervention with waiting controls was used to maximize statistical power. One-third (n=17) of the group was administered 50,000 IU vitamin D2 (ergocalciferol) monthly and the remainder (n=33) were administered 400 IU monthly. Serum 25-OH vitamin D was assessed at baseline and 5-months. Results: 69% agreed to participate in the study and of those n=40 (80%) remained at 5-months. At baseline, 12% (n=7) were deficient in vitamin D (vitamin D levels (vitamin D level was 59 nmol/L +25 (mean SD), and increased significantly to 72nmol/L +21 nmol/L at 5-months. Conclusion: These data are the first to provide evidence that clinical interventions are feasible in elders who self-neglect. The increase in vitamin D levels confirmed that the study personnel were able to successfully intervene community-dwelling elders with self-neglect. This study sets the precedent for future intervention and prevention studies

  9. Narratives of Self-Neglect: Patterns of Traumatic Personal Experiences and Maladaptive Behaviors in Cognitively Intact Older Adults.

    Science.gov (United States)

    Lien, Cynthia; Rosen, Tony; Bloemen, Elizabeth M; Abrams, Robert C; Pavlou, Maria; Lachs, Mark S

    2016-11-01

    To identify patterns of personal experience or behavior in self-neglect by exploring narratives of cognitively intact older adults. Descriptive study involving semistructured interviews and unstructured narratives. A parent study of self-neglect characteristics. Cognitively intact, self-neglecting older adults referred from 11 community-based senior services agencies (N = 69). Interviews included a comprehensive psychiatric assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis-I and II Disorders and an unstructured interview that allowed subjects to describe important elements of their life stories. Content analysis was used to identify personal experiences and behavior patterns in each subject's narrative. Four types of traumatic personal experiences (psychologically traumatic loss, separation or abandonment (29%); violent victimization, physical trauma, or sexual abuse (19%); exposure to war or political violence (9%); prolonged mourning (7%)) and five behavior patterns (significant financial instability (23%), severe lifelong mental illness (16%), mistrust of people or paranoia (13%), distrust and avoidance of the medical establishment (13%), substance abuse or dependence (13%)) were identified in the life stories. Patterns of traumatic personal experiences and maladaptive behaviors that self-neglecters frequently report were identified. Experiences, perceptions, and behaviors developed over a lifetime may contribute to elder self-neglect. Further exploration and better understanding of these patterns may identify potential risk factors and areas for future targeted screening, intervention, and prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  10. Wernicke-Korsakoff syndrome in a patient with self-neglect associated with severe depression.

    Science.gov (United States)

    Cocksedge, Karen A; Flynn, Adrian

    2014-02-01

    Wernicke-Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression.

  11. Wernicke–Korsakoff syndrome in a patient with self-neglect associated with severe depression

    OpenAIRE

    Cocksedge, Karen A; Flynn, Adrian

    2014-01-01

    Lesson Wernicke–Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression.

  12. Wernicke–Korsakoff syndrome in a patient with self-neglect associated with severe depression

    Science.gov (United States)

    Flynn, Adrian

    2014-01-01

    Lesson Wernicke–Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression. PMID:25057374

  13. Report on the Elderly 2001

    NARCIS (Netherlands)

    M.M.Y. de Klerk; J.M. Timmermans

    2001-01-01

    (Full translation from the Dutch: Rapportage Ouderen 2001) Report on the Elderly 2001 presents an overview of the position of the elderly in Dutch society. The central themes of the Report are participation in education and the labour market, financial status, housing situation,

  14. Report on the Elderly 2006

    NARCIS (Netherlands)

    Alice de Boer

    2006-01-01

    The Report on the Elderly 2006 presents an overview of the changes in the life situation and life course of the elderly. Key themes are participation in education and employment, leisure time use, financial position, health and care provisions. Attention is also given to the end of working life,

  15. Report on the Elderly 1998

    NARCIS (Netherlands)

    M.M.Y. de Klerk; J.M. Timmermans

    2000-01-01

    Report on the Elderly 1998 describes various aspects of the living circumstances of the elderly: the labour market position, financial situation, housing circumstances, health and uptake of health care. Extensive attention is also devoted to the scale and consequences of psychiatric disorders

  16. Report on the Elderly 2001

    NARCIS (Netherlands)

    M.M.Y. de Klerk

    2001-01-01

    Original title: Rapportage ouderen 2001. The Report on the Elderly 2001 (Rapportage ouderen 2001) presents a broad picture of the social position of the elderly in the Netherlands. Central themes addressed are participation in education and the labour market, financial position,

  17. Report on the Elderly 1998

    NARCIS (Netherlands)

    M.M.Y. de Klerk; J.M. Timmermans

    1999-01-01

    Original title: Rapportage ouderen 1998. The Report on the Elderly 1998 (Rapportage ouderen 1998) describes various aspects of the life situation of the elderly: labour market position, financial situation, housing conditions, health status and use of care services. Extensive attention is

  18. Report on the Elderly 1996

    NARCIS (Netherlands)

    J.M. Timmermans; M.M.Y. de Klerk

    2000-01-01

    The Social and Cultural Planning Office has been asked to asked to provide information on a regular basis about a number of different population groups. This third report on the elderly looks at the following subjects: demographic trends and networks education and

  19. Factors influencing nurses' judgements about self-neglect cases.

    Science.gov (United States)

    Lauder, W; Ludwick, R; Zeller, R; Winchell, J

    2006-06-01

    From the perspective of the practising nurse self-neglect may best be understood in terms of a set of complex and often poorly defined clinical problems in which two key clinical issues are "how do I judge whether this person has the capacity to make decisions about their lifestyle?" and "do we need to treat this person using mental health legislation?" These are taxing questions as judging if a patient has the capacity to make decisions about their lifestyle choices is difficult for even the most experienced clinicians. Such determinations require nurses to form a judgement as to mental capacity of the patient. We do not know what patient characteristics and in what combination nurses use these when making these judgements. This factorial survey aimed to identify which patient characteristics influenced Registered Nurses' judgements on decision-making capacity and decisions on the use of interventions which require statutory interventions in cases of self-neglect. Judgements on decision-making capacity were overwhelmingly predicted by information of the patients' mental health status. Nurses place patients in one of three broad categories of no mental illness, minor mental illness and severe mental illness. This categorization appears to operate as a fast and frugal heuristic indicating that nurses may use mental status as a cognitive screen to work from in judging self-neglect. Although there is a correlation between the severity of mental illness and the capacity for making decisions they are not the same. This study shows the continued work that needs done in educating nurses not only about self-neglect but also about the role a patient's mental status may have in assessment of problems.

  20. Self-neglect: a case study and implications for clinical practice.

    LENUS (Irish Health Repository)

    Day, Mary Rose

    2015-03-02

    Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.

  1. Elder Abuse Reporting: Limitations of Statutes.

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    Salend, Elyse; And Others

    1984-01-01

    Compares 16 state elder abuse reporting statutes and analyzes their implementation. Generally, the statutes have failed to ensure consistent information about elder abuse within or across states. Neglect is more often reported than abuse and little prosecutory activity was noted. Suggestions for improving reporting policies are made. (JAC)

  2. Project Elderly. Interim and Final Reports.

    Science.gov (United States)

    Miami-Dade Community Coll., FL.

    This report examines Project Elderly, a project developed to provide job possibilities for the older adult in the labor market in metropolitan Miami (FL). A survey questionnaire was developed to (1) assess the opportunities of the elderly for re-entry into volunteer and paid employment positions; (2) determine the extent of the senior population…

  3. Multiple vitamin deficiencies in a patient with a history of chronic alcohol excess and self-neglect in the UK.

    Science.gov (United States)

    Dickson, Jon Mark; Naylor, Greg; Colver, Graham; Powers, Hilary J; Masters, Paul

    2014-09-22

    We report a case of inadequate diet (caused by extreme self-neglect and alcohol excess) which led to chronic severe deficiencies of vitamins A, D and E. At presentation the patient had widespread follicular hyperkeratosis of the skin, keratomalacia of both eyes and a severe cognitive impairment. He responded well to treatment including high dose parenteral vitamins, but lasting impairments in his vision and cognition have caused permanent disability. 2014 BMJ Publishing Group Ltd.

  4. Multiple vitamin deficiencies in a patient with a history of chronic alcohol excess and self-neglect in the UK

    OpenAIRE

    Dickson, Jon Mark; Naylor, Greg; Colver, Graham; J Powers, Hilary; Masters, Paul

    2014-01-01

    We report a case of inadequate diet (caused by extreme self-neglect and alcohol excess) which led to chronic severe deficiencies of vitamins A, D and E. At presentation the patient had widespread follicular hyperkeratosis of the skin, keratomalacia of both eyes and a severe cognitive impairment. He responded well to treatment including high dose parenteral vitamins, but lasting impairments in his vision and cognition have caused permanent disability.

  5. Physicians' Mandatory Reporting of Elder Abuse.

    Science.gov (United States)

    Daniels, R. Steven; And Others

    1989-01-01

    Evaluated physicians' responses to Alabama state elder abuse reporting statutes in Alabama Protective Services Act of 1976. Survey responses from over 100 Alabama physicians suggest that they have reservations about their ability to diagnose abuse, operation of the law, and their willingness to report abuse. (Author/NB)

  6. Collaborative Elder Abuse Prevention Project Quarterly Report.

    Science.gov (United States)

    McDaniel, Garry L.

    The Texas Department of Human Services, in collaboration with 13 other public and private organizations, co-sponsored a statewide collaborative elder abuse prevention project, to prevent abuse of elderly and disabled adults. The goal of this project is to develop a comprehensive, long-range plan for the prevention of elder abuse, a method for…

  7. Discovering the Self in Islam: Self-Striving, Self-Regard, and Self-Neglect

    OpenAIRE

    Nik Ahmad Hisham Ismail, Mustafa Tekke

    2016-01-01

    This study explored some self domains and reviewed them through Islamic perspective, more particularly self-knowledge and faith. It provided an extensive literature on particular concepts of self-striving, self-regard, and self-neglect. To briefly point out, the self has many origins, however deeply noted as such heart, spirit, and psyche in Islam. From these, this study looked at the two known self domains: self-striving, and self-regard. Apart from these concepts, researchers differently ch...

  8. Michigan Physicians' Conference on Elder Abuse. Final Report.

    Science.gov (United States)

    Sengstock, Mary C.; O'Brien, James G.

    The final report describes the Michigan Physicians' Conference on Elder Abuse project. The project conference had four major content areas, including: a general introduction to the problem of elder abuse; clinical symptoms of abuse; legal issues; and referral and case management techniques. Training techniques included lectures, group discussion,…

  9. Dysphagia lusorium in elderly: A case report

    Science.gov (United States)

    Kantarceken, Bulent; Bulbuloglu, Ertan; Yuksel, Murvet; Cetinkaya, Ali

    2004-01-01

    AIM: Late unset of dysphagia due to vascular abnormalities is a rare condition. We aimed to present a case of right subclavian artery abnormalities caused dysphagia in the elderly. METHODS: A 68-year-old female was admitted with dysphagia seven months ago. Upper endoscopic procedures and routine examinations could not demonstrate any etiology. Multislice computed thorax tomography was performed for probable extra- esophagial lesions. RESULTS: Multislice computed thorax tomography showed right subclavian artery abnormality and esophagial compression with this aberrant artery. CONCLUSION: Causes of dysphagia in the elderly are commonly malignancies, strictures and/or motility disorders. If routine examinations and endoscopic procedures fail to show any etiology, rare vascular abnormalities can be considered in such patients. Multislice computed tomography is a usefull choice in such conditions. PMID:15285045

  10. Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture.

    Science.gov (United States)

    Dong, Xinqi

    2014-04-01

    Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults.

  11. Advancing the Field Elder Abuse: Future Directions and Policy Implications

    Science.gov (United States)

    Dong, XinQi

    2012-01-01

    Elder abuse, sometime called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adult experiences some form of elder abuse, and only 1 of out 25 cases are actually reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow/Health and Aging Policy Fellow working with Administration on Community Living (ACL) (Previously known at Administration on Aging (AoA)) for the last two years, I will describe the major functions of the ACL; and highlight on two major pieces of federal legislation: The Older Americans Act (OAA) and the Elder Justice Act (EJA). Moreover, I will highlight major research gaps and future policy relevant research directions for the field of elder abuse. PMID:23110488

  12. Fatal neglect of the elderly.

    Science.gov (United States)

    Ortmann, C; Fechner, G; Bajanowski, T; Brinkmann, B

    2001-01-01

    Maltreatment of the elderly is a common problem that affects more than 3% of the elderly. We report on two cases of fatal neglect. Risk factors of victims and caregivers were analysed in the context of the social history. In both cases, the victims had a dominant personality and the abusers (the sons) had been strictly controlled and formed by the parent. The victims showed typical risk factors such as living together with the abuser, isolation, dependence on care, income and money administration. Initially, the victims declined help from outside and self-neglect occurred. The unemployed perpetrators lived in social isolation and depended financially and mentally on the victims. In both cases no mental illness was present but there was a decrease of social competence. Legal medicine is predominantly involved in fatal cases in connection with external post-mortem examinations and autopsies. Also in the living, the medico-legal expert can assist in the identification of findings in elderly persons in cases of suspected abuse.

  13. Factors Related to Korean Nurses' Willingness to Report Suspected Elder Abuse

    Directory of Open Access Journals (Sweden)

    Chungmee Ko, PhD

    2012-09-01

    Conclusion: As the Welfare of the Aged Act included a clause on mandated reporters, nurses' role in intervening in elder abuse cases has become more critical. In order to increase nurses' reporting, education on elder abuse should be provided to all nurses, and support programs should be designed for nurses to effectively involve them in reporting elder abuse.

  14. Rhabdomyosarcoma in an elderly patient. A case report

    OpenAIRE

    Leopoldo Garduño-Vieyra; Sergio E. Hernandez-Da Mota; Claudia Ruth Gonzalez; Roberto Gamez-Carrillo

    2017-01-01

    Purpose: To describe a case of rhabdomyosarcoma in an elderly patient. Methods: An exenteration surgery was performed of the right orbit with desperiostization and temporal muscle-skin flap rotation to cover the defect in a 96 year old patient with a history of right eye exotropia. Results: The pathology report showed a malignant striate muscle neoplasm with pleomorphic neuclei of variable size with discromic and disperse cromatine that was consistent with pleomorphic rhabdomyosarcoma. ...

  15. Advancing the field of elder abuse: future directions and policy implications.

    Science.gov (United States)

    Dong, XinQi

    2012-11-01

    Elder abuse, sometimes called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse; neglect (caregiver neglect and self-neglect); and financial exploitation. Evidence suggests that one in 10 older adults experiences some form of elder abuse, but only one in 25 cases is reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy addressing the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow and Health and Aging Policy Fellow working with the Administration on Community Living (ACL) (previously known as the Administration on Aging) for the last 2 years, I will describe the major functions of the ACL and highlight two major pieces of federal legislation: The Older Americans Act and the Elder Justice Act. I will also highlight major research gaps and future policy relevant research directions for the field of elder abuse. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  16. LITHIUM TOXICITY IN ELDERLY-A CASE REPORT AND DISCUSSION

    Directory of Open Access Journals (Sweden)

    Mariana D. Arnaoudova

    2014-07-01

    Full Text Available Background: The therapeutic effect of Lithium as a mono therapy or as an augmenting agent in a variety of medical and psychiatric disorders is under doubt. However, lithium is associated with a number of adverse effects. Method and objective: A review of the literature on lithium use in older adults and a case report presentation. Summary of results: The literature, concerning current uses of Lithium in older patients, especially for patients with neurologic or cognitive impairments is limited due to the lack of well-designed, large clinical trials. Elderly patients are at higher risk to develop neurotoxicity in the course of lithium therapy. We present a case of 66 years old female patient, suffering bipolar disorder, who developed lithium toxicity and was admitted at the gerontopsychiatric department due to a confusional state, tremor and gait abnormality. Lithium toxicity was suspected when sufficient information about previous medical history of lithium therapy has been obtained. Lithium level found to be 1.69mmol/L. The patient has developed intoxication during maintenance therapy with a lithium dosage which had been unchanged for months. Conclusion: Elderly patients require lower doses of Lithium to achieve similar serum concentrations as those in younger adults. Neurotoxicity could be suspected at serum lithium levels which are considered therapeutic in younger adults. When prescribing lithium agents in elderly we should consider age-related changes in pharmacokinetics. The best way to prevent lithium toxicity is to control the serum concentration regularly during therapy.

  17. Giant Sacral Chondrosarcoma in an Elderly Male : A Case Report

    Directory of Open Access Journals (Sweden)

    HZ Chan

    2014-03-01

    Full Text Available Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.

  18. Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

    Science.gov (United States)

    Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

    2015-01-01

    The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

  19. Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

    Science.gov (United States)

    Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

    2013-01-01

    Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

  20. [Elder].

    Science.gov (United States)

    Arroyo, Pedro; Gutiérrez-Robledo, Luis Miguel

    2016-09-01

    The aim of this review is to present scientific evidence on the biological, dietary, cultural and economic advantages of cow´s milk and dairy products intake in adults, with emphasis on the elderly. The role of milk and dairy products as part of the regular diet, as well as their contribution to a healthy diet for the aged population is described. The updated scientific references on the importance of milk and dairy products on the dietary management of the most prevalent diseases of the eldery -among these energy-protein malnutrition, sarcopenia, obesity, sarcopenic obesity, osteoporosis, diabetes and cardiovascular diseases- are presented.

  1. Elders with implant overdentures: a 22-year clinical report.

    Science.gov (United States)

    Alsabeeha, Nabeel H M

    2012-09-01

    To report on the long-term survival and prosthodontic maintenance of two edentulous adults with mandibular overdentures supported by hydroxyapatite (HA)-coated implants. Mandibular implant overdentures are a successful treatment option with positive impact on the quality of life of elderly edentulous adults. Long-term survival of the implants requires continued rigorous prosthodontic maintenance. Two elderly edentulous adults with mandibular overdentures supported by 2 HA-coated implants were presented for prosthodontic rehabilitation after 22 years of placement. The implants were osseo-integrated and surviving at presentation based on accepted criteria. The mandibular implant overdentures suffered recurrent loss of retention and stability. Prosthodontic treatment involving the replacement of defective attachment systems and construction of new sets of mandibular implant overdentures opposing complete maxillary dentures is presented. The long-term survival of mandibular 2-implant overdentures requires continued prosthodontic maintenance. A conservative approach in the rehabilitation of two older edentulous adults with mandibular 2-implant overdentures was described including proper selection of attachment systems. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  2. Elder abuse awareness in Italy: analysis of reports to the Prosecutor Office of Bologna.

    Science.gov (United States)

    Salsi, Giancarlo; Mazzotti, Maria Carla; Carosielli, Grazia; Ingravallo, Francesca; Pelotti, Susi

    2015-06-01

    In Italy, the prevalence of elder abuse is estimated from 10 to 12.7 %. Even if the elderly are not specifically protected by the Italian Penal Code, it contains several articles punishing crimes against disadvantaged groups in which elders may be included. Article 572 about mistreatment of family members or cohabitants, and article 643 about circumvention of incapable best fit elder abuse or neglect and financial fraud and exploitation, respectively. To evaluate the prevalence of reported elder abuse in Bologna and province (Italy) compared to available data on prevalence obtained by population-based surveys. Reports to the Prosecutor Office about articles 572 and 643 in the period from 2000 to 2013 were collected and analyzed according to victim's age at the report time. For article 572 a total of 3,713 reports were found. The prevalence of reports ranged from 0.005 to 0.024 % for victims older than 65 years. Concerning article 643 a total of 786 reports were detected, with a prevalence ranging from 0.007 to 0.016 % for victims older than 65 years. A large gap was found between reported crimes related to elder abuse and the estimated prevalence of elder abuse in Italy. Our results showed that in Italy efforts to improve strategic approach on elder abuse as well as research at various levels following the examples of other abusive situations are needed in both health and legal systems.

  3. Elderly with remaining teeth report less frailty and better quality of life than edentulous elderly : a cross-sectional study

    NARCIS (Netherlands)

    Hoeksema, A. R.; Spoorenberg, S. L. W.; Peters, L. L.; Meijer, H. J. A.; Raghoebar, G. M.; Vissink, A.; Wynia, K.; Visser, A.

    ObjectiveTo assess oral status and self-reported oral health in community-living elderly and to determine differences between relevant subgroups of oral status (remaining teeth, edentulous, implant-retained overdentures) and case complexity (robust, frail, complex care needs). Subjects and methodsIn

  4. Elder abuse and dementia: a review of the research and health policy.

    Science.gov (United States)

    Dong, XinQi; Chen, Ruijia; Simon, Melissa A

    2014-04-01

    Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimer's Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.

  5. The Elder Abuse Prevention Project, Phase Two, Three and Four. Final Report.

    Science.gov (United States)

    Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.

    This document presents the final report from an educational and community development program designed to raise awareness about the abuse and neglect of the elderly. The Elder Abuse Prevention Project is briefly described in terms of project goals, objectives, the model used, the target groups served, and the evaluation processes employed. It is…

  6. Prevalence of elder abuse and neglect in seniors with psychiatric morbidity - example from central moravia, czech republic.

    Science.gov (United States)

    Luzny, Jan; Jurickova, Lubica

    2012-01-01

    Elder abuse and neglect (EAN) comprises emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. Elder abuse and neglect in seniors with psychiatric morbidity was not monitored in the Czech Republic at all, despite the literature shows mental morbidity as one of the important risk factor for developing elder abuse and neglect. We designed comparative cross sectional study comprising 305 seniors hospitalized in Mental Hospital Kromeriz in June 2011 - group of 202 seniors hospitalized due to mental disorder in psychogeriatric ward and group of 103 seniors hospitalized due to somatic disorder in internal ward. Content analysis of medical records was done in both groups of seniors, with regards to symptoms of elder abuse. Then, we discussed the topic of elder abuse with 30 nurses of psychogeriatric ward in focus group interview. Between two compared groups of seniors we detected statistically higher prevalence of elder abuse in seniors with psychiatric morbidity (48 cases, 23.8% prevalence of EAN), compared to somatically ill seniors (3 cases, 2.9%). As for nursing staff, 5 from 30 nurses (16.7%) have never heard about symptoms of elder abuse and neglect, 10 from 30 nurses (33.3%) had just a partial knowledge about elder abuse and neglect and its symptoms, the rest of nurses (15 from 30 nurses, 50.0%) had good knowledge about elder abuse and neglect and its symptoms. Elder abuse and neglect seems to be a relevant problem in senior population with mental disorders. Development of educational programs for nursing and medical staff about Elder abuse and neglect (symptoms of EAN, early detection of EAN, knowledge how to report cases of EAN) could improve the situation and help mentally ill seniors to better quality of life.

  7. Healthcare Professionals’ Perspectives on Barriers to Elder Abuse Detection and Reporting in Primary Care Settings

    Science.gov (United States)

    SCHMEIDEL, AMY N.; DALY, JEANETTE M.; ROSENBAUM, MARCY E.; SCHMUCH, GRETCHEN A.; JOGERST, GERALD J.

    2012-01-01

    The purpose of this study was to explore through interviews of healthcare professionals their perspectives on elder abuse to achieve a better understanding of the problems of reporting and generate ideas for improving the process. Through a mailed survey, nurses, physicians, and social workers were invited to participate in an interview. Nine nurses, 8 physicians, and 6 social workers were interviewed and thematic analysis was used to identify the following core themes: professional orientation, assessment, interpretation, systems, and knowledge and education. The impact by healthcare professionals in recognizing and reporting elder abuse and obtaining resources for those mistreated can be profound. Nurses tended to perceive elder abuse as uncommon and generally did not feel it was their role nor did they have time to assess patients for potential abuse. Physicians felt that other patient care issues, time limitations and maintaining trust in the clinician-patient relationship outweighed the importance of detecting and pursuing suspected cases of elder abuse. Social workers, although having the most knowledge and experience related to elder abuse, relied on nurses and physicians to detect potential abusive situations and to work with them in making appropriate referrals. The three disciplines acknowledged the need for more and better education about elder abuse detection and reporting. Participants suggested a reorganization of the external reporting system. More frequent and pragmatic education is necessary to strengthen practical knowledge about elder abuse. PMID:22206510

  8. Survey of Key Informants on Elder Abuse and Neglect: Report to the Texas Senate Select Subcommittee on Elder Abuse, 70th Legislative Session.

    Science.gov (United States)

    Anderson, Jeffrey M.; Theiss, John T.

    This document reports the findings of a study conducted for the Texas legislature to use in evaluating alternatives for dealing with elder abuse. The described study analyzed experiences with elder abuse of 1,653 Texas professionals in the fields of health and medicine, the judiciary, financial services, law enforcement, and social services. The…

  9. Nonaneurysmatic Dysphagia Aortica in the Elderly: Three Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Yi-Hsueh Chan

    2016-03-01

    Full Text Available Dysphagia is a remarkably prevalent disorder in the elderly. Both age-related changes in swallowing physiology and age-related diseases are predisposing factors for dysphagia in the elderly. Dysphagia aortica is a rare etiology of dysphagia resulting from extrinsic compression of the esophagus by an aneurysm or by a tortuous and elongated thoracic aorta. Clinical findings of dysphagia aortica resemble those of esophageal malignancy or esophageal motility disorders. Dysphagia aortica not related to an aneurysm is usually observed in the elderly, especially in female patients with hypertensive cardiomyopathy or kyphosis. However, dysphagia aortica may occur in the aging population without underlying aneurysm or kyphosis. Here, we report three cases of nonaneurysmatic dysphagia aortica and review the literature to report the diagnostic approach and treatments used for this condition. Dysphagia aortica should be considered in the differential diagnosis of dysphagia, especially in the growing elderly population with cardiovascular disease or hypertension.

  10. Tacrolimus Therapy for Three Patients with Elderly-Onset Ulcerative Colitis: Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Rumiko Kobayashi

    2016-07-01

    Full Text Available In recent years, cases of elderly-onset ulcerative colitis (UC have been increasing in number and are currently reported to account for 10–15% of all cases of UC. Although the treatment of UC is essentially similar between older and younger patients, evidence of the therapeutic efficacy of tacrolimus in elderly-onset UC patients is still limited. Herein, we report our attempt to induce remission using tacrolimus in three patients with elderly-onset UC. A 75-year-old Japanese woman, a 71-year-old Japanese man and a 76-year-old Japanese woman with severe elderly-onset UC of the pancolitis type were treated with tacrolimus. Although all three patients showed response to the drug, the eventual outcome was poor in the first patient, who developed toxic megacolon, underwent surgery, and suffered from recurrent infections and hemorrhage after the surgery. However, clinical remission was successfully achieved in the second and third patient. Tacrolimus shows some indication of effectiveness in the treatment of elderly-onset UC. However, in elderly-onset UC patients, it is necessary to keep in mind the higher risk of adverse effects of medical therapy and postoperative complications because of the high comorbidity rates. Moreover, in situations where surgery needs to be considered, it is important to ensure appropriate timing of the surgery.

  11. Website design: technical, social and medical issues for self-reporting by elderly patients.

    Science.gov (United States)

    Taylor, Mark J; Stables, Rod; Matata, Bashir; Lisboa, Paulo J G; Laws, Andy; Almond, Peter

    2014-06-01

    There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this article, we examine the issues in designing healthcare websites for elderly users. In particular, this article uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based on the European Quality of Life 5-Dimensions health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific coronary revascularisation outcome questionnaire. Currently, self-reporting is generally administered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. There are a variety of issues relating to elderly users, which imply that websites for elderly patients may involve different design considerations to other types of websites.

  12. Neuroleptic malignant syndrome in an elderly with quetiapine: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Devakshi Dua

    2017-01-01

    Full Text Available Over the years, there is an increase in the prescription of antipsychotics among elderly patients, and these are used for various clinical indications such as psychotic disorders, affective disorders, behavioral and psychological symptoms of dementia and delirium. Quetiapine is one of the preferred antipsychotics among elderly because of its safety profile. However, quetiapine has been rarely been associated with the development of neuroleptic malignant syndrome (NMS among elderly. In this report, we discuss a case of NMS in a 70-year-old female, who developed symptoms of NMS at the dose of 200 mg/day, while quetiapine was being used along with lithium. A review of literature suggests that there are 12 cases of NMS reported in subjects older than 55 years of age.

  13. Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department

    DEFF Research Database (Denmark)

    Nielsen, Louise M.; Kirkegaard, Hans; Østergaard, Lisa Gregersen

    2016-01-01

    Background Assessment of functional ability in elderly patients is often based on self-reported rather than performance-based measures. This study aims to compare self-reported and performance-based measures of functional ability in a population of elderly patients at an emergency department (ED)...

  14. Suspected adverse drug reactions in elderly patients reported to the Committee on Safety of Medicines.

    Science.gov (United States)

    Castleden, C M; Pickles, H

    1988-10-01

    1. Spontaneous reports of suspected adverse drug reactions (ADRs) reported to the Committee on Safety of Medicines (CSM) have been studied in relation to patient age. 2. The proportion of reports received for the elderly increased between 1965 and 1983. 3. There was a correlation between the use of drugs and the number of ADR reports. Thus age-related prescription figures for two non-steroidal anti-inflammatory drugs (NSAI) and co-trimoxazole matched ADR reports for each drug in each age group. 4. The reported ADR was more likely to be serious or fatal in the elderly. 5. The commonest ADRs reported for the elderly affected the gastrointestinal (GIT) and haemopoietic systems, where more reports were received than would be expected from prescription figures. 6. The drug suspected of causing a GIT reaction was a NSAI in 75% of the reports. 7. Ninety-one per cent of fatal reports of GIT bleeds and perforations associated with NSAI drugs were in patients over 60 years of age.

  15. Diogenes Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Projna Biswas

    2013-01-01

    Full Text Available Cessation of normal skin cleansing seen in geriatric or self-neglected patients can cause accumulation of keratinous crusts on the skin. In the extreme end of this spectrum is a condition known as Diogenes syndrome (DS. These patients may have psychiatric disorders like paranoid disorders, mood affection, or temporofrontal dementia. Subjects are mainly the elderly but few cases in younger age group of patients have also been reported. Lesions of DS are usually found over upper central chest, back, and groin. In the young, lesions are mainly found over scalp, face, or arms. Absence of normal skin cleaning causes keratin and dirty debris to accumulate and with time form a thick shell. These debris can be secondarily infected by bacteria, fungus, and so forth. These skin lesions are not usually seen in individual with proper hygiene. We report a case of Diogenes syndrome in a 34-year-old young male patient who had associated schizophrenia.

  16. Report on Focus on Elder Abuse Workshop (Regina, Saskachewan, May 31-June 1, 1989).

    Science.gov (United States)

    Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.

    This report describes a 2-day elder abuse workshop, hosted by the Seniors' Education Centre, University Extension, University of Regina in 1989 and attended by 96 participants from across Saskatchewan, Canada. Included is the text from the keynote address by Geri McGrath, a social worker from the Psychogeriatrics Day Hospital, Seven Oaks General…

  17. Predictors of self-reported health among the elderly in Ghana: a cross sectional study.

    Science.gov (United States)

    Fonta, Cynthia Lum; Nonvignon, Justice; Aikins, Moses; Nwosu, Emmanuel; Aryeetey, Genevieve Cecilia

    2017-07-31

    Self-reported health is a widely used measure of health status across individuals. As the ageing population increases, the health of the elderly also becomes of growing concern. The elderly go through life facing social, economic and financial hardships. These hardships are known to affect the health status of people as they age. The purpose of this study is to assess social and health related factors of self-reported health among the elderly in Ghana. A multivariate regression analysis in form of a binary and ordinal logistic regression were used to determine the association between socioeconomic, demographic and health related factors, on self-reported health. The data used for this study was drawn from the World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) Wave 1. In total, out of 2613 respondent, 579 (20.1%) rated their health status as poor and 2034 (79.9%) as good. The results showed that the odds of reporting poor health was 2.5 times higher among the old-old compared to the young old. The elderly with one or more than one chronic condition had the odds of 1.6 times and 2 times respectively, of reporting poor health. Engaging in mild to moderate exercise increased the chances of reporting poor health by 1.8 times. The elderly who had never worked in a lifetime were 2 times more likely to report poor health. In the same way, residents of Eastern and Western parts of Ghana were 2 times more likely to report poor health compared to those in the Upper West region. Respondents with functional limitations and disabilities were 3.6 times and 2.4 times respectively, more likely to report poor health. On the other hand, the odds of reporting poor health was 29, 36 and 27% less among respondents in the highest income quintiles, former users of tobacco and those satisfied with certain aspects of life respectively. Also, current alcohol users were 41% less likely to report poor health. The health status of the elderly is to an extent

  18. Elder Physical Abuse and Failure to Report Cases: Similarities and Differences in Case Type and the Justice System's Response

    Science.gov (United States)

    Payne, Brian K.

    2013-01-01

    Treated initially as a social problem, elder abuse has only recently been criminalized. The criminalization of elder abuse involves penalizing offenders for actively abusing offenders as well as for violating mandatory reporting laws. Mandatory reporting laws exist to encourage professionals to report suspected cases of elder abuse. In this study,…

  19. Suspected adverse drug reactions in elderly patients reported to the Committee on Safety of Medicines.

    OpenAIRE

    Castleden, C M; Pickles, H

    1988-01-01

    1. Spontaneous reports of suspected adverse drug reactions (ADRs) reported to the Committee on Safety of Medicines (CSM) have been studied in relation to patient age. 2. The proportion of reports received for the elderly increased between 1965 and 1983. 3. There was a correlation between the use of drugs and the number of ADR reports. Thus age-related prescription figures for two non-steroidal anti-inflammatory drugs (NSAI) and co-trimoxazole matched ADR reports for each drug in each age grou...

  20. Association between self-reported sleep duration and serum vitamin D level in elderly Korean adults.

    Science.gov (United States)

    Kim, Jeong Hong; Chang, Jung Hyun; Kim, Dong Young; Kang, Ju Wan

    2014-12-01

    To investigate the association between self-reported sleep duration and serum vitamin D level in elderly Korean adults. Cross-sectional data analysis. Korean National Health and Nutrition Examination Survey 2010. Noninstitutionalized adults aged 60 to 80 (N = 1,614). The confounding variables were serum 25-hydroxy vitamin D level, age, sex, body mass index, smoking history, alcohol consumption, and self-reported daily sun exposure and sleep duration. Self-reported daily sleep duration was divided into four groups: Q1 (≤4 hours), Q2 (5-6 hours), Q3 (7-8 hours), and Q4 (≥9 hours). Mean serum vitamin D levels of subjects in the Q1, Q2, Q3, and Q4 groups were 44.18, 48.08, 48.83, and 51.78 nmol/L, respectively. On multivariate linear regression analysis, subjects in the Q2 (B = 3.80, 95% confidence interval (CI) = 0.42-7.19), Q3 (B = 4.89, 95% CI = 1.54-8.24), and Q4 (B = 5.18, 95% CI = 0.78-9.58) groups had significantly higher serum vitamin D levels than subjects in the Q1 group. Serum vitamin D level is positively associated with self-reported daily sleep duration in elderly Korean individuals. These results suggest that inadequate sleep duration may be associated with lower vitamin D levels in elderly adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  1. Bilateral calf chronic compartment syndrome in an elderly male: a case report.

    LENUS (Irish Health Repository)

    Siau, Keith

    2009-01-01

    Leg pain is a common presentation to the outpatient department. Bilateral calf chronic compartment syndrome is a rare cause of bilateral calf pain. Although this condition has been well documented in young athletes, it has rarely been reported in the elderly. We present the case of a 68-year-old male bodybuilder with bilateral calf chronic compartment syndrome, describe the presentation and evaluation of the condition, and provide a review of the literature herewith.

  2. Prediction of cardiorespiratory fitness from self-reported data in elderly

    Directory of Open Access Journals (Sweden)

    Geraldo A Maranhao Neto

    2017-12-01

    Full Text Available Cardiorespiratory fitness (CRF is associated with several health outcomes. Some non-exercise equations are available for CRF estimation. However, little is known about the validation of these equations among elderly. The aim of this study was to exam the validity of non-exercise equations with self-reported information in elderly. Participants (n= 93 aged 60 to 91 years measured CRF using maximal cardiopulmonary exercise test. Five non-exercise equations were selected. Data included in the equations (age, sex, weight, height, body mass index, physical activity and smoking were self-reported. Coefficient of determination (R2 of linear regressions with laboratory-measured VO2 peak ranged from 0.04 to 0.64. The Bland-Altman plots showed higher agreement between achieved and predicted CRF obtained by Jackson and colleagues, and Wier and colleagues equations. On the other hand, the other equations showed lower agreement and overestimation. Our findings provide evidences that two non-exercise equations, previously developed, could be used on the prediction of CRF among elderly.

  3. Interdisciplinary Trauma Management in an Elderly Patient, A Case Report

    Science.gov (United States)

    Felt, George T; Soolari, Ahmad

    2014-01-01

    The current report reviews a case of mixed dental trauma consequent to a fall by an older patient. The patient’s teeth were forced out of alignment by the trauma and suffered pulpal necrosis. Treatment involved not only healing the acute injuries, but also attending to some subtle delayed problems that became apparent during treatment. Treatments involving endodontics, periodontics, orthodontics, and restorative dentistry were used to address all of the patient’s concerns. This insured that the traumatic occlusion was corrected, appropriate esthetics was restored and normal speech and function was regained. All signs of trauma were recognized, every treatment step was documented, and appropriate follow-up was provided throughout the recovery period. PMID:25419251

  4. Atypical mycobacterial infection mimicking carbuncle in an elderly patient: A case report

    Directory of Open Access Journals (Sweden)

    Terlinda Barros

    2015-08-01

    Full Text Available Background: Atypical mycobacterium infection occurs under certain skin conditions, namely the disruption of skin integrity and mucous membranes accompanied by the reduction of cellular immunity. However, atypical mycobacterial infection in elderly patients is rarely reported. Case: A 64 years old male patient, complained of red lumps on the upper-backfor a month, accompanied by mild fever and minimal pain. Three months before, the patient had accupuncture on the neck and upper back. Physical examination showed multiple miliar to lenticular sized papules and pustules on an erythematous-violaceus base with hard and immobile palpable nodes and infiltrate. After clinical and laboratory workup, the patient was diagnosed withcarbuncle with Candida spp colonization. The treatment consisted of systemicantibiotics and topical antifungals. There was no clinical improvement after 3 weeks. Histopathology and laboratory results suggested atypical mycobacterium infection. Discussion: Atypical mycobacterium infection should be considered in elderly patients with skin and soft tissue infections that show no clinical improvement tostandard therapy.

  5. Self-Reported Oral Health and Quality of Life in the Elderly

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Morowatisharifabad

    2016-12-01

    Full Text Available Introduction: Given growing elderly population and high prevalence of oral and dental diseases in this age group, this study was conducted to investigate oral health status and related quality of life among older adults in Yazd located in central Iran. Methods: The cross sectional study was carried out on 210 elderly people aged ≥ 60 years under the guise of Yazd health care centers who entered the study via cluster random sampling. Oral health was assessed by DMFT index; and self-reported oral and dental health scale was also tested. Further, to measure the oral health-related quality of life, the Geriatric Oral Health Assessment Index was applied. Data were then analyzed by SPSS software through descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean score of age for the studied population was 67.22 ± 5.62 years. Of whom 60.48 % were women, 79.05 % were married and 42.4% were edentulous. The oral health-related quality of life mean score was 42.46 ± 5.76 (possible rang 12-60 and the DMFT index mean score was 20.33 ± 4.76. The correlation of oral health-related quality of life score with age (r=-0.213, p=0.002 and DMFT index (r= -0.542, p<0.001 was inversely significant. Further, that had a direct significant correlation with self-reported oral health score(r= 0.302, p<0.001. Conclusion: Elderly people's oral health-related quality of life, self-reported oral and dental health status was not desirable. These factors have significant relationships with each other so that increase in DMFT index was associated with decrease in self-reported oral and dental health. 

  6. Helping Elderly Users Report Pain Levels: A Study of User Experience with Mobile and Wearable Interfaces

    Directory of Open Access Journals (Sweden)

    Iyubanit Rodríguez

    2017-01-01

    Full Text Available Pain is usually measured through patient reports during doctor visits, but it requires regular evaluation under real-life conditions to be resolved effectively. Over half of older adults suffer from pain. Chronic conditions such as this one may be monitored through technology; however, elderly users require technology to be specifically designed for them, because many have cognitive and physical limitations and lack digital skills. The purpose of this article is to study whether mobile or wearable devices are appropriate to self-report pain levels and to find which body position is more appropriate for elderly people to wear a device to self-report pain. We implemented three prototypes and conducted two phases of evaluation. We found that users preferred the wearable device over the mobile application and that a wearable to self-report pain should be designed specifically for this purpose. Regarding the placement of the wearable, we found that there was no preferred position overall, although the neck position received the most positive feedback. We believe that the possibility of creating a wearable device that may be placed in different positions may be the best solution to satisfy users’ individual preferences.

  7. Dietary Behaviors of Elderly People Residing in Central Iran: A Preliminary Report of Yazd Health Study (YAHS

    Directory of Open Access Journals (Sweden)

    Davood Bahrami

    2016-06-01

    Full Text Available Introduction: Food habits play important roles in maintaining physical and mental health and preventing chronic illnesses in the elderly. The aim of the present study was to investigate dietary behaviors of elderly people residing in Yazd city which is located in central Iran. Methods: The present analysis was conducted on 1684 participants entered to Yazd Health Study (YAHS aged over 60 years during 2014-2015. Demographic characteristics, health status, physical activity, economic status, education and dietary behaviors were collected by using a validated questionnaire. Results: Our analysis revealed that only 1.2% of the elderly consumed more than two servings of dairy per day. Furthermore only 3 and 9.8 percent of elders consumed more than three servings/day of vegetables and fruits, respectively. The study also showed that 22.9% ate more than five servings of sugar per day, 22.5% took more than four units of legumes weekly, 56.1% ate two to three servings of poultry per week, 77% reported eating fast foods for at least once a week, 47.8% consumed canned foods less than once a week of and 86.3% reported taking breakfast for at least five times a week. For cooking 18.9% of elderly still use hydrogenated vegetable oils, 52.8% of the elderly did not separate visible fats from red meat before cooking, 65.8% chose high-fat dairy and  24% of older people reported using frying and grilling as their primary cooking method. Our findings also suggest that dietary behavior is different between elder men and women. Conclusion: Unhealthy dietary habits, including low vegetables, fruits and dairy products intake, are highly prevalent among elderly people residing in Yazd. Community based interventions targeting this age group, in order to improve their dietary intake, are highly recommended.

  8. The violence against the elderly in films

    Directory of Open Access Journals (Sweden)

    Lucy Gomes Vianna

    2015-07-01

    Full Text Available Introduction: With the aging of the population, the issue of violence against the elderly need to be debated, in order to enlighten and educate the população about this issue. The movies utilization is a effective educational resource, contributing to reflection and understanding of these situation. Objective: To collect and analyze images in film productions that express the different types of violence against the elderly. Material and methods: Analysis of the national and international filmography, identifying scenes in commercial films portraying the violence against the elderly. We searched up the sites www.cinema10.com.br, www.adorocinema.com, www.cinemateca.gov.br, www.filmesdecinema.com.br, www.cineplayers, www.interfilmes,  www.cineclick.com.br, and  www.revistaforum.com.br. The films with scenes of violence against the elderly were listed. Results: We listed up 58 films showing scenes displaying different types of violence against the elderly: 24 (41% physical violence; 18 (31% psychological violence; 14 (24% social violence, 10 (17% self-neglect, 10 (17% economic abuse, 6 (10% abandonment, 3 (5% sexual violence, and 3 (5% negligence. Conclusion: Using film imagery, we can diffuse the issue of mistreatment against the elderly, as well as broaden the instances to denounce this violence. Thus, we search  to focus on the elderly citizenship, guaranteeing their rights and attending reframe the context and the images of aging.  

  9. Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports.

    Science.gov (United States)

    Anno, Takatoshi; Kaneto, Hideaki; Shigemoto, Ryo; Kawasaki, Fumiko; Kawai, Yasuhiro; Urata, Noriyo; Kawamoto, Hirofumi; Kaku, Kohei; Okimoto, Niro

    2018-01-01

    Hypoglycemia is induced by many causes, especially over-dose of insulin or oral hypoglycemic agents in diabetic subjects. In such a case, hyperinsulinemic hypoglycemia is usually observed. On the other hand, it is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia. Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in clinical practice. Herein, we experienced similar 2 cases of non-diabetic hypoinsulinemic hypoglycemia. Both of them were elderly subjects with low body weight. Furthermore, it is likely that hypoinsulinemic hypoglycemia in both subjects was triggered by severe liver injury, at least in part, due to possible limited liver glycogen store. In elderly subjects with low body weight and/or malnutrition, metabolism in the liver is reduced and glycogen accumulation is decreased. Such alteration brings out acute and marked liver injury, which finally leads to the onset of severe hypoglycemia. It is known that not only liver injury but also multiple organ failure could be induced due to extreme emaciation in subjects. It is likely that in elderly subjects with low body weight and/or malnutrition, multiple organ failure including liver failure could be induced due to the similar reason. Therefore, we should be very careful of such subjects in order to avoid the development of multiple organ failure which leads to life-threatening situations. In conclusion, we should keep in mind the possibility of hypoinsulinemic hypoglycemia when we examine severe liver injury, especially in elderly or starving subjects with low body weight and limited liver glycogen stores. It is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia.Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in everyday clinical practice.Herein, we reported similar 2 cases of hypoinsulinemic hypoglycemia without diabetes presumably triggered

  10. The Experience of Counseling Among a Singaporean Elderly Population: A Qualitative Account of What Clients Report as Beneficial.

    Science.gov (United States)

    Mathews, Mathew

    2016-09-01

    Adjustments that accompany ageing pose a challenge to the mental health of the elderly. Psychologically based counseling has been documented in Western societies as an appropriate intervention for elderly persons with depressive episodes. There is however very little research documenting how Asian elderly populations experience and benefit from counseling. This study addresses this research gap through a qualitative study based on post-counseling interviews with a sample of 41 elderly persons who received counseling at a dedicated organisation catering to the elderly in Singapore. The qualitative data revealed that clients benefitted from counseling through better emotional management - they received emotional support, found emotional healing and learnt to deal with the emotions associated with grief and loss. Clients also reported that counseling assisted them in decision making processes - older persons were able to conceive of alternatives to their predicament, obtained insights to embark on change, were enabled to take the perspective of others and found validation for their decisions. While many elderly clients greatly appreciated and benefitted from this service, citing demonstrable changes, among the very old such changes were uncommon. Cultural explanations for these differential reports and possible directions for much needed future research are provided.

  11. Sacubitril/Valsartan in an Elderly Patient with Heart Failure: A Case Report.

    Science.gov (United States)

    Cameli, Matteo; Pastore, Maria Concetta; Pagliaro, Antonio; Di Tommaso, Cristina; Reccia, Rosanna; Curci, Valeria; Mandoli, Giulia Elena; Mondillo, Sergio

    2017-01-01

    Sacubitril/valsartan has recently been approved for the treatment of heart failure with reduced ejection fraction. Given its recent introduction in the armamentarium for the treatment of heart failure (HF), "field-practice" evidence is required to deepen the clinical management of sacubitril/valsartan therapy. We report a relevant case of an elderly patient who achieved major clinical benefits after only 3 months of sacubitril/valsartan therapy. Importantly, in our assessment, we employed speckle tracking echocardiography (STE), a recent echocardiography technique that is non-Doppler and not angle dependent, which analyzes deformations of heart chambers from standard images and allows a fast, reliable, and reproducible assessment of heart function. After 3 months of therapy, NHYA class decreased from III to I-II and hypertension was controlled. Echocardiography examination also showed a marked improvement, with a reduction of left ventricular diameter, improved diastolic function (E = 0.39 m/s; A 0.69 m/s; E/A 0.55), normalized diastolic function index (E/E' TDI = 6.93), normalized atrial volume (63 mL), and improved atrial strain (15.44%). This case report documents the fast clinical and symptom improvement with sacubitril/valsartan in an elderly patient with HF; comprehensive echocardiographic assessment, including STE, also revealed a marked functional improvement with this compound. © 2017 S. Karger AG, Basel.

  12. Purple urine bag syndrome in nursing homes: Ten elderly case reports and a literature review

    Directory of Open Access Journals (Sweden)

    Chi-Hung Lin

    2008-12-01

    Full Text Available Chi-Hung Lin1, Hsien-Te Huang1, Chia-Chang Chien1, Dong-Sheng Tzeng1,2, For-Wey Lung1,3–51Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; 2Graduate Institute of Occupational Safety and Health; 3Graduate Institute of Behavioral Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan; 5Calo Psychiatric Center, Pingtung County, TaiwanAbstract: Purple urine bag syndrome (PUBS is a rare occurrence, in which the patient has a purple-colored urine bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue and indirubin (red that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1% were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer’s, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes.Keyword: purple urine bag syndrome, indigo, indirubin, nursing home, bacteriuria, indoxyl sulphatase

  13. Atomoxetine for Orthostatic Hypotension in an Elderly Patient Over 10 Weeks: A Case Report.

    Science.gov (United States)

    Hale, Genevieve M; Brenner, Michael

    2015-09-01

    Several nonpharmacologic strategies for orthostatic hypotension exist including avoiding large carbohydrate-rich meals; limiting alcohol consumption; maintaining adequate hydration; adding salt to foods; and using compression stockings, tilt-table exercises, or abdominal binders. If these fail, however, only limited evidence-based pharmacologic treatment options are available including the use of fludrocortisone, midodrine, pyridostigmine, and droxidopa as well as pseudoephedrine, ocetreotide, and atomoxetine. This report discusses a case of atomoxetine use for 10 weeks in an elderly patient with primary orthostatic hypotension. An 84-year-old man with long-standing primary orthostatic hypotension presented to our ambulatory cardiology pharmacotherapy clinic after several unsuccessful pharmacologic therapies including fludrocortisone, midodrine, and pyridostigmine. Nonpharmacologic strategies were also implemented. Atomoxetine was initiated, and the patient showed gradual improvements in symptoms and blood pressure control over the course of 10 weeks. Our data suggest that low-dose atomoxetine is an effective and safe agent for symptom improvement and blood pressure control in elderly patients with primary orthostatic hypotension. © 2015 Pharmacotherapy Publications, Inc.

  14. Relevance of Perpetrator Identity to Reporting Elder Financial and Emotional Mistreatment.

    Science.gov (United States)

    Acierno, Ron; Steedley, Mara; Hernandez-Tejada, Melba A; Frook, Gabrielle; Watkins, Jordan; Muzzy, Wendy

    2018-04-01

    The National Elder Mistreatment Study (NEMS) found that 5.2% of community older adults experienced financial abuse, and 4.6% experienced emotional mistreatment in the past year. Unfortunately, the majority of abuse was not reported to the authorities. This study investigated reasons for non-reporting. In all, 774 NEMS participants were surveyed 8 years later via telephone to assess past-year financial and emotional mistreatment, perpetrator status, and whether any of these episodes were reported to authorities. In total, 87.5% of financial abuse by family, friends, or acquaintances was not reported versus 33% of that perpetrated by strangers; for emotional mistreatment, 89.9% of that perpetrated by family, friends, and acquaintances was not reported, compared with 83.3% by strangers. Reasons for non-reporting of emotional abuse centered largely around with "not wanting publicity" and "not wanting to get the perpetrator in trouble," while no consistent reason emerged for failure to report stranger-perpetrated mistreatment.

  15. Validity of the Clock Drawing Test in predicting reports of driving problems in the elderly

    Directory of Open Access Journals (Sweden)

    Banou Evangelia

    2004-10-01

    Full Text Available Abstract Background This study examined the use of the Folstein Mini Mental Status Exam (MMSE and the Clock Drawing Test (CDT in predicting retrospective reports of driving problems among the elderly. The utility of existing scoring systems for the CDT was also examined. Methods Archival chart records of 325 patients of a geriatric outpatient clinic were reviewed, of which 162 had CDT results (including original clock drawings. T-test, correlation, and regression procedures were used to analyze the data. Results Both CDT and MMSE scores were significantly worse among non-drivers than individuals who were currently or recently driving. Among current or recent drivers, scores on both instruments correlated significantly with the total number of reported accidents or near misses, although the magnitude of the respective correlations was small. Only MMSE scores, however, significantly predicted whether or not any accidents or near misses were reported at all. Neither MMSE nor CDT scores predicted unique variance in the regressions. Conclusions The overall results suggest that both the MMSE and CDT have limited utility as potential indicators of driving problems in the elderly. The demonstrated predictive power for these instruments appears to be redundant, such that both appear to assess general cognitive function versus more specific abilities. Furthermore, the lack of robust prediction suggests that neither are sufficient to serve as stand-alone instruments on which to solely base decisions of driving capacity. Rather, individuals who evidence impairment should be provided a more thorough and comprehensive assessment than can be obtained through screening tools.

  16. Durable response using regorafenib in an elderly patient with metastatic colorectal cancer: case report

    Directory of Open Access Journals (Sweden)

    Tang R

    2015-11-01

    Full Text Available Ronald Tang,1 Tatiana Kain,2 June Herman,2 Tara Seery1 1Division of Hematology-Oncology, 2Division of Nuclear Medicine and Molecular Imaging, University of California, Irvine, Orange, CA, USA Abstract: Regorafenib, an oral multikinase inhibitor, was approved in September 2012 by the US Food and Drug Administration for the treatment of patients with metastatic colorectal cancer. Since this time, however, few case reports outlining real-world usage have been published in the literature. Here, we detail the clinical history of an elderly woman with KRAS wild-type colon cancer who received regorafenib after prior treatment with other agents. We show that by employing dose modification strategies to address adverse events, this patient was able to remain on therapy for 11 months and achieve stable disease. Keywords: regorafenib, metastatic colorectal cancer, oral multikinase inhibitor

  17. Self-reported urinary incontinence in elderly and its associated factors

    Directory of Open Access Journals (Sweden)

    Alisson Fernandes Bolina

    2013-05-01

    Full Text Available Household survey, cross-sectional and observational study that aimed to verify the socio-demographic factors and self-reported morbidities associated with urinary incontinence (UI. The research was carried out between August and December 2008 with 2,142 elderly people. We used a semi-structured instrument, and performed a descriptive analysis and logistic regression (p<0.05. Most were female and with income of up to one minimum wage. UI prevailed among those aged 70├80 years, widowed and uneducated; for the group without UI: 60├70 years, married or living with partner and 4├8 years of study. The factors associated with increased chances of presenting UI were: 70├80 years and 80 years and older, no education and obesity. It is important to pay attention to the factors associated with UI in the development of effective actions on health prevention.

  18. Kidney failure in the elderly due to hypothyroidism: a case report

    Directory of Open Access Journals (Sweden)

    Graziela Cristina Pichinin Ledo Silva

    Full Text Available CONTEXT: Hypothyroidism is more prevalent in the elderly and its symptoms can be confused with other changes due to aging. Doctors caring for the elderly need to be attentive to this diagnostic possibility. This case report case is notable not only because it presents a rare complication of hypothyroidism (kidney failure, but also because patients with chronic kidney failure of any etiology may suffer increased renal dysfunction as a result. CASE REPORT: This was a 66-year-old male outpatient with a history of generalized edema over the preceding eight years, with periods of worsening, that was intractable to treatment with diuretics. Physical examination revealed bradycardia (heart rate: 52 bpm, pallor, dry and infiltrated skin, macroglossia, edema in the lower limbs and a palpable thyroid with hard consistency. Laboratory tests showed: creatinine 3.9 mg/dl; urea 95 mg/dl; potassium 6.0 mEq/l; thyroid-stimulating hormone > 100 mUI/ml; triiodothyronine 0.01 ng/dl; free thyroxin 0.01 ng/dl; antithyroglobulin 31 IU/ml (normal values: < 40 IU/ml; antithyroperoxidase 85 IU/ml (normal values: < 15 IU/ml; creatinine clearance 30 ml/min/1.73 m²; and proteinuria 122 mg/24 h. After five months of treatment with thyroxin (100 mcg/day, the patient returned without any symptoms and presented the following test results: urea 48 mg/dl; creatinine 1.4 mg/dl; creatinine clearance 67 ml/min/1.73 m²; potassium 4.2 mEq/l; thyroid-stimulating hormone: 20.85 mUI/ml; free thyroxin: 0.71 ng/dl. Hypothyroidism alone can cause renal impairment or worsen renal function in preexisting illnesses. Its treatment can stabilize the clinical condition, or possibly improve it.

  19. User-friendly cognitive training for the elderly: a technical report.

    Science.gov (United States)

    Boquete, Luciano; Rodríguez-Ascariz, José Manuel; Amo-Usanos, Carlos; Martínez-Arribas, Alejandro; Amo-Usanos, Javier; Otón, Salvador

    2011-01-01

    This article presents a system that implements a cognitive training program in users' homes. The system comprises various applications designed to create a daily brain-fitness regime. The proposed mental training system uses television and a remote control specially designed for the elderly. This system integrates Java applications to promote brain-fitness training in three areas: arithmetic, memory, and idea association. The system comprises the following: Standard television set, simplified wireless remote control, black box (system's core hardware and software), brain-fitness games (language Java), and Wi-Fi-enabled Internet-connected router. All data from the user training sessions are monitored through a control center. This control center analyzes the evolution of the user and the proper performance of the system during the test. The implemented system has been tested by six healthy volunteers. The results for this user group demonstrated the accessibility and usability of the system in a controlled real environment. The impressions of the users were very favorable, and they reported high adaptability to the system. The mean score for usability and accessibility assigned by the users was 3.56 out of 5 points. The operation stress test (over 200 h) was successful. The proposed system was used to implement a cognitive training program in users' homes, which was developed to be a low-cost tool with a high degree of user interactivity. The results of this preliminary study indicate that this user-friendly system could be adopted as a form of cognitive training for the elderly.

  20. Elder abuse

    OpenAIRE

    1999-01-01

    Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.

  1. Unusual presentation of cactus spines in the flank of an elderly man: a case report

    Directory of Open Access Journals (Sweden)

    Freeman Scott

    2010-05-01

    Full Text Available Abstract Introduction Splinters and spines of plant matter are common foreign bodies in skin wounds of the extremities, and often present embedded in the dermis or subcutaneous tissue. Vegetative foreign bodies are highly inflammatory and, if not completely removed, can cause infection, toxic reactions, or granuloma formation. Older patients are at increased risk for infection from untreated plant foreign bodies. The most common error in plant splinter and spine management is failure to detect their presence. Case presentation Here we report a case of cactus spines in an 84-year-old Caucasian man presenting on the right flank as multiple, red papules with spiny extensions. This presentation was unusual both in location and the spinous character of the lesions, and only after punch biopsy analysis was a diagnosis of cactus matter spines made. Conclusions Our patient presented with an unusual case of cactus spines that required histopathology for identification. Skin lesions with neglected foreign bodies are a common cause of malpractice claims. If not removed, foreign bodies of the skin, particularly in elderly individuals, can result in inflammatory and infectious sequela. This report underscores the importance of thoroughly evaluating penetrating skin lesions for the presence of foreign bodies, such as splinters and spines.

  2. Empirically derived dimensional syndromes of self-reported psychopathology: Cross-cultural comparisons of Portuguese and US elders.

    Science.gov (United States)

    Ivanova, Masha Y; Achenbach, Thomas; Leite, Manuela; Almeida, Vera; Caldas, Carlos; Turner, Lori; Dumas, Julie A

    2018-05-01

    As the world population ages, mental health professionals increasingly need empirically supported assessment instruments for older adult psychopathology. This study tested the degree to which syndromes derived from self-ratings of psychopathology by elders in the US would fit self-ratings by elders in Portugal. The Older Adult Self-Report (OASR) was completed by 352 60- to 102-year-olds in Portuguese community and residential settings. Confirmatory factor analyses tested the fit of the 7-syndrome OASR model to self-ratings by Portuguese elders. The primary fit index (Root Mean Square Error of Approximation) showed good fit, while secondary fit indices (the Comparative Fit Index and the Tucker-Lewis Index) showed acceptable fit. Loadings of 95 of the 97 items on their expected syndromes were statistically significant (mean = .63), indicating that the items measured the syndromes well. Correlations between latent factors, ie, between the hypothesized syndrome constructs measured by the items, averaged .66. The correlations between syndromes reflect varying degrees of comorbidity between problems comprising particular pairs of syndromes. The results support the syndrome structure of the OASR for Portuguese elders, offering Portuguese clinicians and researchers a useful instrument for assessing a broad spectrum of psychopathology. The results also offer a core of empirically supported taxonomic constructs of later life psychopathology as a basis for advancing clinical practice, training, and cross-cultural research. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Relationships between street characteristics and perceived attractiveness for walking reported by elderly people

    NARCIS (Netherlands)

    Borst, H.C.; Miedema, H.M.E.; Vries, S.I. de; Graham, J.M.A.; Dongen, J.E.F. van

    2008-01-01

    Walking is important for the health of elderly people. Previous studies have found a relationship between neighbourhood characteristics, physical activity and related health aspects. The multivariate linear regression model presented here describes the relationships between the perceived

  4. Nonaneurysmatic Dysphagia Aortica in the Elderly: Three Case Reports and Literature Review

    OpenAIRE

    Yi-Hsueh Chan; Chien-Yuan Hung; Tze-Yu Shieh; Horng-Yuan Wang; Ching-Wei Chang; Shou-Chuan Shih; Ming-Jen Chen

    2016-01-01

    Dysphagia is a remarkably prevalent disorder in the elderly. Both age-related changes in swallowing physiology and age-related diseases are predisposing factors for dysphagia in the elderly. Dysphagia aortica is a rare etiology of dysphagia resulting from extrinsic compression of the esophagus by an aneurysm or by a tortuous and elongated thoracic aorta. Clinical findings of dysphagia aortica resemble those of esophageal malignancy or esophageal motility disorders. Dysphagia aortica not relat...

  5. Diagnosis and management of an elderly patient with severe tracheomalacia: A case report and review of the literature

    OpenAIRE

    JIANG, AI-GUI; GAO, XIAO-YAN; LU, HUI-YU

    2013-01-01

    Severe adult tracheomalacia is a dangerous disease that is difficult to manage, particularly at the time of airway infection, and has a high mortality rate. The present study reports the diagnosis and treatment of an elderly patient with severe adult tracheomalacia. In March 2012, the 59-year-old patient presented with progressive dyspnea to the Department of Respiratory Medicine, Taizhou People?s Hospital (Jiangsu, China). Following admission, chest radiography revealed symptoms consistent w...

  6. Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2012-01-01

    Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

  7. The measurement of disability in the elderly: a systematic review of self-reported questionnaires.

    Science.gov (United States)

    Yang, Ming; Ding, Xiang; Dong, Birong

    2014-02-01

    To analyze the contents and formats of general self-reported questionnaires on disability that are designed for and/or are widely applied in the elderly population to depict a complete picture of this field and help researchers to choose proper tools more efficiently. A broad systematic literature search was performed in September 2013 and included the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and PROQOLID. The publication language was limited to English and Chinese. Two review authors independently performed the study selection and data extraction. All of the included instruments were extracted and classified using the International Classification of Functioning, Disability, and Health framework. Of 5569 articles retrieved from the searches and 156 articles retrieved from the pearling, 22 studies (including 24 questionnaires) fulfilled the inclusion criteria. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the Barthel Index followed by the Lawton and Brody Instrumental Activities of Daily Living Scale and the Katz Index of Activities of Daily Living, respectively. The contents and formats of the questionnaires varied considerably. Activities and participation were the most commonly assessed dimensions. In addition, the Activities of Daily Living, mobility and the Instrumental Activities of Daily Living Scale were the most common domains assessed among the included questionnaires. Among the 24 included questionnaires, the most frequently used questionnaires were the Barthel Index, Lawton and Brody Instrumental Activities of Daily Living Scale, and Katz Index of Activities of Daily Living. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all essential dimensions of the International Classification of Functioning, Disability, and Health framework. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All

  8. A population-based study of physical function and risk for elder abuse reported to social service agency: findings from the Chicago health and aging project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2014-10-01

    We examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse. The independent variable was objectively assessed physical function using both directly observed physical performance testing and self-reported physical function (Katz activity of daily living scale, Nagi physical activity scale, and Rosow Breslau mobility scales). Outcomes were elder abuse and specific subtypes of elder abuse. After adjusting for confounders, lower levels of physical performance testing (OR, 2.71[1.58-4.64]), Katz impairment (OR, 1.84[1.29-2.59]), Nagi impairment (OR, 1.65[1.15-2.37]) and Rosow Breslau (OR, 1.76[1.26-2.47]) were associated with increased risk for elder abuse. Lowest levels of physical performance testing were associated with increased risk for psychological abuse (OR, 2.69[1.27-5.71]), caregiver neglect (OR, 2.66[1.22-5.79]), and financial exploitation (OR, 2.35 [1.21-4.55]). Our results may have important implications to healthcare professional, social services and other disciplines to prevent and treat elder abuse. © The Author(s) 2012.

  9. Fibrous dysplasia of the maxilla in an elderly female: Case report on a 14-year quiescent phase

    International Nuclear Information System (INIS)

    Lee, Byung Do; Lee, Wan; Park, Yong Chan; Choi, Moon Ki; Kim, Myong Hyoun; Yoon, Jung Hoon

    2016-01-01

    Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal bone is replaced by abnormal fibroosseous tissue. Mainly, FD is found in children, and by adulthood it usually becomes quiescent. Our case showed FD of more than 14-year duration in the left maxilla. Our evaluation was that growth ceased in adulthood and had achieved the static stage. Because FD cases in elderly patients are rarely reported, we hereby present a monostotic FD case in a 65-year-old female. We presented sequential radiographic images and scintigraphic images of this case, and combined them with a literature review that emphasized the progression of the disease

  10. Fibrous dysplasia of the maxilla in an elderly female: Case report on a 14-year quiescent phase

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Do; Lee, Wan; Park, Yong Chan; Choi, Moon Ki [College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Kim, Myong Hyoun [Dept. of Nuclear Medicine, Wonkwang University, School of Medicine and Institute of Wonkwang Medical Science, Iksan (Korea, Republic of); Yoon, Jung Hoon [Dept. of Oral and Maxillofacial Pathology, College of Dentistry, Wonkwang Bone Regeneration Research Institute, Daejeon Dental Hospital, Wonkwang University, Daejeon (Korea, Republic of)

    2016-12-15

    Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal bone is replaced by abnormal fibroosseous tissue. Mainly, FD is found in children, and by adulthood it usually becomes quiescent. Our case showed FD of more than 14-year duration in the left maxilla. Our evaluation was that growth ceased in adulthood and had achieved the static stage. Because FD cases in elderly patients are rarely reported, we hereby present a monostotic FD case in a 65-year-old female. We presented sequential radiographic images and scintigraphic images of this case, and combined them with a literature review that emphasized the progression of the disease.

  11. Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports

    Directory of Open Access Journals (Sweden)

    Takatoshi Anno

    2018-03-01

    Full Text Available Hypoglycemia is induced by many causes, especially over-dose of insulin or oral hypoglycemic agents in diabetic subjects. In such a case, hyperinsulinemic hypoglycemia is usually observed. On the other hand, it is important to classify secondary hypoglycemia and hypoinsulinemic hypoglycemia. Liver injury-induced hypoglycemia is one of the causes of hypoinsulinemic hypoglycemia but rarely observed in clinical practice. Herein, we experienced similar 2 cases of non-diabetic hypoinsulinemic hypoglycemia. Both of them were elderly subjects with low body weight. Furthermore, it is likely that hypoinsulinemic hypoglycemia in both subjects was triggered by severe liver injury, at least in part, due to possible limited liver glycogen store. In elderly subjects with low body weight and/or malnutrition, metabolism in the liver is reduced and glycogen accumulation is decreased. Such alteration brings out acute and marked liver injury, which finally leads to the onset of severe hypoglycemia. It is known that not only liver injury but also multiple organ failure could be induced due to extreme emaciation in subjects. It is likely that in elderly subjects with low body weight and/or malnutrition, multiple organ failure including liver failure could be induced due to the similar reason. Therefore, we should be very careful of such subjects in order to avoid the development of multiple organ failure which leads to life-threatening situations. In conclusion, we should keep in mind the possibility of hypoinsulinemic hypoglycemia when we examine severe liver injury, especially in elderly or starving subjects with low body weight and limited liver glycogen stores.

  12. Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

  13. Primitive neuroectodermal tumor of the maxillary sinus in an elderly male: A case report and literature review

    International Nuclear Information System (INIS)

    Shah, Saiquat; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul

    2014-01-01

    Primitive neuroectodermal tumor (PNET), which belongs to the Ewing's sarcoma (ES) family of tumors, is mainly seen in children and young adults. PNETs are extremely rare in the maxilla. Here, we report a case of PNET of the left maxillary sinus in an elderly male. Magnetic resonance imaging (MRI) revealed a slightly enhanced solid mass occupying the left maxillary sinus and infiltrating into the retroantral space. A partial maxillectomy was performed. Despite postoperative chemotherapy, follow-up computed tomography (CT) and MRI revealed a nodal metastasis in the submandibular space. Neck dissection was performed. However, the patient died 10 months after the second surgery because of distant metastasis to the liver. MRI and CT were particularly useful in detecting the extent of the tumor, recurrence, and metastasis. Further, a literature review of the previously reported PNET cases of the maxilla was carried out. In this paper, we also discuss the current approach for the diagnosis and management of these tumors.

  14. Primitive neuroectodermal tumor of the maxillary sinus in an elderly male: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Saiquat [Dept. of Dental Public Health, Bangladesh Dental College, Dhaka (Bangladesh); Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2014-12-15

    Primitive neuroectodermal tumor (PNET), which belongs to the Ewing's sarcoma (ES) family of tumors, is mainly seen in children and young adults. PNETs are extremely rare in the maxilla. Here, we report a case of PNET of the left maxillary sinus in an elderly male. Magnetic resonance imaging (MRI) revealed a slightly enhanced solid mass occupying the left maxillary sinus and infiltrating into the retroantral space. A partial maxillectomy was performed. Despite postoperative chemotherapy, follow-up computed tomography (CT) and MRI revealed a nodal metastasis in the submandibular space. Neck dissection was performed. However, the patient died 10 months after the second surgery because of distant metastasis to the liver. MRI and CT were particularly useful in detecting the extent of the tumor, recurrence, and metastasis. Further, a literature review of the previously reported PNET cases of the maxilla was carried out. In this paper, we also discuss the current approach for the diagnosis and management of these tumors.

  15. Elderly Suicide

    Science.gov (United States)

    Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

  16. New-onset headache in an elderly man with uremia that improved only after correction of hyperphosphatemia ("uremic headache": a case report

    Directory of Open Access Journals (Sweden)

    Chopra Vanilla

    2011-02-01

    Full Text Available Abstract Introduction New-onset headaches in the elderly are usually secondary and rarely primary. We present the case of an elderly man with recent-onset headache due to uremic hyperphosphatemia and hypocalcemia. To the best of our knowledge, this is the first case report of its kind in the literature. Case presentation We present the case of a 70-year-old Indian man with chronic kidney disease whose new-onset headache improved only when his hyperphosphatemia and hypocalcemia were corrected. He had diffuse, dense calcification of tentorium cerebelli and falx due to hyperphosphatemia. Conclusions This case report reinforces the importance of identifying the cause of a new-onset headache, particularly in the elderly, and treating it before blaming a tension headache or primary headache as the cause.

  17. Tubercular spondylodiscitis in elderly is a more severe disease: a report of 66 consecutive patients.

    Science.gov (United States)

    Shetty, Ajoy Prasad; Viswanathan, Vibhu Krishnan; Kanna, Rishi Mukesh; Shanmuganathan, Rajasekaran

    2017-12-01

    (1) To analyze peculiarities of presentation and prognosis of tubercular spondylodiscitis (TBS) in elderly. (2) To assess if associated co-morbidities and risks lead to poorer outcome (3) To observe if different management strategy needs to be implemented in them. Retrospective analysis of 66 consecutive elderly TBS patients (>60 years) treated conservatively or surgically between January 2010 and July 2013 was performed. Details regarding clinical presentation (general health, ambulatory status, co-morbidities), neurological status, medical or surgical complications and outcome measurements [visual analog score, clinico-radiological evidence of healing and lumbar lordosis in lumbar (L) or lumbo-sacral (LS) or focal kyphosis in thoracic (T) or thoraco-lumbar (TL) disease] were analysed. Of 66 patients (mean age 67.9 years), 85% had at least one medical co-morbidity and only 45% were community ambulators. Mean delay in presentation was 132 days and lumbar disease was commonest. 35% had neuro-deficit. Most patients had stage 2 (38%) or 3 (42.4%) disease. 19 patients were conservatively managed, while others underwent surgery. Significant complications occurred in 23 patients, most common being liver dysfunction (9 patients). Five patients (8%) expired during treatment: three succumbed to multi-focal tubercular disease, while two expired secondary to medical illnesses. Mean loss of lordosis in conservatively treated (CG) L/LS disease was 8°, while lordosis was restored by 11.6° in operative group (OG). In T/TL disease, sagittal alignment correction by 12.6° was observed in OG as against 5.7° kyphotic collapse in CG patients. 92% patients were cured with no recurrences. The final VAS scores in operative and conservative groups were not significantly different (OG 1.4 ± 0.6, CG 1.9 ± 0.7). TBS in elderly differed from that in younger by having a higher co-morbidities, later presentation, higher neuro-deficit, greater mortality and increased complications

  18. The complexities of elder abuse.

    Science.gov (United States)

    Roberto, Karen A

    2016-01-01

    Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Isolated bladder rupture in an elderly patient after blunt trauma. Case report and review

    Directory of Open Access Journals (Sweden)

    Bardia Bidarmaghz

    2017-04-01

    Full Text Available A 74-year-old man presented to the hospital after having a mechanical fall at home on his left side of the body. On arrival he was stable, and investigation revealed fractured left humerus, and he was admitted for observation and pain management. Two days later he started to have severe lower abdominal pain and acute kidney injury. Urinary catheter inserted and about 2 liters of bloody urine emptied, and Abdominopelvic CT scan requested which showed massive fluid in the retroperitoneal area, subsequent CT Cystogram confirmed perforation of the bladder on the left lateral wall. The patient was hemodynamically stable and kept in a high intensive care unit for close observation, and he improved dramatically, and follow-up scan showed healing of perforated bladder. Bladder rupture is not a standard presentation after blunt trauma but should be kept in mind when dealing with elderly patients with pre-existing urinary retention or other medical comorbidities.

  20. Complicated acute appendicitis presenting as an abscess in the abdominal wall in an elderly patient: A case report

    Directory of Open Access Journals (Sweden)

    Ibrahim Massuqueto Andrade Gomes de Souza

    Full Text Available Introduction: Appendicitis is a common cause of acute abdomen; however, the classic clinical signs are not often present, and it has unusual presentations. Thus, its diagnosis can be challenging. PRESENTATION OF CASE: We describe the case of an elderly man who presented with right abdominal wall abscess with spontaneous drainage in the emergency department. Since we suspected a subjacent abdominal pathology, we performed surgery, and intraoperatively, we observed that the Appendix tip had invaded the abdominal wall. Discussion: This patient had a challenging diagnostic process and surgical visualization of the appendicular tip invading the abdominal wall was an important characteristic in proving the cause of the abdominal wall abscess. Conclusion: The onset of an abdominal wall abscess without a known cause needs to be thoroughly investigated, with consideration of a subjacent abdominal cause and appendicitis necessitatis. Keywords: Appendicitis, Abdominal abscess, Appendicitis necessitatis, Case report

  1. Small cell carcinoma of the prostate in an elderly patient: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Dale Alan Whitaker Jr.

    2016-12-01

    Full Text Available Prostate cancer is the most common malignancy of men in the United States. Small-cell carcinoma (SCC, which typically presents as an aggressive lung malignancy, is a rare diagnosis within the setting of prostate cancer pathology. Due to its limited prevalence, little information regarding the treatment and prognosis of this disease in large populations is available. To date our current knowledge base is largely limited to case reports and retrospective case reviews. The mainstay of treatment for this particular histology most often involves a multimodality approach utilizing chemotherapy in conjunction with radiation therapy, androgen deprivation therapy, or prostatectomy. Here we present the case of an elderly 89- year-old Caucasian male who was diagnosed with SCC of the prostate. Despite proceeding with a course of definitive radiotherapy, the patient experienced rapid progression of disease and ultimately elected to discontinue radiation therapy and receive hospice care.

  2. Diagnosis and management of an elderly patient with severe tracheomalacia: A case report and review of the literature.

    Science.gov (United States)

    Jiang, Ai-Gui; Gao, Xiao-Yan; Lu, Hui-Yu

    2013-09-01

    Severe adult tracheomalacia is a dangerous disease that is difficult to manage, particularly at the time of airway infection, and has a high mortality rate. The present study reports the diagnosis and treatment of an elderly patient with severe adult tracheomalacia. In March 2012, the 59-year-old patient presented with progressive dyspnea to the Department of Respiratory Medicine, Taizhou People's Hospital (Jiangsu, China). Following admission, chest radiography revealed symptoms consistent with chronic obstructive pulmonary disease (COPD) and chest computed tomography (CT) demonstrated an evident stenosis of the tracheal lumen at the end of expiration. Bronchoscopy revealed a 91% reduction in the cross-sectional area of the tracheal lumen at the end of expiration. Following the final diagnosis, the patient was successfully treated with nasal continuous positive airway pressure (CPAP) combined with implantation of a temporary Chinese Li's metallic stent. These treatment methods appeared to be temporarily effective in alleviating the symptoms of the disease.

  3. Elder Abuse Demonstration Project. Third Interim Report to the Illinois General Assembly on Public Acts 83-1259 and 83-1432.

    Science.gov (United States)

    Illinois State Dept. on Aging, Springfield.

    This document contains the third annual interim report of the Illinois Elder Abuse Demonstration Program. It discusses the overall intent of the demonstration program, trends and changes in the third year of the demonstration program compared with the results from the first two years of the program, and achievements and recommendations for a…

  4. X-ray and computed tomography findings in macrodystrophia lipomatosa of the foot with secondary osteoarthritic changes diagnosed in an elderly female: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Rajesh; Gupta, Puneet; Mahajan, Manik; Arora, Manjit; Gupta, Anchal, E-mail: drrajeshradiology@gmail.com [Department of Radio-diagnosis and Imaging, Acharya Shri Chander College of Medical Sciences Hospital, Sidhra, Jammu, Jammu and Kashmir (India)

    2017-03-15

    Macrodystrophia lipomatosa is a rare entity that is mostly diagnosed in children. It has been very rarely reported in adults. Here, we describe the X-ray and computed tomography findings in a case of macrodystrophia lipomatosa in an elderly female presenting with an enlarged second toe since birth and bony outgrowths causing pressure effects and cosmetic problems. (author)

  5. Characteristics of Elderly and Other Vulnerable Adult Victims of Homicide by a Caregiver: National Violent Death Reporting System--17 U.S. States, 2003-2007

    Science.gov (United States)

    Karch, Debra; Nunn, Kelly Cole

    2011-01-01

    Homicides of dependent elderly and nonelderly adults by their caregivers violate trust and have long-term consequences for families. A better understanding of the characteristics of homicide by caregivers may provide insights that can inform prevention efforts. Data collected in the National Violent Death Reporting System (NVDRS) between 2003 and…

  6. Elder physical abuse.

    Science.gov (United States)

    Young, Lisa M

    2014-11-01

    Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Is there an association between rumination and self-reported physical health? A one-year follow-up in a young and an elderly sample

    DEFF Research Database (Denmark)

    Thomsen, Dorthe Kirkegaard; Mehlsen, Mimi Yung; Olesen, Frede

    2004-01-01

    Cross-sectional studies have suggested an association between rumination and subjective health. The aim of the present study was to investigate in a longitudinal design whether rumination was related to self-reported physical health. A total of 96 young (age range 20-35) and 110 elderly (age range...... 70-85) participants completed questionnaires measuring rumination, negative affect, life events, and self-reported physical health at baseline and at 1-year follow-up. Multiple linear regressions showed a significant association between self-reported physical health at time I only for the elderly...... and negative affect mediated the association. At follow-up, rumination was significantly associated with self-reported physical health only for the young and the association was only partly mediated by negative affect. In conclusion, rumination is associated with poorer self-reported physical health...

  8. Relations between postural stability, gait and falls in elderly persons--preliminary report.

    Science.gov (United States)

    Baczkowicz, Dawid; Szczegielniak, Jan; Proszkowiec, Małgorzata

    2008-01-01

    Balance control in elderly patients is the area of interest of many researchers. The results of their studies suggest that the measurement of shifts in the centre of foot pressure on the support base (COP) can be used as a tool for identification of fall-prone persons. It is interesting whether there are any relations between functional status, gait, posture stability and the risk of falling. The aim of this study was to find the answer to this question. The study involved 20 patients (mean age 78.1+/-11.6). The functional status of the patients was evaluated according to the Barthel Index. Postural stability was assessed with the use of a Neurocom Balance Master platform. Three measurements were taken with visual feedback (eyes open-EO) and three without visual feedback (eyes closed-EC). Balance control was also evaluated with the Berg test and on the basis of the history of episodes of falling in the preceding six months. Gait was evaluated with the six-minute walking test. The parameters recorded by the force platform showed a significant relation to the values obtained in the Berg test (r=-0.60; pfalls showed a significant relation only to the EO test (r=0.4; pfalls was connected with increased body sway. 3. The functional status of the patient and the balance control evaluation according to the Berg test failed to determine the risk of falling. 4. A relation was observed between postural stability, functional status and gait.

  9. OK-432 (Picibanil) sclerotherapy for recurrent dislocation of the temporomandibular joint in elderly edentulous patients: Case reports.

    Science.gov (United States)

    Matsushita, Kazuhiro; Abe, Takae; Fujiwara, Toshikatsu

    2007-09-01

    Dislocation of the temporomandibular joint (TMJ) is a thorny problem not only for a patient but also a doctor. Especially for the elderly edentulous patients, it is very hard to treat the condition although there are many surgical and non-surgical procedures. We successfully treated it in two elderly edentulous patients by injection of OK-432 as a sclerosing agent.

  10. Methodological systematic review: mortality in elderly patients with cervical spine injury: a critical appraisal of the reporting of baseline characteristics, follow-up, cause of death, and analysis of risk factors.

    NARCIS (Netherlands)

    Middendorp, J.J. van; Albert, T.J.; Veth, R.P.H.; Hosman, A.J.F.

    2010-01-01

    STUDY DESIGN: Methodologic systematic review. OBJECTIVE: To determine the validity of reported risk factors for mortality in elderly patients with cervical spine injury. SUMMARY OF BACKGROUND DATA: In elderly patients with cervical spine injury, mortality has frequently been associated with the type

  11. AN UNUSUAL PRESENTATION OF A HUGE BREAST TUMOUR IN AN ELDERLY FEMALE: A CASE REPORT

    OpenAIRE

    Prasenjit; Sudipta; Subir Kumar; Himadri Sekhar; Amalesh

    2014-01-01

    Pleomorphic breast carcinoma is a rare variety of breast carcinoma, with a highly aggresive behaviour and poor prognosis, which usually presents after 50 years of age. Our case presented in a very similar way as phyllodes’ tumour of breast (even the FNAC report also suggested it as a case of phyllodes’ tumour). But postoperative histopathological report clearly revealed it as a case of this rare entity of pleomorphic carcinoma of breast

  12. Primary intestinal lymphangiectasia in an elderly female patient: A case report on a rare cause of secondary immunodeficiency.

    Science.gov (United States)

    Huber, Xaver; Degen, Lukas; Muenst, Simone; Trendelenburg, Marten

    2017-08-01

    Protein loss via the gut can be caused by a number of gastrointestinal disorders, among which intestinal lymphangiectasia has been described to not only lead to a loss of proteins but also to a loss of lymphocytes, resembling secondary immunodeficiency. We are reporting on a 75-year-old female patient who came to our hospital because of a minor stroke. She had no history of serious infections. During the diagnostic work-up, we detected an apparent immunodeficiency syndrome associated with primary intestinal lymphangiectasia. Trying to characterize the alterations of the immune system, we not only found hypogammaglobulinemia and lymphopenia primarily affecting CD4+, and also CD8+ T cells, but also marked hypocomplementemia affecting levels of complement C4, C2, and C3. The loss of components of the immune system most likely was due to a chronic loss of immune cells and proteins via the intestinal lymphangiectasia, with levels of complement components following the pattern of protein electrophoresis. Thus, intestinal lymphangiectasia should not only be considered as a potential cause of secondary immune defects in an elderly patient, but can also be associated with additional hypocomplementemia.

  13. Pressure ulcers induced by drug administration: A new concept and report of four cases in elderly patients.

    Science.gov (United States)

    Mizokami, Fumihiro; Takahashi, Yoshiko; Hasegawa, Keiko; Hattori, Hideyuki; Nishihara, Keiji; Endo, Hidetoshi; Furuta, Katsunori; Isogai, Zenzo

    2016-04-01

    Drug-induced akinesia is a potential cause of pressure ulcers. However, pressure ulcers that are caused by drug-induced akinesia are not considered an adverse drug reaction (ADR). We propose that drug-induced pressure ulcers (DIPU) are pressure ulcers that are caused by an external force that is experienced after drug administration, and we considered resolution of these ulcers after drug discontinuation to be a supportive finding. In this report, we reviewed the medical records of pressure ulcer cases from a 300-bed hospital. Among 148 patients, four patients with pressure ulcers met the criterion for DIPU. In these cases, the suspected DIPU were related to treatment with olanzapine, fluvoxamine, valproic acid, clotiazepam, triazolam and rilmazafone. These drugs were administrated to manage the patients' behavioral and psychological symptoms that accompanied dementia. The DIPU in these patients were categorized as stage IV according to the National Pressure Ulcer Advisory Panel criteria. Discontinuation of the causal drugs led to significant improvements or complete healing of the pressure ulcers, and the patients subsequently recovered their mobility. Therefore, we propose that DIPU are potential ADR that have been overlooked in clinical practice. Thus, recognition of DIPU as an ADR may be important in preventing and appropriately managing pressure ulcers among elderly patients. © 2015 Japanese Dermatological Association.

  14. Self-reported napping and duration and quality of sleep in the lifestyle interventions and independence for elders pilot study.

    Science.gov (United States)

    Picarsic, Jennifer L; Glynn, Nancy W; Taylor, Christopher A; Katula, Jeffrey A; Goldman, Suzanne E; Studenski, Stephanie A; Newman, Anne B

    2008-09-01

    To determine the prevalence of self-reported napping and its association with subjective nighttime sleep duration and quality, as measured according to sleep-onset latency and sleep efficiency. Cross-sectional study. Lifestyle Interventions and Independence for Elders Pilot Study. Community-dwelling older adults (N=414) aged 70 to 89. Self-report questionnaire on napping and sleep derived from the Pittsburgh Sleep Quality Index (PSQI) scale. Fifty-four percent of participants reported napping, with mean nap duration of 55.0+/-41.2 minutes. Nappers were more likely to be male (37.3% vs 23.8%, P=.003) and African American (20.4% vs 14.4%, P=.06) and to have diabetes mellitus (28% vs 14.3%, P=.007) than non-nappers. Nappers and non-nappers had similar nighttime sleep duration and quality, but nappers spent approximately 10% of their 24-hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for subjects with diabetes mellitus (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2-3.0) and men (OR=1.9, 95% CI=1.2-3.0). In nappers, diabetes mellitus (beta=12.3 minutes, P=.005), male sex (beta=9.0 minutes, P=.04), higher body mass index (beta=0.8 minutes, P=.02), and lower Mini-Mental State Examination score (beta=2.2 minutes, P=.03) were independently associated with longer nap duration. Napping was a common practice in community-dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes mellitus, napping behavior should be assessed as part of sleep behavior in future research and in clinical practice.

  15. Rapid improvement of depressive symptoms and cognition in an elderly patient with a single session of piano playing: a clinical treatment report.

    Science.gov (United States)

    Manalai, Gul; Manalai, Partam; Dutta, Raja; Fegan, Gerald; Scrofani, Philip

    2012-06-01

    Music has been used as a non-pharmacological modality in the treatment of different conditions since ancient times. It has received attention in modern medicine in recent decades, particularly in geriatric population. The effects of music on mood and cognition are well documented. The aim of the current case report is to highlight the benefits of musical activities in the geriatric population. We report a naturalistic treatment outcome in an elderly patient on a geriatric psychiatric unit related to a single session of piano playing. A rapid and sustained improvement in mood and cognition of an elderly patient was observed after a single session of playing piano. Notwithstanding the limitations of a single subject, uncontrolled case study, the effect was dramatic. Our findings support previous claims regarding music therapy including effects of a single session music-based therapeutic interventions, and we conclude that music therapy for geriatric patients with mood and cognitive deficits is worth further systematic investigation.

  16. Merkel cell carcinoma of right buttock in an elderly patient: a case report

    Directory of Open Access Journals (Sweden)

    Shiromani Debbarma

    2015-11-01

    Full Text Available Merkel cell carcinoma is a rare primary cutaneous tumor. So far, few cases have been reported.  Herewith we report a case of an 87-years-old male with painless, ulceroproliferative growth measuring 6x6 cm, over right upper outer quadrant of buttock; stage IIB (TNM, T3cNoMo. Patient received neo-adjuvant chemotherapy, injection of carboplatin 420 mg (day one and etoposide 140 mg (day one to three three weekly for three cycles followed external beam radiotherapy by Cobalt 60. At three months post-treatment follow-up, clinically no evidence of residual disease or recurrences noted. The purpose of reporting this case was to emphasize to its rarity, early asymptomatic clinical course leading to possibility of delayed diagnosis and paramount importance of high index of clinical suspicion in definitive diagnosis for better treatment result.

  17. Investigating the associations between productive housework activities, sleep hours and self-reported health among elderly men and women in western industrialised countries.

    Science.gov (United States)

    Adjei, Nicholas Kofi; Brand, Tilman

    2018-01-11

    After retirement, elderly men and women allocate more time to housework activities, compared to working-age adults. Nonetheless, sleep constitutes the lengthiest time use activity among the elderly, but there has not been any study on the associations between time spent on housework activities, sleep duration and self-reported health among the older population. This study not only examined individual associations between self-reported health and both housework activities and sleep duration, but it also explored self-reported health by the interaction effect between housework activities and sleep duration separately for men and women. Pooled data from the Multinational Time Use Study (MTUS) on 15,333 men and 20,907 women from Germany, Italy, Spain, UK, France, the Netherlands and the US were analysed. Multiple binary logistic regression models were used to examine the associations between three broad categories of housework activities ((1) cooking, cleaning and shopping, (2) gardening and maintenance; (3) childcare) and health. We further investigated the extent to which total housework hours and sleep duration were associated with self-reported health for men and women separately. We found a positive association between time devoted to housework activities, total housework and health status among elderly men and women. Compared to those who spent 1 to 3 h on total productive housework, elderly people who spent >3 to 6 h/day had higher odds of reporting good health (OR = 1.25; 95% CI = 1.14-1.37 among men and OR = 1.10; 95% CI = 1.01-1.20 among women). Both short (8 h) sleep duration were negatively associated with health for both genders. However, the interactive associations between total productive housework, sleep duration, and self-reported health varied among men and women. Among women, long hours of housework combined with either short or long sleep was negatively associated with health. Although time allocation to housework activities may

  18. Primary Gastric Small Cell Carcinoma in Elderly Patients: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jian-Han Lai

    2017-03-01

    Full Text Available We report the case of an 86-year-old man with primary gastric small cell carcinoma (SmCC. He was admitted to our hospital owing to gastrointestinal bleeding complicated by anemia. An upper gastrointestinal endoscopic examination revealed a large, irregularly ulcerated tumor on the upper to middle body of the stomach. Small cell carcinoma was diagnosed based on the results of histologic and immunohistochemical studies of an endoscopic biopsy specimen. According to previous reports of gastric SmCC, only one-sixth of cases have been correctly diagnosed preoperatively. In our case, it was an aggressive malignancy that had an extremely poor prognosis. We believe that careful endoscopic examination including immunohistochemical investigation is necessary to accurately diagnose gastric SmCC in clinical practice.

  19. Elder Abuse: What's a Clinician To Do?

    Science.gov (United States)

    Reis, Bruce E.

    Incidence rates are critically examined in light of varying definitions of what constitutes elder abuse. It is suggested that the clinician's position of mandatory reporting is an unrealistic response in many cases of elder abuse due to the lack of adequate support services for either the abuser or the elder. Outcome studies are used to support…

  20. Frontiers in the Education of the Elderly.

    Science.gov (United States)

    Peterson, James A.

    Demographic trends indicate a continued population rise among the elderly, suggesting an expanded market for adult education efforts. Early retirement, unemployment due to technological change, as well as the need for older workers to stay current in their fields all point in the direction of education of the elderly. The elderly report great…

  1. Self-reported vaccination in the elderly: SABE Bogotá study, Colombia

    OpenAIRE

    Cano Gutiérrez, Carlos; Reyes-Ortiz, Carlos; Borda, Miguel Germán; Arciniegas, Antonio

    2016-01-01

    Objectives: To determine the frequency of vaccination in older adults within the city of Bogotá and to estimate the association with sociodemographic and health factors. Methods: This is a secondary data analysis from the SABE-Bogotá Study, a cross-sectional population-based study that included a total of 2,000 persons aged 60 years. Weighted percentages for self-reported vaccination [influenza, pneumococcal, tetanus] were determined. The association between vaccination and covariates was eva...

  2. Cemento-osseous dysplasia in an elderly Asian male: a case report.

    Science.gov (United States)

    Komabayashi, Takashi; Zhu, Qiang

    2011-03-01

    Cemento-osseous dysplasia is a disorder typically found in middle-aged black women. However, the present report describes a case in a 61-year-old Vietnamese male. Without proper pulp testing and diagnosis, the radiographic presentation can easily be misdiagnosed as periapical periodontitis. On the basis of pulp vitality, lack of clinical symptoms and radiographic features, the diagnosis in this case was periapical cemento-osseous dysplasia at the mixed stage, which generally requires no treatment. At the 18-month follow-up, the patient was still asymptomatic and none of the clinical signs had changed. This case highlights the importance of careful clinical examination, including a pulp vitality test, and of having an unbiased view of age, gender, and ethnicity when diagnosing this condition.

  3. Bupropion Induced Hyponatremia in an Elderly Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sahil Munjal

    2016-01-01

    Full Text Available We present the case of a 72-year-old female with a major depressive episode who developed hyponatremia associated with bupropion. In reviewing the literature, there are only a few case reports which pertain to this topic. The clinical symptoms of hyponatremia can be misinterpreted as a worsening of the primary psychiatric illness and can lead to potentially serious consequences if not fully evaluated. We recommend that clinicians should be well aware of this side effect and that sodium levels should be checked within the first 2 weeks after initiating treatment in patients, especially those with additional risk factors for hyponatremia, such as older age, female sex, diuretic use, low BMI, and unexplained mental status changes at any time during treatment with antidepressants. The risk for hyponatremia associated with mirtazapine appears to be low and its use can be helpful in patients who have developed hyponatremia induced by other antidepressants and who experienced symptoms of weight loss and insomnia.

  4. [Cardiac safety of electroconvulsive therapy in an elderly patient--a case report].

    Science.gov (United States)

    Karakuła-Juchnowicz, Hanna; Próchnicki, Michał; Kiciński, Paweł; Olajossy, Marcin; Pelczarska-Jamroga, Agnieszka; Dzikowski, Michał; Jaroszyński, Andrzej

    2015-10-01

    Since electroconvulsive therapy (ECT) was introduced as treatment for psychiatric disorders in 1938, it has remained one of the most effective therapeutic methods. ECT is often used as a "treatment of last resort" when other methods fail, and a life-saving procedure in acute clinical states when a rapid therapeutic effect is needed. Mortality associated with ECT is lower, compared to the treatment with tricyclic antidepressants, and comparable to that observed in so-called minor surgery. In the literature, cases of effective and safe electroconvulsive therapy have been described in patients of advanced age, with a burden of many somatic disorders. However, cases of acute cardiac episodes have also been reported during ECT. The qualification of patients for ECT and the selection of a group of patients at the highest risk of cardiovascular complications remains a serious clinical problem. An assessment of the predictive value of parameters of standard electrocardiogram (ECG), which is a simple, cheap and easily available procedure, deserves special attention. This paper reports a case of a 74-year-old male patient treated with ECT for a severe depressive episode, in the context of cardiologic safety. Both every single ECT session and the full course were assessed to examine their impact on levels of troponin T, which is a basic marker of cardiac damage, and selected ECG parameters (QTc, QRS). In the presented case ECT demonstrated its high general and cardiac safety with no negative effect on cardiac troponin (TnT) levels, corrected QT interval (QTc) duration, or other measured ECG parameters despite initially increased troponin levels, the patient's advanced age, the burden of a severe somatic disease and its treatment (anticancer therapy). © 2015 MEDPRESS.

  5. Drug-induced lupus: simvastatin or amiodarone? A case report in elderly

    Directory of Open Access Journals (Sweden)

    Mauro Turrin

    2013-03-01

    Full Text Available Reports of systemic lupus erythematosus (SLE seen during treatment with amiodarone are rare in the literature. SLE or immunological abnormalities induced by treatment with statins are more frequent. In this issue we report a case of a 81-year-old male who, after a 2-year therapy with amiodarone, developed a clinical and serologic picture of drug-induced SLE (DILE. He was admitted for congestive heart failure in mechanical aortic valve prosthesis, permanent atrial fibrillation (anticoagulation with warfarin, hypercholesterolaemia, and hypothyroidism. Amiodarone was started two years earlier for polymorphic ventricular tachycardia, statin and L-thyroxine the following year. At admission he presented pleuro-pericardical effusion detected by CT-scan (also indicative of interstitial lung involvement and echocardiography. Serological main indicative findings were: elevation of inflammatory markers, ANA (Anti-Nuclear Antibodies titers = 1:320 (indirect immune-fluorescence – IIF – assay on HEp-2, homogeneous/fine speckled pattern, anti-dsDNA titers = 1:80 (IIF on Crithidia luciliae, negative ENA (Extractable Nuclear Antigens and antibodies anti-citrulline, rheumatoid factor = 253 KU/l, normal C3-C4, negative HbsAg and anti-HCV, negative anticardiolipin antibodies IgG and IgM, negative anti-beta2GPI IgG and IgM. Amiodarone was discontinued and methylprednisolone was started, since the patient was severely ill. At discharge, after a month, the patient was better and pleuro-pericardical effusion was reduced. Readmitted few weeks later for bradyarithmia and worsening of dyspnoea, pericardial effusion was further reduced but he died for refractory congestive heart failure and pneumonia. Clinical picture (sierositis, neither skin nor kidney involvement, other typical side effects of amiodarone (hypothyroidism and lung interstitial pathology and serological findings are suggestive of amiodarone-induced SLE.

  6. Gender inequality in self-reported health among the elderly in contemporary welfare countries: A cross-country analysis of time use activities, socioeconomic positions and family characteristics.

    Science.gov (United States)

    Adjei, Nicholas Kofi; Brand, Tilman; Zeeb, Hajo

    2017-01-01

    Paradoxically, despite their longer life expectancy, women report poorer health than men. Time devoted to differing social roles could be an explanation for the observed gender differences in health among the elderly. The objective of this study was to explain gender differences in self-reported health among the elderly by taking time use activities, socio-economic positions, family characteristics and cross-national differences into account. Data from the Multinational Time Use Study (MTUS) on 13,223 men and 18,192 women from Germany, Italy, Spain, UK and the US were analyzed. Multiple binary logistic regression models were used to examine the association between social factors and health for men and women separately. We further identified the relative contribution of different factors to total gender inequality in health using the Blinder-Oaxaca decomposition method. Whereas time allocated to paid work, housework and active leisure activities were positively associated with health, time devoted to passive leisure and personal activities were negatively associated with health among both men and women, but the magnitude of the association varied by gender and country. We found significant gender differences in health in Germany, Italy and Spain, but not in the other countries. The decomposition showed that differences in the time allocated to active leisure and level of educational attainment accounted for the largest health gap. Our study represents a first step in understanding cross-national differences in the association between health status and time devoted to role-related activities among elderly men and women. The results, therefore, demonstrate the need of using an integrated framework of social factors in analyzing and explaining the gender and cross-national differences in the health of the elderly population.

  7. Gender inequality in self-reported health among the elderly in contemporary welfare countries: A cross-country analysis of time use activities, socioeconomic positions and family characteristics.

    Directory of Open Access Journals (Sweden)

    Nicholas Kofi Adjei

    Full Text Available Paradoxically, despite their longer life expectancy, women report poorer health than men. Time devoted to differing social roles could be an explanation for the observed gender differences in health among the elderly. The objective of this study was to explain gender differences in self-reported health among the elderly by taking time use activities, socio-economic positions, family characteristics and cross-national differences into account.Data from the Multinational Time Use Study (MTUS on 13,223 men and 18,192 women from Germany, Italy, Spain, UK and the US were analyzed. Multiple binary logistic regression models were used to examine the association between social factors and health for men and women separately. We further identified the relative contribution of different factors to total gender inequality in health using the Blinder-Oaxaca decomposition method.Whereas time allocated to paid work, housework and active leisure activities were positively associated with health, time devoted to passive leisure and personal activities were negatively associated with health among both men and women, but the magnitude of the association varied by gender and country. We found significant gender differences in health in Germany, Italy and Spain, but not in the other countries. The decomposition showed that differences in the time allocated to active leisure and level of educational attainment accounted for the largest health gap.Our study represents a first step in understanding cross-national differences in the association between health status and time devoted to role-related activities among elderly men and women. The results, therefore, demonstrate the need of using an integrated framework of social factors in analyzing and explaining the gender and cross-national differences in the health of the elderly population.

  8. Gender inequality in self-reported health among the elderly in contemporary welfare countries: A cross-country analysis of time use activities, socioeconomic positions and family characteristics

    Science.gov (United States)

    Adjei, Nicholas Kofi; Brand, Tilman; Zeeb, Hajo

    2017-01-01

    Background Paradoxically, despite their longer life expectancy, women report poorer health than men. Time devoted to differing social roles could be an explanation for the observed gender differences in health among the elderly. The objective of this study was to explain gender differences in self-reported health among the elderly by taking time use activities, socio-economic positions, family characteristics and cross-national differences into account. Methods Data from the Multinational Time Use Study (MTUS) on 13,223 men and 18,192 women from Germany, Italy, Spain, UK and the US were analyzed. Multiple binary logistic regression models were used to examine the association between social factors and health for men and women separately. We further identified the relative contribution of different factors to total gender inequality in health using the Blinder-Oaxaca decomposition method. Results Whereas time allocated to paid work, housework and active leisure activities were positively associated with health, time devoted to passive leisure and personal activities were negatively associated with health among both men and women, but the magnitude of the association varied by gender and country. We found significant gender differences in health in Germany, Italy and Spain, but not in the other countries. The decomposition showed that differences in the time allocated to active leisure and level of educational attainment accounted for the largest health gap. Conclusions Our study represents a first step in understanding cross-national differences in the association between health status and time devoted to role-related activities among elderly men and women. The results, therefore, demonstrate the need of using an integrated framework of social factors in analyzing and explaining the gender and cross-national differences in the health of the elderly population. PMID:28949984

  9. Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population.

    Science.gov (United States)

    Broström, Anders; Wahlin, Ake; Alehagen, Urban; Ulander, Martin; Johansson, Peter

    2017-01-05

    Both short and long sleep durations have been associated to increased mortality. Knowledge about sex-specific differences among elderly regarding associations between sleep duration, cardiovascular health, and mortality is sparse. The aims of this study are to examine the association between self-reported sleep duration and mortality and to investigate whether this association is sex specific and/or moderated by cardiovascular morbidity, and also to explore potential mediators of sleep duration effects on mortality. A population-based, observational, cross-sectional design with 6-year follow-up with mortality as primary outcome was conducted. Self-rated sleep duration, clinical examinations, echocardiography, and blood samples (N-terminal fragment of proBNP) were collected. A total of 675 persons (50% women; mean age, 78 years) were divided into short sleepers (≤6 hours; n = 231), normal sleepers (7-8 hours; n = 338), and long sleepers (≥9 hours; n = 61). Data were subjected to principal component analyses. Cardiovascular disease (CVD) and hypertension factors were extracted and used as moderators and as mediators in the regression analyses. During follow-up, 55 short sleepers (24%), 68 normal sleepers (20%), and 21 long sleepers (34%) died. Mediator analyses showed that long sleep was associated with mortality in men (hazard ratio [HR], 1.8; P = .049), independently of CVD and hypertension. In men with short sleep, CVD acted as a moderator of the association with mortality (HR, 4.1; P = .025). However, when using N-terminal fragment of proBNP, this effect became nonsignificant (HR, 3.1; P = .06). In woman, a trend to moderation involving the hypertension factor and short sleep was found (HR, 4.6; P = .09). Short and long sleep duration may be seen as risk markers, particularly among older men with cardiovascular morbidity.

  10. Successful treatment of methemoglobinemia in an elderly couple with severe cyanosis: two case reports

    Directory of Open Access Journals (Sweden)

    Su Ying-Fu

    2012-09-01

    Full Text Available Abstract Introduction Methemoglobinemia should be considered in all cyanotic patients who remain unresponsive to oxygen therapy. Rapid diagnosis is very important in emergency cases. Here, we present the cases of two patients, a married couple, admitted to our hospital with methemoglobinemia after exposure to sodium nitrite. Case presentation Two patients, a married couple, presented with methemoglobinemia. The 72-year-old Taiwanese man and 68-year-old Taiwanese woman were referred to our hospital with dizziness and tachypnea. On examination, their mucous membranes were cyanotic, and their blood samples showed the classic ‘chocolate brown’ appearance. The man also reported having experienced twitching of his right arm for a few minutes before arrival at the hospital. The symptoms of both patients failed to improve in response to supplemental oxygen delivered via oxygen masks, although the arterial blood gas data of these patients were normal and their pulse oximetry showed oxyhemoglobin levels of approximately 85%. A carbon monoxide-oximeter showed that the man’s methemoglobin concentration was 48.3%, and the woman’s was 36.4%. Methylene blue (100mg was administered intravenously to both patients, and their symptoms improved dramatically. They were admitted to the intensive care unit and discharged three days later, without neurological sequelae. Conclusion Severe methemoglobinemia is a life-threatening condition and, if untreated, may result in death. Early diagnosis and appropriate antidotal treatment are crucial in treating this emergency situation.

  11. Mobility of people and goods in the urban environment: mobility of the handicapped and elderly. Second year final report. [Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Falcocchio, J.; Santimataneedol, S.; Horwitz, L.; Stephanis, B.

    1976-09-01

    An evaluation methodology for the analysis of alternative transportation improvements for the handicapped and elderly is proposed. The approach is based on the ability to incorporate the qualitative attributes of transportation systems which are particularly significant to the handicapped and elderly groups. These attributes include comfort and convenience, security and safety, and accessibility. In addition, this study addresses the issues of demonstration projects planning and offers guidelines for the design of demonstration experiments which can produce results that are capable of objective analytical interpretation.

  12. Delusional parasitosis with hyperthyroidism in an elderly woman: a case report

    Directory of Open Access Journals (Sweden)

    Ozten Eylem

    2013-01-01

    Full Text Available Abstract Introduction Delusional parasitosis is a rare, monosymptomatic psychosis involving a delusion of being infested with parasites. It is commonly observed among female patients over the age of 50. It is classified as a ‘delusional disorder’ according to the 10th revision of the International Classification of Diseases and as a ‘delusional disorder - somatic type’ according to the Diagnostic and Statistical Manual, Fourth Edition. Delusional parasitosis was reported to be associated with physical disorders such as hypoparathyroidism, Huntington’s chorea and Alzheimer’s disease, among others. Other than vitamin deficiencies however, a causal relationship has not to date been identified. We present this case due to the rarity of Turkish patients with this condition, its duration of follow-up, and its temporal pattern of symptoms paralleling thyroid function tests. Case presentation Our patient was a 70-year-old white Anatolian Turkish woman with primary school education who had been living alone for the past five years. She presented to our psychiatry department complaining of ‘feeling large worms moving in her body’. The complaints started after she was diagnosed with hyperthyroidism, increased when she did not use her thyroid medications and remitted when she was compliant with treatment. She was treated with pimozide 2mg/day for 20 months and followed-up without any antipsychotic treatment for an additional nine months. At her last examination, she was euthyroid, not receiving antipsychotics and was not having any delusions. Conclusion Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the

  13. Mood expression by seniors in digital communication : Evaluative comparison of four mood-reporting instruments with elderly users

    NARCIS (Netherlands)

    Alberts, J.W.; Vastenburg, M.H.; Desmet, P.M.A.

    2013-01-01

    Elderly users have widely adopted digital communication. Digital communication is often text-only, e.g. instant messaging (IM) and e-mail. Text-only communication has been found less effective than communication that uses richer channels such as audio and video. Mood expression instruments, such as

  14. National profiling of elder abuse referrals.

    LENUS (Irish Health Repository)

    Clancy, Marguerite

    2011-05-01

    there is little consistent data on patterns of reporting of elder abuse in Europe. Between 2002 and 2007, the Irish Health Service Executive developed dedicated structures and staff to support the prevention, detection and management of elder abuse without mandatory reporting. Public awareness campaigns, staff training and management briefings heightened awareness regarding this new service. Central to this process is the development of a national database which could provide useful insights for developing coordinated responses to elder abuse in Europe.

  15. The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly.

    Science.gov (United States)

    1987-04-01

    Although falls among the elderly carry high costs to individuals and society, the prevention of falls in later life has not received adequate attention from health care professionals. The prevalence of falls appears to involve roughly one-third of persons aged 65 and over, and the risk of falling and suffering serious injury increases substantially up to the eighth decade of life. The proportion of falls which result in fracture is low, but the absolute number of older people who suffer fractures is high and places heavy demands on health care systems. Even falls which result in no physical injury often have serious social and psychological consequences for the elderly, including loss of confidence and restrictions in mobility, and high proportions of older people report fears of falling. There is a need to provide accurate information about the causes and prevention of falls in later life. Falls are not part of the normal aging process. Rather, they are due to underlying physical illnesses, medications, and environmental hazards, often in interaction. This report provides an overview of the elderly population at risk of falling and suffering serious injury, some of the reasons older people fall, and the methods to prevent falls which have been developed in both community and institutional settings. In addition, it suggests some of the practical steps which can be taken by health and social care professionals and by older people and their families in order to prevent falls. Empirical knowledge about the causes of falls by the elderly and the most effective methods of prevention remains limited. Major barriers to research have been the lack of a clear definition of a fall and the fact that falls are not included in medical diagnostic indices. It is recommended that falls be recorded as a disease entity in Index Medicus and in the International Classification of Diseases Xth Revision. To facilitate future comparisons of research findings on falls, a definition of a

  16. A global response to elder abuse and neglect: building primary health care capacity to deal with the problem worldwide : main report

    National Research Council Canada - National Science Library

    Kaindl, Karina

    2008-01-01

    ....Elder.abuse.and.neglect.and.the.role.of.PHC.professionals. . ... 3 1.4.Detecting.elder.abuse.in.a.PHC.setting... 5 2 The project ...7 2.1.Aims.and.objectives... 7 2.2.The.Elder.Abuse.Suspicion.Index. . ... 8 2.3...

  17. Protocols for the Assessment of Elder Abuse.

    Science.gov (United States)

    Fulmer, Terry; Wetle, Terrie

    The fact that many states have passed elder abuse reporting laws has left care providers with a dilemma. If suspected abuse is reported, the relationship between caregiver and patient may change and the family's difficulties may increase. Indicators of abuse are not easy to differentiate from health problems, especially in the frail elderly. An…

  18. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs for physical activity in chronically ill and elderly people

    Directory of Open Access Journals (Sweden)

    Frei Anja

    2011-12-01

    Full Text Available Abstract Background Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. Methods We conducted a systematic literature search of electronic databases (Medline, Embase, Psychinfo, Cinahl and hand searches. We included studies describing the original development of fully structured instruments measuring dimensions of physical activity or related constructs in chronically ills or elderly. We broadened the population to elderly because they are likely to share physical activity limitations. At least two reviewers independently conducted title and abstract screening and full text assessment. We evaluated instruments in terms of their aim, items identification and selection, domain development, test-retest reliability, internal consistency, validity and responsiveness. Results Of the 2542 references from the database search and 89 from the hand search, 103 full texts which covered 104 instruments met our inclusion criteria. For almost half of the instruments the authors clearly described the aim of the instruments before the scales were developed. For item identification, patient input was used in 38% of the instruments and in 32% adaptation of existing scales and/or unsystematic literature searches were the only sources for the generation of items. For item reduction, in 56% of the instruments patient input was used and in 33% the item reduction process was not clearly described. Test-retest reliability was assessed for 61%, validity for 85% and responsiveness to change for 19% of the instruments. Conclusions Many PRO instruments exist to measure

  19. Is Peritonitis Risk Increased in Elderly Patients on Peritoneal Dialysis? Report from the French Language Peritoneal Dialysis Registry (RDPLF).

    Science.gov (United States)

    Duquennoy, Simon; Béchade, Clémence; Verger, Christian; Ficheux, Maxence; Ryckelynck, Jean-Philippe; Lobbedez, Thierry

    2016-01-01

    ♦ This study was carried out to examine whether or not elderly patients on peritoneal dialysis (PD) had an increased risk of peritonitis. ♦ This was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 8,396 incident patients starting PD between January 2003 and December 2010. The end of the observation period was 31 December 2012. Patients were separated into 2 age groups: up to 75 and over of 75 years old. ♦ Among 8,396 patients starting dialysis there were 3,173 patients older than 75. When using a Cox model, no association was found between age greater than 75 years and increased risk of peritonitis (hazard ratio [HR]: 0.97 [0.88 - 1.07]). Diabetes (HR: 1.14 [1.01 - 1.28] and continuous ambulatory PD (HR: 1.13 [1.04 - 1.23]) were significantly associated with a higher risk of peritoneal infection whereas nurse-assisted PD was associated with a lower risk of peritonitis (HR: 0.85 [0.78 - 0.94]. In the analysis restricted to the 3,840 self-care PD patients, there was no association between age older than 75 years and risk of peritonitis. ♦ The risk of peritonitis is not increased in elderly patients on PD in a country where assisted PD is available. Copyright © 2016 International Society for Peritoneal Dialysis.

  20. Improvement in Oral Health-related Quality of Life by Periodontal Treatment: A Case Report on Elderly Patient with Chronic Periodontitis.

    Science.gov (United States)

    Suzuki, Eiichi; Aoki, Hideo; Tomita, Sachiyo; Saito, Atsushi

    2016-01-01

    We report a case of an elderly patient with chronic periodontitis requiring periodontal surgery. An 86-year-old man presented to Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth fracture in the anterior region and occlusal pain in the posterior region. Clinical examination revealed 47% of sites with a probing depth (PD) of ≥4 mm and 47% of sites with bleeding on probing. Radiographic examination revealed generalized moderate horizontal bone loss with localized vertical defects. A clinical diagnosis of moderate chronic periodontitis was made. The patient's oral health-related quality of life (QoL) was also assessed at the time of each periodontal assessment. Initial periodontal therapy was provided followed by periodontal surgery. Open flap debridement was performed at sites with a PD of ≥5 mm (teeth #15-17). Surgical crown lengthening with an apically positioned flap was performed on #11 and 13 to gain an adequate biological width for the subsequent crown restoration. After confirming the stability of the periodontal tissue, provisional restorations were replaced with final restorations. No further deterioration was observed in the periodontal condition during the subsequent 1-year period of supportive periodontal therapy. Oral health-related QoL was markedly improved by the periodontal therapy. This suggests that periodontal therapy plays an important role in improving and maintaining oral health-related QoL in elderly people.

  1. Elder abuse telephone screen reliability and validity.

    Science.gov (United States)

    Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

    2009-01-01

    (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

  2. Contribution of Physical Fitness Component to Health Status in Elderly Males and Females over 60 years – Short Report

    Directory of Open Access Journals (Sweden)

    Antonio Ignacio Cuesta-Vargas

    2012-12-01

    Full Text Available The purpose of this study was to identify the physicalfitness (PF level of a cohort of elderly people that are subjected tophysical activity (PA, and to establish a regression model for theevaluation of health status (HS of elderly people based on their PF.This is a Cross-sectional study. Consists of 114 Participants over60 years old, that were recruited from a physical activity program.Were measured variables about anthropometric characteristics,jumping tests with jumping platform, dynamic and static balance, riskof falls, lung capacity, HS and quality of life (QoL. We used Pearson’slinear correlation with 95% Zr. We looked for simple and multiple regression models. We used the bayesianinformation criterion approach and statistical inference to find and calculated a numerical estimate of thebest regression model. We used the dependent variable physical function of SF-12. Physical fitness variablesselected for the models were weight, height, Countermovement Jump test (flight time, Functional Reachtest, lumbosacral flexion mobility, Extended Timed Get Up and Go (ETGUG (10 meters time score andtotal time score. The HS and QoL measurement are important for the prevention of injury during physicalexercise and should be conducted whenever is possible. The regression models proposed in this study can beused as an initial screening of HS or QoL at fitness facilities and fitness clubs that do not provide HS or QoLquestionnaires. However, these models are not an alternative to health care for a detailed determination ofHS and is not intended for use as a final evaluation.

  3. Qualitative study on suicide attempts and ideations with 60 elderly in Brazil.

    Science.gov (United States)

    Cavalcante, Fátima Gonçalves; Minayo, Maria Cecília de Souza

    2015-06-01

    Sixty cases of suicidal attempts and ideations among elderly people from thirteen Brazilian municipalities were studied, with the objective of discovering, from what they had to say, their reasons and interpretations for attempting to take their own life. The study, with a hermeneutic and dialectic basis, was based on an interview guide, to steer the conversation with these individuals. It starts with a sociodemographic classification and looks in depth at the person's situation according to their social, community and family circumstances and their physical and mental health, functional capacity, and the reasons given for the suicidal ideations and attempts. This field information was first analysed locally and then cross-categorized according to the method used, severity of the events and reasons given by the elderly people, by sex, age, socioeconomic profile and risk and protection factors. A comprehensive, critical and interpretative summary was made of the material. The results show that failure to listen to and the isolation of elderly people, lack of awareness of the risks on the part of family, the association with physical and mental, functional, social and family losses and violence are predisposing factors, and concurrent in many cases. The conclusion is that vulnerability and self-neglect are reduced where there is family support, care and bonds of unity.

  4. Elder Abuse: A National Disgrace. A Report by the Chairman of the Subcommittee on Health and Long-Term Care of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

    Science.gov (United States)

    Cravedi, Kathleen Gardner; And Others

    This report presents the results of efforts of the Subcommittee on Health and Long-Term Care to examine the extent of elder abuse in the United States. The executive summary presents details of the actions taken by Congress to pass legislation (H.R. 7551) to help control unwarranted violence against the aged and by the states to pass elder…

  5. The elderly patients' dignity

    DEFF Research Database (Denmark)

    Høy, Bente; Hall, E.O.C.; Wagner, L.

    2007-01-01

    the principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...... patient and what goals should be defined. Key words: Dignity, elderly patient, phenomenological hermeneutical method....

  6. Leukocyte telomere dynamics in the elderly

    DEFF Research Database (Denmark)

    Steenstrup, Troels; Hjelmborg, Jacob V B; Mortensen, Laust H

    2013-01-01

    Limited data suggest that leukocytes of the elderly display ultra-short telomeres. It was reported that in some elderly persons leukocyte telomere length (LTL) shows age-dependent elongation. Using cross-sectional and longitudinal models, we characterized LTL dynamics in participants...

  7. Care and housing for vulnerable elderly

    NARCIS (Netherlands)

    M.M.Y. de Klerk

    2004-01-01

    Original title: Zorg en wonen voor kwetsbare ouderen. There is a general belief that old age automatically brings infirmities, though this is by no means always the case. This edition of the Report on the Elderly investigates which elderly people are vulnerable. They include older persons

  8. Dizziness in elderly men.

    Science.gov (United States)

    Davis, L E

    1994-11-01

    To evaluate the causes of dizziness in elderly men. A descriptive study involving the clinical and laboratory features of elderly men with dizziness. A university-affiliated Veterans Affairs medical center. One hundred seventeen consecutive men more than 50 years of age attending a general neurology clinic with the chief complaint of dizziness. The median duration of dizziness at first office visit was 45 weeks. Forty-nine percent of patients had more than one diagnosis that contributed to their dizziness. Dysfunctions of the peripheral vestibular system were found in 71% and were the principal causes in 56%. Benign positional vertigo was present in 34%. Disorders of the visual system were found in 26% but were the major cause in only 1%. Diagnoses involving the proprioceptive system were present in 17% and were the principal cause in 7%. Structural lesions of the brainstem or cerebellum or metabolic disorders that affected normal brainstem function were identified in 59% and were the major diagnoses in 22%. A psychophysiologic diagnosis was made in 6% but was the major diagnosis in only 3%. At the 6-months follow-up, 55% of patients improved, 34% were unchanged, 4% worsened, and 7% were lost to follow-up. Contrary to reports in the literature, dizziness in the elderly is more persistent, has more causes, is less often due to a psychophysiologic cause, and seems to be more incapacitating than dizziness in younger patients.

  9. Validation of the Hwalek-Sengstock Elder Abuse Screening Test.

    Science.gov (United States)

    Neale, Anne Victoria; And Others

    Elder abuse is recognized as an under-detected and under-reported social problem. Difficulties in detecting elder abuse are compounded by the lack of a standardized, psychometrically valid instrument for case finding. The development of the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) followed a larger effort to identify indicators and…

  10. [Central cervical cord syndrome: a case report on rehabilitation, with special references to accidental falls in the elderly].

    Science.gov (United States)

    Ina, G; Eto, F; Furuichi, T; Suzuki, H; Shibuya, K

    1995-03-01

    An 81-year-old man with Parkinson's disease was admitted to our hospital with impaired function of all extremities. Four weeks before his symptoms developed, he had tripped on the steps, fallen and bruised his jaw. Following this episode he experienced a few more falls inside his house. On examination his greatest weakness was in the hands and wrists. He was hyper-reflexic in all extremities and had bilateral Babinski's sign. He could not walk and needed physical assistance in most of his daily living activities. X-ray films of the cervical spine showed significant degenerative changes. The magnetic resonance images suggested central cervical cord damage at the level of the C6 vertebral body. After three months' rehabilitation treatment, he became able to walk with a cane and became independent in all the basic activities of daily living except for bathing. He never regained skillful function of his hands despite later levodopa treatment of Parkinson's disease. His clinical features were consistent with the central cervical cord syndrome, described by Schnneider and co-workers in 1954. This syndrome may occur as a result of hyperextension neck injury, occasionally associated with an accidental fall in the elderly with cervical spondylosis. Thirteen patients with cervical spinal cord injury above 65 of age were admitted to our department from 1983 to 1993. Six of them presented with the central cervical cord syndrome, and all patients had a history of accidental injuries related to falling.

  11. Predictive value of health-related fitness tests for self-reported mobility difficulties among high-functioning elderly men and women.

    Science.gov (United States)

    Hämäläinen, H Pauliina; Suni, Jaana H; Pasanen, Matti E; Malmberg, Jarmo J; Miilunpalo, Seppo I

    2006-06-01

    The functional independence of elderly populations deteriorates with age. Several tests of physical performance have been developed for screening elderly persons who are at risk of losing their functional independence. The purpose of the present study was to investigate whether several components of health-related fitness (HRF) are valid in predicting the occurrence of self-reported mobility difficulties (MD) among high-functioning older adults. Subjects were community-dwelling men and women, born 1917-1941, who participated in the assessment of HRF [6.1-m (20-ft) walk, one-leg stand, backwards walk, trunk side-bending, dynamic back extension, one-leg squat, 1-km walk] and who were free of MD in 1996 (no difficulties in walking 2- km, n=788; no difficulties in climbing stairs, n=647). Postal questionnaires were used to assess the prevalence of MD in 1996 and the occurrence of new MD in 2002. Logistic regression analysis was used as the statistical method. Both inability to perform the backwards walk and a poorer result in it were associated with risk of walking difficulties in the logistic model, with all the statistically significant single test items included. Results of 1-km walk time and one-leg squat strength test were also associated with risk, although the squat was statistically significant only in two older birth cohorts. Regarding stair-climbing difficulties, poorer results in the 1-km walk, dynamic back extension and one-leg squat tests were associated with increased risk of MD. The backwards walk, one-leg squat, dynamic back extension and 1-km walk tests were the best predictors of MD. These tests are recommended for use in screening high-functioning older people at risk of MD, as well as to target physical activity counseling to those components of HRF that are important for functional independence.

  12. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial.

    Science.gov (United States)

    Trombini-Souza, Francis; Matias, Alessandra B; Yokota, Mariane; Butugan, Marco K; Goldenstein-Schainberg, Claudia; Fuller, Ricardo; Sacco, Isabel C N

    2015-12-01

    Efforts have been made to retard the progressive debilitating pain and joint dysfunction in patients with knee osteoarthritis. We aimed to evaluate the therapeutic effect of a low-cost minimalist footwear on pain, function, clinical and gait-biomechanical aspects of elderly women with knee osteoarthritis. Throughout a randomized, parallel and controlled clinical trial, fifty-six patients with medial knee osteoarthritis were randomly allocated to an intervention (n=28) or control group (n=28), and assessed at baseline and after three and six months. The intervention involved wearing Moleca(®) footwear for at least 6h/day, 7 days/week, over 6 months. The pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index was the primary outcome. The secondary outcomes were the other subscales, Lequesne score, distance walked in 6 min, knee oedema and effusion, knee adduction moment and paracetamol intake. Intention-to-treat analysis was performed using two-way casewise ANOVA (coefficient. Intervention group showed improvement in pain (effect size: 1.41, p<.001), function (effect size: 1.22, p=.001), stiffness (effect size: 0.76, p=.001), Lequesne score (effect size: 1.07, p<.001), and reduction by 21.8% in the knee adduction moment impulse (p=.017) during gait wearing Moleca(®). The analgesic intake was lower in the intervention group. The long-term use of Moleca(®) footwear relieves pain, improves self-reported function, reduces the knee loading while wearing Moleca(®), refrains the increase of analgesic intake in elderly women with knee osteoarthritis and can be considered as a conservative mechanical treatment option. ClinicalTrials.gov (NCT01342458). Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Self-reported factors associated with engagement in moderate to vigorous physical activity among elderly people: A population-based study

    Directory of Open Access Journals (Sweden)

    Ramin Shiraly

    2017-01-01

    Full Text Available Background: Physical activity (PA typically decreases with aging, especially of moderate to vigorous level, and this change affects health outcomes of older adults. Age-related decline is not evenly distributed across elderly population and is attributed to psychosocial, physical, and environmental determinants. Methods: We selected a sample of 1000 elderly people from urban parts of Shiraz in Southern Iran with a two-stage random sampling procedure. Self-reported PA data and correlates of moderate to vigorous activity were collected by interview with the respondents from selected households. Bivariate associations were examined using Chi-square test. Log-binomial regression was used to weigh variables associated with more than light PA. Results: Some demographic variables (older age, female sex, lower education level, retirement, and single or widowed status, health problems (lower extremity pain and hypertension, and psychosocial factors (lack of motivation, fear of injury, unsafe roads, and daily life problems were potential correlates of inadequate PA with bivariate analysis. In log-binomial regression model, lack of motivation (adjusted prevalence ratio [APR] = 2.11, 95% confidence interval [CI]: 1.25–3.56, daily life problems (APR = 1.82, 95% CI: 1.26–2.62, lower educational level (APR = 1.64, 95% CI: 1.08–2.49, unsafe roads (APR = 1.59, 95% CI: 1.02–2.49, and knee pain (APR = 1.68, 95% CI: 1.09–2.58 were associated with lower engagement in moderate to vigorous PA among Iranian older adults. Conclusions: Psychosocial attributes considerably influence PA behaviors in older adults. Lower extremity joint pain is a key medical concern. Interventions to promote PA among older adults should be multilevel and particularly targeting personal psychosocial factors.

  14. Understanding elder abuse in family practice

    Science.gov (United States)

    Yaffe, Mark J.; Tazkarji, Bachir

    2012-01-01

    Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889

  15. Successful treatment of radiation-induced proctitis pain by blockade of the ganglion impar in an elderly patient with prostate cancer: a case report.

    Science.gov (United States)

    Khosla, Ankur; Adeyefa, Oludayo; Nasir, Syed

    2013-05-01

    Chronic rectal pain secondary to radiation-induced proctitis is fast-becoming a leading cause of chronic pain, especially for prostate cancer survivors. Currently, many elderly patients resort to increased opioid intake to alleviate the pain. However, this increase in opioid consumption often leads to constipation and further aggravates the anorectal pain, thus leading to a perpetual, vicious cycle. We reasoned that blocking the ganglion impar could attenuate this sympathetically maintained pain, which would lead to a reduction in the consumption of opioids, lessen constipation, and lead to an improvement in the patient's quality of life. Case report. An academic tertiary pain management clinic. The authors report the case of a 73-year-old African American man with a history of prostate cancer who presented to the pain management clinic for evaluation and treatment of his chronic anorectal pain secondary to radiation-induced proctitis. The patient underwent a ganglion impar block, using the transcoccygeal technique, and consequently reported excellent pain relief with little or no use for opioid pain medications at a 2-month follow-up. Ultimately, this approach led to improved mobility and an increase in the patient's quality of life. Based on this case's success, a prospective study or randomized control trial evaluating the efficacy of the ganglion impar block as a treatment option for chronic anorectal pain secondary to radiation-induced proctitis appears warranted. Wiley Periodicals, Inc.

  16. Clinical use of Nintendo Wii bowling simulation to decrease fall risk in an elderly resident of a nursing home: a case report.

    Science.gov (United States)

    Clark, Robert; Kraemer, Theresa

    2009-01-01

    Of the estimated 1.7 million residents of nursing homes in the United States, approximately half fall annually; and 11% of these sustain injury. This is twice the rate for persons dwelling in the community. By addressing fall risk, physical therapists have an opportunity to reduce falls which are the leading cause of injury deaths, as well as the most common cause of nonfatal injuries for older adults in the United States. This case report examines the effect of a novel interactive video game intervention to address balance dysfunction in an elderly resident of a nursing home who was at risk for falls. The patient is an 89-year-old resident diagnosed with an unspecified balance disorder and a history of multiple falls. Self reports of gait abnormalities, scores on several clinical measures, and her fall history classified her as having substantial risk for future falls. A nontraditional approach to balance training, employing the Nintendo Wii bowling simulation, was used as intervention for this patient's balance disorder. After 6 one-hour treatment sessions, the patient's Berg Balance Score improved from 48 to 53. On the Dynamic Gait Index, the patient improved her score from 19 to 21. The patient's Timed Up and Go Test improved from 14.9 to 10.5 seconds, all suggesting a reduced risk of falling. The patient's ABC Score improved from 88 to 90%. Physical therapy intervention, using the Nintendo Wii bowling simulation, may have decreased fall risk for this individual.

  17. Barriers in detecting elder abuse among emergency medical technicians.

    Science.gov (United States)

    Reingle Gonzalez, Jennifer M; Cannell, M Brad; Jetelina, Katelyn K; Radpour, Sepeadeh

    2016-09-02

    Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was to describe EMTs' experience detecting and reporting elder abuse. Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders. Findings suggest a number of barriers prevent EMTs from reporting elder abuse to APS. Participants suggested that limited training on elder abuse detection or reporting has been provided to them. EMTs suggested that training, creation of an automated reporting system or brief screening tool could be used to enhance EMT's ability to detect and communicate suspected cases of elder abuse to APS. Results from the present study suggest that EMTs may be uniquely situated to serve as elder abuse and neglect surveillance personnel. EMTs are eager to work with APS to address the under-reporting of elder abuse and neglect, but training is minimal and current reporting procedures are time-prohibitive given their primary role as emergency healthcare providers. Future studies should seek to translate these findings into practice by identifying specific indicators predictive of elder abuse and neglect for inclusion on an automated reporting instrument for EMTs.

  18. Elderly Turkish Migrants in Denmark

    DEFF Research Database (Denmark)

    Blaakilde, Anne Leonora; Petersen, Signe Sofia Gronwald; Yazici, Suzan

    and a higher proportion of self-reported illness and are in higher risk of health problems and morbidity than their Danish counterparts. Furthermore, their health differences increase more by age. The research project aimed at finding possible explanations for these differences among Turkish and ethnic Danish......Elderly Turkish migrants in Denmark: Health in a life course perspective Objective According to Statistics Denmark, Turkish immigrants constitute the largest immigrant group in Denmark with 1.1% of the population (60,390 people) in 2012. They account for a higher rate of chronic ailments...... elderly people by studying the every day life of elderly Turkish migrants. Methods Qualitative interviews were carried out with 12 Turkish men and 18 women aged 54-80. The interviews had a focus on their health practices and health perceptions in a life history perspective. The interviews were...

  19. Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report 

    Directory of Open Access Journals (Sweden)

    Guerriero F

    2015-08-01

    Full Text Available Fabio Guerriero,1,2 Niccolo Maurizi,1 Matthew Francis,1 Carmelo Sgarlata,1 Giovanni Ricevuti,1,2 Mariangela Rondanelli,2,3 Simone Perna,2,3 Marco Rollone21Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, 2Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, 3Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Pavia, Italy Abstract: Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient’s quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and undertreated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly. However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids. This case report describes an elderly diabetic patient with multiple ulcers of the lower limbs suffering wound-related pain. In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients. Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy. Keywords: chronic pain, skin ulcers, elderly, opioids, oxycodone, naloxone

  20. Traditional use of medicinal plants by elderly

    Directory of Open Access Journals (Sweden)

    Alexandre Rocha Alves Pereira

    2016-06-01

    Full Text Available Objective: identify the traditional use of medicinal plants by the elderly. Methods: exploratory and descriptive study conducted in the Intermunicipal Consortium on Health. Three hundred and fifty-one questionnaires were applied to the elderly to survey socio-demographic information and issues related to plants. Results: the use of plants was reported by 78.4% of the elderly, and these were collected in backyards. The most often cited plants were mint, boldo, fennel, lemongrass and chamomile. Regarding the reason for use, 33.3% participants said that “it’s not harmful to health”, 61.8% usually indicate the use to other people. Most elderly make use of plants in a safe manner, and these are present in the daily lives of these people as a therapeutic method. Conclusion: the elderly make use of medicinal plants as an important therapeutic resource.

  1. Elder Abuse - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Elder Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Elder Abuse - Multiple Languages To use the sharing features on ...

  2. High-Intensity Atorvastatin-Induced Rhabdomyolysis in an Elderly Patient With NSTEMI: A Case Report and Review of the Literature.

    Science.gov (United States)

    Huynh, Glen A; Lee, Audrey J

    2017-12-01

    A 91-year-old male was admitted to the hospital for worsening muscle weakness, muscle pain, and unexplained soreness for the past 10 days. Four months prior to his admission, the patient had experienced a myocardial infarction and was initiated on atorvastatin 80 mg daily. Although the provider had instructed the patient to decrease the atorvastatin dose to 40 mg daily 3 months prior to admission, the patient did not adhere to the lower dose regimen until 10 days prior to hospitalization. Upon admission, the patient presented with muscle weakness and pain, a serum creatinine phosphokinase of 18 723 U/L, and a serum creatinine of 1.6 mg/dL. The atorvastatin dose was held and the patient was treated with intravenous fluids. The 2013 American College of Cardiology and American Heart Association Blood Cholesterol Practice Guidelines recommend the use of moderate-intensity statins in patients older than 75 years to prevent myopathy. However, in clinical practice, aggressive statin therapy is often prescribed for significant coronary disease. Prescribing high-intensity statins for patients with advanced age, such as this case, may increase the risk of rhabdomyolysis and other complications. This case report suggests that providers should avoid or be cautious with initiating high-intensity atorvastatin in elderly patients over 75 years to minimize the risk of rhabdomyolysis.

  3. A rare case of methimazole-induced cholestatic jaundice in an elderly man of Asian ethnicity with hyperthyroidism: A case report.

    Science.gov (United States)

    Ji, Hongjian; Yue, Feng; Song, Jianxiang; Zhou, Xiaohua

    2017-12-01

    Methimazole is an antithyroid drug that is widely used for the treatment of hyperthyroidism. As an inhibitor of the enzyme thyroperoxidase, methimazole is generally well-tolerated. However, there have been increasing reports of methimazole-induced liver damage, although this effect of methimazole has been limited by the absence of objective diagnosis of the liver condition or the inappropriate use of the Naranjo scale. We present the case of an elderly man with hyperthyroidism, gastritis, and epilepsy who developed liver damage after administration of multiple drugs. Considering the low sensitivity of the Naranjo scale in detecting rare reactions associated with liver damage, we used the Roussel-Uclaf Causality Assessment Method scale, with a finding of cholestatic jaundice hepatitis induced by methimazole. The patient's liver enzyme levels improved after discontinuation of methimazole. Our case underlines the possible hepatoxicity associated with the use of methimazole. A review of the literature confirmed a selective hepatoxicity risk in individuals of Asian ethnicity, which has not been identified in Caucasian or Black populations. Physicians should be aware of the risk of hepatoxicity when prescribing oral methimazole to patients of Asian ethnicity.

  4. Obtaining Self-Report Data from Cognitively Impaired Elders: Methodological Issues and Clinical Implications for Nursing Home Pain Assessment

    Science.gov (United States)

    Fisher, Susan E.; Burgio, Louis D.; Thorn, Beverly E.; Hardin, J. Michael

    2006-01-01

    Purpose: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Design and Methods: Using a modification of the Geriatric Pain Measure (GPM-M2), we…

  5. Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.

    Science.gov (United States)

    Rosen, Tony; Bloemen, Elizabeth M; Harpe, Jasmin; Sanchez, Allen M; Mennitt, Kevin W; McCarthy, Thomas J; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M; Flomenbaum, Neal; Lachs, Mark S

    2016-12-01

    Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.

  6. Orientações para idosas que cuidam de idosos no domicílio Orientaciones para mujeres ancianas que cuidan de familiares ancianos en su domicilio: relato de experiencia Teaching program for elderly women who care for elderly relatives in their home: report of experience

    Directory of Open Access Journals (Sweden)

    Maria José D'Elboux Diogo

    2005-03-01

    Full Text Available Trata-se de um relato de experiência de um programa de orientação para idosas cuidadoras de idosos no domicílio, realizado pelo Grupo de Atenção à Saúde do Idoso (GRASI, do Hospital de Clínicas da Universidade Estadual de Campinas. Esse programa foi elaborado e desenvolvido para atender uma solicitação de idosas cuidadoras, e participantes do GRASI. Ao final das atividades, as participantes relataram que o programa possibilitou o melhor enfrentamento das dificuldades, a compreensão das distintas alterações presentes na velhice, e o desenvolvimento de procedimentos que facilitam a relação com o idoso no dia-a-dia.Este artículo es el relato de experiencia de un programa de orientación a mujeres ancianas que cuidan de familiares ancianos en su domicilio. Este programa fue desarrollado por el Grupo de Atención a la Salud del Anciano (GRASI, del Hospital de las Clínicas de la Universidad Estatal de Campinas. El objetivo del programa fue atender a la solicitud de mujeres ancianas cuidadoras y que participaban del GRASI. Al final de las actividades del mismo, las cuidadoras relataron que el programa posibilitó un mejor enfrentamiento de las dificultades vividas, la mejor comprensión de los cambios que suceden en la vejez y el desarrollo de procedimientos que favorecen la relación cotidiana con el anciano.This is a report of experience about the development of a program designed especially for the orientation of elderly people who care for elderly relatives at home. It was carried out by the coordinators of the Group of Attention for Elderly People's Health (GRASI, of the Campinas State University's Clinics Hospital. This program was developed based on the needs reported by elderly caregivers who take part in the activities of the GRASI. The participants reported that the program made coping with the difficulties related to caregiving better; that there had been an improvement in the understanding of the changes brought by the

  7. Prevalence of falls in elderly women

    OpenAIRE

    Vitor,Priscila Regina Rorato; Oliveira,Ana Carolina Kovaleski de; Kohler,Renan; Winter,Gabriele Regiane; Rodacki,Cintia; Krause,Maressa Priscila

    2015-01-01

    OBJECTIVE: To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. METHODS: Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. RES...

  8. Validation of FRAX and the impact of self-reported falls among elderly in a general population

    DEFF Research Database (Denmark)

    Hoff, M.; Meyer, H. E.; Skurtveit, S.

    2017-01-01

    for the youngest and oldest men. Self-reported fall was an independent risk factor for fracture in women. Introduction: The primary aim was to validate FRAX without BMD for hip fracture prediction in a Norwegian population of men and women 50–90 years. Secondary, to study whether information of falls could improve......Summary: Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD) for hip fracture prediction was validated in a Norwegian population 50–90 years. Fracture risk increased with higher FRAX score, and the observed number of hip fractures agreed well with the predicted number, except...

  9. Prevalence of falls in elderly women.

    Science.gov (United States)

    Vitor, Priscila Regina Rorato; de Oliveira, Ana Carolina Kovaleski; Kohler, Renan; Winter, Gabriele Regiane; Rodacki, Cintia; Krause, Maressa Priscila

    2015-01-01

    To verify prevalence of falls and fear of falling, and to compare functional fitness among elderly women fallers and non-fallers. Seventy-eight elderly women participated in this study. Cases of falls and the fear of falling were self-reported by the elderly women, while the functional fitness was measured by a set of functional tests. Mean and standard deviation were used to describe the sample. Independent t-test was used to compare functional fitness between groups. The prevalence of falls in this sample was 32.4%. Among women fallers, 40% self-reported a high fear of falling. It is recommended that functional and resistance exercises are included in the preventive strategies for reducing risk factors for falls and its determinants in elderly women. Level of Evidence II, Prognostic-Prospective Study.

  10. The prevalence of self-reported underuse of medications due to cost for the elderly: results from seven European urban communities.

    Science.gov (United States)

    Stankuniene, Aurima; Stankunas, Mindaugas; Avery, Mark; Lindert, Jutta; Mikalauskiene, Rita; Melchiorre, Maria Gabriella; Torres-Gonzalez, Francisco; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Savickas, Arūnas; Radziunas, Raimondas; Soares, Joaquim J F

    2015-09-26

    The aim of this study was to evaluate the prevalence of self-reported underuse of medications due to procurement costs amongst older persons from seven European urban communities. The data were collected in a cross-sectional study ("ABUEL, Elder abuse: A multinational prevalence survey") in 2009. Randomly selected people aged 60-84 years (n = 4,467) from seven urban communities: Stuttgart (Germany), Athens (Greece), Ancona (Italy), Kaunas (Lithuania), Porto (Portugal), Granada (Spain) and Stockholm (Sweden) were interviewed. Response rate - 45.2%. Ethical permission was received in each country. The results indicate that 3.6% (n = 162) of the respondents self-reported refraining from buying prescribed medications due to cost. The highest prevalence of this problem was identified in Lithuania (15.7%, n = 99) and Portugal (4.3%, n = 28). Other countries reported lower percentages of refraining from buying medications (Germany - 2.0%, Italy - 1.6%, Sweden - 1.0%, Greece - 0.6%, Spain - 0.3%). Females refrained more often from buying medications than males (2.6% vs. 4.4%, p < 0.0001). The prevalence of this refraining tended to increase with economic hardship. These differences between countries can be only partly described by the financing of health-care systems. In spite of the presence of cost reimbursement mechanisms, patients need to make co-payments (or in some cases to pay the full price) for prescribed medications. This indicates that the purchasing power of people in 10.1186/s12913-015-1089-4 the particular country can play a major role and be related with the economic situation in the country. Lithuania, which has reported the highest refrain rates, had the lowest gross domestic product (at the time of conducting this study) of all participating countries in the study. Refraining from buying the prescribed medications due to cost is a problem for women and men in respect to ageing people in Europe. Prevalence varies by country, sex, and

  11. Prevalence of Skin Tears in Elderly Patients: A Retrospective Chart Review of Incidence Reports in 6 Long-term Care Facilities.

    Science.gov (United States)

    Hawk, Joyce; Shannon, Mary

    2018-04-01

    The incidence and prevalence of skin tears in long-term care (LTC) facilities has not been well established. To ascertain the point prevalence of reported skin tears, a retrospective review of incident reports was performed in 6 LTC facilities in western Pennsylvania from November 1, 2016 through December 31, 2016. Report data, including resident age; gender; mobility limitations; skin tear location, number, and cause (if known); occurrence time (7 am to 3 pm, 3 pm to 11 pm, or 11 pm to 7 am nursing shift); and history of previous skin tears, were abstracted. All data were entered into a statistical analysis program and analyzed using descriptive statistics. Period prevalence was used to determine prevalence rate; an independent t test was used to compare the presence of skin tears between genders. Differences between location and cause of skin tears were evaluated using a multinomial test of related proportions. A test of proportions was used to evaluate skin tear occurrence time (nursing shift) differences. The overall point prevalence rate was 9% (N = 1253 residents) ranging from 6 to 28 skin tears per facility. The average age of residents with a skin tear (n = 119) was 83.5 years. The majority (111, 93%) had mobility limitations. Falls accounted for 38 skin tears (31.9%), followed by propelling in a wheelchair (18, 15.1%; X2 =7.14; P = .008). Forearm skin tears (37, 31.1%) occurred significantly more frequently than lower leg skin tears (19, 16%; P = .016). Significantly more skin tears occurred during the 7 am to 3 pm shift (47, 39.5%) and 3 pm to 11 pm shift (49, 41.2%) than during the 11 pm to 7 am shift (23, 19.3%; X2 = 5.78; P skin tears are a significant problem among elderly residents in LTC, especially because the reported rate is likely lower than the actual rate. Research to further elucidate the incidence and prevalence of skin tears and associated risk factors is needed to help develop evidence-based risk assessment, classification systems

  12. Cemento-ossifying fibroma occurring in an elderly patient. A case report and a review of literature.

    Science.gov (United States)

    Dalghous, Abdulbaset; Alkhabuli, Juma O

    2007-06-01

    Cemento-ossifying fibromas (COF) are benign lesions affecting the jaws and other craniofacial bones. They commonly affect adults between the third and fourth decade of life. Radiographically, they appear as well-defined unilocular or multilocular intraosseous masses, commonly in the premolar/molar region of the mandible. The lesion is invariably encapsulated and of mixed radiolucent densities. The tumour may grow quite extensively, thus the term aggressive is some times applied. Their clinical, radiographical and histopathological features and those of fibro-osseous lesions are overlapping and may cause confusion in classification, diagnosis, and treatment. The histopathology is composed of fibrous tissues with calcified structures resembling bone or cementum. Surgical enucleation or resection is the treatment of choice. They are insensitive to radiotherapy and recurrences are uncommon. This case report presents a case of COF in 70 years old female patient that was asymptomatic. Clinically, there was an expansion of the buccal plate but not the lingual plate of the right mandible. The covering mucosa was normal and there was no tenderness or paraesthesia. Radiographically, the lesion extends superio-inferiory from the alveolar ridge to the area of inferior dental canal and mesiodistally from the premolar region to the retro-molar area. The lesion was of mixed radiolucent densities. The patient was followed up periodically for 5 years without any treatment. The patient continued to be asymptomatic with minimum changes. Occurrence of cemento-ossifying fibroma in patients over 60 years of age is unusual and had not been reported. The clinical, radiographic, histopathology and literature review are discussed.

  13. Cemento-ossifying fibroma occurring in an elderly patient: A case report and a review of literature

    Directory of Open Access Journals (Sweden)

    Juma O. Alkhabuli

    2007-01-01

    Full Text Available Cemento-ossifying fibromas (COF are benign lesions affecting the jaws and other craniofacial bones. They commonly affect adults between the third and fourth decade of life. Radiographically, they appear as well-defined unilocular or multilocular intraosseous masses, commonly in the premolar/molar region of the mandible. The lesion is invariably encapsulated and of mixed radiolucent densities. The tumour may grow quite extensively, thus the term aggressive is some times applied. Their clinical, radiographical and histopathological features and those of fibro-osseous lesions are overlapping and may cause confusion in classification, diagnosis, and treatment.The histopathology is composed of fibrous tissues with calcified structures resembling bone or cementum. Surgical enucleation or resection is the treatment of choice. They are insensitive to radiotherapy and recurrences are uncommon. This case report presents a case of COF in 70 years old female patient that was asymptomatic.Clinically, there was an expansion of the buccal plate but not the lingual plate of the right mandible. The covering mucosa was normal and there was no tenderness or paraesthesia. Radiographically, the lesion extends superio-inferiory from the alveolar ridge to the area of inferior dental canal and mesiodistally from the premolar region to the retro-molar area. The lesion was of mixed radiolucent densities. The patient was followed up periodically for 5 years without any treatment. The patient continued to be asymptomatic with minimum changes. Occurrence of cemento-ossifying fibroma in patients over 60 years of age is unusual and had not been reported. The clinical, radiographic, histopathology and literature review are discussed.

  14. Adherence to recommendations of the Therapeutic Positioning Report about treatment with oral anticoagulants in elderly patients with atrial fibrillation. The ESPARTA study.

    Science.gov (United States)

    Suárez Fernández, Carmen; Mostaza, Jose María; Castilla Guerra, Luis; Cantero Hinojosa, Jesus; Suriñach, Josep Maria; Acosta de Bilbao, Fernando; Tamarit, Juan José; Diaz Diaz, José Luis; Hernandez, Jose Luis; Cazorla, Daniel; Ràfols, Carles

    2017-10-06

    To evaluate the adherence to the recommendations in clinical practice performed by the Therapeutic Positioning Report (TPR) of the Spanish Agency of Medicines and Sanitary Products about the treatment with oral anticoagulants in patients aged≥75 years old with nonvalvular atrial fibrillation (NVAF) treated in Internal Medicine departments in Spain. Observational, cross-sectional and multicenter study in which 837 patients aged≥75 years old with NVAF, with stable treatment with oral anticoagulants at least 3 months before inclusion, and that had started treatment with oral anticoagulants before the inclusion period were included. Mean age was 83.0±5.0 years old, mean CHADS 2 score 3.2±1.2, mean CHA 2 DS 2 -VASc score 5.0±1.4, and mean HAS-BLED score 2.1±0.9. A percentage of 70.8 of patients were treated with vitamin K antagonists (VKA) and the rest of patients with direct oral anticoagulants (DOACs). A percentage of 65.6 of patients treated with VKA did not follow the recommendations made by the TPR compared with 43.0% of patients treated with DOACs (P<.0001). In the case of VKA, the main reason for being considered as not appropriate according to the TPR was having poor control of anticoagulation and not switching to DOACs, whereas in the case of DOACs, it was not receiving the adequate dose according to the TPR. In a high proportion of anticoagulated elderly patients with NVAF in Spain, the recommendations performed by the TPR are not followed, particularly with VKA, since patients are not switched to DOACs despite time in therapeutic range. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Isolated unilateral vertebral pedicle fracture caused by a back massage in an elderly patient: a case report and literature review.

    Science.gov (United States)

    Guo, Zhiping; Chen, Wei; Su, Yanling; Yuan, Junhui; Zhang, Yingze

    2013-11-01

    The vertebral pedicle injuries are clinically common. However, the isolated vertebral pedicle fracture with intact vertebral bodies is a rare lesion. We reported a case of a 66-year-old man who experienced a pedicle fracture after a back massage. The patient sustained osteoporosis, long-existing low back pain and nerve compression symptoms without antecedent major trauma. Imaging findings demonstrated an isolated unilateral L5 vertebral pedicle fracture with intact vertebral bodies, spinal canal stenosis at the L4-5 levels, bulging annulus fibrosus at the L4-S1 levels, bilateral spondylolysis and an L5/S1 spondylolisthesis. The patient underwent L4-S1 decompressive laminectomy, L5/S1 discectomy and neurolysis, and reduction and fixation of the L5 vertebral pedicle fracture and L5/S1 spondylolisthesis using the pedicle nail system. At follow-ups, the patient showed good recovery without pain or numbness in the low back and bilateral lower extremities. This study raises the awareness of a complication of alternative medicine and the possibility of a pedicle fracture caused by a low-energy trauma.

  16. Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature

    International Nuclear Information System (INIS)

    Antar, A; El Hajj, H; Jabbour, M; Khalifeh, I; EL-Merhi, F; Mahfouz, R; Bazarbachi, A

    2014-01-01

    Primary effusion lymphoma (PEL) is a rare aggressive subset of non-Hodgkin B-cell lymphoma. It is caused by Kaposi sarcoma-associated herpesvirus/human herpesvirus type 8 (KSHV/HHV8). It occurs mainly, but not exclusively, in HIV-positive patients. PEL predominantly develops in serous cavities and occasionally in extracavitary regions. PEL carries a very poor prognosis with a median survival time of <6 months. Indeed, currently used treatment modalities such as CHOP chemotherapy are far from achieving complete and sustainable remission. Therefore, there is no clear standard of care established in the treatment of PEL patients, stressing the need for novel-targeted approaches. Here, we have attempted a comprehensive assessment of the treatment of PEL, discussed avant-garde therapies and updated the state of preclinical research with promising clinical applications in the field. These include inhibitors of viral replication, modulators of cell signaling and inflammation, nuclear factor kappa B (NF-κB) and histone deacetylase inhibitors, and recently the combination of arsenic trioxide and interferon-alpha. Some of these targeted therapies have not yet reached clinical studies, although others were used in a few individual case reports with low numbers of patients. We also describe the first case of a 77-year-old, HIV-negative, HHV8-positive patient diagnosed with PEL limited to the pleural and peritoneal cavities. He received lenalidomide 25 mg/day for 21 days every 28 days. Treatment was well tolerated with no side effects. He rapidly improved after 1 month of treatment and progressively achieved complete remission persistent after 18 months of therapy. We believe that this review will bridge an important gap between classical chemotherapy and modern approaches of targeted therapy. Finally, our findings warrant further evaluation of lenalidomide in future prospective clinical studies

  17. Dyadic Vulnerability and Risk Profiling for Elder Neglect

    Science.gov (United States)

    Fulmer, Terry; Paveza, Gregory; VandeWeerd, Carla; Fairchild, Susan; Guadagno, Lisa; Bolton-Blatt, Marguarette; Norman, Robert

    2005-01-01

    Purpose: Neglect of older adults accounts for 60% to 70% of all elder-mistreatment reports made to adult protective services. The purpose of this article is to report data from research, using a risk-and-vulnerability model, that captures the independent contributions of both the elder and the caregiver as they relate to the outcome of neglect.…

  18. Self-Reported Questionnaire of Functional Health of Home-Dwelling Elderly People Living in Austria: Based on the Patient Questionnaire of the Standardized Assessment of Elderly People in Primary Care.

    Science.gov (United States)

    Schulc, Eva; Gothe, Raffaella Matteucci; Them, Christa; Tufan, İsmail; Mueller, Gerhard

    2017-08-01

    The aim was to review the construct validity and reliability of a functional health assessment questionnaire (Questionnaire on Functional Health 2 [Q-FH2]). The Q-FH2 was used to assess 344 elderly people in a home setting. A polychoric correlation matrix was applied to conduct a principal axis factor analysis with oblique rotation. The number of factors was determined using various procedures and calculated using theta coefficients to estimate ordinal reliability. The exploratory factor analysis supported a 4-factor solution with an explained total variance of 82%. The internal consistency showed  coefficients ranging from 0.758 to 0.854. The Q-FH2 appears to be a useful instrument to assess the multidimensionality of functional health as defined by the International Classification of Functioning, Disability and Health to determine the resources and deficits regarding the independent living of older adults and to derive appropriate consulting measures.

  19. Elder Abuse Awareness Module.

    Science.gov (United States)

    Goettler, Darla

    The Elder Abuse Prevention Project sponsored by the Seniors' Education Centre, University Extension, University of Regina (Saskatchewan, Canada) emerged from a provincial workshop held by the Centre in 1989. The workshop was designed to examine possible avenues for addressing elder abuse issues in Saskatchewan. The purposes of the project were to…

  20. Elder Abuse in Japan

    Science.gov (United States)

    Arai, Mizuho

    2006-01-01

    Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…

  1. Elder Abuse Awareness Project.

    Science.gov (United States)

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  2. [Trauma in the elderly].

    Science.gov (United States)

    de Souza, José Antonio Gomes; Iglesias, Antonio Carlos R G

    2002-01-01

    The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, disproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave differently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and rehabilitation of the elderly victims of trauma.

  3. [Anemia in the elderly].

    Science.gov (United States)

    Maerevoet, M; Sattar, L; Bron, D; Gulbis, B; Pepersack, T

    2014-09-01

    Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).

  4. Clinical Manifestation of Acute Myocardial Infarction in the Elderly

    Directory of Open Access Journals (Sweden)

    Miftah Suryadipradja

    2003-12-01

    Full Text Available A retrospective study were performed in patients with acute myocardial infarction (AMI that hospitalized in ICCU Cipto Mangunkusumo hospital, Jakarta during the period of January 1994 until Decmber 1999. There were 513 patients hospitalized with MCI, 227 patients (44.2% were classified as elderly, and 35.2% of them were female. Most of the elderly AMI patients reported typical chest pain just like their younger counterparts. Elderly AMI patients tend to come later to the hospital, and more Q-wave myocardial infarction were identified compared to non- Q-wave myocardial infarction. Risk factors of diabetes mellitus and hypertension were more common among the elderly. The prevalence of atrial fibrillation and the mortality rate were higher among elderly AMI patients. (Med J Indones 2003; 12: 229-35 Keywords: clinical manifestation, acute myocardial infarction, elderly

  5. Elderly people with chronic disease in the knowledge society

    DEFF Research Database (Denmark)

    Dahl, Mads Ronald

    2007-01-01

    elderly people use it? The focus of this paper is to evaluate whether elderly Danes with chronic disease use the internet to seek knowledge on health information. The study was conducted among 2000 Danes over 60 years of age as a cross-sectional survey using a postal questionnaire. The theoretical...... foundation of the study was a constructivistic evaluation of the problem domain followed by a quantitative evaluation. The results showed that elderly people with a chronic disease do not use the internet as source for health information any different then elderly people without chronic disease. Thus chronic...... diseases were not found to be a motivation factor or determinant for using the internet as tool to increase personal knowledge on general health information. Furthermore it showed that elderly people who reported having a good general health were more often users than elderly having a suboptimal general...

  6. The impact of elder abuse education on young adults.

    Science.gov (United States)

    Hayslip, Bert; Reinberg, Julie; Williams, Jennifer

    2015-01-01

    The present study examined the effectiveness of educational interventions in altering tolerance for and behavioral intentions of elder abuse among college student young adults. Participants were 225 undergraduates who were assigned to one of four educational groups: Elder Abuse Education, Aging Education, Family Education, and a Pre- and Posttest only condition. While the Elder Abuse Education group reported less tolerance and intentions for elder abuse compared to the other groups at the immediate posttest, a decrement in such positive changes at 1-month follow-up was observed in such persons. These mixed findings suggest that while specific interventions may reduce elder abuse tolerance, supplemental educational efforts over time may be necessary to maintain intervention-specific gains in intentions and behaviors particular to elder abuse.

  7. The Elder Problem

    Directory of Open Access Journals (Sweden)

    John W. Elder

    2017-03-01

    Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

  8. Acute Systemic Viral Infection Masquerading as an Infiltrating Lymphoma in an Elderly Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hani M. Babiker

    2013-01-01

    Full Text Available Primary Epstein-Barr virus (EBV infection occurs mainly in adolescents and young adults, with more than 90% of adults having serological evidence of past infection. Primary infection in those over the age of 40 is associated with an atypical and often more severe presentation that can lead to more extensive and invasive, and often unnecessary, diagnostic testing. The incidence of severe EBV-related illness in older adults has been observed to be increasing in industrialized nations. The characteristic presentation of infectious mononucleosis (IM syndrome in elderly patients (age > 65 is not clearly defined in the literature. Here, we describe a case of primary EBV infection in an 80-year-old female and review the literature regarding primary seroconversion in elderly patients.

  9. Caustic Ingestion in the Elderly: Influence of Age on Clinical Outcome

    Directory of Open Access Journals (Sweden)

    Blazena Caganova

    2017-10-01

    Full Text Available Caustic poisonings are still associated with many fatalities. Studies focusing on the elderly are rare. The purpose of the present study was to compare the clinical outcomes of caustic ingestion injury in elderly and non-elderly adults with regard to gender, intent of exposure, substance ingested, severity of mucosal injury, complications, and mortality. Caustic substance exposures reported to the National Toxicological Information Centre in Slovakia during 1998–2015 were reviewed retrospectively. The patients were divided into two groups: the non-elderly (<60 years and elderly adults (≥60 years. The mortality rate in the elderly was significantly higher (elderly 23.0% vs. non-elderly 11.3%; p = 0.041. The risk of fatal outcome in the elderly was increased by acid ingestion (OR = 7.822; p = 0.002, particularly hydrochloric acid (OR = 5.714, p = 0.006. The incidence of respiratory complications was almost two times higher in the elderly was 31.1% vs. 17.4% for the non-elderly (p = 0.037. Respiratory complications significantly correlated with an increased mortality rate (p = 0.001 in the elderly whereas there was no association between GI complications and mortality in the elderly (p = 0.480. Elderly patients with respiratory complications had the poorest clinical outcomes. The highest risk of complications and fatalities was observed in patients after hydrochloric acid ingestion.

  10. A Profile of Elder Abuse and Neglect in Tennessee.

    Science.gov (United States)

    Villas, Paul

    A survey of 35 cases of reported abuse to individuals aged 60 and older in the state of Tennessee sought to determine demographic characteristics of the abused, perpetrators of elder abuse and neglect, types of abuse that occur, and any existence of relationships in elder abuse and neglect between urban and rural counties and eastern and western…

  11. Health status of Hispanic elders.

    Science.gov (United States)

    Bassford, T L

    1995-02-01

    Hispanic elders living in the United States compose a rapidly increasing population. They are underinsured and more likely to be living in poverty. Health care is hindered in this population by lower access to health services and less use of preventive services. Barriers to access are primarily socioeconomic. Acculturation exerts an effect, primarily through its association with language skills, employment, and education. Cardiovascular disease is the leading cause of mortality for Hispanics, who have a higher prevalence of risk factors for cardiovascular disease, such as diabetes mellitus, obesity, and hyperlipidemia. Although neoplasia is the second most frequent cause of death among Hispanics, as it is in whites who are not Hispanic, Hispanics have an overall lower cancer rate. Cancer rates are increasing, however. Non-insulin-dependent diabetes mellitus is a significant cause of morbidity and mortality in the Hispanic population, affecting nearly a quarter of adult Puerto Ricans and Mexican Americans. Although higher prevalence of obesity in the Hispanic population accounts for some of this difference, some data suggest the possibility of a genetic component as well. Assessment of psychological health in Hispanic elders is impeded by the lack of instruments designed for this population. Distress is often expressed as somatic symptoms. Values traditional to Hispanic culture, such as respeto, allocentrism, and familialism, are important to US Hispanic elders, many of whom were born in rural Mexico. Our knowledge of determinants of healthy aging in this population is still preliminary, but rapidly expanding, in part, because of increased attention to ethnicity in health reporting.

  12. Elder Abuse and Neglect

    Directory of Open Access Journals (Sweden)

    Muge Gulen

    2013-06-01

    Full Text Available Abuse and neglect are preventable societal problems that influence elderly individuals physically, spiritually and socially. Elder abuse is neglected for many years and is a growing problem all over the world. The aim of this article is to review the evaluation of elderly individuals who are exposed to abuse and neglect with systematic detailed history and physical examination and to describe individual, familial, and social measures that should be taken to prevent these abuses. [Archives Medical Review Journal 2013; 22(3.000: 393-407

  13. Elder abuse in Chinese populations: a global review.

    Science.gov (United States)

    Dong, XinQi

    2015-01-01

    This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.

  14. The Effectiveness of Subdural Drains Using Urokinase after Burr Hole Evacuation of Subacute Subdural Hematoma in Elderly Patients: A Prelimilary Report

    Science.gov (United States)

    Yeo, Chang-Gi; Jeon, Woo-Yeol; Kim, Seong-Ho; Kim, Oh-Lyong

    2016-01-01

    Objective A subdural drain using urokinase after a burr hole hematoma evacuation was performed for subacute subdural hematoma (SASDH), and its effectiveness and safety in elderly patients were evaluated. Methods Between January 2013 and May 2015, subdural drains using urokinase after burr hole hematoma evacuation were performed in 19 elderly patients. The inclusion criteria were as follows: 1) a subdural hematoma occurring between 4 and 20 days after injury; 2) worsening neurological symptoms, from mild to moderate or severe, due to injury during the subacute stage; 3) a mix of solid clots (high-density lighter shadow) and fluid hematoma (low-density darker shadow) on the computed tomography (CT) scan; 4) a score of ≥9 on the Glasgow Coma Scale (GCS) assessed immediately before surgery; and 5) an age of ≥65 years. When the majority of the hematoma was evacuated on the CT, we removed the catheter. Results Under local anesthesia, a catheter was inserted into the hematoma through a burr hole. The mean age of the patients was 73.7 years (range, 65-87 years). The mean preoperative GCS score was 11.2 (range, 10-13), and the mean Glasgow Outcome Scale score for all patients was 5 at discharge. No recurrences of hematomas or surgical complications were observed. Conclusion A subdural drain using urokinase after burr hole hematoma evacuation under local anesthesia is thought to be an effective and safe method of blood clot removal with low morbidity. This surgical method is less invasive for treating elderly patients with SASDH. PMID:27857916

  15. De novo adamantinomatous craniopharyngioma presenting anew in an elderly patient with previous normal CT and MRI studies: A case report and implications on pathogenesis

    Directory of Open Access Journals (Sweden)

    Amy Walker, B.S.

    2015-09-01

    Full Text Available Adamantinomatous craniopharyngiomas are histologically benign epithelial tumors which arise from embryonic remnants of the craniopharyngeal duct and Rathke’s pouch. They are thought to have a congenital origin and are histologically unique from papillary craniopharyngioma. We describe the case of an elderly male who presented with symptoms related to a large craniopharyngioma with previously normal brain magnetic resonance and computed tomography imaging studies. These findings dispute the embryogenic theory that craniopharyngiomas observed in adults develop from the persistent slow growth of embryonic remnants.

  16. Benzodiazepine poisoning in elderly

    OpenAIRE

    Perković-Vukčević Nataša; Vuković-Ercegović Gordana; Šegrt Zoran; Đorđević Snežana; Jović-Stošić Jasmina

    2016-01-01

    Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collecte...

  17. Robots in Elderly Care

    OpenAIRE

    Alessandro Vercelli; Innocenzo Rainero; Ludovico Ciferri; Marina Boido; Fabrizio Pirri

    2018-01-01

    Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general p...

  18. Differences in the clinical presentation and the frequency of complications between elderly and non-elderly scrub typhus patients.

    Science.gov (United States)

    Jang, Mi-Ok; Kim, Ji Eun; Kim, Uh Jin; Ahn, Joon Hwan; Kang, Seung-Ji; Jang, Hee-Chang; Jung, Sook-In; Park, Kyung-Hwa

    2014-01-01

    Age can affect the clinical features and severity of infectious disorders, such as scrub typhus. We performed this study to examine differences between elderly and non-elderly scrub typhus patients, and to identify risk factors predictive of disease outcomes. This retrospective study included patients admitted to a tertiary hospital with scrub typhus between 2001 and 2011. A total of 615 patients were enrolled in this study, 328 of which were >65 years of age. Of the elderly patients, 46.0% (151/328) experienced at least one complication compared to only 23.0% (66/287) in younger patients. A linear trend was observed between age and complication rates (p=0.002). The most common complication in elderly patients was acute kidney injury (75, 22.9%). Treatment failure was reported in 10 elderly patients (3.0%) compared to one non-elderly patient (0.3%). Mental confusion and dyspnea of clinical manifestations at admission were common in elderly patients. Frequency of fever, rash, and eschar were similar in both groups. The following four factors were significantly associated with severe scrub typhus in elderly patients: (1) white blood cell (WBC) counts>10,000/mm(3) (OR=2.569, CI=1.298-5.086), (2) MDRD GFR10 points (OR=3.304, CI=1.793-60.87). Complications and mortality were more common in elderly patients, often associated with delays in diagnosis and treatment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Analysis of elder abuse statutes across the United States, 2011-2012.

    Science.gov (United States)

    Jirik, Stacey; Sanders, Sara

    2014-01-01

    The purpose of this article is to describe the state elder abuse statutes in the United States and Washington DC during 2011-2012. The last review of elder abuse statutes occurred in 2001; thus, a reexamination is warranted given the increased awareness of elder abuse at the state and national level and the growing number of older adults in the United States. This descriptive study analyzed the following components of elder or dependent abuse statutes: definitions, reporting requirements, training, and consequences for failure to report. It was determined that differences remain in how states respond to elder abuse at the community-based level.

  20. Elder Mistreatment Perpetrators with Substance Abuse and/or Mental Health Conditions: Results from the National Elder Mistreatment Study.

    Science.gov (United States)

    Labrum, Travis; Solomon, Phyllis L

    2018-03-01

    A large portion of persons who commit elder mistreatment have long been known to have indicators of substance abuse and/or mental health conditions (SAMHC). However, few studies have specifically examined elder mistreatment by persons with SAMHC, preventing the development of specialized intervention strategies. Using results from the National Elder Mistreatment Study, the current article examines victim, perpetrator, and interaction characteristics between cases of emotional and physical elder mistreatment in which the perpetrator is reported to have vs. not have SAMHC. Chi square tests and Mann-Whitney-Wilcoxon non-parametric tests were performed. 210 perpetrators of emotional elder mistreatment were reported to have SAMHC with 412 perpetrators of emotional mistreatment reported to not have SAMHC. 57 perpetrators of physical elder mistreatment were reported to have SAMHC with 38 perpetrators of physical mistreatment not having SAMHC. Emotional elder mistreatment committed by persons with SAMHC was associated with the following characteristics: perpetrator-unemployment, history of involvement with police, and fewer friendships; victim-female gender, greater emotional problems, and greater occurrences of lifetime emotional mistreatment; interaction-co-residence, and reporting of mistreatment to authorities. Physical elder mistreatment committed by persons with SAMHC was associated with police involvement of the perpetrator and greater occurrences of lifetime physical mistreatment experienced by the victim. These findings indicate that victims of elder mistreatment by persons with SAMHC are in particular need of intervention services as they have greater histories of mistreatment and experience greater emotional problems. Implications for effectively intervening in cases of elder mistreatment by persons with SAMHC are discussed.

  1. Benzodiazepine poisoning in elderly.

    Science.gov (United States)

    Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

    2016-03-01

    Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  2. Epilepsy in the Elderly

    Directory of Open Access Journals (Sweden)

    Lu-An Chen

    2012-06-01

    Full Text Available Elderly people are the largest and continuously fastest growing population among patients with epilepsy. Elderly patients with epilepsy are very different from other age groups in many respects and clinicians shouldn’t treat them in the same way as younger adults. Accurate diagnosis of epilepsy in the elderly is much more difficult and atypical manifestations and misdiagnoses are certainly not the exception. Syncope is probably the most important differential diagnosis. High clinical suspicion and proper investigation are the best tools for prompt diagnosis. Etiologies of late-onset epilepsy are mainly symptomatic and cerebrovascular diseases are the most common causes in this age group, followed by degenerative diseases such as Alzheimer’s disease. It is appropriate to consider starting antiepileptic drug (AED treatment at the first-ever seizure in elderly patients who have remote symptomatic causes such as stroke and dementia. According to the high recurrence rate of seizure and the good response to AEDs in elderly patients, the proper choice from various AEDs for seizure control is very important. Decision-making for AED choice depends on many different factors, including pharmacological properties, efficacy, tolerability from side effects, drug interactions, and medical comorbidities. The newer AEDs with lesser adverse effects and fewer drug interactions appear to be reasonable treatment options for elderly patients. However, more evidence from clinical trials in this specific age group is warranted.

  3. Radiologists’ Training, Experience, and Attitudes About Elder Abuse Detection

    Science.gov (United States)

    Rosen, Tony; Bloemen, Elizabeth M.; Harpe, Jasmin; Sanchez, Allen M.; Mennitt, Kevin W.; McCarthy, Thomas J.; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M.; Flomenbaum, Neal; Lachs, Mark S.

    2017-01-01

    OBJECTIVE Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists’ experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. SUBJECTS AND METHODS We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. RESULTS Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. CONCLUSION Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice. PMID:27732066

  4. Prosthetic outcome, patient complaints, and nutritional effects on elderly patients with magnet-retained, implant-supported overdentures--a 1-year report.

    Science.gov (United States)

    Khoo, Huan Ding; Chai, John; Chow, Tak Wah

    2013-01-01

    To study the changes in treatment outcomes of complete dentures and magnet-retained, implant-supported overdentures in a group of elderly patients. In this nonrandomized trial, 43 edentulous patients (14 men and 29 women) were fitted with complete dentures followed by implant-supported mandibular overdenture in a sequential model. Treatment outcomes used for analysis included objective assessment of denture quality (Woelfel's index), patient satisfaction, nutritional status, body mass index (BMI), and serum albumin level. The McNemar test was used to determine if significant differences in the Woelfel's index and nutritional status existed at different treatment phases. Repeated measures ANOVA and multiple pairwise comparison tests were used to analyze patient satisfaction. BMI status and serum albumin level at different treatment phases were analyzed with one-way ANOVA and Tukey post hoc test. At the 1-year follow-up, significant improvements were recorded for the objective assessment of denture quality and patient complaints (P .05) CONCLUSIONS: The present study demonstrated that in elderly patients with stable health and nutritional status, complete dentures made in a university clinic brought about overall improvement in denture quality and reduction in denture complaint score. Insertion of mandibular implant-supported overdentures further improved the mandibular denture quality and reduced the mandibular denture complaint score. In this group of patients, no improvement in BMI, serum albumin value, and nutritional status were documented.

  5. Barium enema in frail elderly patients.

    Science.gov (United States)

    Segal, R; Khahil, A; Leibovitz, A; Gil, I; Annuar, M; Habot, B

    2000-01-01

    Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients. The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients. Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed. One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001). The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly. Copyright 2000 S. Karger AG, Basel

  6. Effect of Tai Ji Quan training on self-reported sleep quality in elderly Chinese women with knee osteoarthritis: a randomized controlled trail.

    Science.gov (United States)

    Lü, Jiaojiao; Huang, Lingyan; Wu, Xie; Fu, Weijie; Liu, Yu

    2017-05-01

    The purpose of this study was to explore the effects of a 24-week Tai Ji Quan training program on sleep quality, quality of life, and physical performance among elderly Chinese women with knee osteoarthritis (OA). A 24-week randomized, controlled trial of 46 elderly women with knee OA. Participants were randomly assigned to either a Tai Ji Quan group (n = 23) or a control group (n = 23). Participants in the Tai Ji Quan group completed training sessions three times per week, while those in the control group had bi-weekly educational classes. The primary outcome was total score of the Pittsburgh Sleep Quality of Index (PSQI). Secondary outcomes were: seven subscales of the PSQI; sleep latency; total sleep time; sleep efficiency; physical component summary (PCS) and mental component summary (MCS) of the 36-item Short Form Health Survey (SF-36); Berg Balance Scale (BBS); and Timed Up and Go (TUG). Compared with the control group, participants in the Tai Ji Quan group had significantly improved primary outcome (global PSQI score, p = 0.006) and secondary outcomes, including three PSQI sub-scores (sleep latency, p = 0.031; sleep duration, p = 0.043; daytime dysfunction, p = 0.007), total sleep time (p = 0.033), and SF-36 PCS (p = 0.006). The Tai Ji Quan group also had significant improvements compared with baseline in three PSQI sub-scores (sleep latency, p = 0.031; habitual sleep efficiency, p = 0.049; sleep disturbance, p = 0.016), sleep latency (p = 0.003), BBS (p = 0.001), and TUG (p = 0.006). Tai Ji Quan training is an effective treatment approach to improve sleep quality and quality of life in elderly Chinese women with knee OA. Chinese Clinical Trial Registry (June 16, 2013): ChiCTR-TRC-13003264. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Elder Abuse: Systematic Review and Implications for Practice.

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  8. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......, including hypertension, musculoskeletal and respiratory diseases were underreported by study participants. Erectile dysfunction and hypogonadism were substantially underreported in the study population even though these diseases were found to affect 48 and 21% of the participants, respectively. CONCLUSIONS...

  9. National Center on Elder Abuse

    Science.gov (United States)

    ... Research Synthesize and disseminate high quality research on elder abuse to encourage the translation of research into practice. ... to further the field for those interested in elder abuse identification and prevention. What’s Happening National Center on ...

  10. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

  11. Cancer in the Elderly

    International Nuclear Information System (INIS)

    Buntinx, F.; Akker, M. V. D.; Buntinx, F.; Akker, M. V. D.; Campbell, C.

    2014-01-01

    The incidence of cancer rises among older populations [1,2] and continuous improvement in treatment outcomes is resulting in even greater increases in the prevalence of cancer survivors in this age group [3]. There is considerable variation in cancer mortality rates in the elderly among high-income countries, with the UK having poorer outcomes compared to the USA and Western and Northern European countries [4]. The diagnosis of cancer and treatment decisions following diagnosis at an older age bring specific challenges to health care providers. Further, living with cancer has specific characteristics and consequences for older people. The five papers (three from North America, two from Europe) included in this special issue address some of these topics: increasing awareness of breast cancer symptoms, management of patients with lung and breast cancers, and survivorship issues specific to older patients. There is good evidence that age is a risk factor for the delay in presentation with breast cancer [5]. L. J. L. Forbes et al. describe the implementation into routine clinical practice of an evidence-based brief intervention designed to promote earlier symptomatic presentation of breast cancer among older women. The authors have previously reported on the effectiveness of the intervention in a randomised control trial [6]; this further work shows that its introduction into routine mammography appointments at four pilot areas within the UK’s Breast Screening Programme results in similar levels of breast cancer awareness among participating women (mean age 71 years, 4 months) as in the trial setting. The intervention was acceptable to women and to mammography providers. Given the low awareness of age-related cancer risk within the UK compared to a number of other countries [7], interventions of this nature, conveying key cancer messages as patients are entering the age group with highest risk of breast cancer, have the potential to contribute to earlier health

  12. Lung cancer in elderly

    International Nuclear Information System (INIS)

    Wagnerova, M.

    2007-01-01

    Lung cancer is the leading cause of cancer deaths in Europe and USA. The median age of diagnosis is currently 69 years, however this is gradually increasing with the aging population. Patients over age of 70 represent 40 % of all patients with non-small cell lung cancer. Age alone has not been found to be a significant prognostic factor in many malignancies, including lung cancer with performance status and stage being of greater importance. In lung cancer it is also evident that older patients gain equivalent benefit from cancer therapies as their younger counterparts. Elderly patients are under-treated in all aspects of their disease course from histological diagnosis to active therapy with surgical resection, radiotherapy or chemotherapy, irrespective of performance status or co-morbidities. Elderly patients are also underrepresented in lung cancer clinical trials. In this review is presented knowledge about lung cancer in elderly. (author)

  13. Elderly Care Centre

    Science.gov (United States)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina

    2016-02-01

    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  14. Poverty among Elderly in India

    Science.gov (United States)

    Srivastava, Akanksha; Mohanty, Sanjay K.

    2012-01-01

    Using consumption expenditure data of the National Sample Survey 2004-2005, this paper estimates the size of elderly poor and tests the hypotheses that elderly households are not economically better-off compared to non-elderly households in India. Poverty estimates are derived under three scenarios--by applying the official cut-off point of the…

  15. Israeli Perspectives on Elder Abuse

    Science.gov (United States)

    Rabi, Keren

    2006-01-01

    Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…

  16. Benzodiazepine poisoning in elderly

    Directory of Open Access Journals (Sweden)

    Perković-Vukčević Nataša

    2016-01-01

    Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

  17. Physical activity in elderly

    Directory of Open Access Journals (Sweden)

    Jan Cvecka

    2015-08-01

    Full Text Available Aging is a multifactorial irreversible process associated with significant decline in muscle mass and neuromuscular functions. One of the most efficient methods to counteract age-related changes in muscle mass and function is physical exercise. An alternative effective intervention to improve muscle structure and performance is electrical stimulation. In the present work we present the positive effects of physical activity in elderly and a study where the effects of a 8-week period of functional electrical stimulation and strength training with proprioceptive stimulation in elderly are compared.

  18. Tremor in the elderly

    DEFF Research Database (Denmark)

    Deuschl, Günther; Petersen, Inge; Lorenz, Delia

    2015-01-01

    Isolated tremor in the elderly is commonly diagnosed as essential tremor (ET). The prevalence of tremor increases steeply with increasing age, whereas hereditary tremor is becoming less common. Moreover, late-manifesting tremor seems to be associated with dementia and earlier mortality. We...... hypothesize that different entities underlie tremor in the elderly. Two thousand four hundred forty-eight subjects from the Longitudinal Study of Aging Danish Twins older than 70 y answered screening questions for ET in 2001. Two thousan fifty-six (84%) participants drew Archimedes spirals to measure...

  19. Struggles in (Elderly) Care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    This book provides a critical engagement with the intensified struggles to be found within elderly care provision. Various social and political processes, including the forces of globalisation and the de-gendering of care, have changed how we might understand this national and global political...... of contestation. Dahl approaches these issues from a post-structuralist and radical feminist position, while drawing from feminist sociology, feminist political science, nursing philosophy and feminist history. In particular, Struggles In (Elderly) Care highlights how the predominantly feminist theorization...

  20. Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people.

    Science.gov (United States)

    Svensson, Bengt; Hansson, Lars

    2017-06-01

    Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Single group pre-test-post-test design. The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

  1. Violência contra a pessoa idosa: análise das notificações realizadas no setor saúde - Brasil, 2010 Violence against the elderly: analysis of the reports made in the health sector - Brazil, 2010

    Directory of Open Access Journals (Sweden)

    Márcio Dênis Medeiros Mascarenhas

    2012-09-01

    Full Text Available O objetivo do estudo foi descrever notificações de violência contra os idosos (> 60 anos captadas pelo Sistema de Informação de Agravos de Notificação - versão net (Sinan Net em 2010. Realizou-se estudo descritivo, retrospectivo, com dados analisados no Stata versão 11. Estimaram-se razões de proporção (RP de violência segundo variáveis selecionadas. Das 3.593 notificações de violência contra idosos, 52,3% eram referentes ao sexo feminino. A violência física foi significativamente mais frequente no sexo masculino (RP = 0,82, no grupo com 60 a 69 anos, fora do domicílio, praticada por agressores que não eram filhos, com suspeita de ingestão de bebida alcoólica. A violência psicológica foi mais frequente entre idosas (RP = 2,17, no domicílio, infligida pelos filhos, com suspeita de uso de bebida alcoólica e de maneira crônica. A negligência predominou no sexo feminino (RP = 1,24, no grupo a partir de 70 anos, no domicílio, perpetrada pelos filhos e recorrente. A violência sexual foi mais comum no sexo feminino (RP = 5,21, por agressores que não eram filhos, mas que consumiram bebida alcoólica. O conhecimento das diferentes manifestações da violência contra idosos subsidia ações para o seu enfrentamento, identificando características de vulnerabilidade onde as redes de apoio podem intervir.The scope of this study was to describe reports of violence against the elderly (e" 60 years reported in the Information System for Notifiable Diseases - net version (Sinan Net in 2010. We conducted a descriptive, retrospective study with data analyzed by Stata version 11. We estimated proportion ratios (PR of violence according to selected variables. Of the 3,593 reports of violence against the elderly, 52.3% were against females. Physical violence was significantly more frequent against males (PR=0.82 in the group aged 60 to 69 years, out of the home, committed by offenders who were not sons and were suspected of drinking

  2. Prevalence of metabolic syndrome among elderly Mexicans.

    Science.gov (United States)

    Ortiz-Rodríguez, María Araceli; Yáñez-Velasco, Lucía; Carnevale, Alessandra; Romero-Hidalgo, Sandra; Bernal, Demetrio; Aguilar-Salinas, Carlos; Rojas, Rosalba; Villa, Antonio; Tur, Josep A

    2017-11-01

    One of the most prevalent chronic diseases among elderly population is the Metabolic Syndrome (MetS). The aim of this study was to assess the prevalence of MetS and associated factors among Mexican elderly people. Cross-sectional survey carried out in Mexico (2007). A random sample (n=516) of the elderly population (≥65years; 277 female, 239 male) was interviewed. Anthropometric and analytical measurements, and a general questionnaire incorporating questions related to socio-demographic and life-style factors were used. MetS definition AHA/NHLBI/IDF was applied. The prevalence of MetS in the elderly (≥65years) was of 72.9% (75.7% men; 70.4% women). Participants with values above MetS cut-off points were 92.4% (hypertension), 77.8% (hypertriglyceridemia), 77.1% (low HDL-cholesterol), 71.1% (hyperglycaemia), and 65.4% (central obesity). People with MetS showed higher values of anthropometric and biochemical variables than those without MetS, except for the height, cholesterol and creatinine. Mid-high education level (9-12 years), no smokers and former smokers, and Central-Western inhabitants of Mexico were associated with MetS components. BMI status was the main determinant of MetS prevalence and MetS components. The reported prevalence of MetS among the elderly Mexican population was higher than those previously obtained in the geographical area, showing a major public health problem in Mexican elders. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Depression among elderly Chinese-Canadian immigrants from Mainland China

    Institute of Scientific and Technical Information of China (English)

    Daniel W.L. Lai

    2004-01-01

    Background This study examined the prevalence of depressive symptoms among elderly immigrants from Mainland China to Canada and the impact of various psychosocial factors as predictors of the number of depressive symptoms reported by the elderly Chinese immigrants.Methods The participants were 444 elderly immigrants who migrated from Mainland China to Canada. They were a part of a random sample of 2272 elderly Chinese living in the communities and took part in a face-to-face interview to answer questions in an orally administrated questionnaire. The depressive symptoms of the participants were measured by a Chinese version of the Geriatric Depression Scale. Data obtained from the 444 elderly Chinese immigrants was analyzed to assess the impact of various psychosocial factors on the number of depressive symptoms that they reported.Results The findings indicated that 23.2% of the elderly immigrants were assessed to have some depressive symptoms. When other predicting variables were adjusted, elderly immigrants with more chronic illnesses, less positive attitude towards ageing, poorer physical health, less adequate financial situation, lower level of ethnic identification as Chinese, more service barriers, lower level of life satisfaction, shorter length of residency in Canada and those who lived alone tended to have more depressive symptoms.Conclusions The findings indicate that the prevalence rate of depressive symptoms among our elderly immigrant sample is higher than the one reported in a general elderly population. While further research is recommended to examine the reasons for such a difference, culturally appropriate health services, including health promotion programs, should be promoted to reduce mental health disparities.

  4. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    Science.gov (United States)

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  5. Cholecystectomy for the elderly

    DEFF Research Database (Denmark)

    Nielsen, Liv Bjerre Juul; Harboe, Kirstine Moll; Bardram, Linda

    2014-01-01

    The number of Danish inhabitants older than 65 years is increasing, and cholecystectomy is one of the most common surgical procedures performed for this age group. This study aimed to analyze the role of age as an independent predictor of outcome for elderly cholecystectomy patients....

  6. [Dignity of the elderly].

    Science.gov (United States)

    Ribera Casado, José Manuel

    2015-01-01

    A discussion is presented on what is understood by «dignity» when applied to the elderly, highlighting it universal character and contrasting it with the greater risks of suffering «indignities» to which the elderly are exposed. The discussion is divided into 3 sections. In the first, the risk factors in this sense could lead to physiological losses and illnessess, which in in the physical, mental and social sense are associated with ageing. In the second, the question of discrimination of the elderly as a form of aggression due to age, and is so widespread and infrequently studied. Lastly, it is discussed how to interpret the advice of the United Nations on how to promote active ageing as a defence system against indignities. It concludes with the message that neither the limitations that accompany the ageing process, nor the different forms of aggression that the elderly may be subjected to, provide sufficient argument neither for a loss of individual nor collective dignity. This is something which we all must endeavour to achieve and which must be maintained and be respected by individuals and by society at all times. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  7. Diabetes in the elderly

    Directory of Open Access Journals (Sweden)

    Katarzyna Mordarska

    2017-06-01

    Full Text Available The prevalence of both type 2 diabetes and prediabetes increases with advancing age. The most important factors leading to hyperglycaemia are as follows: deficiency of insulin secretion developing with age, and growing insulin resistance caused by a change in body composition and sarcopaenia. Clinical features of diabetes in the elderly could be different. Diabetes in elderly people is often diagnosed with delay due to atypical symptoms (dementia, urinary incontinence and occurrence of mainly postprandial hyperglycaemia. Elderly people are more exposed to diabetes complications, have more risk of myocardial infarction and end-stage renal disease, and are hospitalised more often due to hypoglycaemia than are younger patients. Elderly people with diabetes are a heterogeneous group with different life expectancy, concomitant of chronic diseases, and the ability to self-control blood glucose or give themselves an injection. The therapy should be individualised. Older people with long-term diabetes and numerous chronic complications need a more liberal approach to reach specific goals of therapy. Additional goals should be avoiding hypoglycaemia, safety of the therapy, and its acceptance by the patient.

  8. Vaccines for the elderly.

    Science.gov (United States)

    Del Giudice, Giuseppe; Weinberger, Birgit; Grubeck-Loebenstein, Beatrix

    2015-01-01

    The aging of the human population is posing serious challenges to research and to public health authorities in order to prevent diseases that more frequently affect the elderly, a portion of the population that will increase more and more in the coming years. While some vaccines exist and are used in the elderly to effectively fight against some infections (e.g. influenza, pneumococci, varicella-zoster virus, diphtheria, and tetanus), still a lot of work remains to be done to better adapt these vaccines and to develop new ones for this age group. The prevention of infectious diseases affecting the elderly can be successful only through a holistic approach. This approach will aim at the following: (1) a deeper understanding of the mechanisms leading to the senescence of the immune system, (2) a better and broader use of vaccines recommended for the elderly, (3) the use of vaccines currently considered only for other age groups and (4) actively priming the population when they are immunological competent, before the physiological waning of immune responsiveness may affect the beneficial effects of vaccination. © 2014 S. Karger AG, Basel

  9. Um olhar para mulheres idosas: relato de uma experiência de intervenção Elderly women in the limelight: report on an intervention experience

    Directory of Open Access Journals (Sweden)

    Marly Lamb

    2000-03-01

    Full Text Available O presente artigo é resultado de um projeto de intervenção realizado com quarenta e oito mulheres idosas que participam de um grupo de convivência. As atividades desenvolvidas tiveram como objetivo propiciar trocas de experiências buscando oportunizar um maior crescimento subjetivo às idosas, bem como a construção da percepção de si mesmas enquanto membros de um grupo, com vistas a ressaltar a importância do idoso no contexto do desenvolvimento sociocultural.This article is the result of a project of intervention carried out with forty-eight elderly women who took part in an acquaintanceship group. Developed activities offered the participants opportunity to exchange experiences. The latter provided a subjective development to the group and the construction of their own perception as group members. At the same time the importance of old people in a context of social-cultural development was highlighted.

  10. Robots in Elderly Care

    Directory of Open Access Journals (Sweden)

    Alessandro Vercelli

    2018-03-01

    Full Text Available Low birth rate and the long life expectancy represent an explosive mixture, resulting in the rapid aging of population. The costs of healthcare in the grey society are increasing dramatically, and soon there will be not enough resources and people for care. This context requires conceptually new elderly care solutions progressively reducing the percentages of the human-based care. Research on robot-based solutions for elderly care and active ageing aims to answer these needs. From a general perspective, robotics has the power to completely reshape the landscape of healthcare both in its structure and its operation. In fact, the long-term sustainability of healthcare systems could be addressed by automation powered by digital health technologies, such as artificial intelligence, 3D-printing or robotics. The latter could take over monotonous work from healthcare workers, which would allow them to focus more on patients and to have lesser workload. Robots might be used in elder care with several different aims. (i Robots may act as caregivers, i.e. assist the elderly, (ii they can provide remainders and instructions for activities of daily life and safety, and/or assist their carers in daily tasks; (iii they can help monitor their behaviour and health; and (iv provide companionship, including entertainment and hobbies, reminiscence and social contact. The use of Robots with human subjects/patients raise several sensitive questions. First of all, robots may represent information hubs, and can collect an incredible amount of data about the subjects and their environment. In fact, they record habits such as sleeping, exercising, third persons entering in the house, appointments. Communications may be continuously recorded. Moreover, by connecting with medical devices, they can store medical data. On one hand, this represents a very powerful tool to collect information about the single subject (precision medicine, about disease (thus eventually finding

  11. Interventions for preventing abuse in the elderly.

    Science.gov (United States)

    Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen

    2016-08-16

    Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts‎, ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. Two review authors

  12. Insomnia in the elderly: cause, approach, and treatment.

    Science.gov (United States)

    Kamel, Nabil S; Gammack, Julie K

    2006-06-01

    Insomnia is a prevalent problem in late life. Sleep problems in the elderly are often mistakenly considered a normal part of aging. Insomnia, the most common sleep disorder, is a subjective report of insufficient or nonrestorative sleep despite adequate opportunity to sleep. Despite the fact that more than 50% of elderly people have insomnia, it is typically undertreated, and nonpharmacologic interventions are underused by health care practitioners. This article will review the causes of insomnia in the elderly, the approach to patient evaluation, and the nonpharmacologic and pharmacologic treatment of insomnia.

  13. Advanced Merkel cell cancer and the elderly.

    LENUS (Irish Health Repository)

    Bird, B R

    2012-02-03

    BACKGROUND: Merkel cell cancer (MCC) is an uncommon neuroendocrine skin cancer occurring predominantly in elderly Caucasians. It tends to metastasize to regional lymph nodes and viscera and is sensitive to chemotherapy but recurs rapidly. AIM: To report one such case, its response to chemotherapy and briefly review the literature. METHODS: A 73-year-old male with a fungating primary lesion on his left knee and ulcerated inguinal lymph nodes was diagnosed with MCC and treated with chemotherapy. The two largest case series and reviews of case reports were summarised. RESULTS: His ulcer healed after two cycles of carboplatin and etoposide with improvement in quality of life. Overall response rates of nearly 60% to chemotherapy are reported but median survival is only nine months with metastatic disease. CONCLUSIONS: Chemotherapy should be considered for fit elderly patients with MCC who have recurrent or advanced disease.

  14. Factors Influencing Depression among Elderly Patients in Geriatric Hospitals

    OpenAIRE

    Jee, Young Ju; Lee, Yun Bok

    2013-01-01

    [Purpose] The purpose of this study was to investigate the prevalence of depression among elderly patients and identify the factors influencing depression in a geriatric hospital in Korea. [Subjects] A self-report questionnaire was administered to the patients in community geriatric hospitals. Participants were 195 elderly patients. [Methods] The instruments utilized in this study were the Geriatric Depression Scale Short Form Korea (GDSSF-K), an activity of daily living scale, a self-esteem ...

  15. Quality of reporting and study design of CKD cohort studies assessing mortality in the elderly before and after STROBE : A systematic review

    NARCIS (Netherlands)

    Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S.; Jager, Kitty J.; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

    2016-01-01

    Background: The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and

  16. Depression in elderly: A review of Indian research

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2015-01-01

    Full Text Available To review the existing literature on depression among elderly arising from India. Search was carried out using PubMed, Google Scholar, Google, and Medknow search engines to identify the relevant studies. Most of the literatures that are available are in terms of prevalence of depression. Community-based studies involving 70 to 7,150 elderly subjects report prevalence rate varying from 8.9% to 62.16%. Clinic-based studies involving 50 to 5,260 participants report prevalence rates ranging from 42.4% to 72%. Studies have reported depression to be more common among females. Other demographic factors that have been associated with depression among elderly include being unmarried, divorced or widowed elderly, residing in rural locality, being illiterate, increasing age, lower socioeconomic status, and unemployment. Depression has also been shown to be associated with various psychosocial factors, lifestyle and dietary factors, and presence of chronic physical illness. There are limited data on various therapeutic interventions. Available data suggest usefulness of pranayam, cognitive behavior therapy, and electroconvulsive therapy. The review of data suggests that prevalence of depression among elderly in India is high. However, there is lack of data on symptom profile and limited data is available on various therapeutic interventions for the management of depression in elderly from India. There is urgent need to conduct large multicentric studies to fill this void in research.

  17. Association Between Depression and Elder Abuse and the Mediation of Social Support: A Cross-Sectional Study of Elder Females in Mexico City.

    Science.gov (United States)

    Vilar-Compte, Mireya; Giraldo-Rodríguez, Liliana; Ochoa-Laginas, Adriana; Gaitan-Rossi, Pablo

    2018-04-01

    We assessed the association between depression and elder abuse, and the mediation effect of social support among elder women in Mexico City. A total of 526 noninstitutionalized elder women, residing in Mexico City and attending public community centers were selected. Logistic regressions and structural equation models (SEM) were estimated. One fifth of the elderly women were at risk of depression, one third suffered some type of abuse in the past 12 months, and 82% reported low social support. Logistic models confirmed that depression was statistically associated with elder abuse and vice versa (odds ratio [OR] = 1.97 and 1.96, respectively). In both models, social support significantly reduced the association between these variables leading to study these associations through SEM. This approach highlighted that social support buffers the association between depression and elder abuse. Findings underline the relevance of programs and strategies targeted at increasing social support among urban older adults.

  18. [Suicide in the Elderly].

    Science.gov (United States)

    Velásquez Suarez, Juliana María

    2013-01-01

    Suicide is a public health problem worldwide, with multiple features and risk factors. It has some common and unique trends in each phase across the lifespan. To review the medical literature related to suicide in the elderly, in order to determine the current status of this problem in the world, and especially in Colombia. Literature review. There is a high volume of articles about suicide in general, even in Colombia, with many papers describing the problem in a comprehensive manner, but there is a need for more studies and publications on the scope of this problem in the elderly. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  19. Substance abuse associated with elder abuse in the United States.

    Science.gov (United States)

    Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui

    2012-01-01

    Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

  20. SIMILARITIES OF ELDERLY AND THERAPY-RELATED AML

    Directory of Open Access Journals (Sweden)

    Francesco D'Alò

    2011-11-01

    Full Text Available Acute myeloid leukemia (AML is a clonal disorder of the hematopoietic stem cell, typical of the elderly, with a median age of over 60 years at diagnosis. In AML, older age is one of the strongest independent adverse prognostic factor, associated with decreased complete response rate, worse disease-free and overall survival, with highest rates of treatment related mortality, resistant disease and relapse, compared to younger patients. While clinical risk factors do not significantly differ between older and younger patients, outcomes are compromised in elderly patients not only by increased comorbidities and susceptibility to toxicity from therapy, but it is now recognized that elderly AML represents a biologically distinct disease, that is itself more aggressive and less responsive to therapy. In elderly individuals prolonged exposure to environmental carcinogens may be the basis for the aggressive biology of the disease. This may also be the basis for similarities between elderly AML and therapy-related myeloid malignancies, mimicking toxic effects of previous cytotoxic treatments on hematopoietic stem cells. Age is itself a risk factor for t-MN, which are more frequent in elderly patients, where also a shorter latency between treatment of primary tumor and t-MN has been reported. Similarities between therapy-related malignancies and elderly AML include morphological aspects, as the presence of multilineage dysplasia preceding and/or concomitant to the development of leukemia, and adverse cytogenetics, including poor karyotype and chromosome 5 and/or 7 abnormalities. Looking at molecular prognosticators in elderly AML, similar to t-MN,  reduced frequency of favorable factors, as reduced number of NPM1 and CEBPA mutated cases has been observed, together with increased incidence of negative factors, as increased MDR1 expression, accelerated telomere shortening  and frequency of methylation changes. Given the unfavorable prognosis of elderly and

  1. AN ELDERLY WOMAN WITH INTERMITTENT CLAUDICATION

    Directory of Open Access Journals (Sweden)

    Nayyer Naveed Wazir

    2006-01-01

    Full Text Available This case report illustrates the misdiagnosis of intermittent claudication in an elderly with multiple cardiac risk factors. Careful clinical evaluation and imaging shifts the diagnosis from peripheral vascular disease to spinal stenosis. The decision whether to offer conservative therapy or proceed to spinal surgery requires an accurate assessment of the severity of the symptoms without ignoring the important role of patient preferences.

  2. Domestic elder abuse in Yazd, Iran: a cross-sectional study.

    Science.gov (United States)

    Morowatisharifabad, Mohammad Ali; Rezaeipandari, Hassan; Dehghani, Ali; Zeinali, Ahmad

    2016-01-01

    Social changes due to urbanism, acculturation, and fading of values have led to some challenges in family relationships, including domestic elder abuse. This study was conducted to determine elder abuse status in Yazd, Iran. This cross-sectional study was conducted on 250 elderly people over 60 years in Yazd in 2014-2015. Clustered random sampling was used to recruit the participants from 10 clusters in Yazd (25 individuals from each cluster). The data were gathered by the 49-item,Iranian Domestic Elder Abuse Questionnaire which was filled out through private interviews with the participants. Mean score of elder abuse was 11.84 (SD: 12.70) of total 100. Of the participants,79.6% (95% CI: 74.5-84.6) experienced at least one type of abuse. Emotional neglect was the most reported abuse and physical abuse was the least reported. Abuse score was associated with age, education level, living status, and insurance status of elders. Further, those who reported history of gastrointestinal problems, dyslipidemia, respiratory diseases, sleep disorders, audiovisual problems, joints pain, hypertension, dental/oral problems, cardiovascular disease,urinary incontinence and disability, reported a statistically significant higher abuse score. Despite overall low rate of domestic elder abuse, its high prevalence indicates that some interventions are necessary to decrease domestic elder abuse. Emotional neglect of elders should be addressed more than other abuse types.

  3. Iatrogenic disease in the elderly: risk factors, consequences, and prevention

    Directory of Open Access Journals (Sweden)

    Sompol Permpongkosol

    2011-03-01

    Full Text Available Sompol PermpongkosolDivision of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandAbstract: The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.Keywords: iatrogenic disease, elderly, risk factors, prevention

  4. Elderly\\'s Medical Therapy Status

    Directory of Open Access Journals (Sweden)

    Malihe Saboor

    2007-04-01

    Full Text Available Studies show that the elderly are more prone to chronic diseases in comparison to other age groups. Medical treatment is very common in aged people. On average, every aged person uses 4.5 prescribed and 2.1 over the counter medicines. And every year they have 12 to 17 prescriptions. Indeed, medicines are mostly used in hospitals and geriatrics. (1 the most common used medicines are: analgesics, anti-inflammatory, hypertensive drugs, cardiovascular medicines & tranquilizers. Natural trend of aging emphasizes on need of change in the way of drug administration in aged people. Because of different age-related diseases, the prescriptions and dosing of different drugs has been changed specially in hospitals and geriatrics. The changing in quality of life style in aged people has also affected the way of drug administration. In this article we emphasize treatment problems, drug side effects, physiological variations and their effects on pharmacokinetic and pharmacodynamic of drugs in aging population and we also have many suggestions for increasing health in the aged and their quality of life.

  5. Comparing the effects of reflexology and foot bath on sleep quality in the elderly

    OpenAIRE

    Seyyedrasooli

    2015-01-01

    Introduction: Sleep disturbances are common mental problems reported among elders. It seems some non-pharmacological interventions, can improve their sleep quality. The aim of this study is to compare the effectiveness of two interventions, reflexology and foot bath, on sleep quality in elderly people. Methods: This is a clinical trial without control group, conducted on 46 elderly men in two groups of reflexology and foot bath. Written informed consent was completed by subjects. Reflexolo...

  6. Fall Injuries and Related Factors of Elderly Patients at a Medical Center in Taiwan

    OpenAIRE

    Tsai, Li-Yun; Tsay, Shiow-Luan; Hsieh, Ruey-Kuen; Yu, Shu; Tsai, Jung-Mei; Chien, Hui-Hsien; Liu, Shu-Jung

    2014-01-01

    Background: Elderly patients have a high incidence of falls and injuries in hospitals due to various reasons. The aims of this study were to explore the characteristics and factors associated with fall injuries among elderly patients. Methods: A retrospective survey study was conducted. Data were retrieved from the patient safety reporting system of a medical center in Taiwan query for patient fall incidents of elderly patients aged 65 years or older between 2010 and 2012. Statistics were ...

  7. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  8. Elder Abuse and Help-Seeking Behavior in Elderly Chinese.

    Science.gov (United States)

    Yan, Elsie

    2015-09-01

    Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. © The Author(s) 2014.

  9. Relationships and Community Risk Factors for Elder Abuse and Neglect: Findings from the First National Prevalence Study on Elder Maltreatment

    Directory of Open Access Journals (Sweden)

    Dimitrinka Jordanova Peshevska

    2014-06-01

    Full Text Available OBJECTIVES: The objective of the study was to mesaure the 12-months prevalence of elder abuse and neglect in private huousehold and to examine the relationship and community level risk factors for elder abuse and neglect. METHOD: Total of 960 respondents aged 65 years and above in private households, from all eight statistical regions participated in the study.  Nationally stratified quota sampling procedure was applied, through four stages. Information was collected in face-to face interview on socio-demographic, healthy life style, physical and mental health, and abuse and neglect types characteristics of elder population. Data were examined using descriptive statistics, binary logistic regression, and odd ratios (OR. Statistical significance was set up at p < 0.05. RESULTS: The respondents reported prevalence of psychological abuse 25.7%, followed by financial abuse 12 %, neglect 6.6%, physical abuse 5.7%, physical injury 3.1%, and sexual abuse 1.3% (reported only in female respondents in the previous 12-months. Living with close relatives, dissatisfaction with the household income, less equipped households, lacking property of house/flat are associated risk factors for elder maltreatment on relationship level. Living in the northeast, southeast, and Polog region are associated risk for elder maltreatment. CONCLUSION: Study findings emphasised the previous data obtained with regards to the community and relationships risk factors for elder maltreatment.

  10. The role of the dermatologist in detecting elder abuse and neglect.

    Science.gov (United States)

    Danesh, Melissa J; Chang, Anne Lynn S

    2015-08-01

    The National Research Council of the National Academies defines elder mistreatment as: (1) intentional actions that cause harm or create serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder; or (2) failure by a caregiver to satisfy the elder's basic needs or to protect the elder from harm. Estimates of the prevalence of elder abuse have ranged from 2.2% to 18.4%. Dermatologists are uniquely positioned to identify and manage suspected cases of elder abuse given their expertise in distinguishing skin lesions of abuse from organic medical disease and their patient populations with strong elderly representation. This article discusses aspects of both the screening and management of elder abuse with particular relevance to dermatologists. Like physicians across medical specialties, dermatologists must be familiar with those aspects of elder abuse in screening, diagnosis, management, and reporting that are unique to their field and to those aspects that are applicable to all health care providers. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Oral health in frail elderly

    NARCIS (Netherlands)

    Hoeksema, Albert

    2016-01-01

    Ageing points towards increasing health problems and rising costs for the society. One of these health problems is the deteriorating oral health in care dependent elderly. The latter is related to the high need for care on many levels in these elderly. The lack of attention for oral care can be

  12. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

  13. Cultural definitions of elder maltreatment in Portugal.

    Science.gov (United States)

    Mercurio, Andrea E; Nyborn, Justin

    2006-01-01

    A small convenience sample of 34 participants (17 males, 17 females) from the Portuguese islands of the Azores and Madeira were asked to provide examples of how extreme, moderate, and mild maltreatment towards an elder would be defined in their culture and society. Neglect, especially psychological neglect, physical maltreatment, and psychological maltreatment were the most frequently reported types of maltreatment. References to neglect and physical maltreatment appeared most often as examples of extreme maltreatment. In general, men were somewhat more likely than women to provide examples of physical aggression in their examples of maltreatment. As examples of extreme maltreatment, females provided significantly more examples of abandonment than males. Although interpretations of the findings must be cautious because of the small sample size and limited statistical power, the study illustrates a procedure for assessing constructs of elder mistreatment in a way that attends to respondents' own constructions of the phenomenon.

  14. [Atrial fibrillation in elderly].

    Science.gov (United States)

    Arquizan, Caroline

    2012-11-01

    Atrial fibrilation (AF) is frequent and a strong risk factor for ischemic stroke in elderly. Ischemic stroke in patients with AF are more severe. Vitamine K antagonist therapy is highly effective for stroke prevention but is associated with hemorrhagic risk. The new oral anticoagulants (direct thrombin inhibitor [dabigatran], and direct factor Xa inhibitors [rivaroxaban and apixaban]) have all shown non inferiority or superiority, with better safety, considering the risk of intracranial haemorrhage. On this basis, it is justified to give them in priority in the vast majority of patients with AF, the choice of the drug and the dose is individual.

  15. Dysphagia in the Elderly

    Science.gov (United States)

    Aslam, Muhammad

    2013-01-01

    Elderly patients are inherently predisposed to dysphagia predominately because of comorbid health conditions. With the aging of the population in the United States, along with the increased prevalence of obesity and gastroesophageal reflux disease, healthcare providers will increasingly encounter older patients with either oropharyngeal or esophageal disease and complaints of dysphagia. Useful tests to evaluate dysphagia include the videofluoroscopic swallowing study and the fiberoptic endoscopic evaluation of swallowing. Swallow rehabilitation is useful to help patients compensate for swallowing difficulty and ultimately help strengthen the neuromusculature involved in swallowing. PMID:24772045

  16. [Muscle and bone health as a risk factor of fall among the elderly. Kaigoyobou and prevention of falling].

    Science.gov (United States)

    Obuchi, Shuichi

    2008-06-01

    Kaigoyobou, prevention of long-term care use, is a comprehensive approach, including physical, nutritional, and social, to maintain independent living in the elderly. Prevention of falling is one useful method of Kaigoyobou. From literature review, post-fall syndrome should be primarily eliminated in the elderly since falling rate of the elderly with the falling history reported significantly greater falling rate than the other community dwelling elderly. The ability to avoid falling when they trip or slip during walking may be the most important physical function needed to be intervened. In order to train elderly person successfully, nutritional intervention need to be considered into fall prevention program.

  17. Take a Multidisciplinary, Team-based Approach on Elder Abuse.

    Science.gov (United States)

    2016-07-01

    While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem. Providing great care to a victim of elder abuse requires time and setting up a circumstance whereby one can actually communicate with the patient reliably and alone. While most states require providers to report suspected cases of elder abuse to Adult Protective Services, there is little evidence this requirement has incentivized more reports in the same way a similar requirement has prompted providers to report cases of suspected child abuse. Investigators advise ED leaders to train and empower every member of their team to identify potential signs of elder abuse.

  18. NutriCancer: A French observational multicentre cross-sectional study of malnutrition in elderly patients with cancer.

    Science.gov (United States)

    Lacau St Guily, Jean; Bouvard, Éric; Raynard, Bruno; Goldwasser, François; Maget, Brigitte; Prevost, Alain; Seguy, David; Romano, Olivier; Narciso, Bérengère; Couet, Charles; Balon, Jean-Michel; Vansteene, Damien; Salas, Sébastien; Grandval, Philippe; Gyan, Emmanuel; Hebuterne, Xavier

    2018-01-01

    To compare the prevalence of malnutrition and nutritional management between elderly (≥70years old) and younger patients (malnutrition in adult patients with cancer in France. Patients diagnosed with cancer at the study date in both inpatient and outpatient settings were included. Data collection was performed by means of questionnaires completed by the physician, the patient and the caregiver. This post-hoc analysis compared 578 elderly patients (27.6%) vs. 1517 younger patients (72.4%). There were significant differences in cancer localization between the groups particularly in gastrointestinal cancer (27% in younger patients vs. 42% in elderly), breast cancer (17% vs 8% in elderly) and oropharyngeal (15% vs. 9% in elderly). Weight loss was significantly more reported in the elderly than in younger patients (73.6% vs. 67.6%, p=0.009). Elderly patients were more frequently malnourished than younger patients (44.9% vs. 36.7%, p=0.0006). Food intake was comparable between the groups; however, physicians overestimated the food intake, particularly in the elderly. The malnutrition management was more frequently proposed in elderly, as dietary advice and oral nutritional supplements, than in younger patients; however, enteral nutrition was significantly less undertaken in the elderly. Malnutrition is prevalent in elderly patients with cancer, and more frequent than in younger patients. There is a need for an early integration of the nutritional counselling in patients with cancer, and particularly in the elderly. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Viral hepatitis in the elderly.

    Science.gov (United States)

    Carrion, Andres F; Martin, Paul

    2012-05-01

    As life expectancy continues to rise, elderly adults represent a rapidly growing proportion of the population. The likelihood of complications of acute and chronic liver disease and overall mortality are higher in elderly populations. Several physiological changes associated with aging, greater prevalence of co-morbid conditions, and cumulative exposure to hepatotropic viruses and environmental hepatotoxins may contribute to worse outcomes of viral hepatitis in the elderly. Although pharmacotherapy for hepatitis B and C continues to evolve, the efficacy, tolerability, and side effects of these agents have not been studied extensively in elderly adults. Immunization against hepatitis A and B in naïve elderly adults is an important public health intervention that needs to be revised and broadened.

  20. Reliability of self-reported use of amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates among acutely hospitalized elderly medical patients

    DEFF Research Database (Denmark)

    Glintborg, B.; Olsen, L.; Poulsen, H.

    2008-01-01

    Undisclosed use of illicit drugs and prescription controlled substances is frequent in some settings. The aim of the present study was to estimate the reliability of self-reported use of amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates among acutely...

  1. Violence against Elderly Migrants and Its Consequences on Their Health: Experience from Monterrey, Mexico

    Directory of Open Access Journals (Sweden)

    Acharya Arun Kumar

    2014-12-01

    Full Text Available In this paper, an attempt has been made to analyse how the violence and abuse against elderly migrants in Monterrey, Mexico affects their health. For this research, 257 elderly Mexican migrants were surveyed in the Metropolitan Area of Monterrey during 2012 through 2013. The study found that the majority of elderly people migrate to urban areas in search of a better economic opportunity. Once in the city, they are absorbed into the informal economic sectors. Results indicate that most of these elderly people suffer physical, sexual and psychological violence, as well as neglect and financial abuse from their employer, relatives, clients and pedestrians, which has an adverse effect on their health. Elderly migrants reported numerous health problems, where many of them were suffering from different types of injuries, stress and depression, among others. This paper concluded that violence suffered by elderly migrants has a significant impact on their health.

  2. The Effect of Consuming Ambon Banana (Musa paradisiaca Var. Sapientum on Sleep Latency of Elderly Hypertension

    Directory of Open Access Journals (Sweden)

    Selvi Ria Ristania

    2017-08-01

    Full Text Available Elderly hypertension often reported that their latency elongated was less compared to healthy elderly. The increase of latency impact on health, it causes susceptibility to illness, stress, confusion, disorientation, mood disorders, less fresh, decrease ability to make decisions. The aim of this research was to explain the effect of consuming Ambon banana on sleep latency of elderly hypertension in Mulyorejo, Surabaya. Time series one group pre-test post test design was used in this research. Affordable population in this research was elderly hypertension in RW 2 and RW 3 Mulyorejo Surabaya. Total sample was 15 respondents and taken by total sampling technique. The independent variable was consuming Ambon banana, and dependent variable was sleep latency of elderly hypertension. Every day the latency and blood pressure on elderly was monitored. Data was collected using questionnaire, and then analyzed using Wilcoxon Signed Rank Test. The result showed that consuming Ambon banana affect sleep latency (p=0.009.

  3. Drug and Solvent Abuse Among Ahwaz\\'s Elderlies

    Directory of Open Access Journals (Sweden)

    Abdolrahim Asadollahi

    2007-10-01

    Full Text Available Objectives: There are researches to point epidemiology of addiction to drugs, chemical and solvent abuse in elderlies. Drug and Solvent abuse is considered as one of these addictions. This study was point to chemical abuse among elderly population of Ahwaz an Iranian city during year of 2007. Methods & Materials: Research method is description-exploration with use to questionnaire, clinical interview and survey of medical and clinical reports among volunteer clients. Statistical community is all elderly population at one of citizen region in Ahwaz city (Iran. Seventy four dossiers were considered via random sampling; with 30 Elder volunteer clients been interviewed and replied to Elderly Drug Abuse Questionnaire (EDAQ. Results: Signification of hypothesis with X2 test was considered significant relation between age and addiction record variables to solvent abuse; this relation is very significant to second value of drug's derivations such as Morphine, Codeine, Tebaine and Heroine. Interview showed psychological dependent due to appeal them to solvent abuse. Kind of abuse among elderly was snuffing and abuse of medicine drugs which were been recommended to them by their physician. Conclusion: Although study of solvent and chemical abuse's epidemiology pointed less average of this addiction in samples, should be considered important and notice in studies. Finally, researchers were suggested to avoid of this new drug abuse and so to control behavior and interaction of these addicted and their behavior development; it's better to control on distribution of solvent and glue materials and recommending of medicine drug via physicians visiting exderlies.

  4. The assessment of social skills deficits in the elderly.

    Science.gov (United States)

    Furnham, A; Pendleton, D

    1983-01-01

    This paper tested the hypothesis that a sample of elderly people compared to a matched sample of younger people reports an increase in difficulty and social anxiety in dealing with a wide range of everyday social situations. The literature on assertiveness and social skills training with the elderly was first reviewed. Then an assertiveness and social difficulty scale was administered to a group of eighty participants divided by age and sex. It was found that older people experienced less discomfort in situations requiring assertiveness, yet were less likely to respond assertively. Older people reported higher incidence of social anxiety across forty everyday situations. In general females reported more difficulty than males, though there were no interaction effects. The results are discussed in terms of the assessment and training of social skills in the elderly.

  5. Hyperglycemia associated dissociative fugue (organic dissociative disorder) in an elderly.

    Science.gov (United States)

    Ram, Dushad; Ashoka, H G; Gowdappa, Basavnna

    2015-01-01

    Inadequate glycemic control in patients with diabetes is known to be associated with psychiatric disorders such as depression, anxiety disorder, and cognitive impairment. However, dissociative syndrome has not been reported so far. Here we are reporting a case of repeated dissociative fugue associated with hyperglycemia, in an elderly with type II diabetes. Possible neurobiological mechanism has been discussed.

  6. Hyperglycemia associated dissociative fugue (organic dissociative disorder) in an elderly

    OpenAIRE

    Ram, Dushad; Ashoka, H. G; Gowdappa, Basavnna

    2015-01-01

    Inadequate glycemic control in patients with diabetes is known to be associated with psychiatric disorders such as depression, anxiety disorder, and cognitive impairment. However, dissociative syndrome has not been reported so far. Here we are reporting a case of repeated dissociative fugue associated with hyperglycemia, in an elderly with type II diabetes. Possible neurobiological mechanism has been discussed.

  7. Hyperglycemia associated dissociative fugue (organic dissociative disorder in an elderly

    Directory of Open Access Journals (Sweden)

    Dushad Ram

    2015-01-01

    Full Text Available Inadequate glycemic control in patients with diabetes is known to be associated with psychiatric disorders such as depression, anxiety disorder, and cognitive impairment. However, dissociative syndrome has not been reported so far. Here we are reporting a case of repeated dissociative fugue associated with hyperglycemia, in an elderly with type II diabetes. Possible neurobiological mechanism has been discussed.

  8. Death and Dying Anxiety among Elderly Arab Muslims in Israel

    Science.gov (United States)

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Gigini, Ibrahim

    2010-01-01

    Death and dying anxiety were examined among elderly Arab Muslims in Israel. A total of 145 people aged 60 and over were interviewed using a standardized questionnaire. Nursing home residents reported higher death anxiety than others; women and uneducated participants reported greater levels of fear of death and dying than others. There were no…

  9. Adrenal Ewing's Sarcoma in an Elderly Man.

    Science.gov (United States)

    Toda, Kazuyoshi; Ishii, Sumiyasu; Yasuoka, Hidetoshi; Nishioka, Masaki; Kobayashi, Takayuki; Horiguchi, Kazuhiko; Tomaru, Takuya; Ozawa, Atsushi; Shibusawa, Nobuyuki; Satoh, Tetsurou; Koshi, Hiromi; Segawa, Atsuki; Shimizu, Shin-Ichi; Oyama, Tetsunari; Yamada, Masanobu

    2018-02-15

    Ewing's sarcoma usually arises in the bones of children and adolescents. We herein report a 74-year-old man with Ewing's sarcoma in the adrenal gland. The diagnosis was confirmed by a genetic test, pathological studies, and several imaging studies. He already had multiple liver metastases when he was transferred to our hospital and died on the 37th day. The diagnosis was further confirmed by autopsy studies. Adrenal Ewing's sarcoma is very rare, and our patient was older than other reported cases. Ewing's sarcoma should be considered even in elderly patients with adrenal tumors.

  10. A literature review of findings in physical elder abuse.

    Science.gov (United States)

    Murphy, Kieran; Waa, Sheila; Jaffer, Hussein; Sauter, Agnes; Chan, Amanda

    2013-02-01

    To review the medical literature for reports on the types of physical injuries in elder abuse with the aim of eliciting patterns that will aid its detection. The databases of PubMed, CINAHL, EMBASE, and TRIP were searched from 1975 to March 2012 for articles that contained the following phrases: "physical elder abuse," "older adult abuse," "elder mistreatment," "geriatric abuse," "geriatric trauma," and "nonaccidental geriatric injury." Distribution and description of injuries in physical elder abuse from case-control studies, cross-sectional studies, case series, and case reports as seen at autopsy, in hospital emergency departments, or in medicolegal reports were tabulated and summarized. A review of 9 articles from a total of 574 articles screened yielded 839 injuries. The anatomic distribution in these was as follows: upper extremity, 43.98%; maxillofacial, dental, and neck, 22.88%; skull and brain, 12.28%; lower extremity, 10.61%; and torso, 10.25%. Two-thirds of injuries that occur in elder abuse are to the upper extremity and maxillofacial region. The social context in which the injuries takes place remains crucial to accurate identification of abuse. This includes a culture of violence in the family; a demented, debilitated, or depressed and socially isolated victim; and a perpetrator profile of mental illness, alcohol or drug abuse, or emotional and/or financial dependence on the victim. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Self-reported Napping, Sleep Duration and Quality in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Study

    Science.gov (United States)

    Picarsic, Jennifer L.; Glynn, Nancy W.; Taylor, Christopher A.; Katula, Jeffery; Goldman, Suzanne E.; Studenski, Stephanie; Newman, Anne B.

    2010-01-01

    OBJECTIVES To determine the prevalence of self-reported napping and its association with subjective nighttime sleep duration and quality, as measured by sleep-onset latency and sleep efficiency. DESIGN Cross-sectional study. SETTING Lifestyle Interventions and Independence for Elder’s Pilot Study. PARTICIPANTS Community-dwelling older adults (N=414), aged 70 to 89 years. MEASUREMENTS Self-report questionnaire on napping and sleep, derived from the Pittsburgh Sleep Quality Index (PSQI) scale. RESULTS A total of 54 percent of participants reported napping with mean nap duration of 55 minutes, (SD 41.2 minutes). Compared to non-nappers, nappers were more often men (37.3% vs. 23.8%, P = .003), African American (20.4% vs.14.4%, P = .06), or diabetic (28% vs. 14.3%, P = .007). Nappers and non-nappers had similar nighttime sleep duration and quality, but nappers spent about 10 percent of their 24-hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for diabetics (OR: 1.9; 95% CI: 1.2–3.0) and men (OR: 1.9; 95% CI: 1.2–3.0)). In nappers, diabetes mellitus (β = 12.3 minutes, P =.005), male gender (β = 9.0 minutes, P = .04), higher BMI (β = 0.8 minutes, P = .02), and lower MMSE (β = 2.2, P = .03) were independently associated with longer nap duration. CONCLUSION Napping was a common practice in community-dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes, napping behavior should be assessed as part of sleep behavior, both in future research and in clinical practice. PMID:18662202

  12. Memory complaints are frequent but qualitatively different in young and elderly healthy people

    NARCIS (Netherlands)

    Ginó, Sandra; Mendes, Tiago; Maroco, João; Ribeiro, Filipa; Schmand, Ben A.; de Mendonça, Alexandre; Guerreiro, Manuela

    2010-01-01

    BACKGROUND: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. OBJECTIVE: To determine different memory complaints between young and elderly people with the use of the Subjective

  13. Memory complaints are frequent but qualitatively different in young and elderly healthy people

    NARCIS (Netherlands)

    Ginó, S.; Mendes, T.; Maroco, J.; Ribeiro, F.; Schmand, B.A.; de Mendonca, A.; Guerreiro, M.

    2010-01-01

    Background: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. Objective: To determine different memory complaints between young and elderly people with the use of the Subjective

  14. Vertigo and Dizziness in the Elderly

    Science.gov (United States)

    Fernández, Lara; Breinbauer, Hayo A.; Delano, Paul Hinckley

    2015-01-01

    The prevalence of vertigo and dizziness in people aged more than 60 years reaches 30%, and due to aging of world population, the number of patients is rapidly increasing. The presence of dizziness in the elderly is a strong predictor of falls, which is the leading cause of accidental death in people older than 65 years. Balance disorders in the elderly constitute a major public health problem, and require an adequate diagnosis and management by trained physicians. In the elderly, common causes of vertigo may manifest differently, as patients tend to report less rotatory vertigo and more non-specific dizziness and instability than younger patients, making diagnosis more complex. In this mini review, age-related degenerative processes that affect balance are presented. Diagnostic and therapeutic approaches oriented to the specific impaired system, including visual, proprioceptive, and vestibular pathways, are proposed. In addition, presbystasis – the loss of vestibular and balance functions associated with aging – benign paroxysmal positional vertigo, and stroke (in acute syndromes) should always be considered. PMID:26167157

  15. Visual function, driving safety, and the elderly.

    Science.gov (United States)

    Keltner, J L; Johnson, C A

    1987-09-01

    The authors have conducted a survey of the Departments of Motor Vehicles in all 50 states, the District of Columbia, and Puerto Rico requesting information about the visual standards, accidents, and conviction rates for different age groups. In addition, we have reviewed the literature on visual function and traffic safety. Elderly drivers have a greater number of vision problems that affect visual acuity and/or peripheral visual fields. Although the elderly are responsible for a small percentage of the total number of traffic accidents, the types of accidents they are involved in (e.g., failure to yield the right-of-way, intersection collisions, left turns onto crossing streets) may be related to peripheral and central visual field problems. Because age-related changes in performance occur at different rates for various individuals, licensing of the elderly driver should be based on functional abilities rather than age. Based on information currently available, we can make the following recommendations: (1) periodic evaluations of visual acuity and visual fields should be performed every 1 to 2 years in the population over age 65; (2) drivers of any age with multiple accidents or moving violations should have visual acuity and visual fields evaluated; and (3) a system should be developed for physicians to report patients with potentially unsafe visual function. The authors believe that these recommendations may help to reduce the number of traffic accidents that result from peripheral visual field deficits.

  16. Live Fish Impaction in Hypopharynx in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Subramanian Senthilkumaran

    2011-12-01

    Full Text Available Successful removal of a live fish impacted in the hypopharynx of a 65-year-old male is reported to emphasize the importance of the speed with which it has to be recognized and intervened. The present report also highlights the altered sensory perception in the oral cavity of elderly people as a potential risk factor for airway obstruction due to a foreign body. Moreover, the possibility of a foreign body has to be suspected, if an elderly patient without any cardiorespiratory illness presents with an acute onset of progressive respiratory distress.

  17. Elder Abuse; Joint Hearing Before the Special Committee on Aging, United States Senate and the Select Committee on Aging, House of Representatives, Ninety-Sixth Congress, Second Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    This report of a joint hearing before the Senate and House Committees on Aging examines elder abuse as a growing problem in America. The testimony considers the benefits of community-based services for the elderly living with relatives, explores other forms of long-term care, and investigates ways to aid victims of elder abuse. An overview of the…

  18. Intraspinal Leakage of Cement During Vertebroplasty for an Elderly Woman with Osteoporotic Burst Fracture: A Case Report and Short Review of Prevention and Management

    Directory of Open Access Journals (Sweden)

    Yuk-Chuen Siu

    2015-12-01

    Full Text Available Osteoporotic spine fracture is very common nowadays due to the aging population. It may result in prolonged immobilization due to significant back pain. Cement vertebroplasty helps to relieve pain, provides immediate stability and allows early mobilization. Intraspinal leakage of cement is a rare complication but it may lead to catastrophic neurological injuries. Evidence-based management guidelines for this complication are lacking. This is a case report about intraspinal leakage of cement during vertebroplasty for an 85-year-old woman with osteoporotic burst fractures over the lumbar spine. Urgent exploration and decompression was performed. No neurological injury was found after the operation and the patient recovered from osteoporotic back pain uneventfully.

  19. Benzodiazepine abuse among the elderly

    Directory of Open Access Journals (Sweden)

    Shalini Singh

    2016-01-01

    Full Text Available Benzodiazepines belong to the hypnotic-sedative class of drugs which have anxiolytic, sedative, and hypnotic properties. These drugs have been in clinical use for at least half a century. The propensity for development of dependence, especially on prescription benzodiazepines, coupled with the risk of falls and cognitive impairment due to benzodiazepines makes the elderly population susceptible to adverse outcomes with the use of benzodiazepines, and hence, cautious use is desired in this population. This review discusses the various aspects pertaining to benzodiazepine abuse in the elderly including pharmacology, prevalence of abuse, adverse consequences of benzodiazepine abuse, and subsequently assessment and management of elderly patients with benzodiazepine abuse.

  20. Improving Customer Service in Elderly Care

    OpenAIRE

    Nielsen, Chris

    2015-01-01

    The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

  1. Applicability of a cognitive questionnaire in the elderly and proxy

    Directory of Open Access Journals (Sweden)

    Renata Areza Fegyveres

    Full Text Available Abstract The Informant Questionnaire on Cognitive Decline in the Elderly with the Proxy (IQCODE was developed as a screening tool for cognition alterations. Objectives: 1 To verify the applicability of IQCODE in the elderly with limited schooling, 2 To verify the reliability of the responses supplied by the aged and their proxies. Methods: Individuals of a Community Group were evaluated using the Mini-Mental State Examination (MMSE, IQCODE and Geriatric Depression Scale (GDS. The IQCODE was applied to informants and proxies. Results: We analyzed 44 individuals, aged between 58-82 years (M=66.8, SD=5.97 with mean elderly-schooling level of 3.75, SD=2.82 and 44 proxies aged 44.5 (SD=13.3, with mean schooling level of 8.25 (SD=4.3. The mean GDS was 8.22, SD=4.90 and 13 participants presented a score suggestive of depressive symptoms. The mean elderly IQCODE score was 3.26, SD=0.69 and 3.21, SD=0.65, for proxy responses. There was no statistical difference between these means. On the MMSE, the mean score was 24.20, SD=4.14 and 18 participants presented scores below the cut-off. The IQCODE answers by the elderly in this latter group were more congruent with MMSE than the answers of proxies. Conclusions: The applicability of the IQCODE in a population with little schooling was verified in that the proxy-report was similar to the elderly report. We can affirm that the elderly answers were more accurate than the proxies, as they were closer to MMSE score. The inclusion of a greater number of participants from community-dwelling settings is necessary to confirm the results obtained in this study.

  2. Travel Patterns and Characteristics of Elderly Subpopulation in New York State

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Daniel W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reuscher, Tim [Macrosys, Arlington, VA (United States); Yang, Jianjiang [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Taylor, Rob D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Chin, Shih-Miao [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-03-01

    With the increasing demographic shift towards a larger population of elderly (individuals 65 years and older), it is essential for policy makers and planners to have an understanding of transportation issues that affect the elderly. These issues include livability of the community, factors impacting travel behavior and mobility, transportation safety, etc. In this study, Oak Ridge National Laboratory was tasked by the New York State (NYS) Department of Transportation to conduct a detailed examination of travel behaviors, and identify patterns and trends of the elderly within NYS. The National Household Travel Survey (NHTS) was used as the primary data source to analyze subjects and address questions such as: Are there differences in traveler demographics between the elderly population and those of younger age groups who live in various NYS regions; e.g., New York City, other urban areas of NYS, or other parts of the country? How do they compare with the population at large? Are there any regional differences (e.g., urban versus rural)? Gender differences? Do any unique travel characteristics or patterns exist within the elderly group? In addition to analysis of NHTS data, roadway travel safety concerns associated with elderly travelers were also investigated in this study. Specifically, data on accidents involving the elderly (including drivers, passengers, and others) as captured in the Fatal Analysis Reporting System (FARS) database was analyzed to examine elderly driver and elderly pedestrian travel safety issues in NYS. The analyses of these data sets provide a greater understanding of the elderly within NYS and their associated transportation issues. Through this study, various key findings on elderly population size, household characteristics, and travel patterns were produced and are report herein this report.

  3. Robot Games for Elderly

    DEFF Research Database (Denmark)

    Hansen, Søren Tranberg

    2011-01-01

    improve a person’s overall health, and this thesis investigates how games based on an autonomous, mobile robot platform, can be used to motivate elderly to move physically while playing. The focus of the investigation is on the development of games for an autonomous, mobile robot based on algorithms using...... spatio-temporal information about player behaviour - more specifically, I investigate three types of games each using a different control strategy. The first game is based on basic robot control which allows the robot to detect and follow a person. A field study in a rehabilitation centre and a nursing....... The robot facilitates interaction, and the study suggests that robot based games potentially can be used for training balance and orientation. The second game consists in an adaptive game algorithm which gradually adjusts the game challenge to the mobility skills of the player based on spatio...

  4. Elders Health Empowerment Scale

    Science.gov (United States)

    2014-01-01

    Introduction: Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Objective: Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. Methods: The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. Results: The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. Conclusions: HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs. PMID:25767307

  5. Knowledge, perceptions and preferences of elderly regarding protein-enriched functional food.

    Science.gov (United States)

    van der Zanden, Lotte D T; van Kleef, Ellen; de Wijk, René A; van Trijp, Hans C M

    2014-09-01

    Promoting protein consumption in the elderly population may contribute to improving the quality of their later years in life. Our study aimed to explore knowledge, perceptions and preferences of elderly consumers regarding protein-enriched food. We conducted three focus groups with independently living (ID) elderly (N = 24, Mage = 67 years) and three with elderly living in a residential home (RH) (N = 18, Mage = 83 years). Both the ID and RH elderly were predominantly sceptical about functional food in general. Confusion, distrust and a perceived lack of personal relevance were main perceived barriers to purchasing and consuming these products, although a majority of the participants did report occasionally consuming at least one type of functional food. For the ID elderly, medical advice was an important facilitator that could overcome barriers to purchasing and consuming protein-enriched food, indicating the importance of personal relevance for this group. For the RH elderly, in contrast, sensory appeal of protein-enriched foods was a facilitator. Carrier preferences were similar for the two groups; the elderly preferred protein-enriched foods based on healthy products that they consumed frequently. Future studies should explore ways to deal with the confusion and distrust regarding functional food within the heterogeneous population of elderly. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Healthy Eating Exploratory Program for the Elderly: Low Salt Intake in Congregate Meal Service.

    Science.gov (United States)

    Seo, S; Kim, O Y; Ahn, J

    2016-03-01

    This study reported on an exploratory program to help the low income elderly improve healthy eating behavior, specifically by reducing salt intake. We conducted an exploratory program for 4 weeks for this study. The exploratory program involved offering menus with reduced salt and providing education on healthy eating. After the exploratory program, a survey of the elderly and in-depth interviews allowed us to evaluate the program for foodservice providers (dietitian, social workers, and volunteer workers). This study included both foodservice workers and elderly who actually used the foodservice in a congregate meal service system. This is a unique approach. A congregate meal service center in Seoul, Korea. Seventy four elderly in a congregate meal service center. Demographics were collected, and the healthy eating program and healthy eating education for elderly respondents were evaluated. The elderly showed high satisfaction with the exploratory program for healthy eating. We found no significant differences in satisfaction with the program between the elderly who attended education sessions and those who did not, but more of the elderly from the education sessions showed positive behavioral change intentions. The exploratory program influenced to reduce the salt intake of the elderly in congregate meal service. This study suggests cooperation of foodservice providers and the support of administrators is critical to the success of such programs.

  7. Patterns and Trends in Elder Homicide Across Race and Ethnicity, 1985-2009

    Science.gov (United States)

    Feldmeyer, Ben; Steffensmeier, Darrell

    2014-01-01

    In this report, we assess total and race/ethnicity-disaggregated patterns and temporal trends in elderly homicide (age 55-74) compared with younger age groups for the 1985-to-2009 period. To do this, we use California arrest statistics that provide annual homicide figures by race and ethnicity (including a Hispanic identifier) and by age. Major aims of our analysis are to establish whether (a) elderly homicide rates are different/similar across race/ethnic comparisons; (b) the elderly share of homicide and age-homicide distributions more generally differ across race/ethnicity; and (c) elderly rates of homicide and the share of elderly homicide relative to younger age groups is similar or different now as compared with 20 to 30 years ago. Our analysis is important and timely because some commentators have suggested that elderly homicide levels have been rising over the past one to two decades and because there is a virtual absence of research of any sort on elderly homicide trends that involve comparisons by race and ethnicity. Key findings are that elderly shares of homicide offending relative to younger ages have not increased (or decreased), that elder homicides continue to account for a small fraction of all homicides, and that these patterns persist across race/ethnicity comparisons. PMID:25598653

  8. Elder abuse in Europe's "most elderly" city: an assessment of the phenomenon and an analysis of the data from the Penal Court of Genoa from 2010 to 2015.

    Science.gov (United States)

    Molinelli, Andrea; Ventura, Francesco; Pinto, Sara Lo; Drommi, Martina; De Stefano, Francesco

    2017-12-01

    In Italy, 5% of the elderly are estimated to have suffered abuse. While the Penal Code refers to generic types of abuse, such as physical and psychological maltreatment, abandonment and financial fraud, it does not specifically protect the elderly as a category. To assess the frequency and modalities of elder abuse in Genoa and its Province, and to compare these data with those reported in the literature, in order to provide a picture of the current situation that can be used by the authorities to combat this phenomenon. We analysed the first-degree verdicts issued by the Court of Genoa regarding accusations of physical, psychological and moral abuse and maltreatment of elderly subjects (over 65 years) in the period 2010-2015. Only 85 of the 4028 court verdicts analysed involved elderly persons: 19 cases of domestic maltreatment, 3 of abuse of the means of correction or discipline, 18 of personal injury, 5 of abandonment and 40 of circumvention (deceiving someone, especially an elderly or mentally impaired person, to obtain a profit). A gap was observed between the number of crimes reported to the judicial authorities (tip of the iceberg) and the estimated prevalence of the phenomenon in the literature. There is a need both to create a network of protection for the elderly involving medical and judicial specialists and to train healthcare professionals to better recognise and report cases of maltreatment.

  9. The background factor of the driving compensation behavior among elderly drivers

    OpenAIRE

    Usui, Shinnosuke; Taishi, Nozomi

    2016-01-01

    The purpose of this study is to examine what factors lead to driving compensation behavior among elderly drivers, particularly focusing on the effect of self-reported driving performance, and to investigate the relationship between driving compensation behavior and traffic accidents or violations. After analyzing 237 elderly drivers, the results showed that whereas self-reported driving performances influenced driving compensation behaviors, the relationship between self-reported driving perf...

  10. Phenomenology of ELDER dark matter

    Science.gov (United States)

    Kuflik, Eric; Perelstein, Maxim; Lorier, Nicolas Rey-Le; Tsai, Yu-Dai

    2017-08-01

    We explore the phenomenology of Elastically Decoupling Relic (ELDER) dark matter. ELDER is a thermal relic whose present density is determined primarily by the cross-section of its elastic scattering off Standard Model (SM) particles. Assuming that this scattering is mediated by a kinetically mixed dark photon, we argue that the ELDER scenario makes robust predictions for electron-recoil direct-detection experiments, as well as for dark photon searches. These predictions are independent of the details of interactions within the dark sector. Together with the closely related Strongly-Interacting Massive Particle (SIMP) scenario, the ELDER predictions provide a physically motivated, well-defined target region, which will be almost entirely accessible to the next generation of searches for sub-GeV dark matter and dark photons. We provide useful analytic approximations for various quantities of interest in the ELDER scenario, and discuss two simple renormalizable toy models which incorporate the required strong number-changing interactions among the ELDERs, as well as explicitly implement the coupling to electrons via the dark photon portal.

  11. Association between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa

    2015-01-01

    Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. The Chicago Health and Aging Project (CHAP) cohort is a population-based study (n = 4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes [22.4 vs. 10.7% (WHO), 50.7 vs. 40.0% (AHA) and 47.7 vs. 33.5% (IDF)]. After adjusting for potential confounding factors, elder abuse was associated with an increased risk for metabolic syndromes according to WHO [OR, 3.95 (2.86-5.47)], AHA [OR, 2.03 (1.56-2.64)] and IDF [OR, 2.55 (1.97-3.29)] criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics but not by health-related or psychosocial factors. Elder abuse is associated with an increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease.

  12. Dengue severity in the elderly in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Enid J. García-Rivera

    2003-06-01

    Full Text Available OBJECTIVE: Severe dengue affects all age groups in the Americas, but little detailed information is available about this disease in the elderly. The objective of this article is to describe the disease in this age group. METHODS: We reviewed suspected dengue-case investigation forms submitted with diagnostic samples as well as clinical reports from infection control nurses in Puerto Rico, for the period of 1994 through 1999. RESULTS: We assigned the laboratory-positive case-patients to four age groups: infants (1 year: 554, youth (2 to 18 years: 6 857, adults (19 to 64 years: 9 433, and elderly (> 65 years: 822. Regardless of infecting serotype, the elderly were more likely to have been hospitalized (48% vs. 33% (P <0.01 and were less likely to show hemorrhage (26% vs. 33% (P <0.01. On multivariate analysis, controlling for gender and the presence of hemorrhage, the elderly had a higher risk for hospitalization and death than did the youths and the adults. CONCLUSIONS: The elderly appear to be more likely than youth and younger adults to develop severe illness when infected with the dengue virus, in a pattern similar to that of infants. The clinical evaluation of elderly patients with dengue must include a careful assessment of increased capillary permeability and occult hemorrhage in order to avoid complications from delayed identification and treatment of severe dengue infection. These findings are of increasing importance for dengue epidemiology and medical care in view of the expanding nature of dengue and dengue hemorrhagic fever in a world that also has a growing number and proportion of elderly persons.

  13. National survey of the Portuguese elderly nutritional status: study protocol.

    Science.gov (United States)

    Madeira, Teresa; Peixoto-Plácido, Catarina; Goulão, Beatriz; Mendonça, Nuno; Alarcão, Violeta; Santos, Nuno; de Oliveira, Rita Machado; Yngve, Agneta; Bye, Asta; Bergland, Astrid; Lopes, Carla; Nicola, Paulo; Santos, Osvaldo; Clara, João Gorjão

    2016-07-16

    Worldwide we are facing a serious demographic challenge due to the dramatic growth of the population over 60 years. It is expected that the proportion of this population will nearly double from 12 to 22 %, between 2015 and 2050. This demographic shift comes with major health and socio-economic concerns. Nutrition is a fundamental determinant of both health and disease and its role in extending a healthy lifespan is the object of considerable research. Notably, malnutrition is one of the main threats to health and quality of life among the elderly. Therefore, knowledge about nutritional status among the elderly is essential for the promotion and maintenance of healthy ageing and to support the development of health protection policies and equity in elderly health care. This is a nationwide nutrition survey of the Portuguese population over 65 years old, with data collection through face-to-face interviews. A representative and random sample of community dwelling elderly and nursing homes residents will be obtained by multistage sampling stratified per main Portuguese regions, sex and age groups. Minimum sample size was estimated to be 2077 elderly (979 in the community and 1098 in nursing homes). Data will be collected on food habits and eating patterns, nutritional status, food insecurity, lifestyle, self-rated general health status and self-reported diseases, functionality, loneliness, cognitive function, emotional status and demographic and socio-economic characterization. This is the first national survey to evaluate the prevalence of nutritional risk and malnutrition of the Portuguese population above 65 years old, including those living in nursing homes. It will allow the identification of population subgroups of elderly with increased odds of malnutrition and nutritional risk. In addition, this survey will contribute to the identification of psychosocial and clinical predictors of malnutrition among elderly, which is an important risk factor for other

  14. Cushing's disease in the elderly patient

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    Maritza Cardosa Samón

    2012-05-01

    Full Text Available Introduction: Cushing's disease arises from increased ACTH secretion from a pituitary tumor that stimulates the area fasciculata of the adrenal cortex and produces hypersecretion of glucocorticoids. Objectives: To explain the clinical and humoral manifestations of Cushing's disease in elderly adults. Methods: The article is a descriptive and retrospective study of a case report on a 62 year old patient that is admitted to our Center with manifestations of facial plethora and centripetal obesity. Onset was characterized by hypertension and diabetes mellitus. Definitive diagnosis was Cushing's disease from a macroadenoma with increased ACTH secretion.

  15. Cervical spine injury in the elderly: imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Ehara, S. [Dept. of Radiology, Iwate Medical University School of Medicine, Morioka (Japan); Shimamura, Tadashi [Dept. of Orthopedic Surgery, Iwate Medical University School of Medicine, Morioka (Japan)

    2001-01-01

    An increase in the elderly population has resulted in an increased incidence of cervical spine injury in this group. No specific type of cervical spine trauma is seen in the elderly, although dens fractures are reported to be common. Hyperextension injuries due to falling and the resultant central cord syndrome in the mid and lower cervical segments due to decreased elasticity as a result of spondylosis may be also characteristic. The imaging features of cervical spine injury are often modified by associated spondylosis deformans, DISH and other systemic disorders. The value of MR imaging in such cases is emphasized. (orig.)

  16. Successful ageing amongst elderly women living independently in ...

    African Journals Online (AJOL)

    This qualitative study explores successful ageing among a group of old ... were 3 million in 2011 Stats SA) and those above 65 years were reported to have grown ... Alpaslan (2011), with students as fieldworkers, gave a baseline overview of elderly ... life experiences (Wagnild 2003), a theoretical approach that has been ...

  17. Death and Dying Anxiety among Bereaved and Nonbereaved Elderly Parents

    Science.gov (United States)

    Azaiza, Faisal; Ron, Pnina; Shoham, Meyrav; Tinsky-Roimi, Tal

    2011-01-01

    This study examines differences in death and dying anxiety between bereaved and nonbereaved elderly Israeli parents, as well as correlates of these factors among bereaved parents. A total of 97 parents (49 bereaved, 48 nonbereaved) completed measures of death and dying anxiety and religiosity. Bereaved parents reported significantly higher dying…

  18. Association Between Sleep Duration and Health Outcome in Elderly Taiwanese

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    Meng-Ting Tsou

    2011-12-01

    Conclusion: A U-shaped relationship was observed between the self-reported sleep duration with risk prevalence and health outcome in the elderly population, although not all results showed a significant difference. A progressively higher change was observed during short and long sleep durations in our study.

  19. [Sexuality in the elderly].

    Science.gov (United States)

    Wilk, Bartosz

    2015-03-01

    Sustaining and strengthening the ability of the elderly to continue their sexual needs can be realized as part of improving their quality of life, health and well-being. There is no age at which ends the expression of sexuality and intimacy. Through education, quality of life and advances in medicine, the average life expectancy is still increasing. Sexual activity of older people society usually describe using pejorative terms as an inappropriate, bizarre or obscene, but these labels are different than reality. Hormonal changes and other physiological changes associated with aging affect sexual interest. Erectile dysfunction is a problem in men increasing with age. There is no evidence that premature ejaculation is more common in older age. Cross-sectional studies showed no difference in sexual dysfunction between older and younger women. Age is not a barrier to sexually transmitted diseases. The most common pathogenetic factors for male erectile dysfunction are vascular diseases. In women, the most important symptoms of sexual dysfunction are lack of emotional wellbeing and a sense of intimacy during sexual intercourse. © 2015 MEDPRESS.

  20. Diabetes mellitus in elderly

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    Farida Chentli

    2015-01-01

    Full Text Available Diabetes mellitus (DM frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60–65 years old, DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is "go slowly and individualize" to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin.

  1. Mechanisms of tactile sensory deterioration amongst the elderly.

    Science.gov (United States)

    Skedung, Lisa; El Rawadi, Charles; Arvidsson, Martin; Farcet, Céline; Luengo, Gustavo S; Breton, Lionel; Rutland, Mark W

    2018-04-19

    It is known that roughness-smoothness, hardness-softness, stickiness-slipperiness and warm-cold are predominant perceptual dimensions in macro-, micro- and nano- texture perception. However, it is not clear to what extent active tactile texture discrimination remains intact with age. The general decrease in tactile ability induces physical and emotional dysfunction in elderly, and has increasing significance for an aging population. We report a method to quantify tactile acuity based on blinded active exploration of systematically varying micro-textured surfaces and a same-different paradigm. It reveals that elderly participants show significantly reduced fine texture discrimination ability. The elderly group also displays statistically lower finger friction coefficient, moisture and elasticity, suggesting a link. However, a subpopulation of the elderly retains discrimination ability irrespective of cutaneous condition and this can be related to a higher density of somatosensory receptors on the finger pads. Skin tribology is thus not the primary reason for decline of tactile discrimination with age. The remediation of cutaneous properties through rehydration, however leads to a significantly improved tactile acuity. This indicates unambiguously that neurological tactile loss can be temporarily compensated by restoring the cutaneous contact mechanics. Such mechanical restoration of tactile ability has the potential to increase the quality of life in elderly.

  2. Metabolic syndrome in Iranian elderly

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    Nizal Sarrafzadegan

    2012-01-01

    Full Text Available BACKGROUND: This study aimed to compare Iranian elderly with the youth and middle aged population in terms of the prevalence of metabolic syndrome and its components in Iranian elderly METHODS: This cross-sectional study was conducted using the information from the third phase of Isfahan Healthy Heart Program. Male and female residents of Isfahan who aged over 19 years were selected by multistage cluster random sampling. A questionnaire including demographic characteristics, health status, medical history, medications used, as well as waist circumference, weight, height and systolic and diastolic blood pressures was completed for all participants. Fasting blood samples were obtained from all subjects and examined for fasting blood sugar and lipid profile. RESULTS: The prevalence of metabolic syndrome in individuals aged over 60 years was significantly higher than those under 60 (49.5% vs. 17.5%, respectively; P < 0.001. It was also more prevalent among elderly females than in males (59.2% vs. 39.8%, respectively; P < 0.005. Some anthropometric measures such as height, body mass index, abdominal circumference, waist-hip ratio, and waist to height ratio were significantly different in men and women below 60 years in comparison with those over 60 years (P < 0.05. Moreover, there were significant differences in most studied parameters between the elderly and non-elderly women (P < 0.001. Based on the findings of this study, the risk factors for cardiovascular diseases were significantly more prevalent in men and women over 60 years. T-test and Mann-Whitney were used for quantitative data and the square-chi test is performed for qualitative data.    CONCLUSION: This study showed that metabolic syndrome has a relatively high prevalence in Iranian elderly people (especially in women. Therefore, early diagnosis and management of the complication are recommended among this high-risk group. Keywords: Metabolic Syndrome, Elderly, Iran

  3. Effectiveness of Pranayama on Depression in Elderly

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    Kannan K

    2015-01-01

    Full Text Available The knowledge of Pranayama in elderly is very important in day to day life. In case of mental health problem like depression, the availability of the source of Complementary and Alternative Medicine (CAM like Pranayama helps to decrease depression. The aim of the review is to discuss the articles pertaining to pranayama on depression in elderly including both quantitative and qualitative studies published and unpublished and to review the related studies and other articles regarding effectiveness of pranayama on depression in elderly. The review was based on the studies conducted globally. Systematic searches were conducted on a range of databases, citations were sought from relevant reviews and several websites were also included in the search, including those of MIND and the Mental Health Foundation. MEDline, EMBASE, and PsycINFO were searched for studies published from 2000 January to December 2013. Five independent reviewers assessed the eligibility of each report based on predefined inclusion criteria (study design and measure of depression. Individual effect sizes were standardized. Results of 87 abstracts reviewed, 7 results were not Randomized Controlled Trial (RCT, 36 Studies were excluded due to their intervention and other problems, 25 Studies were excluded due to their outcomes, 2 dissertations was excluded, 17 Full Text articles were assessed for eligibility, Exclusion of study reports through full text screening n=8 duplicated: editorial review article: 3 Did not meet inclusion criteria: 4 Incomplete information: 9 studies met inclusion criteria and were included for final review. Heterogeneity between studies was not explained by age or sex, but could be partly explained by the types of depression and assessments. Collaborative care interventions are more effective for depression in older people than usual care and are also of high value. Pranayama are effective component with depression.

  4. Elder Abuse in the African Diaspora: A Review.

    Science.gov (United States)

    Mouton, Charles P; Southerland, Janet H

    2017-01-01

    As with many other populations, abuse of older adults is a growing problem across the Africa Diaspora. Modernization and urbanization are eroding the traditional values of respect for older adults. Also, older adults living in environments with limited social and economic resources, and having no means of economic support create a recipe for elder abuse and neglect. This article reviews the current literature on the epidemiology, risk factors, and interventions used for elder abuse across the African Diaspora. Reports of elder abuse range from 24.9% to 81.1% across the Diaspora. Risk factors include cognitive and physical impairment, social isolation, lack of resources and widowhood. Community-based programs using the unique social networks of older populations of African descent can provide a venue to improve caregiver training and support, reinforce traditional filial and informal caregiving practices, increase the utilization of available governmental and institutional. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

  5. Social inclusion affects elderly suicide mortality.

    Science.gov (United States)

    Yur'yev, Andriy; Leppik, Lauri; Tooding, Liina-Mai; Sisask, Merike; Värnik, Peeter; Wu, Jing; Värnik, Airi

    2010-12-01

    National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared. For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens' attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database. Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicide rates are lower in countries where the elderly live with their families more often. Elderly suicide mortality and labor-market exit age are inversely correlated. In Eastern European countries, elderly people's status and economic contribution are seen as less important. Western Europeans regard the elderly with more admiration, consider them more friendly and more often have elderly relatives in the family. The data also show gender differences. Society's attitudes influence elderly suicide mortality; attitudes towards the elderly are more favorable among Western European citizens; and extended labor-market inclusion of the elderly is a suicide-protective factor.

  6. Types of abuse and risk factors associated with elder abuse.

    Science.gov (United States)

    Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann

    2016-01-01

    Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.

  7. Falls prevention for the elderly

    Directory of Open Access Journals (Sweden)

    Dagmar Lühmann

    2012-04-01

    Full Text Available Background: An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors. However, the clinical and economic effectiveness of the majority of recommended strategies for fall prevention is unclear. Against this background, the literature analyses in this HTA report aim to support decision-making for effective and efficient fall prevention.Research questions: The pivotal research question addresses the effectiveness of single interventions and complex programmes for the prevention of falls and fall-related injuries. The target population are the elderly (> 60 years, living in their own housing or in long term care facilities. Further research questions refer to the cost-effectiveness of fall prevention measures, and their ethical, social and legal implications. Methods: Systematic literature searches were performed in 31 databases covering the publication period from January 2003 to January 2010. While the effectiveness of interventions is solely assessed on the basis of randomised controlled trials (RCT, the assessment of the effectiveness of diagnostic procedures also considers prospective accuracy studies. In order to clarify social, ethical and legal aspects all studies deemed relevant with regard to content were taken into consideration, irrespective of their study design. Study selection and critical appraisal were conducted by two independent assessors. Due to clinical heterogeneity of the studies no meta-analyses were performed.Results: Out of 12,000 references retrieved by literature searches, 184 meet the

  8. Health-related quality of life of elderly living in the rural community and homes for the elderly in a district of India. Application of the short form 36 (SF-36) health survey questionnaire.

    Science.gov (United States)

    Varma, G R; Kusuma, Y S; Babu, B V

    2010-08-01

    The present investigation aimed to assess the health-related QoL (HRQoL) of elderly people living in two settings: (i) rural community and (ii) homes for the elderly in a district of South India. The data are drawn from elderly (>60 years of age) sampled from both settings. The short form 36-item health survey (SF-36) was administered to all respondents. The average scores for several domains, including total physical health, total mental health and overall health (total SF-36 score) were around 50, which can be interpreted as a moderate level of health-related QoL. Residents living in a home for the elderly scored better in all domains except for role-physical and role-emotional. Though univariate analysis revealed some associations between characteristics of elderly SF-36 scores, the multiple regression analysis indicated that working status yields a significant but negative coefficient for total SF-36 score among community dwelling elderly. The elderly report that their lives are better when they are staying in homes for the elderly. Hence, despite the socio-economic conditions, provision of a better and conducive environment by setting up more charity-based homes for the elderly may be one of the options for relative betterment of the QoL of the elderly, particularly those who are socially and economically deprived. Finally, the study warrants the need of normative values of SF-36 for various population groups in India.

  9. Prevalence and risk factors of abuse among community dwelling elderly of Guwahati City, Assam

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    Anku Moni Saikia

    2015-01-01

    Full Text Available Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST. Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population.

  10. Concern with falls in elderly people attended in an Integral Attention Center

    Directory of Open Access Journals (Sweden)

    Elizandro Correia de Araújo

    2016-11-01

    Full Text Available Falls are concerning factors in elderly people, because they cause diverse complications. The objective of this study was to identify the level of concern with falls, associating them with self-reported diseases and history of falls of elderly attended in an Integral Attention Center. This was a descriptive study with 80 elderly. The results demonstrated an extreme concern regarding the possibility of falling for most female, married, of 60-79 years and receiving low monthly income; there is also extreme concern for those with hypertension and arthrosis. Nursing should establish integral actions to map elderly with risk of falling and, that promote awareness for these elderly and their family members regarding fall prevention measures, to prevent falls and to reduce the fear of falling.

  11. Quality of Elderly\\'s Life in Shiraz, Jahandidegan Club

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    Mohammad Rafi' Bazrafshan

    2008-04-01

    Full Text Available Objectives: Aging is a personal and social experience. while experiences may cause happiness for some individuals, it may cause sadness or tedious in the others. Making decision and planning aimed to improve elderly quality of life among older people, require identification of their problems . Methods & Materials: This study was a cross–sectional study conduced in Jahandidegan Club Foundation for elderly in 2007. Participants were 232 elderly women aged 60–79 years old recruited through a random zed sampling. Data collection was conducted through LEIPAD questionnaire including two domains (essential domain and simplify domain. Data were analyzed using T-test, ANOVA and linear regression in SPSS. Results: The results indicated that there was a significant difference between QOL mean scores (in each of the two domains and total scoreand marital status (P<0.05, as singles had better scores in total than divorced and the other groups, Widowed and divorced elderly women had lower QOL scores than married. QOL scores (in each two domain and total score were strongly correlated with educational level however, only in essential domain a significant difference was observed (P=0.047. QOL mean score decreased with increasing age (P<0.05. There was a significant difference between QOL scores (in essential domain and total score with age of the elderly women, there was also a significant difference between QOL scores (in each two domain and total score with income (P<0.05, QOL mean increased with increasing income. There was a significant difference between QOL mean (in each two domain and total score with existence chronic disease (P<0.05. Conclusion: Results of this study demonstrated some factors such as disease, level of education, marital status, age, income and job may affect quality of elderly's life, Therefore these factors need to be considered in planning and solving older people's problems.

  12. Elder Abuse and Neglect in Israel: A Comparison between the General Elderly Population and Elderly New Immigrants

    Science.gov (United States)

    Iecovich, Esther

    2005-01-01

    The present study investigated differences between the general elderly population and elderly new immigrants from former Soviet Union countries in regard to the incidence of elder abuse and neglect, victims' characteristics, and perpetrators' characteristics. In addition, the study sought to examine predictors of various types of abuse and…

  13. Profile and prevalence of hearing complaints in the elderly

    Directory of Open Access Journals (Sweden)

    Magda Aline Bauer

    Full Text Available Abstract Introduction: Hearing is essential for the processing of acoustic information and the understanding of speech signals. Hearing loss may be associated with cognitive decline, depression and reduced functionality. Objective: To analyze the prevalence of hearing complaints in elderly individuals from Rio Grande do Sul and describe the profile of the study participants with and without hearing complaints. Methods: 7315 elderly individuals interviewed in their homes, in 59 cities in the state of Rio Grande do Sul, Brazil, participated in the study. Inclusion criteria were age 60 years or older and answering the question on auditory self-perception. For statistical purposes, the chi-square test and logistic regression were performed to assess the correlations between variables. Results: 139 elderly individuals who did not answer the question on auditory self-perception and 9 who self-reported hearing loss were excluded, totaling 7167 elderly participants. Hearing loss complaint rate was 28% (2011 among the elderly, showing differences between genders, ethnicity, income, and social participation. The mean age of the elderly without hearing complaints was 69.44 (±6.91 and among those with complaint, 72.8 (±7.75 years. Elderly individuals without hearing complaints had 5.10 (±3.78 years of formal education compared to 4.48 (±3.49 years among those who had complaints. Multiple logistic regression observed that protective factors for hearing complaints were: higher level of schooling, contributing to the family income and having received health care in the last six months. Risk factors for hearing complaints were: older age, male gender, experiencing difficulty in leaving home and carrying out social activities. Conclusions: Among the elderly population of the state of Rio Grande do Sul, the prevalence of hearing complaints reached 28%. The complaint is more often present in elderly men who did not participate in the generation of family

  14. Elder-Abuse Offenders: A Typology.

    Science.gov (United States)

    Ramsey-Klawsnik, Holly

    2000-01-01

    Addresses some of the perplexing issues involved in understanding and responding to elder-abuse offenders. Offers a typology of offenders to elucidate the dynamics when people mistreat the elderly. (Contains 13 references.) (Author)

  15. The Neural Correlates of Spatial and Object Working Memory in Elderly and Parkinson's Disease Subjects

    OpenAIRE

    Caminiti, Silvia P.; Siri, Chiara; Guidi, Lucia; Antonini, Angelo; Perani, Daniela

    2015-01-01

    This fMRI study deals with the neural correlates of spatial and objects working memory (SWM and OWM) in elderly subjects (ESs) and idiopathic Parkinson’s disease (IPD). Normal aging and IPD can be associated with a WM decline. In IPD population, some studies reported similar SWM and OWM deficits; others reported a greater SWM than OWM impairment. In the present fMRI research, we investigated whether compensated IPD patients and elderly subjects with comparable performance during the execution...

  16. Developing an In-depth Understanding of Elderly Adult's Vulnerability to Climate Change.

    Science.gov (United States)

    Rhoades, Jason L; Gruber, James S; Horton, Bill

    2018-05-08

    Recent reports highlight the vulnerability of elderly adults to climate change, yet limited research has focused on this topic. To address this, the purpose of this study was to develop an in-depth understanding of elderly adult's vulnerability to climate change within the context of a specific community. A case study methodology utilizing a community-based action research approach was employed to engage elderly participants living in Bridgeport, CT, in exploring their vulnerability to current and predicted climate stressors with a focus on extreme heat, flooding and storms, and air pollution. This research identifies personal characteristics that interact with contextual factors to influence elderly adult's vulnerability to climate change. Personal characteristics include health, economic, and social considerations. Contextual factors include the adequacy of emergency preparedness measures, transportation resources, and coping and recovery resources. As a result of the interplay of these characteristics and factors, predicted climate changes could have serious consequences for Bridgeport's elderly adults. This research provides a contextualized and detailed illustration of how climate change could overwhelm elderly adult's adaptive capacity and highlights the need for support services to provide safeguards. The issues and concerns raised may bear similarities to other locations, especially urban settings facing similar climate stressors with similar socioeconomic conditions. The findings suggest a need for further research to improve our understanding and serve as the basis for collaborative adaptation planning that engages elderly communities with local governments and a broad coalition of partners to keep elders safe.

  17. Lymphocytic hypophysitis in the elderly: A case presentation and review of the literature

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    Teresa Brown, DO

    2017-06-01

    Full Text Available Lymphocytic hypophysitis (LH, an autoimmune mediated chronic inflammation of the pituitary gland, is uncommon in the elderly population greater than 70 years old. It most commonly occurs in peripartum women and classically presents with mass-effect symptoms, hyperprolactinemia, or with symptoms of adenohypophysial or neurohypophysial involvement. We report a case of an elderly female who presented with headaches, visual defects, panhypopituitarism, and a sellar mass thought to be a non-functioning pituitary macroadenoma. On surgical pathology the diagnosis of LH was made. In a comprehensive literature search, we have found only sixteen cases of LH in the elderly. A comparison of the clinical differences between the pediatric, adult, and elderly populations with LH revealed notable differences between the clinical presentations and hormonal deficiencies present in the pediatric versus the adult and elderly populations. A much larger portion of adults and the elderly present with headache and visual disturbances, while a majority of the pediatric population presents with diabetes insipidus and growth hormone deficiency. Adults and elderly with LH have a much higher association with autoimmune disease than children. There was no gender predilection found in the elderly population, which is a notable difference from the adult population in which female cases of LH are much more common.

  18. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study.

    Science.gov (United States)

    Sahaf, Robab; Sadat Ilali, Ehteram; Peyrovi, Hamid; Akbari Kamrani, Ahmad Ali; Spahbodi, Fatemeh

    2017-01-01

    The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. One of the most important findings emerging in the main study was "uncertainty", which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications.

  19. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Robab Sahaf

    2017-01-01

    Full Text Available Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. Results: One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems. Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications.

  20. Uncertainty, the Overbearing Lived Experience of the Elderly People Undergoing Hemodialysis: A Qualitative Study

    Science.gov (United States)

    Sahaf, Robab; Sadat Ilali, Ehteram; Peyrovi, Hamid; Akbari Kamrani, Ahmad Ali; Spahbodi, Fatemeh

    2017-01-01

    ABSTRACT Background: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. Methods: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach. Results: One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis. Conclusion: The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications. PMID:28097174

  1. Colonization of the Tongue Surface in Japanese Independent Elders: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Tomohisa Ohno

    2017-09-01

    Full Text Available Oral care is important to decrease oral bacteria, especially in the dependent elders. There have been some reports on oral microflora in the dependent elders. However, investigations involving healthy independent elders are limited. The purpose of this study was to obtain more information on the microflora in Japanese independent elders. One hundred Japanese independent elders aged 65 years or older participated in this study. Eighty-one independent elders (male: 44, female: 37, mean age: 72.7 ± 5.8 participated in this study. Their mean Barthel Index was 99.1 ± 3.1, and mean score of MMSE was 28.0 ± 2.3. The tongue bacterial flora was examinved to identify microorganisms by the culture method. The predominant aerobic organisms were Streptococcus spp. (detection rate: 100%, Neisseria spp. (96%, and Corynebacterium spp. (56%. Candida spp. was also isolated (32%. In this study, the oral microflora of the tongue in Japanese independent elders was clarified. The results of this investigation may contribute to research on oral bacteria in elder persons in the future.

  2. Sexuality through the eyes of the elderly.

    OpenAIRE

    Uchôa,Yasmim da Silva; Costa,Dayara Carla Amaral da; Silva Junior,Ivan Arnaldo Pamplona da; Silva,Saulo de Tarso Saldanha Eremita de; Freitas,Wiviane Maria Torres de Matos; Soares,Soanne Chyara da Silva

    2016-01-01

    Abstract Objective: to identify the perception of elderly persons about sexuality. Methods: a quantitative, observational and analytical cross-sectional study was performed in an institution specializing in elderly care in Belém, in the state of Pará. A questionnaire, produced by the authors, was applied to 200 elderly persons, aiming to identify issues related to sexuality both in their youth and today, as well as stimulant strategies and sexuality inhibiting factors among the elderly, amo...

  3. [Addictive behavior among the elderly].

    Science.gov (United States)

    Menecier, Pascal; Fernandez, Lydia

    2012-12-01

    Addictive behavior still persists among the elderly, mainly concerning substance abuse, such as alcohol, tobacco or psychotropic drugs and addictive practices such as gambling. Illegal substances or cyber-addictions appear much less often. The environment (place of residence or care) and/or economic factors may influence behavior and practices. The incidence of somatic illness or psychiatric disorders, such as cognitive impairment among the elderly patients, complicates even further the presentation of addictive disorders and their treatment. The age factor does not seem to lessen the suffering felt by the patient and care is required in an equal manner for all ages. Prevention (maintenance of personal autonomy and quality of life throughout the ageing process) plays an essential role along with the offer of care. The lack of scientific data such as the absence of validation for adult care among the elderly, leave wide scope for epidemiological, clinical and theoretical research. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Challenges in anaesthesia for elderly

    DEFF Research Database (Denmark)

    Strøm, Camilla; Rasmussen, L S

    2014-01-01

    The segment of elderly individuals comprises a growing proportion of the global population. Health care systems and health care providers worldwide need to understand the specific challenges related to treatment of this heterogeneous patient population. The process of ageing is complex and under...... constant influence by numerous factors, for which reason the way human age is extremely individual. It is important to understand and acknowledge how elderly differ from younger adults, and how management needs to be modified and tailored to the individual patient in order to improve outcomes. The goal...... of treatment of an elderly patient is not necessarily to increase human longevity regardless of the consequences, but to increase active longevity free from disability and functional dependence. For older people, deterioration in function can be devastating and is often precipitated by a stressful event...

  5. Management of epilepsy in elderly

    Directory of Open Access Journals (Sweden)

    Harsono Harsono

    2003-03-01

    Full Text Available Management of epilepsy in elderly requires understanding the unique biochemical and pharmacological characteristics of these patients. Management decisions must be based on accurate classification of seizures or epilepsy syndromes, a thorough neurological assessment to define etiology, and a comprehensive assessment of the patient’s health and living situation. Concomitant illnesses such as neurological, psychiatric, metabolic, or cardiac disorders will require individualization of plans and instructions. Specific problems of treatment of epilepsy in the elderly compared to childhood patients are as follows: distinctive range of causes of epilepsy, distinctive differential diagnosis, concurrent pathologies unrelated to epilepsy, pharmacokinetic and pharmacodynamic differences, and distinctive psychosocial effects. (Med J Indones 2003; 12: 40-7 Keywords:  epilepsy, elderly, management, concomitant illness, pharmacokinetic

  6. Kidney transplantation in the elderly.

    Science.gov (United States)

    Singh, Neeraj; Nori, Uday; Pesavento, Todd

    2009-08-01

    Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

  7. [Liver diseases in the elderly].

    Science.gov (United States)

    Bruguera, Miguel

    2014-11-01

    Liver diseases in the elderly have aroused less interest than diseases of other organs, since the liver plays a limited role in aging. There are no specific liver diseases of old age, but age-related anatomical and functional modifications of the liver cause changes in the frequency and clinical behavior of some liver diseases compared with those in younger patients. This review discusses the most important features of liver function in the healthy elderly population, as well as the features of the most prevalent liver diseases in this age group, especially the diagnostic approach to the most common liver problems in the elderly: asymptomatic elevation of serum transaminases and jaundice. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  8. [Articles on elderly in Serbian medical journals].

    Science.gov (United States)

    Despotović, Nebojsa; Milosević, Dragoslav P; Erceg, Predrag; Davidović, Mladen

    2009-01-01

    Population aging is a feature of all countries in the world. According to statistics, the Republic of Serbia is one of the countries with the majority of the elderly. Taking this into account, are articles on the elderly well represented in domestic medical journals? The aim of the paper was to determine whether there was a sufficient number of articles on the elderly in domestic medical journals. The articles on the elderly were searched using search engines in domestic and foreign medical journals for the last 5 years compared with the number of articles on children in the same publications for the same period. In the Serbian Citation Index, 11 articles on the topic of the elderly, and 487 on children were registered. In Srpski arhivza celokupno lekarstvo, there was registered only one article on the topic of the elderly, and 30 on children. In Vojnosanitetskipregled, 2 articles on the elderly and 13 on children were registered (p articles on the elderly and 759 articles on children; in the JAMA, there were 63 articles on the elderly and 303 articles on children; and in The Lancet, in the last five years, 46 articles on the elderly and 148 articles on children were published. The themes of the elderly were rarely represented in Serbian medical journals.This has reduced the interest of physicians in medical problems of this growing population of patients and further sent them away from making standards in the diagnosis and treatment of the elderly.

  9. Carotid angioplasty and stenting in the elderly

    International Nuclear Information System (INIS)

    Kadkhodayan, Yasha; Cross, DeWitte T.; Moran, Christopher J.; Derdeyn, Colin P.

    2007-01-01

    To investigate the technical success rate as well as the procedural and mid-term complication rates of carotid angioplasty and stenting in elderly patients, a group excluded from large randomized endarterectomy trials given their perceived high surgical risk. Of 200 consecutive carotid angioplasty and/or stenting procedures performed between March 1996 and March 2005, 21 procedures were performed without cerebral protection devices in 20 patients over the age of 79 years (mean age: 83 years, 12 men, eight women). These patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and mid-term complication rates were calculated and compared to a previously published cohort of 133 consecutive patients ≤79 years of age who also underwent endovascular treatment at our institution. Carotid stenosis was reduced from a mean of 82% to no significant stenosis in all procedures. The procedural stroke rate was zero of 21 procedures. The procedural transient ischemic attack rate (TIA) was one of 21 procedures (4.8%). Mean follow-up was 24.6 months (range: 1.0-79.5 months) with at least a 30-day follow-up for 20 of the 21 procedures (95.2%). There were no new strokes. There was one recurrent ipsilateral TIA at 1.9 months. In five cases with follow-up carotid ultrasonography, no hemodynamically significant restenosis had occurred. There were three myocardial infarctions (MI) occurring at 0.5, 2.1, and 15.2 months, of which the last MI was fatal. The composite 30-day stroke and death rate was zero of 21 procedures (95% confidence interval: 0-14%). No significant difference was found in the 30-day rate of stroke, TIA, MI, or death between the elderly and younger patients. Carotid angioplasty and stenting in elderly patients can be performed successfully with acceptable procedural and mid-term complication rates comparable to younger patients. (orig.)

  10. Cognitive impairment in elderly women

    DEFF Research Database (Denmark)

    Rasmussen, Henrik Berg; Bagger, Yu Z; Tankó, László B

    2006-01-01

    BACKGROUND: A variety of factors contribute to the development of cognitive impairment in elderly people. Previous studies have focused upon a single or a few risk factors. In this study we assessed and compared the significance of a wide variety of potential risk factors for cognitive impairment...... in postmenopausal women. METHODS: A total of 208 pairs of elderly women (mean age = 73.2 years) were examined in a cross-sectional case-control study. Each pair consisted of a case (with impaired cognition) and a control subject matched by age and educational status. Cognitive functions were determined using...

  11. [Hypochondriasis and somatisation in elderly].

    Science.gov (United States)

    Thomas, Philippe; Hazif-Thomas, Cyril; Pareaud, Maurice

    2008-11-30

    Anxiety or masked depression are often associated with somatisation in elderly. Hypochondriasis is an excessive preoccupation or worry about having a serious illness. The DSM-IV defines it as a somatoform disorder. It affects about 3% of the population but has a heavy health care cost. Depression, obsessive-compulsive disorder generalized anxiety and somatization disorder are common in elderly and are the most common accompanying conditions in people with hypochondriasis. Old persons' unexplained medical symptoms in generalized anxiety and their relationship to the somatoform disorders are presented. Supportive care and psychotherapy are as necessary as antidepressant to help patients.

  12. Self-reported health problems, health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal.

    Science.gov (United States)

    Kshetri, Dan B B; Smith, William C S

    2011-06-01

    The study aimed to identify the felt common health problems, utilisation of health services and unmet needs of urban and rural elderly people of Bhaktapur district, Nepal. It was a cross sectional population study of people aged 60 years or more where 204 respondents were interviewed in 2009. The common felt problems were pain and swelling of joints (65.7%), indigestion (63.7%), excessive tiredness (38.2%) and hypertension (35.8%). Pain and swelling of joints (72.5%) and back pain (40.4%) were higher in rural elderly population whereas indigestion (67.6%) and hypertension (37.85%) were higher in urban population. Pain and swelling of joints (66.7%) and indigestion (69.6%) were higher in males, and hypertension (50.0%), back pain (38.2%) and chronic bronchitis/asthma (39.2%) were higher in females. The unmet needs varied between different health problems. In general women had more unmet needs than men, where 80 unmet needs were identified for the 102 men compared with 105 for the 102 women, and these unmet needs increased dramatically with age. This approach yields new insights into the health care needs of the elderly and will be helpful to health care planners.

  13. Assessing the level of elder abuse knowledge preprofessionals possess: implications for the further development of university curriculum.

    Science.gov (United States)

    Policastro, Christina; Payne, Brian K

    2014-01-01

    Elder abuse is a multifaceted problemthat requires interdisciplinary prevention and intervention strategies. An important question that arises is whether professionals are adequately prepared to address elder abuse in this collaborative network. Unfortunately, no studies have been conducted to assess the varying levels of knowledge that preprofessionals enrolled in university courses possess with regard to elder abuse. To fill this void, this study assesses the levels of elder abuse awareness among social work, nursing, health professions, and criminal justice students. Specific attention is given to determining whether there are differences in the amount of exposure to elder abuse literature across the disciplines. The study involves the analysis of survey data collected from 202 students enrolled in health and human sciences classes at a large university. Results show that none of the preprofessional groups, on average, reported knowing enough about elder abuse. Implications for future practice and research are provided.

  14. Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.

    Science.gov (United States)

    Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

    2016-05-25

    Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and

  15. Restless Legs Syndrome in a Nigerian Elderly Population

    Science.gov (United States)

    Fawale, Michael B.; Ismaila, Isiaka Alani; Mustapha, Adekunle F.; Komolafe, Morenikeji A.; Adedeji, Tewogbade A.

    2016-01-01

    Study Objectives: The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. Methods: The study population comprised of 633 consecutive elderly individuals aged 65–105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Results: Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283–8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750–12.577; p = 0.002) was found. Conclusions: Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. Citation: Fawale MB, Ismaila IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless legs syndrome in a Nigerian elderly population. J Clin Sleep Med 2016;12(7):965–972. PMID:27070251

  16. Impulse control disorders in elderly patients.

    Science.gov (United States)

    Tamam, Lut; Bican, Mehtap; Keskin, Necla

    2014-05-01

    There is no epidemiological study on the prevalence of impulse control disorders (ICDs) in the elderly population. The studies on ICDs in elderly patients are limited and some of them are case reports about pathological gambling and kleptomania. The comorbidity of other psychiatric disorders makes diagnosis difficult and has negative effects on both treatment and the prognosis of ICDs. The aim of this study was to determine the prevalence of ICDs among elderly patients and to evaluate the related sociodemographic and clinical features. A total of 76 patients aged 60 and over who have been referred to our outpatient clinics in a one-year period were included in the study. A demographic data form was completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) was used to determine axis I psychiatric disorders. The prevalence of ICDs was investigated by using the modified version of the Minnesota Impulse Disorders Interview (MIDI). Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). The Mini-Mental State Examination (MMSE) test was performed to evaluate the cognitive status of patients and to exclude the diagnosis of dementia. In addition, all patients completed Symptom Check List-90 (SCL-90). The prevalence rate of at least one comorbid ICD in our sample was 17%. When patients with a diagnosis of ICDs not otherwise specified (ICD-NOS) were included, the prevalence rate increased to 22.4%. The most common ICD was intermittent explosive disorder (15.8%), followed by pathological gambling (9.2%). The majority of the sample was men (54%), married (80%), had a high school education (51%), and mid-level socioeconomic status (79%). The only statistically significant difference between the sociodemographic characteristics of patients with or without ICDs was gender. The lifetime prevalence of ICDs was 34.1% in men and 8.6% in women. The prevalence of childhood conduct disorder

  17. Pneumonia and hospitalizations in the elderly

    Directory of Open Access Journals (Sweden)

    Francesco Cacciatore

    2017-05-01

    Full Text Available Pneumonia in the elderly is a common and severe problem. In this review we analyze the state of the art for pneumonia in the elderly. Several aspects are discussed: i how common is the disease; signs and symptoms in the elderly; ii the elderly must always be hospitalized and which is the best place - Intensive Care Unit or medical ward?; iii the role of comorbidities; iv etiology and pathogenesis; medical treatment - when and how to start; v antibiotic resistance; vi antibiotics in hospital acquired and ventilator related pneumonia; vii assisted non-invasive ventilation; viii the treatment in the terminally ill elderly patient.

  18. Testing Happiness Hypothesis among the Elderly

    Directory of Open Access Journals (Sweden)

    Rossi Máximo

    2008-08-01

    Full Text Available We use a rich data set that allows us to test different happiness hypotheses employing four methodological approaches. We find that older people in Uruguay have a tendency to report themselves happy when they are married, when they have higher standards of health and when they earn higher levels of income or they consider that their income is suitable for their standard of living. On the contrary, they report lower levels of happiness when they live alone and when their nutrition is insufficient. We also find that education has no clear impact on happiness. We think that our study is a contribution to the study of those factors that can explain happiness among the elderly in Latin American countries. Future work will focus on enhanced empirical analysis and in extending our study to other countries.

  19. A review on the prevalence and measurement of elder abuse in the community.

    Science.gov (United States)

    Sooryanarayana, Rajini; Choo, Wan-Yuen; Hairi, Noran N

    2013-10-01

    Aging is a rising phenomenon globally and elder abuse is becoming increasingly recognized as a health and social problem. This review aimed to identify the prevalence of elder abuse in community settings, and discuss issues regarding measurement tools and strategies to measure elderly abuse by systematically reviewing all community-based studies conducted worldwide. Articles on elder abuse from 1990 to 2011 were reviewed. A total of 1,832 articles referring to elders residing at home either in their own or at relatives' houses were searched via CINAHL and MEDLINE electronic databases, in addition to a hand search of the latest articles in geriatric textbooks and screening references, choosing a total of 26 articles for review. Highest prevalence was reported in developed countries, with Spain having 44.6% overall prevalence of suspicion of abuse and developing countries exhibiting lower estimates, from 13.5% to 28.8%. Physical abuse was among the least encountered, with psychological abuse and financial exploitation being the most common types of maltreatment reported. To date, there is no single gold standard test to ascertain abuse, with numerous tools and different methods employed in various studies, coupled with varying definitions of thresholds for age. Current evidences show that elder abuse is a common problem in both developed and developing countries. It is important that social, health care, and legal systems take these findings into consideration in screening for abuse or reforming existing services to protect the health and welfare of the elderly.

  20. Depression in elderly women resident in a long-stay nursing home.

    Science.gov (United States)

    Lampert, Melissa Agostini; Rosso, Ana Luiza Pereira

    2015-01-01

    Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH). This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version) above 5. Other clinical and psychiatric diagnoses were obtained from medical files. Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3%) of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

  1. Depression in elderly women resident in a long-stay nursing home

    Directory of Open Access Journals (Sweden)

    Melissa Agostini Lampert

    Full Text Available Depression is the most common psychiatric disorder among the elderly: it is present in 23-40% of community-dwelling elderly and in 25-80% of institutionalized elderly. Depressive symptoms are most prevalent in elderly women because they more readily seek healthcare services, are more vulnerable to stress and live longer than men. OBJECTIVE: To investigate the prevalence of depression and its comorbidities in a long-stay nursing home (NH. METHODS: This retrospective, descriptive, epidemiological study was performed at a NH in southern Brazil and comprised the first part of a larger project to determine depression and its relationship with psychosocial factors in NH residents. Sociodemographic and medical data were obtained through the examination of medical files from November 2012 to January 2013. Depression was defined as the diagnosis reported by physicians in medical files and scores on the Geriatric Depression Scale (15-item version above 5. Other clinical and psychiatric diagnoses were obtained from medical files. RESULTS: Out of a total of 142 elderly women, 51.4% had at least one psychiatric disorder, the most common being depression, affective bipolar disorder and mental retardation. Almost one third (32.3% of the elderly women were depressed. The ward containing the highest number of cognitively and physically independent women contained 41.3% of the total depressed elderly. A total of 52.1% of all depressed elderly had other associated clinical or psychiatric disorders, with mental retardation and hypothyroidism being the most frequent. CONCLUSION: The prevalence of dementia was high in this NH. Further studies evaluating the psychosocial factors involved in depressed elders should be conducted in an effort to prevent depression and promote mental health in institutionalized elders.

  2. Rational Suicide among the Elderly.

    Science.gov (United States)

    Humphry, Derek

    1992-01-01

    Contends that old age, in and of itself, should never need to be a cause for self-destruction. Further argues that suicide and assisted suicide carried out in the face of terminal illness causing unbearable suffering should be ethically and legally acceptable. Outlines a perspective on rational suicide among the elderly. (Author/NB)

  3. Suicidal Tendencies in the Elderly.

    Science.gov (United States)

    Achte, Kalle

    1988-01-01

    Claims elderly suicides are more frequent, and more likely to be multifactorial, including loneliness, isolation, depression, somatic illnesses, having suffered numerous losses, and injuries to the self-esteem (concerns regarding emptiness, uselessness, and body image). Aggressive impulses previously neutralized by work and social life now break…

  4. Breast cancer in the elderly

    African Journals Online (AJOL)

    JhfBK: A I'ccr-mvicw Journal of liiomeclical Scicnccs. July 2002, Vol. 1 No. 1 pp 33-42. Breast cancer in the elderly. ABSTRACT. Between Janua~y 1997 and December 2001,107 patients were admitted and treated for breast cancer at the University of Benin Teaching Hospital, Nigeria. Of these, 27. (25.2%) were aged 60 ...

  5. Elder Abuse among African Americans

    Science.gov (United States)

    Tauriac, Jesse J.; Scruggs, Natoschia

    2006-01-01

    Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…

  6. Robots for elderly care institutions

    DEFF Research Database (Denmark)

    Krüger, Norbert; Bodenhagen, Leon; Juel, William Kristian

    In this paper we raise questions about the ethically appropriate use of welfare robots. As engineers, we proceed from concrete examples. We present certain use cases for ”welfare robots” that are supposed to help to maintain the quality of elder care in a Danish institution, while a dramatic demo...

  7. Elderly alcoholics in outpatient treatment

    DEFF Research Database (Denmark)

    Nielsen, Bent; Nielsen, Anette Søgaard; Lolk, Anette

    2010-01-01

    In Denmark, the treatment of alcoholics is provided by public outpatient alcohol clinics. The purpose of this study was to investigate whether elderly patients differ from younger patients with regards to sociodemographic data, drinking pattern and psychiatric comorbidity which may affect...

  8. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

    Science.gov (United States)

    Lochner, Kimberly A; Wynne, Marc

    2011-12-21

    Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring

  9. [The medical autonomy of elderly in Taiwan].

    Science.gov (United States)

    Chen, Kai-Li; Chen, Ching-Huey

    2014-10-01

    The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

  10. Inappropriate prescribing in the elderly.

    LENUS (Irish Health Repository)

    Gallagher, P

    2012-02-03

    BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug

  11. [Examination results and autopsy findings in assaults on elderly people].

    Science.gov (United States)

    Bode-Jänisch, Stefanie; Havermann, Robert; Germerott, Tanja; Fieguth, Armin

    2010-01-01

    As the percentage of elderly people in the population grows, violence against persons of advanced age constitutes an increasing social problem. The findings of the clinical forensic examinations (CE group) and autopsies performed on elderly violence victims (> or = 60 years) between 1999 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In all, the study material comprised 55 victims of the CE group (35 females and 20 males, median age 73.5 years) and 55 autopsies (33 females and 22 males, median age 72.7 years). In most of the autopsy cases, the suspect was a family member or partner. In contrast, the alleged perpetrator was a stranger in most cases of the CE group. Blunt force injuries were most often found in the CE group victims (63.6%). Altogether, 38.2% (CE group) and 20.0% (autopsy cases) of the violent assaults were associated with robbery. In the majority of the CE cases, the victims suffered potentially or acute life-threatening injuries. In summary, the analysis shows that elderly people frequently become victims of robbery and blunt force injury. In most homicides of old people, the perpetrator is familiar to the victim. In surviving elderly violence victims, the assault is more likely to be reported to the police if the suspect is a stranger.

  12. Dehydration in the Elderly: A Review Focused on Economic Burden.

    Science.gov (United States)

    Frangeskou, M; Lopez-Valcarcel, B; Serra-Majem, L

    2015-06-01

    Dehydration is the most common fluid and electrolyte problem among elderly patients. It is reported to be widely prevalent and costly to individuals and to the health care system. The purpose of this review is to summarize the literature on the economic burden of dehydration in the elderly. A comprehensive search of several databases from database inception to November 2013, only in English language, was conducted. The databases included Pubmed and ISI Web of Science. The search terms «dehydration» / "hyponaremia" / "hypernatremia" AND «cost» AND «elderly» were used to search for comparative studies of the economic burden of dehydration. A total of 15 papers were identified. Dehydration in the elderly is an independent factor of higher health care expenditures. It is directly associated with an increase in hospital mortality, as well as with an increase in the utilization of ICU, short and long term care facilities, readmission rates and hospital resources, especially among those with moderate to severe hyponatremia. Dehydration represents a potential target for intervention to reduce healthcare expenditures and improve patients' quality of life.

  13. EDUCATIONAL ACTIONS TO PREVENT DENGUE: EXPERIENCES AND STRATEGIES WITH ELDERLY

    Directory of Open Access Journals (Sweden)

    Rosamaria Rodrigues Garcia

    2015-04-01

    Full Text Available Objective: Describe the activities performed on apublic specialized ambulatory care for dengue prevention among elderly. Case report: the epidemiological outlook of dengue is scaring being characterized as a public health problem. The elderly are most at risk for hospitalization and severe forms of the disease, thus health education activities are essential to improve awareness of the need to fight and prevent the disease. A Health Education project was created, evolving communication strategies to raise awareness on the issue. They were performed by a post graduate Gerontology group in activities such as interactive puppet show, myths and truths dynamic, informative folder, parody, posters, training seniors, caregivers and family members, internal and external health professionals, staff and residents of nearby long term care facilities. The materials were available in print and digital version. 2,500 elderly and 350 professionals were trained and encouraged to multiply the information and inspire adoption of preventive measures. The actions provided intergenerational interaction and empowerment of the elderly, whom trained, had the opportunity to exercise social participation and disseminate recommendations for other users. Conclusion: the project enabled the construction of knowledge through interactive educational activities that contributed to strengthen the individual and collective awareness, awareopinion leaderstothe importance of communication/education in the fight against dengue, which emphasized social responsibility in rescuing citizenship in a perspective thateach citizen is responsible for himself and for community. DESCRIPTORS: Dengue. Aged. Disease prevention. Health education.

  14. Relation between oral health and nutritional condition in the elderly

    Directory of Open Access Journals (Sweden)

    Humberto Lauro Rodrigues Junior

    2012-02-01

    Full Text Available Oral health is a prerequisite for a good chewing function, which may have an impact on food choices and nutritional well-being. OBJECTIVE: This study was designed to evaluate the relationship between oral health status and nutritional status in the elderly. MATERIAL AND METHODS: In this cross-sectional study, 33 elderly people from the Group for the Elderly Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal University, Niteroi, RJ, Brazil, completed a questionnaire to collect information on socioeconomic status, eating habits, physical activity and health habits, undertook a clinical oral examination, blood test, and anthropometric measurements, and were allocated into groups according to age. The oral health status was assessed using the index for decayed, missing and filled teeth (DMFT. The nutritional status was assessed using hemoglobin, hematocrit and albumin concentrations in blood, anthropometric values and the body mass index. RESULTS: Tooth loss was the biggest nuisance to the elderly subjects (57.6%, followed by the use of dentures (30.3% and ill-fitting dentures (33.3%. 66.6% of patients had difficulty in chewing, and 54.5% reported this to be due to prostheses and 13.6% to the absence of teeth. A significant correlation was found between DMFT and the value of suprailiac skinfold thickness (rho=0.380, p=0.029. CONCLUSION: The results support the temporal association between tooth loss and detrimental changes in anthropometry, which could contribute to increased risk of developing chronic diseases.

  15. Aripiprazole for acute mania in an elderly person

    Directory of Open Access Journals (Sweden)

    Balaji Bharadwaj

    2011-01-01

    Full Text Available New-onset bipolar disorder is rare in the elderly. Symptom profile is similar to that in young adults but the elderly are more likely to have neurological co-morbidities. There are no case reports of elderly mania being treated with aripiprazole, an atypical antipsychotic. A 78-year-old gentleman presented to us with symptoms suggestive of mania of 1 month′s duration. He had similar history 3 years ago and a family history of postpartum psychosis in his mother. There were no neurological signs on examination and work-up for an organic etiology was negative except for age-related cerebral atrophy. He improved with aripiprazole and tolerated the medications well. The use of psychotropic medications in the elderly is associated with side-effects of sedation, increased cardiovascular risk, and greater risk of extra-pyramidal side-effects. The use of partial dopaminergic antagonists like aripiprazole may be useful in the balancing of effects and side-effects.

  16. Perioperative morbidity and mortality after lumbar trauma in the elderly.

    Science.gov (United States)

    Winkler, Ethan A; Yue, John K; Birk, Harjus; Robinson, Caitlin K; Manley, Geoffrey T; Dhall, Sanjay S; Tarapore, Phiroz E

    2015-10-01

    OBJECT Traumatic fractures of the thoracolumbar spine are common injuries, accounting for approximately 90% of all spinal trauma. Lumbar spine trauma in the elderly is a growing public health problem with relatively little evidence to guide clinical management. The authors sought to characterize the complications, morbidity, and mortality associated with surgical and nonsurgical management in elderly patients with traumatic fractures of the lumbar spine. METHODS Using the National Sample Program of the National Trauma Data Bank, the authors performed a retrospective analysis of patients ≥ 55 years of age who had traumatic fracture to the lumbar spine. This group was divided into middle-aged (55-69 years) and elderly (≥ 70 years) cohorts. Cohorts were subdivided into nonoperative, vertebroplasty or kyphoplasty, noninstrumented surgery, and instrumented surgery. Univariate and multivariable analyses were used to characterize and identify predictors of medical and surgical complications, mortality, hospital length of stay, ICU length of stay, number of days on ventilator, and hospital discharge in each subgroup. Adjusted odds ratios, mean differences, and associated 95% CIs were reported. Statistical significance was assessed at p elderly is associated with increased morbidity. In particular, instrumented fusion is associated with periprocedural complications, prolonged hospitalization, and a decreased likelihood of being discharged home. However, fusion surgery is also associated with reduced mortality. Age alone should not be an exclusionary factor in identifying surgical candidates for instrumented lumbar spinal fusion. Future studies are needed to confirm these findings.

  17. Relation between oral health and nutritional condition in the elderly

    Science.gov (United States)

    RODRIGUES JUNIOR, Humberto Lauro; SCELZA, Miriam F. Zaccaro; BOAVENTURA, Gilson Teles; CUSTÓDIO, Silvia Maria; MOREIRA, Emília Addison Machado; OLIVEIRA, Diane de Lima

    2012-01-01

    Oral health is a prerequisite for a good chewing function, which may have an impact on food choices and nutritional well-being. Objective This study was designed to evaluate the relationship between oral health status and nutritional status in the elderly. Material and Methods In this cross-sectional study, 33 elderly people from the Group for the Elderly Interdisciplinary Geriatrics and Gerontology Program, at Fluminense Federal University, Niteroi, RJ, Brazil, completed a questionnaire to collect information on socioeconomic status, eating habits, physical activity and health habits, undertook a clinical oral examination, blood test, and anthropometric measurements, and were allocated into groups according to age. The oral health status was assessed using the index for decayed, missing and filled teeth (DMFT). The nutritional status was assessed using hemoglobin, hematocrit and albumin concentrations in blood, anthropometric values and the body mass index. Results Tooth loss was the biggest nuisance to the elderly subjects (57.6%), followed by the use of dentures (30.3%) and ill-fitting dentures (33.3%). 66.6% of patients had difficulty in chewing, and 54.5% reported this to be due to prostheses and 13.6% to the absence of teeth. A significant correlation was found between DMFT and the value of suprailiac skinfold thickness (rho=0.380, p=0.029). Conclusion The results support the temporal association between tooth loss and detrimental changes in anthropometry, which could contribute to increased risk of developing chronic diseases. PMID:22437676

  18. Clostridium difficile infection in the elderly: an update on management.

    Science.gov (United States)

    Asempa, Tomefa E; Nicolau, David P

    2017-01-01

    The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care-associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care-associated CDIs occur in patients 65 years or older. Additionally, the elderly are at higher risk for recurrent CDI. Existing therapeutic options include metronidazole, oral vancomycin, and fidaxomicin. Choice of agent depends on disease severity, history of recurrence, and, increasingly, the drug cost. Bezlotoxumab, a recently approved monoclonal antibody targeting C. difficile toxin B, offers an exciting advancement into immunologic therapies. Similarly, fecal microbiota transplantation is gaining popularity as an effective option mainly for recurrent CDI. The challenge of decreasing CDI burden in the elderly involves adopting preventative strategies, optimizing initial treatment, and decreasing the risk of recurrence. Expanded strategies are certainly needed to improve outcomes in this high-risk population. This review considers available data from prospective and retrospective studies as well as case reports to illustrate the merits and gaps in care related to the management of CDI in the elderly.

  19. Self-Esteem Among the Elderly Visiting the Healthcare Centers in Kermanshah-Iran (2012)

    Science.gov (United States)

    Franak, Jafari; Alireza, Khatony; Malek, Mehrdad

    2015-01-01

    Background and Objective: Self-esteem is viewed the most decisive factor in the psychological development of the elderly. This study was performed to assess self-esteem among the elderly referring to the elderly consulting unit of the healthcare centers in Kermanshah, Iran. Methods: A cross-sectional study was completed with 201 elderly respondents visiting the consulting unit of the healthcare services in Kermanshah, Iran. The samples were selected through convenience sampling. Rosenberg Self-esteem Scale (RSC) was used to gather the required data. Data were analyzed by using both descriptive (frequency, mean, median and standard deviation) and inferential statistics (chi-square and independent t-test). Results: The findings showed a mean of 35.63±5.25 for self-esteem, indicating a high level of self-esteem (66.2%) among the elderly. A statistically significant difference was reported between the mean of self-esteem and career (pself-esteem, which is indicative of the need to promote the self-esteem of the elderly in order to reduce their physical, psychological and social problems. Thus, it is necessary for the healthcare authorities to provide the elderly with financial, social and psychological support. PMID:26156932

  20. Acute Precipitants of Physical Elder Abuse: Qualitative Analysis of Legal Records From Highly Adjudicated Cases.

    Science.gov (United States)

    Rosen, Tony; Bloemen, Elizabeth M; LoFaso, Veronica M; Clark, Sunday; Flomenbaum, Neal E; Breckman, Risa; Markarian, Arlene; Riffin, Catherine; Lachs, Mark S; Pillemer, Karl

    2016-08-01

    Elder abuse is a common phenomenon with potentially devastating consequences for older adults. Although researchers have begun to identify predisposing risk factors for elder abuse victims and abusers, little is known about the acute precipitants that lead to escalation to physical violence. We analyzed legal records from highly adjudicated cases to describe these acute precipitants for physical elder abuse. In collaboration with a large, urban district attorney's office, we qualitatively evaluated legal records from 87 successfully prosecuted physical elder abuse cases from 2003 to 2015. We transcribed and analyzed narratives of the events surrounding physical abuse within victim statements, police reports, and prosecutor records. We identified major themes using content analysis. We identified 10 categories of acute precipitants that commonly triggered physical elder abuse, including victim attempting to prevent the abuser from entering or demanding that he or she leave, victim threatening or attempting to leave/escape, threat or perception that the victim would involve the authorities, conflict about a romantic relationship, presence during/intervention in ongoing family violence, issues in multi-generational child rearing, conflict about the abuser's substance abuse, confrontation about financial exploitation, dispute over theft/destruction of property, and disputes over minor household issues. Common acute precipitants of physical elder abuse may be identified. Improved understanding of these acute precipitants for escalation to physical violence and their contribution to elder abuse may assist in the development of prevention and management strategies.

  1. A systematic review on community-based interventions for elder abuse and neglect.

    Science.gov (United States)

    Fearing, Gwendolyn; Sheppard, Christine L; McDonald, Lynn; Beaulieu, Marie; Hitzig, Sander L

    2017-03-01

    Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.

  2. Self-Esteem Among the Elderly Visiting the Healthcare Centers in Kermanshah-Iran (2012).

    Science.gov (United States)

    Jafari, Franak; Khatony, Alireza; Mehrdad, Malek

    2015-04-15

    Self-esteem is viewed the most decisive factor in the psychological development of the elderly. This study was performed to assess self-esteem among the elderly referring to the elderly consulting unit of the healthcare centers in Kermanshah, Iran. A cross-sectional study was completed with 201 elderly respondents visiting the consulting unit of the healthcare services in Kermanshah, Iran. The samples were selected through convenience sampling. Rosenberg Self-esteem Scale (RSC) was used to gather the required data. Data were analyzed by using both descriptive (frequency, mean, median and standard deviation) and inferential statistics (chi-square and independent t-test). The findings showed a mean of 35.63±5.25 for self-esteem, indicating a high level of self-esteem (66.2%) among the elderly. A statistically significant difference was reported between the mean of self-esteem and career (pself-esteem, which is indicative of the need to promote the self-esteem of the elderly in order to reduce their physical, psychological and social problems. Thus, it is necessary for the healthcare authorities to provide the elderly with financial, social and psychological support.

  3. The Impact of Emotional Social Support on Elders' Food Security

    Directory of Open Access Journals (Sweden)

    Jennifer Woltil

    2012-10-01

    Full Text Available Food insecurity persists as a social problem in the U.S., putting its victims at risk of poor nutritional and overall health. Being food insecure is defined as the limited or uncertain availability of nutritionally safe foods or the inability to access such foods in socially acceptable ways. Food insecurity research tends to focus on younger populations, particularly households with children. Food insecurity among the elderly is, therefore, poorly understood, both in prevalence and in prevention and intervention methods. Addressing this gap, the present study examined the relationships between emotional social support and food security using data from the 2007-08 National Health and Nutrition Examination Survey in an effort to further the understanding of food insecurity among elders. Specifically, the effects of an emotional social support presence, number of support sources and types of support sources on food security were observed using OLS linear regression. Results indicated that emotional social support alleviated the risk of food insecurity, even when household income, marital/partnership status and health status were controlled for. However, the source of the support mattered: elders who reported a spouse as the primary source of support were more likely to report being food secure, while those who reported an “other” primary source of support were more likely to report being food insecure. Number of support sources were not significantly related to food security.

  4. Balance control in elderly people with osteoporosis

    Directory of Open Access Journals (Sweden)

    Wei-Li Hsu

    2014-06-01

    Full Text Available Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that incur fracture, injury, or mortality. Identifying the risk factors of falls within this population is essential for the development of effective regimes for fall prevention. Studies have shown that muscle quality and good posture alignments are critical for balance control in elderly individuals. People with osteoporosis often have muscle weakness and increased spine kyphosis leading to vertebral fractures and poor balance control, or even falls. Therefore, improving muscle quality, strengthening weak muscles, and correcting postural alignment are essential elements for the prevention of falls and fractures in older adults with osteoporosis. This review reports the necessary information regarding the critical factors of balance control in older adults with osteoporosis, as well as testing the clinical innovations of exercise training to improve the long-term prognosis of osteoporosis in this vulnerable population.

  5. Management of Odontoid Fracture in Elderly

    Directory of Open Access Journals (Sweden)

    Muhammad Nadeem

    2014-03-01

    Full Text Available Odontoid type II fractures are associated with high mortality in the elderly. Their management can be done either conservatively or surgically, however, surgical treatment is technically demanding and relatively new. We report a case of 75 years old man who presented to our clinical setting, following a history of fall. The CT scan and MRI showed odontoid type II fracture. With time, the neurological deficit got marked and he underwent transoral odontoidectomy and occipitocervical fixation using rods and screws via posterior approach. Patient’s neurological condition improved dramatically and on the short term follow up, he had no motor deficit. Our experience suggests that occipitocervical fixation via posterior approach is a viable option for the management of odontoid type II fracture in the geriatric population.

  6. Global Prevalence of Elder Abuse: A Meta-analysis and Meta-regression.

    Science.gov (United States)

    Ho, C Sh; Wong, S Y; Chiu, M M; Ho, R Cm

    2017-06-01

    Elder abuse is increasingly recognised as a global public health and social problem. There has been limited inter-study comparison of the prevalence and risk factors for elder abuse. This study aimed to estimate the pooled and subtype prevalence of elder abuse worldwide and identify significant associated risk factors. We conducted a meta-analysis and meta-regression of 34 population-based and 17 non-population-based studies. The pooled prevalences of elder abuse were 10.0% (95% confidence interval, 5.2%-18.6%) and 34.3% (95% confidence interval, 22.9%-47.8%) in population-based studies and third party- or caregiver-reported studies, respectively. Being in a marital relationship was found to be a significant moderator using random-effects model. This meta-analysis revealed that third parties or caregivers were more likely to report abuse than older abused adults. Subgroup analyses showed that females and those resident in non-western countries were more likely to be abused. Emotional abuse was the most prevalent elder abuse subtype and financial abuse was less commonly reported by third parties or caregivers. Heterogeneity in the prevalence was due to the high proportion of married older adults in the sample. Subgroup analysis showed that cultural factors, subtypes of abuse, and gender also contributed to heterogeneity in the pooled prevalence of elder abuse.

  7. Determining the effectiveness of an Elder Abuse Nurse Examiner Curriculum: A pilot study.

    Science.gov (United States)

    Du Mont, Janice; Kosa, Daisy; Yang, Rebecca; Solomon, Shirley; Macdonald, Sheila

    2017-08-01

    To pilot and evaluate a novel Elder Abuse Nurse Examiner Curriculum and its associated training materials for their efficacy in improving Sexual Assault Nurse Examiner (SANE)s' knowledge of elder abuse and competence in delivering care to abused older adults. Pilot training was held with 18 SANEs from across Ontario, Canada. A 52-item pre- and post-training questionnaire was administered that assessed participants' self-reported knowledge and perceived skills-based competence related to elder abuse care. A curriculum training evaluation survey was also delivered following the training. Qualitative non-participant observational data were collected throughout the training. There were statistically significant improvements in self-reported knowledge and perceived skills-based competence from pre-training to post-training for all content domains of the curriculum: older adults and abuse (pElder Abuse Nurse Examiner Curriculum and associated training materials were efficacious in improving SANEs' self-reported knowledge of and perceived competence in delivering elder abuse care. Future steps will further evaluate these materials as a component of a pilot of a larger comprehensive Elder Abuse Intervention at multiple sites across Ontario. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Indicadores sociais e saúde autorreferida de idosos diabéticos: variações entre os sexos - doi: 10.4025/actascihealthsci.v35i1.10315 Social indicators and self-reported health of elderly diabetic people: variations between the sexes - doi: 10.4025/actascihealthsci.v35i1.10315

    Directory of Open Access Journals (Sweden)

    Jacira dos Santos Oliveira

    2013-03-01

    Full Text Available O diabetes apresenta alta morbimortalidade, com perda importante na qualidade de vida do idoso. Assim, objetivou-se averiguar variações entre os sexos relativos aos indicadores sociais e ao estado de saúde autorreferido de idosos diabéticos. Estudo exploratório, realizado no Ambulatório de Endocrinologia do Hospital Universitário da UFPB, por meio de entrevista a 53 idosos atendidos, de outubro a dezembro de 2009. A análise dos dados foi efetivada pelo SPSS. Dos idosos, 38% eram homens e 62% mulheres; a maioria 58,49% tinha idade entre 60 a 64 anos e 71,70% referiram ser casados. Observou-se maior índice de viuvez entre as mulheres (21,21%. Considerando a renda, advinda especialmente da aposentadoria, 80% no caso dos homens e 54,55% das mulheres. Das mulheres, 42,42% referiram exercer atividade ocupacional apenas no lar e 65% dos homens não exerciam nenhuma. Quanto à falta de ajuda no cuidado em saúde, esta foi expressa por 5% dos homens. Verificou-se que 81,13% dos idosos expressavam duas ou mais enfermidades. Quanto ao uso de tecnologia assistiva, houve um predomínio entre os homens (10%. O estudo contribuiu para ampliar o conhecimento dos indicadores sociais e de saúde de homens e mulheres idosos diabéticos, o que pode melhor direcionar o cuidado de enfermagem.  Diabetes has a high morbidity and mortality, with significant loss in the elderly people’s life quality. Variations between the sexes with regard to social indicators and self-reported health status of elderly people with diabetics are investigated. Current exploratory study has been undertaken at the outpatient endocrinology clinic of the University Hospital of UFPB, through interviews with 53 elderly people, of whom 38% were males and 62% were females, between October and December 2009, and data were analyzed by SPSS. Most of the elderly people (58.49% interviewed were within the 60 - 64 age bracket. Although 71.70% reported being married, a high widowhood rate (21

  9. Case report

    African Journals Online (AJOL)

    abp

    2016-05-13

    May 13, 2016 ... Abstract. We report a rare case of an elderly woman presented with right renal mass with invasion of renal vein and several small lymphadenopathy in the hilar area .the diagnosis of kidney cancer is suspected and the patient underwent open radical nephrectomy, surrenalectomy and lymphadenectomy ...

  10. Driving safety in elderly individuals.

    Science.gov (United States)

    Marottoli, R A

    1993-05-01

    Driving safety in elderly individuals is becoming an increasingly important issue in geriatrics and in medical practice. The number of elderly drivers is increasing as the population ages, and especially as current generations of female drivers age. Concern is raised about their safe operation of motor vehicles because of the increasing likelihood with advancing age of developing conditions that may adversely affect the visual, cognitive, and motor abilities integral to driving. But this issue is not only a medical one, since there are social and political components as well. This discussion will describe the background of this issue, focus on the changes that may occur with aging and their potential relationship to driving ability, and, finally, will outline an approach that physicians may employ in their practice.

  11. Drug treatment in elderly diabetic.

    Science.gov (United States)

    Parikh, A O

    2007-12-01

    Diabetes causes greater decline in physical and functional status in elderly diabetic than in a younger one. Also the rise of MI, stroke and hypertension is also higher. In elderly diabetics management is always on challenging task due to atypical disease presentation, classical symptoms often absent, presence of other coexisting conditions delays the diagnosis, dietary advice not followed properly and due to non-compliance of drug therapy. The antidiabetic drugs which are often used are: sulfonylureas, metformin, thiazolidinediones, meglitinides, alpha-glucosidase inhibitors, insulin. Advantages and disadvantages of these drugs are discussed in a nutshell. Moreover control of hypertension, CAD risk reduction and practice pearls eg, lifestyle changes and goals setting for HbA(1c) are important.

  12. Drug prescription in the elderly

    Directory of Open Access Journals (Sweden)

    Paola Fuentes

    2013-05-01

    Full Text Available The aging process changes the way in which common drugs act in the elderly. Changes in both the pharmacokinetics and pharmacodynamics make prescribing drugs in geriatrics a process very different from that of the young adult. The aim of this article is to review the physiologic changes that occur with aging and that must be considered when indicating drugs in this age group. For this purpose we conducted a literature review of articles from various journals and textbooks devoted to geriatric medicine in order to extract recommendations for appropriate prescribing in the elderly, represented in easy to use listings of potentially inappropriate medications, according to the quality of evidence and rationale for their avoidance in advanced age.

  13. Unusual headaches in the elderly.

    Science.gov (United States)

    Bamford, Cynthia C; Mays, MaryAnn; Tepper, Stewart J

    2011-08-01

    Prevalence of headache lowers with age, and headaches of elderly adults tend to be different than those of the younger population. Secondary headaches, such as headaches associated with vascular disease, head trauma, and neoplasm, are more common. Also, certain headache types tend to be geriatric disorders, such as primary cough headache, hypnic headache, typical aura without headache, exploding head syndrome, and giant cell arteritis. This review provides an overview of some of the major and unusual geriatric headaches, both primary and secondary.

  14. Exoskeleton plantarflexion assistance for elderly.

    Science.gov (United States)

    Galle, S; Derave, W; Bossuyt, F; Calders, P; Malcolm, P; De Clercq, D

    2017-02-01

    Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms 2 ) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Management of epilepsy in elderly

    OpenAIRE

    Harsono Harsono

    2003-01-01

    Management of epilepsy in elderly requires understanding the unique biochemical and pharmacological characteristics of these patients. Management decisions must be based on accurate classification of seizures or epilepsy syndromes, a thorough neurological assessment to define etiology, and a comprehensive assessment of the patient’s health and living situation. Concomitant illnesses such as neurological, psychiatric, metabolic, or cardiac disorders will require individualization of plans and ...

  16. COCHLEAR IMPLANTATION PREVALENCE IN ELDERLY

    Directory of Open Access Journals (Sweden)

    A. V. Starokha

    2014-01-01

    Full Text Available Current paper describes an experience of cochlear implantation in elderly. Cochlear implantation has become a widely accepted intervention in the treatment of individuals with severe-to-profound sensorineural hearing loss. Cochlear implants are now accepted as a standard of care to optimize hearing and subsequent speech development in children and adults with deafness. But cochlear implantation affects not only hearing abilities, speech perception and speech production; it also has an outstanding impact on the social life, activities and self-esteem of each patient. The aim of this study was to evaluate the cochlear implantation efficacy in elderly with severe to profound sensorineural hearing loss. There were 5 patients under our observation. Surgery was performed according to traditional posterior tympanotomy and cochleostomy for cochlear implant electrode insertion for all observed patients. The study was conducted in two stages: before speech processor’s activation and 3 months later. Pure tone free field audiometry was performed to each patient to assess the efficiency of cochlear implantation in dynamics. The aim of the study was also to evaluate quality of life in elderly with severe to profound sensorineural hearing loss after unilateral cochlear implantation. Each patient underwent questioning with 36 Item Short Form Health Survey (SF-36. SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The eight sections are: physical functioning; physical role functioning; emotional role functioning; vitality; emotional well-being; social role functioning; bodily pain; general health perceptions. Our results demonstrate that cochlear implantation in elderly consistently improved quality of life

  17. Nutritional risk of European elderly.

    Science.gov (United States)

    de Morais, C; Oliveira, B; Afonso, C; Lumbers, M; Raats, M; de Almeida, M D V

    2013-11-01

    The elderly constitute a population group with a high prevalence of non-communicable chronic diseases and high risk of malnutrition. The aim of this study was to identify factors associated to nutritional risk in free-living European elderly. The sample included 644 European citizens, free living in the community, aged 65 years or more. The sample was quota controlled for age groups (65-74, ≥75 years), gender (male/female) and living circumstances (living alone/with others). Logistic regression was performed to identify factors associated with nutritional risk. Several variables regarding socio-demographic characteristics, food choice, health status and the satisfaction with food-related life were included in the analysis. According to the recoded score of the 'Determine your nutritional health' (NSI checklist), 53% of the elderly were at nutritional risk. Nutritional risk was more likely to occur in elderly who considered that it was more important to choose foods 'easy to chew'; with lower average number of fruit and vegetables (F&V) intake episodes and lower score for general health. It was also found in non-married participants; those that did not identify changes in their appetite; and those that felt changes in health status. In this sample, the lowest nutritional risk was found for body mass index (BMI) around 18.5 kg/m(2). Country of residence, gender and age were not found to have a significant effect on nutritional risk. Attention should be drawn to the living circumstances, changes in appetite or health, the general heath perception, F&V intake, choice of foods easy to chew and having a low or high BMI.

  18. Two Principles of good elderly care

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene; Eskelinen, Leena; Boll Hansen, Eigil

    ) which is a possibility for the elderly to choose a private provider. Stressing the self-determination of the elderly and the help provided as service is potentially at odds with one of the existing principles of elderly care, namely the professional principle of help-to-self help. It aims at activating...... the elderly person to manage as much as possible themselves and is based upon a socio-pedagogical culture, where the professional is teaching elderly people about the proper behavior. It’s based upon a formal knowledge of aging and upon different techniques to motivate and involve the elderly....... These are clearly different logics. However, no research has so far studied how these concepts are translated from a national to the municipal level to groups of home helpers and to individual home helpers. And how are these principles played out in different contexts of private firms and public providers...

  19. Colonic Diverticulitis in the Elderly

    Directory of Open Access Journals (Sweden)

    Chien-Kuo Liu

    2009-03-01

    Full Text Available Diverticular disease of the colon is a disease that mainly affects the elderly and presents in 50–70% of those aged 80 years or older. The most common complication is colonic diverticulitis. Eighty percent of patients who present with colonic diverticulitis are aged 50 years and older. Diagnosis and treatment of colonic diverticulitis in the elderly is more difficult and complicated owing to more comorbid conditions. Computed tomography is recommended for diagnosis when colonic diverticulitis is suspected. Most patients admitted with acute colonic diverticulitis respond to conservative treatment, but 15–30% of patients require surgery. Because surgery for acute colonic diverticulitis carries significant rates of morbidity and mortality, conservative treatment is recommended in the elderly. Conservative treatment of colonic diverticulitis with antibiotics, bowel rest, possibly including parenteral alimentation, is usually applied for 1–2 weeks. In the absence of a response to conservative treatment, frequent recurrence or complications (abscesses, fistulas, bowel obstructions, and free perforations, surgery is indicated.

  20. Phenotype and natural history of elderly onset inflammatory bowel disease: a multicentre, case-control study.

    Science.gov (United States)

    Mañosa, M; Calafat, M; de Francisco, R; García, C; Casanova, M J; Huelín, P; Calvo, M; Tosca, J; Fernández-Salazar, L; Arajol, C; Zabana, Y; Bastida, G; Hinojosa, J; Márquez, L; Barreiro-de-Acosta, M; Calvet, X; Monfort, D; Gómez-Garcia, M R; Rodríguez, E; Huguet, J M; Rojas-Feria, M; Hervias, D; Atienza, R; Busquets, D; Zapata, E; Dueñas, C; Charro, M; Martínez-Cerezo, F J; Plaza, R; Vázquez, J M; Gisbert, J P; Cañete, F; Cabré, E; Domènech, E

    2018-03-01

    Onset during old age has been reported in upto 10% of total cases of inflammatory bowel disease (IBD). To evaluate phenotypic characteristics and the use of therapeutic resources in patients with elderly onset IBD. Case-control study including all those patients diagnosed with IBD over the age of 60 years since 2000 who were followed-up for >12 months, identified from the IBD databases. Elderly onset cases were compared with IBD patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of IBD (adult-onset). One thousand three hundred and seventy-four elderly onset and 1374 adult-onset cases were included (62% ulcerative colitis (UC), 38% Crohn's disease (CD)). Among UC patients, elderly onset cases had a lower proportion of extensive disease (33% vs 39%; P < 0.0001). In CD, elderly onset cases showed an increased rate of stenosing pattern (24% vs 13%; P < 0.0001) and exclusive colonic location (28% vs 16%; P < 0.0001), whereas penetrating pattern (12% vs 19%; P < 0.0001) was significantly less frequent. Regarding the use of therapeutic resources, there was a significantly lower use of corticosteroids (P < 0.0001), immunosuppressants (P < 0.0001) and anti-TNFs agents (P < 0.0001) in elderly onset cases. Regarding surgery, we found a significantly higher surgery rate among elderly onset UC cases (8.3% vs 5.1%; P < 0.009). Finally, elderly onset cases were characterised by a higher rate of hospitalisations (66% vs 49%; P < 0.0001) and neoplasms (14% vs 0.5%; P < 0.0001). Elderly onset IBD shows specific characteristics and they are managed differently, with a lower use of immunosuppressants and a higher rate of surgery in UC. © 2018 John Wiley & Sons Ltd.

  1. [Nutrition and frail elderly at risk].

    Science.gov (United States)

    Barrière-Arnoux, Cécile

    2015-01-01

    Good health for elderly people depends on some extent on their nutritional status. During the completion of a master's degree in nursing sciences, a study highlighted the need to develop measuring tools for screening for undernutrition in the elderly in community nursing practice. A programme for raising awareness of the consequences of undernutrition in elderly people is an area to develop through broader frailty screening in primary care.

  2. Elderly victims of abuse: a five year document analysis

    OpenAIRE

    Garbin,Cléa Adas Saliba; Joaquim,Renata Colturato; Rovida,Tânia Adas Saliba; Garbin,Artênio José Isper

    2016-01-01

    Objective To verify the occurrence of maltreatment of the elderly and its characteristics (location, type, reason, involvement of alcohol/drugs, profile and family relationship of victims and perpetrators) from the police records of a specialized police station over a five year period. Method A cross-sectional, descriptive and documentary analytical study was performed. The police reports of a medium-sized municipality in the northwest of São Paulo were analyzed from 2008 to 2012. The sociod...

  3. Epidemiological profile of elderly women with burning mouth symptoms

    Directory of Open Access Journals (Sweden)

    Maria Vieira de Lima Saintrain

    2011-09-01

    Full Text Available Objective: To determine the epidemiological profile of elderly women with burning mouth symptoms. Methods: A cross sectional, quantitative, exploratory and descriptive study conducted in two phases: a determining the prevalence of burning mouth symptoms among 263 elderly women aged between 60 and 83 years who attended six public municipal community centers in Fortaleza-CE, Brazil, b defining the epidemiological profile of respondents with burning mouth symptoms, through the variables: self-reported diseases, salivary flow, use of medications, dental prosthesis and oral hygiene habits. Data were organized by the Statistical Package for Social Sciences - SPSS version 15. Results: The prevalence of burning mouth symptoms in the group was 19% (n=50. Of these, 41 (82.0% reported the manifestation of the symptoms as a scalding sensation. Regarding the occurrence, the most referred sites were: tongue (48%; n=24 and gums (22%; n=11. Among elderly women, 24 (48.0% had daily symptoms. Regarding self-reported diseases and habits: 80.0% cited cardiovascular diseases, 74.0% (n=37 musculoskeletal illness and 62.0% (n=31 neurological disorders, besides 56.0% (n=28 present reduction of salivary flow; 70.0% (n=35 took medication, 66.0% (n=33 were users of dental prosthesis and 18.0% (n=9 did not brush their teeth. Conclusions: The prevalence of burning mouth symptoms in this group was 19%; scalding sensation was the main manifestation of the symptom and the tongue was the site of major symptomatology. The epidemiological profile of symptomatic elderly was distinguished by self-reported diseases and habits such as cardiovascular, musculoskeletal and neurological disorders, in addition to reduced salivary flow, as well as the use of medications and dental prosthesis.

  4. Clostridium difficile infection in the elderly: an update on management

    Directory of Open Access Journals (Sweden)

    Asempa TE

    2017-10-01

    Full Text Available Tomefa E Asempa, David P Nicolau Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA Abstract: The burden of Clostridium difficile infection (CDI is profound and growing. CDI now represents a common cause of health care–associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care–associated CDIs occur in patients 65 years or older. Additionally, the elderly are at higher risk for recurrent CDI. Existing therapeutic options include metronidazole, oral vancomycin, and fidaxomicin. Choice of agent depends on disease severity, history of recurrence, and, increasingly, the drug cost. Bezlotoxumab, a recently approved monoclonal antibody targeting C. difficile toxin B, offers an exciting advancement into immunologic therapies. Similarly, fecal microbiota transplantation is gaining popularity as an effective option mainly for recurrent CDI. The challenge of decreasing CDI burden in the elderly involves adopting preventative strategies, optimizing initial treatment, and decreasing the risk of recurrence. Expanded strategies are certainly needed to improve outcomes in this high-risk population. This review considers available data from prospective and retrospective studies as well as case reports to illustrate the merits and gaps in care related to the management of CDI in the elderly. Keywords: Clostridium difficile, recurrence, risk factors, elderly, aging, treatment, bezlotoxumab, fecal microbiota transplant

  5. Factors associated with polypharmacy in elderly home-care patients.

    Science.gov (United States)

    Komiya, Hitoshi; Umegaki, Hiroyuki; Asai, Atsushi; Kanda, Shigeru; Maeda, Keiko; Shimojima, Takuya; Nomura, Hideki; Kuzuya, Masafumi

    2018-01-01

    Polypharmacy, which is often observed in elderly patients, has been associated with several unfavorable outcomes, including an increased risk of potentially inappropriate medications, medication non-adherence, drug duplication, drug-drug interactions, higher healthcare costs and adverse drug reactions. A significant association between polypharmacy and adverse outcomes among older people living in the community has also been confirmed. A reduction in the number of medications should thus be pursued for many older individuals. Nevertheless, the factors associated with polypharmacy in elderly home-care patients have not been reported. Here, we investigated those factors in elderly home-care patients in Japan. We used the data of the participants in the Observational Study of Nagoya Elderly with Home Medical investigation. Polypharmacy was defined as the current use of six or more different medications. We carried out univariate and multivariate logistic regression analyses to assess the associations between polypharmacy and each of several factors. A total of 153 home-care patients were registered. The mean number of medications used per patient was 5.9, and 51.5% of the patients belonged to the polypharmacy group. The multivariate model showed that the patients' scores on the Charlson Comorbidity Index and the Mini-Nutrition Assessment Short Form were inversely associated with polypharmacy, and potentially inappropriate medication was most strongly associated with polypharmacy (odds ratio 4.992). The present findings showed that polypharmacy was quite common among the elderly home-care patients, and they suggest that home-care physicians should prescribe fewer medications in accord with the deterioration of home-care patients' general condition. Geriatr Gerontol Int 2018; 18: 33-41. © 2017 Japan Geriatrics Society.

  6. Theories and measures of elder abuse.

    Science.gov (United States)

    Abolfathi Momtaz, Yadollah; Hamid, Tengku Aizan; Ibrahim, Rahimah

    2013-09-01

    Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

  7. PHARMACOTHERAPY IN ELDERLY NEUROPATHIC PAIN

    Directory of Open Access Journals (Sweden)

    Thomas Eko P

    2013-10-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The incidence of pain increases with age. Neuropathic pain are common in elderly patients and pose challenges in both their diagnosis and treatment. The most common neuropathic pain in elderly are radiculopathy due to foraminal or spinal stenosis, diabetic neuropathy, and postherpetic neuralgia. Pain in the elderly is often unrecognized and undertreated. The main problem with pain in older adults relates to impaired quality of life secondary to pain which may be expressed by depression (including increased suicide risk, anxiety, sleep disruption, appetite disturbance, and weight loss, cognitive impairment, and limitations in the performance of daily activities. Pain management in elderly patients requires a different perspective from that of younger patients. Causes, comorbidities, and responses to both pain and its treatment differ between young healthy and older patients. Effective pain management in elderly patients should include both pharmacologic and nonpharmacologic strategies. Pharmacological approaches are the first line of pain management in older person for neuropathic pain. Pharmacologic strategies call for administration of nonopioid analgesics, opioid analgesics, and adjuvant medication. Polypharmacy, drug-drug and drug-disease interactions, age-associated changes in drug metabolism, and the high frequency of adverse drug reactions need to be carefully considered in using medications in this population /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso

  8. Sobriety and alcohol use among rural Alaska Native elders

    Directory of Open Access Journals (Sweden)

    Monica C. Skewes

    2016-02-01

    Full Text Available Background: Although notable health disparities related to alcohol use persist among Alaska Native people living in rural communities, there is a paucity of research examining drinking behaviour in particular segments of this population, including elders. One explanation for this is the distrust of behavioural health research in general and alcohol research in particular following the legacy of the Barrow Alcohol Study, still regarded as a notable example of ethics violations in cross-cultural research. Objective: The present study reports findings from one of the first research studies asking directly about alcohol abuse among rural Alaska Natives (AN since the study in Barrow took place in 1979. Design: We report findings regarding self-reported alcohol use included in an elder needs assessment conducted with 134 Alaska Native elders from 5 rural villages off the road system in Alaska. Data were collected in partnership between academic researchers and community members in accordance with the principles of Community-Based Participatory Research. Results: Findings showed very high rates of sobriety and low rates of alcohol use, contradicting stereotypes of widespread alcohol abuse among AN. Possible explanations and future research directions are discussed. Conclusions: This research represents one step forward in mending academic–community relationships in rural Alaska to further research on alcohol use and related health disparities.

  9. Rates of renal transplantations in the elderly-data from Europe and the US

    DEFF Research Database (Denmark)

    Sørensen, Søren Schwartz

    2015-01-01

    document a substantial increase in proportion of elderly transplant recipients (65+ years) from 4.2% in 1990 to 17.2% in 2012 and an increase in proportion of prevalent elderly renal transplant patients from 3.8% in 1992 to 23.3% in 2012. Similar changes have been seen in Europe. Due to these alterations......The demography in most part of the world is changing with an increasing proportion of elderly persons. This is expected to reflect demography of patients accepted for renal replacement therapy both in the form of dialysis and transplantation. Based on this, the intention of the present review...... is to collect and describe available data on rates of transplantation with focus on the elderly patients in both Europe and the US. Data were collected from available sources including activity reports from national and supranational registries on uremia, organ procurement, waiting lists, and transplantations...

  10. Biopsychosocial Characteristics, Using a New Functional Measure of Balance, of an Elderly Population with CLBP

    Directory of Open Access Journals (Sweden)

    Ryan Hulla

    2016-08-01

    Full Text Available This study examined the biopsychosocial characteristics of chronic low back pain (CLBP in an understudied but increasingly larger part of the population: the elderly (i.e., 65 years and older. A new innovative physical functioning measure (postural control, which is a proxy for the common problem of slips and falls in the elderly was part of this biopsychosocial evaluation. Also, the National Institutes of Health (NIH-developed Patient-Reported Outcome Measurement Information System (PROMIS was also part of this comprehensive evaluation. Two demographically-matched groups of elderly participants were evaluated: one with CLBP (n = 24; and the other without (NCLBP, n = 24. Results revealed significant differences in most of these measures between the two groups, further confirming the importance of using a biopsychosocial approach for future studies of pain and postural control in the elderly.

  11. Systematization of nursing care to institutionalized elderly based on Virginia Henderson

    Directory of Open Access Journals (Sweden)

    Jorge Wilker Bezerra Clares

    2013-07-01

    Full Text Available This is an experience report that aims to describe the application of the nursing process to an institutionalized elderly, based on Virginia Henderson’s theory. The case study was developed in a long-stay institution for the elderly in Fortaleza, Ceará, Brazil, from May to August 2010, by filling out a form, physical examination and observation. Identifying the needs of elimination, communication, recreation and learning allowed to raise the nursing diagnoses, respectively: urge urinary incontinence; impaired social interaction; diversional activity deficit; and impaired memory. The nursing interventions were directed to the health and independence of the elderly. The application of systematic nursing care impacted positively on the health of the elderly, demonstrating the applicability of the nursing systematization based on Henderson’s theory in the scenery in which the study was developed.

  12. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study

    OpenAIRE

    Chu, Jiao-Jiao; Chen, Xu-Jiao; Shen, Shan-Shan; Zhang, Xue-Feng; Chen, Ling-Yan; Zhang, Jing-Mei; He, Jing; Zhao, Jun-Feng

    2015-01-01

    Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients (age 79.5 ? 6.7 years, male 63.8%) were recruited to the study. Comprehensive g...

  13. Rotationplasty in the Elderly

    Directory of Open Access Journals (Sweden)

    Jendrik Hardes

    2008-01-01

    Full Text Available Purpose. Rotationplasty has proven its efficacy in the treatment of malignant bone tumors of the lower extremity in predominantly young patients. To our knowledge this procedure has not been reported in patients over 60 years before. Materials and Methods. 3 patients over 60 years with an A1-rotationplasty because of a sarcoma were included in this study. Complications and functional results were recorded. In one patient an electromyography was done. Results. Despite electromyography showing good adaptation of the muscles to the altered function, the functional results of these three patients were limited. two out of three patients needed a cane for walking distances over 200 meters. No secondary amputation was necessary. Discussion. Our study demonstrates that rotationplasty is an alternative to an above-knee amputation in older patients but with poorer functional results in comparison to younger patients. However, limb-salvage surgery should be preferred whenever possible.

  14. Poor financial support and lack of knowledge, and neglect among female elders who lived in extended families

    Directory of Open Access Journals (Sweden)

    Setho Hadisuyatmana

    2016-11-01

    Full Text Available Introduction: Elder neglect remains as unreported case that involved old women in Ampenan West Nusa Tenggara. Despite the paucity of evidence to report the significance, an earlier pilot study showed that elders who lived with their family in Ampenan were found dirty, skin dry, and malnourished. The purpose of this study was to explore the correlating factors to the unreported cases of neglect among these elders. Method: This study was a cross sectional conducted using analytic descriptive approach. Thirty-four extended families lived with female elders in the working area of Puskesmas Ampenan were purposively involved as participants to this study. Family’s awareness of abuse was collected using a questionnaire developed based on Elder Abuse Instrument component checklist and the suspicion to neglect among the elders were collected using the 13-item checklist from Elder Abuse Instrument. The data were then analyzed using Spearman’s rho (α ≤ 0,05. Result:  The results show that family’s lack of knowledge has a strong correlation with elder neglect (p= 0,000 with r= 0,643. Discussion: The analysis to this finding suggests that not only were the families lack of knowledge, but they were also being burden by the poor economic situation that trigger the unnecessary neglect to their female elders. These results abridge the paucity of evidence to explain the correlating factors with the incidence of elder abuse in eastern Indonesia. Further research is necessary to explain the size and the impact of neglect toward the elders. It is suggested that local department of health, Puskesmas and health professionals to educate the community as the first step to improve the elders’ quality of life and promote healthy ageing.

  15. The Effectiveness of a Multidisciplinary Group Rehabilitation Program on the Psychosocial Functioning of Elderly People Who Are Visually Impaired

    NARCIS (Netherlands)

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Suurmeijer, Theodorus; van der Mei, Sijrike F.

    2013-01-01

    Introduction: The pilot study reported here determined the effectiveness of a multidisciplinary group rehabilitation program, Visually Impaired Elderly Persons Participating (VIPP), on psychosocial functioning. Methods: The single-group pretest-posttest pilot study included 29 persons with visual

  16. The secure base script and the task of caring for elderly parents: implications for attachment theory and clinical practice.

    Science.gov (United States)

    Chen, Cory K; Waters, Harriet Salatas; Hartman, Marilyn; Zimmerman, Sheryl; Miklowitz, David J; Waters, Everett

    2013-01-01

    This study explores links between adults' attachment representations and the task of caring for elderly parents with dementia. Participants were 87 adults serving as primary caregivers of a parent or parent-in-law with dementia. Waters and Waters' ( 2006 ) Attachment Script Assessment was adapted to assess script-like attachment representation in the context of caring for their elderly parent. The quality of adult-elderly parent interactions was assessed using the Level of Expressed Emotions Scale (Cole & Kazarian, 1988 ) and self-report measures of caregivers' perception of caregiving as difficult. Caregivers' secure base script knowledge predicted lower levels of negative expressed emotion. This effect was moderated by the extent to which participants experienced caring for elderly parents as difficult. Attachment representations played a greater role in caregiving when caregiving tasks were perceived as more difficult. These results support the hypothesis that attachment representations influence the quality of care that adults provide their elderly parents. Clinical implications are discussed.

  17. Idosos vacinados e não vacinados contra a influenza: morbidade relatada e aspectos sociodemográficos, Porto Alegre (RS, Brasil, 2004 Influenza-vaccinated and non-vaccinated elderly: reported morbidity and sociodemographic aspects, Porto Alegre (RS, Brazil, 2004

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Müller Vilarino

    2010-09-01

    analysis of the 1,130 elderly interviewed was quite interesting even not being possible to infer it regarding the universe of the elderly population from Porto Alegre. We found a higher proportion of vaccinated people in the age group of 70 to 79 years old (42%, and a prevalence of non-vaccinated among the age group of 60 to 64 years old (40%. The vaccinated elderly were mostly older; female, who have private health care insurance; with higher income; that perform physical activities and non-smokers. The non-vaccinated were mostly men; younger; with lower income; that do not perform physical exercises; and smoke. A lower percentage of pneumonias reports and hospital admittances was observed among the vaccinated in comparison to the non-vaccinated people.

  18. Socioeconomic inequality of overweight and obesity of the elderly in Iran: Bushehr Elderly Health (BEH) Program.

    Science.gov (United States)

    Raeisi, Alireza; Mehboudi, Mohammadbagher; Darabi, Hossein; Nabipour, Iraj; Larijani, Bagher; Mehrdad, Neda; Heshmat, Ramin; Shafiee, Gita; Sharifi, Farshad; Ostovar, Afshin

    2017-01-13

    The objective of this population-based, large sample size study was to investigate the socioeconomic inequality of overweight and obesity among the elderly in Iran. Baseline data of 3000 persons aged ≥60 years who participated in the Bushehr Elderly Health (BEH) program was analyzed. Overweight and obesity were defined as a body mass index (BMI) equal to or higher than 25 and 30, respectively. Socioeconomic status (SES) was measured by an asset index, constructed using principal component analysis, income, education level, and employment status. The Concentration Index and the Lorenz curve were used to illustrate the levels of inequality for overweight and obesity by gender. The frequencies among men and women were, respectively, 840 (57.7%) and 1131 (73.2%), P < 0.001, for overweight, and 211 (14.7%) and 511 (33.7%), P < 0.001, for obesity. There were direct associations between asset index quintiles and both overweight and obesity among both genders (Ps for trend <0.01) except for obesity among men (P for trend = 0.118). The overall Concentration Indices for overweight and obesity were 0.031 (95%CI = 0.016-0.046, P < 0.001) and 0.041 (95%CI = 0.004-0.078, p = 0.028), respectively. Findings support the direct relationship between SES and obesity among women as previously reported in developing countries.

  19. Depressive symptoms in elderly participants of an open university for elderly

    Directory of Open Access Journals (Sweden)

    Samila Sathler Tavares Batistoni

    Full Text Available Abstract Although the prevalence of depressive disorders among the elderly is lower than among the younger population, the presence of significant symptoms of depression is common in this group. Studies report that participation in social, educational and leisure activities is related to fewer depressive symptoms in this population. Objective: The aim of this study was to examine the prevalence of depression among elderly participants of an Open University for the Third Age, in terms of the time studying. Methods: The study had a cross-sectional design and the participation of 95.2% (n=184 of total enrollers in the first half of 2010 on the activities of the Third Age Open University's School of Arts, Sciences and Humanities of the University of São Paulo. All participants answered a socio-demographic questionnaire and the Geriatric Depression Scale (GDS-15. Results: An association between studying time of over one semester at the University of the Third Age and a lower rate of depressive symptoms, was observed. Conclusion: Study time of over one semester was associated with less depressive symptoms, acting as a possible protective factor against depression.

  20. Oropharyngeal cancer in the elderly

    International Nuclear Information System (INIS)

    Chin, Rebecca; Fisher, Richard J.; Smee, Robert I.; Barton, Michael B.

    1995-01-01

    Purpose: The poor prognosis of elderly patients in many cancers may be due to less thorough investigation and less aggressive treatment because of the perception that radical treatment will be poorly tolerated and that elderly patients have a limited life expectancy. We wished to assess whether older age is associated with (a) less radical treatment, (b) poorer outcome, or (c) greater toxicity, after adjusting for other possible contributing factors. Methods and Materials: A retrospective study of patients with loco-regional oropharyngeal cancer treated between January 1980 and December 1985 was conducted. Patients were treated with radiotherapy, surgery, chemotherapy, or combinations. Cox regression was used to assess age effects while allowing for the influence of other factors. Results: Eighty-eight patients were treated radically and 16 palliatively. Treatment intent (radical or palliative) did not appear to be related to age, before (p 0.42) or after adjusting for other factors (p = 0.34). In a selected group of 86 radically treated patients ages ranged from 33 to 85 (median 60). There were 35 loco-regional failures and 58 deaths (38 related to oropharyngeal cancer). Older patients were prescribed and received lower doses of radiation. However, older age was not related to the risk of loco-regional recurrence (p = 0.96) or shorter survival (p = 0.67), and was not associated with duration of treatment interruption or severity of toxicity after adjustment for prognostic factors. There was some suggestion of a higher risk of recurrence with increasing age for patients under 70 years but with a risk for patients over 70 at least equal to that of the youngest group. Elderly patients in our study may have been a selected group. Conclusion: Older patients with loco-regional oropharyngeal cancer, or at least a subset of them, appear to be able to tolerate radical courses of radiotherapy, and to have similar outcomes as do younger patients

  1. [Transient amnesia in the elderly].

    Science.gov (United States)

    Sellal, François

    2006-03-01

    The two main aetiologies of transient amnesia in the elderly are idiopathic transient global amnesia (TGA) and iatrogenic or toxic amnesia. Vascular and epileptic amnesia are less common. According to the literature, transient psychogenic amnesia, which is a frequent cause of amnesia at age 30 to 50, is very rare in the elderly. TGA is the prototypical picture of transient amnesia. It occurs more often after age 50, with no identified cause, even if some authors accept emotional stress or minor head trauma as occasional precipitants. The mechanism of TGA remains a matter of discussion. It may be the consequence of a spreading depression similar to that described in migraine with aura, but other arguments support an ischemic mechanism. Iatrogenic amnesias are mainly caused by benzodiazepines (BZs) or anticholinergics. The former may occur in a non-anxious subject, who is not a usual consumer of BZ and takes a single dose. The latter are more often due to a hypersensitivity to anticholinergic drugs, in particular in patients presenting with a covert, incipient Alzheimer's disease. A vascular origin must be considered when amnesia is accompanied by other neurological symptoms, and when the regression of the amnesic disorder is slow, lasting several days. It results from lesions involving various mechanisms and locations, mainly subcortical. Partial seizures, most often mesio-temporal, more rarely frontal, may be the cause of transient amnesia in the elderly, in the absence of a past history of epilepsy. The red flag supportive of an epileptic origin is the repetition of stereotyped amnesic episodes. EEG demonstration of seizures may be difficult and the response to antiepileptic drugs effective on partial seizures is usually good.

  2. Cognitive Changes among Institutionalized Elderly People

    Science.gov (United States)

    Navarro, Jose I.; Menacho, Inmaculada; Alcalde, Concepcion; Marchena, Esperanza; Ruiz, Gonzalo; Aguilar, Manuel

    2009-01-01

    The efficiency of different cognitive training procedures in elderly people was studied. Two types of methods to train cognitive and memory functions were compared. One method was based on new technologies and the other one on pencil-and-paper activities. Thirty-six elderly institutionalized people aged 68-94 were trained. Quantitative and memory…

  3. Social innovation in public elder care

    DEFF Research Database (Denmark)

    Bilfeldt, Annette; Andersen, John

    2013-01-01

    The chapter addresses the role of action research in social innovation related to elder care work at public nursing homes in Denmark. It is shown how critical utopian action research can contribute to the development of humanity in elder care to the benefit of the residents life quality...

  4. Pathophysiologic Response to Burns in the Elderly

    Directory of Open Access Journals (Sweden)

    Marc G. Jeschke

    2015-10-01

    Full Text Available Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50 burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p  0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly.

  5. Helicobacter Pylori Infection in the Elderly

    Directory of Open Access Journals (Sweden)

    Jyh-Ming Liou

    2008-12-01

    Full Text Available The elderly often seek medical attention because of gastroduodenal diseases. Helicobacter pylori (H. pylori infection is associated with several gastroduodenal diseases and its prevalence increases with age worldwide. It is estimated that 10–15% of infected patients will have peptic ulcer disease and 1% of patients will have gastric cancer or mucosa-associated lymphoid tissue lymphoma. Notably, the most severe clinical outcomes, i.e., gastric cancer and complicated peptic ulcer diseases, usually occur in elderly patients. Thus the test-and-treatment strategy is not recommended for elderly patients with uninvestigated dyspepsia. However, biopsy specimens for the rapid urease test and histology should be taken from both the antrum and corpus to increase the detection rate in elderly patients, especially in those with atrophic gastritis. The urea breath test may increase the detection rate if the rapid urease test or histology are negative in elderly patients with atrophic gastritis. Standard triple therapy and sequential therapy can achieve satisfactory eradication rates for H. pylori in elderly patients. Elderly patients with peptic ulcers may have a similar benefit from treatment of H. pylori infection as non-elderly patients. Eradication of H. pylori infection may also lead to improvement in histologic grading of gastritis, but the risk of gastric cancer cannot be completely reduced, especially in patients with existing premalignant lesions.

  6. Relational agency in elderly care work

    DEFF Research Database (Denmark)

    Tuominen, Tiina; Fuglsang, Lars; Hasu, Mervi

    In this paper, we aim to understand how elderly care work is changing alongside the introduction of new co-creative frameworks and practices. The ideas of value co-creation and service co-production are expanding rapidly to new service areas also in the public sector. The elderly care context may...

  7. Participation of the elderly after vision loss

    NARCIS (Netherlands)

    Alma, M.A.; Mei, van der S.F.; Melis-Dankers, B.J.M.; Tilburg, van T.G.; Groothoff, J.W.; Suurmeijer, T.P.B.M.

    2011-01-01

    Purpose. To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. Method. This cross-sectional study included visually impaired elderly persons (≥55 years; n=173) who were referred to a low-vision rehabilitation centre.

  8. Erythrocyte seditnentation rate in elderly blacks

    African Journals Online (AJOL)

    Abstract This study inv~tigated the erythrocyte sedimen- tation rate (ESR) in an elderly population with the objective of establishing reference ranges and the diagnostic value of the ESR. Elderly blacks were randomly selected frOIn conununities in the. Orange Free State. ESR determinations were done according to the ...

  9. A Community Response to Elder Abuse.

    Science.gov (United States)

    Foelker, George A., Jr.; And Others

    1990-01-01

    Discusses how Dallas, Texas, Area Agency on Aging met requirement of 1987 amendments to Older Americans Act of 1965 that State Offices on Aging identify agencies involved in identifying and treating abused, neglected, and exploited elders and determine their need for services. Describes impact of Elder Abuse Task Force on state law, adult…

  10. Elder Abuse in American Indian Communities

    Science.gov (United States)

    Anisko, Briana

    2009-01-01

    Although the many American Indian tribes of the United States are unique in their own customs, languages, and histories, a common thread throughout their traditions and cultural lifestyles is that they are of a culture that reveres the elder in their communities. Elders are the carriers of the culture/history; they are the storytellers, holders of…

  11. Perspectives on elder abuse in the Netherlands

    NARCIS (Netherlands)

    Mysyuk, Yuliya

    2015-01-01

    This thesis explores perceptions and views of different groups involved in elder abuse. First chapter provides a general introduction to the topic and current study. In the second chapter of this thesis, definitions of elder abuse and their developments are reviewed. Chapter three explores different

  12. [Male sexuality in the elderly].

    Science.gov (United States)

    Rinnab, L; Schrader, A J; Schrader, M; Zengerling, F

    2012-10-01

    Male sexuality in the elderly is an important issue with a growing relevance. In contrast to the assumption of an asexual state when becoming older, recent representative surveys show that the majority of men maintain sexual desires and fantasies into old age. Sexual activity primarily depends on the availability of a partner and on maintaining intimacy and sexuality in the face of changes in the sexual response cycle and increasing comorbidity. This review aims to clarify the normal aging process, the sexual behavior of aging males and the prevalence of sexual dysfunction.

  13. [Personality disorders in the elderly].

    Science.gov (United States)

    Saarela, Tuula; Stenberg, Jan-Henry

    2011-01-01

    The diagnostic assessment of old age personality disorders is challenging. Medical illnesses and cognitive impairment may influence the clinical symptoms. Common elements of effective approaches such as building a collaborative relationship and maintaining consistency as well as structured framework of treatment can be tailored to the problems of a patient. Pharmacological treatment guidelines of personality disorders need to be individually applied to elderly persons. Comorbid depression is often the primary symptom seen and needs to be treated. Psychiatry should take steps to promote effective treatments and provide support and clinical supervision to health staff treating these individuals.

  14. Atrial fibrillation in the elderly

    Science.gov (United States)

    Franken, Roberto A.; Rosa, Ronaldo F.; Santos, Silvio CM

    2012-01-01

    This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted. PMID:22916053

  15. Radiation therapy in elderly patients

    International Nuclear Information System (INIS)

    Durdux, C.; Boisserie, T.; Gisselbrecht, M.

    2009-01-01

    Cancer is a disease that predominantly occurs in older patients who represent a quarter of the population in western countries. Numerous types of cancer are observed in elderly people. Radiotherapy is one of the most powerful treatment against cancer. Most of published studies have demonstrated feasibility of radiotherapy in curative or palliative intent whatever cancer types are considered. Complete geriatric assessment and a multidisciplinary approach are the key points. The purpose of this review is to highlight sights of radiation oncology specifically related to aging. Particular emphasis is placed on logistic and technical aspects of radiation, as dose, irradiated volume and fractionation. (authors)

  16. Substituted decision making: elder guardianship.

    Science.gov (United States)

    Leatherman, Martha E; Goethe, Katherine E

    2009-11-01

    The goal of this column is to help experienced clinicians navigate the judicial system when they are confronted with requests for capacity evaluations that involve guardianship (conservatorship). The interface between the growing elderly medical population and increasing requests for substituted decision making is becoming more complex. This column will help practicing psychiatrists understand the medical, legal, and societal factors involved in adult guardianship. Such understanding is necessary in order to effectively perform guardianship evaluations and adequately inform courts, patients, and families about the psychiatric diagnoses central to substituted decision making.

  17. Comparative study of adverse events after yellow fever vaccination between elderly and non-elderly travellers: questionnaire survey in Japan over a 1-year period.

    Science.gov (United States)

    Tanizaki, Ryutaro; Ujiie, Mugen; Hori, Narumi; Kanagawa, Shuzo; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Kato, Yasuyuki; Ohmagari, Norio

    2016-03-01

    A live attenuated yellow fever (YF) vaccination is required of all travellers visiting countries where YF virus is endemic. Although the risk of serious adverse events (AEs) after YF vaccination is known to be greater in elderly people than in younger people, information about other AEs among elderly travellers is lacking. A prospective observational questionnaire study was conducted to investigate the occurrence of AEs after YF vaccination in travellers who attended a designated YF vaccination centre in Tokyo, Japan, from 1 November 2011 to 31 October 2012. A questionnaire enquiring about any AEs experienced in the 2 weeks following YF vaccination was distributed to all vaccinees enrolled in this study, and responses were collected subsequently by mail or phone. For child vaccinees, their parents were allowed to respond in their stead. Of the 1298 vaccinees who received the YF vaccine, 1044 (80.4%) were enrolled in the present study and 666 (63.8%) responded to the questionnaire. Of these 666 respondents, 370 (55.6%) reported AEs, of which 258 (38.7%) were systemic and 230 (34.5%) were local. No severe AEs associated with YF vaccination were reported. Elderly vaccinees (aged ≥60 years) reported fewer total AEs than those aged yellow vaccination reported among elderly vaccinees than among non-elderly vaccinees. These results could provide supplementary information for judging the adaptation of vaccination in elderly travellers. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  18. Rating the elderly with terminal cancer disease

    International Nuclear Information System (INIS)

    Riveros Rios, M.

    2012-01-01

    with bone metastasis of lung cancer progression and no response to chemotherapeutic treatment • Less than half of older women terminalidad presented some criteria to be among the most frequent relapse breast cancer and breast cancer with widespread metastatic bone and liver and no response to treatment, cancer Systemic relapse colon • The completion of the comprehensive geriatric Ranking in older adults of both sexes in terminal stage was verified that the Rating physical took place in more than half, almost a quarter functional assessment was performed in less than one quarter the mental assessment was performed, psychological and social • In older adults with criteria or terminally ill hospice bring accurate indication bypass had the same in less than half • Symptoms reported in the medical history who presented the elderly with end-stage disease were by frequencies: pain almost half of patients, constipation, anorexia and nausea / vomiting in nearly a quarter of patients, dyspne a, fatigue, and dysphagia in one fifth of patients and insomnia represents just three patients. • The pharmacological management mentioned in the medical history of the symptoms presented was: For pain alone or in combination: use of opioids (morphine, codeine, tramadol)almost a little over a quarter, NSAIDs on a quarter of patients and others (paracetamole, gabapentin)less than a fifth For nausea and / or vomiting: metaclopramide less than a fifth, ondansetron and haloperidol was not used in only two patients For dyspne a or as adjuvant pain: steroids in one quarter of patients For constipation: laxatives in one quarter of patients For anxiety: short-acting benzodiazepine only in 3 patients To stimulate appetite: steroids / medroxyprogesterone or cyproheptadine only two patients • The associated co morbidities, we found a frequency of: Hypertension nearly half of the patients, type 2 Diabetes Mellitus fifth pulmonary emphysema, kidney failure and heart disease in less than one

  19. [Frailty, disability and multi-morbidity: the relationship with quality of life and healthcare costs in elderly people].

    Science.gov (United States)

    Lutomski, Jennifer E; Baars, Maria A E; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

    2014-01-01

    To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people. Cross-sectional, descriptive study. Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models. A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation. Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.

  20. [Family functioning of elderly with depressive symptoms].

    Science.gov (United States)

    Souza, Rosely Almeida; Desani da Costa, Gislaine; Yamashita, Cintia Hitomi; Amendola, Fernanda; Gaspar, Jaqueline Correa; Alvarenga, Márcia Regina Martins; Faccenda, Odival; Oliveira, Maria Amélia de Campos

    2014-06-01

    To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

  1. [Diagnosis of gastric ulcer in the elderly].

    Science.gov (United States)

    Ashida, Kiyoshi; Fukuchi, Takumi; Yamashita, Hiroshi

    2010-11-01

    It is well known that gastric ulcers are most often found at anglus and upper corpus in the elderly. The number of gastric ulcer found at upper corpus hold half of all cases in the elderly patients with bleeding ulcer. Sixty percent of the elderly patients with bleeding ulcer took NSAIDs including low-dose aspirin in authors' hospital. Now it is easy to treat and cure bleeding ulcers due to development of endoscopic hemostasis and antiulcer drugs such as proton pump inhibitor(PPI). However, the elderly patients sometimes result in fatal outcome on bleeding from gastric ulcer. Therefore, it is important to prevent ulcer complications by PPI for the high-risk group such as elderly patients taking NSAIDs.

  2. Bacterial Pneumonia in Elderly Japanese Populations

    Directory of Open Access Journals (Sweden)

    Naoya Miyashita

    2018-01-01

    Full Text Available Bacterial pneumonia is one of the most important infectious diseases in terms of incidence, effect on quality of life, mortality, and impact on society. Pneumonia was the third leading cause of death in Japan in 2011. In 2016, 119 650 Japanese people died of pneumonia, 96% of whom were aged 65 years and above. The symptoms of pneumonia in elderly people are often atypical. Aspiration pneumonia is seen more frequently than in young people because of swallowing dysfunction in the elderly. The mortality rate is also higher in the elderly than in young people. In Japan, the population is aging at an unprecedented rate, and pneumonia in the elderly will be increasingly important in medicine and medical economics in the future. To manage pneumonia in the elderly, it is important to accurately evaluate its severity, administer appropriate antibiotic treatment, and implement effective preventive measures.

  3. Family functioning of elderly with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Rosely Almeida Souza

    2014-06-01

    Full Text Available Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms. The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

  4. Valoración geriátrica global del anciano por los servicios de urgencias extrahospitalarias: Caso clínico Comprehensive geriatric assessment of elderly for outpatient emergency services: Case report

    Directory of Open Access Journals (Sweden)

    Javier Fernández Eito

    2012-12-01

    Full Text Available El progresivo envejecimiento de la población española conlleva un aumento de la atención sanitaria, por los servicios de urgencias extrahospitalarias (SUE, a este grupo de edad. El objetivo de este trabajo es evidenciar la importancia de realizar una valoración global del anciano en el contexto domiciliario y comunitario, que contemple tanto los aspectos físicos como los psicosociales y ambientales de la persona en situación de urgencia. Para ello, se desarrolla un caso clínico, que se apoya en la evidencia científica, para determinar la actuación más adecuada que mejore las intervenciones de los servicios de urgencias extrahospitalarias. El análisis del caso se estructura en tres apartados: la valoración de enfermería, el registro de los datos y la transmisión de la información a otros equipos de salud. Como conclusión, se identifica la necesidad de valorar y registrar datos sobre el estado físico y fisiológico del anciano al mismo tiempo que se recoge información sobre su contexto familiar, comunitario o ambiental, para proporcionar unos cuidados integrales y de calidad. Asimismo, se recomienda el desarrollo de herramientas de valoración geriátrica específicas para utilizar en situaciones de urgencias extrahospitalarias.The progressive aging of the Spanish population leads to increased health care for Outpatient Emergency Services (EUS, in this age group. The aim of this paper is to highlight the importance of an overall assessment of the elderly in the household and community context, which involves both the physical and psychosocial in the emergency environmental. To do this, we develop a clinical case, which is based on scientific evidence, to determine the most appropriate action to improve interventions in emergency services. The case analysis is divided into three sections: nursing assessment, data recording and transmission of information to other health teams. In conclusion, it identifies the need to assess and

  5. Risk of yellow fever vaccine-associated viscerotropic disease among the elderly: a systematic review.

    Science.gov (United States)

    Rafferty, Ellen; Duclos, Philippe; Yactayo, Sergio; Schuster, Melanie

    2013-12-02

    Yellow fever vaccine-associated viscerotropic disease (YEL-AVD) is a rare and serious adverse event of the yellow fever (YF) vaccine that mimics wild-type YF. Research shows there may be an increased risk of YEL-AVD among the elderly population (≥ 60-65 years old), however this research has yet to be accumulated and reviewed in order to make policy recommendations to countries currently administering the YF vaccine. This paper systematically reviewed all information available on YEL-AVD to determine if there is an increased risk among the elderly, for both travelers and endemic populations. Age-specific reporting rates (RRs) were re-calculated from the literature using the Brighton Collaboration case definition for YEL-AVD and were then analyzed to determine if there was a significant difference between the RRs of younger and older age groups. Two out of the five studies found a significantly higher rate of YEL-AVD among the elderly population. Our findings suggest unexposed elders may be at an increased risk of developing YEF-AVD, however the evidence remains limited. Therefore, our findings for YF vaccination of elderly populations support the recommendations made by the Strategic Advisory Group of Experts (SAGE) in their April 2013 meeting, mainly vaccination of the elderly should be based on a careful risk-benefit analysis. Copyright © 2013 World Health Organization (WHO). Published by Elsevier Ltd.. All rights reserved.

  6. Study deviance-type scale in the development of Korean elder.

    Science.gov (United States)

    Cho, Gun-Sang; Yi, Eun-Surk; Hwang, Hee-Jeong

    2015-12-01

    This research aims to develop a questionnaire of deviant behavior for the Korean elderly people which may make a big contribution to the examination of deviance behavior of the elderly people and may play an important role in providing a methodological basis. In order to accomplish the purpose of the this study, there were three different stages; (a) making preliminary question items, (b) refining the items of the scale through a plot study, and (c) finalizing question items by a main survey. In the first stage, 43 question items were developed using the open-ended questionnaire and structural inquiry of succession from 137 elderly people who are over 65 yr. In the second phase, based on data collected by the 200 elderly people pilot testing was performed through exploratory factor analysis and reliability test. The scale is a 27-item self-report questionnaire. In the main survey conducted by 184 elderly people, 21 items, which consisted of four subfactors, were finalized in order to measure deviance behaviors of the Korean elderly people: social deviance (n=8), economic deviance (n=5), psychological deviance (n=5), and physical deviance (n=3).

  7. Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders.

    Science.gov (United States)

    Harrison, Katrin E; Dombrovski, Alexandre Y; Morse, Jennifer Q; Houck, Patricia; Schlernitzauer, Maryann; Reynolds, Charles F; Szanto, Katalin

    2010-05-01

    Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal thoughts and attempts. 106 individuals aged 60 years and older participated in this cross-sectional, case-control study. They were placed in three groups: suicidal depressed, non-suicidal depressed and non-depressed. Following a detailed clinical characterization, we assessed perceived social support (Interpersonal Support Evaluation List), and chronic interpersonal difficulties (Inventory of Interpersonal Problems). Using general linear models, we explored the relationship between suicidal thoughts/attempts, social support, and chronic interpersonal difficulties. We also examined whether lower perceived social support explained the relationship between chronic interpersonal difficulties and suicidal thoughts/attempts. Suicidal depressed elders reported the lowest levels of perceived social support (belonging, tangible support, and self-esteem) and higher levels of chronic interpersonal difficulties (struggle against others and interpersonal hostility), compared to both non-suicidal depressed and non-depressed elders. The relationship between chronic interpersonal difficulties and suicidal behavior was partially explained by low perceived social support. The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior.

  8. Factors associated with chronic diseases among the elderly receiving treatment under the Family Health Strategy.

    Science.gov (United States)

    Pimenta, Fernanda Batista; Pinho, Lucinéia; Silveira, Marise Fagundes; Botelho, Ana Cristina de Carvalho

    2015-08-01

    The profile of a sample population of elderly receiving treatment under the Family Health Strategy in the municipality of Teófilo Otoni, State of Minas Gerais, Brazil, is described, and the factors associated with diseases prevalence examined. Using simple random sampling, 385 elderly were interviewed using Form A and Elderly Form from the Primary Health Care Information System. The majority of the sample (83.1%) self-reported at least one disease, 69.9% had hypertension, and 17.7% had diabetes. Poisson regression analysis showed that the main factors associated with hypertension and other diseases were being non-white, having a low level of education, medication use, dental prosthesis use, and lack of a private health plan. The prevalence of diabetes was greater among women and individuals who depended on other people to live. It can be concluded that this sample population of elderly has a generally low socioeconomic status and are more susceptible to developing diseases, particularly hypertension. Diabetes should be controlled although had relatively low prevalence. It is suggested investments in structuring the health system network to provide adequate care for the elderly and in training health professionals to play an effective role in improving the quality of life of the elderly in Brazil.

  9. Neurological abnormalities and neurocognitive functions in healthy elder people: A structural equation modeling analysis

    Directory of Open Access Journals (Sweden)

    Chan Raymond CK

    2011-08-01

    Full Text Available Abstract Background/Aims Neurological abnormalities have been reported in normal aging population. However, most of them were limited to extrapyramidal signs and soft signs such as motor coordination and sensory integration have received much less attention. Very little is known about the relationship between neurological soft signs and neurocognitive function in healthy elder people. The current study aimed to examine the underlying relationships between neurological soft signs and neurocognition in a group of healthy elderly. Methods One hundred and eighty healthy elderly participated in the current study. Neurological soft signs were evaluated with the subscales of Cambridge Neurological Inventory. A set of neurocognitive tests was also administered to all the participants. Structural equation modeling was adopted to examine the underlying relationship between neurological soft signs and neurocognition. Results No significant differences were found between the male and female elder people in neurocognitive function performances and neurological soft signs. The model fitted well in the elderly and indicated the moderate associations between neurological soft signs and neurocognition, specifically verbal memory, visual memory and working memory. Conclusions The neurological soft signs are more or less statistically equivalent to capture the similar information done by conventional neurocognitive function tests in the elderly. The implication of these findings may serve as a potential neurological marker for the early detection of pathological aging diseases or related mental status such as mild cognitive impairment and Alzheimer's disease.

  10. The impacts of sarcopenia and obesity on physical performance in the elderly.

    Science.gov (United States)

    Chang, Ching-I; Huang, Kuo-Chin; Chan, Ding-Cheng; Wu, Chih-Hsing; Lin, Cheng-Chieh; Hsiung, Chao A; Hsu, Chih-Cheng; Chen, Ching-Yu

    2015-01-01

    The current definition of sarcopenic obesity in the elderly does not seem to take the ageing difference of body composition into sufficient consideration. The study accordingly attempted to better define sarcopenia/obesity based on various references, and the impacts of sarcopenia/obesity on elderly physical performance were also examined. 2629 elderly subjects (age ≧65) and 998 young adults were recruited for Sarcopenia and Translational Ageing Research in Taiwan (START). For each eligible subject, body composition was measured by bio-impedance analysis and physical performance, including upper and lower extremity function, was examined. The thresholds of sarcopenic obesity were defined as a value at two standard deviations from the gender-specific means of the young population or at the adopted value of our elderly population. Compared to the young adults, the elderly subjects reported a lower appendicular skeletal muscle index (ASMI, kg/m(2)) and a significantly higher fat percentage (%). From three different criteria, thresholds of obesity or sarcopenia were 31.41%, 30.16%, 30.64% (fat percentage) or 6.76kg/m(2), 7.36kg/m(2), 7.09kg/m(2) (ASMI) for men and 39.17%, 41.43%, 43.25% or 5.28kg/m(2), 5.74kg/m(2), 5.70kg/m(2) for women. The elderly subjects were classified into four groups. With covariates adjusted, the "sarcopenia only," "obesity only," and "sarcopenic obesity" elderly subjects were worse than their normal counterparts in physical performance (all pelderly physical performance. Body composition should be an essential part in geriatric assessment and elderly care. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  11. Temporal auditory processing in elders

    Directory of Open Access Journals (Sweden)

    Azzolini, Vanuza Conceição

    2010-03-01

    Full Text Available Introduction: In the trial of aging all the structures of the organism are modified, generating intercurrences in the quality of the hearing and of the comprehension. The hearing loss that occurs in consequence of this trial occasion a reduction of the communicative function, causing, also, a distance of the social relationship. Objective: Comparing the performance of the temporal auditory processing between elderly individuals with and without hearing loss. Method: The present study is characterized for to be a prospective, transversal and of diagnosis character field work. They were analyzed 21 elders (16 women and 5 men, with ages between 60 to 81 years divided in two groups, a group "without hearing loss"; (n = 13 with normal auditive thresholds or restricted hearing loss to the isolated frequencies and a group "with hearing loss" (n = 8 with neurosensory hearing loss of variable degree between light to moderately severe. Both the groups performed the tests of frequency (PPS and duration (DPS, for evaluate the ability of temporal sequencing, and the test Randon Gap Detection Test (RGDT, for evaluate the temporal resolution ability. Results: It had not difference statistically significant between the groups, evaluated by the tests DPS and RGDT. The ability of temporal sequencing was significantly major in the group without hearing loss, when evaluated by the test PPS in the condition "muttering". This result presented a growing one significant in parallel with the increase of the age group. Conclusion: It had not difference in the temporal auditory processing in the comparison between the groups.

  12. Postoperative Ileus in the Elderly

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    Chih-Peng Tu

    2014-03-01

    Full Text Available Postoperative ileus is among the most common complications after surgery. Aging is associated with an increased colonic transit time, and anesthetic disturbance to colonic motility is often aggravated in the elderly. Postoperative ileus increases morbidity, prolongs the length of hospital stay, and constitutes a significant economic burden on the healthcare system. Multimodal enhanced recovery protocols, or fast-track surgeries, have been developed to improve postoperative recovery. Patient education, avoidance of perioperative fluid overload, selective use of nasogastric decompression, early ambulation, adopting a minimally invasive approach, early initiation of clear fluids, and gum chewing are all possible measures to reduce postoperative ileus. Thoracic epidural anesthesia is a well-established technique to hasten recovery, whereas insufficient data are available to ascertain the safety and efficacy of opioid-sparing analgesia in the elderly. The evidence is clear that traditional prokinetic medications are not helpful in the treatment or prevention of postoperative ileus. Early results suggest that alvimopan is a promising agent to reverse opioid-induced ileus. Since postoperative ileus is a multifactorial condition, a concerted effort is therefore necessary to prevent or decrease the duration of postoperative ileus using multimodal strategies.

  13. Skin cancers in elderly patients.

    Science.gov (United States)

    Malaguarnera, Giulia; Giordano, Maria; Cappellani, Alessandro; Berretta, Massimiliano; Malaguarnera, Michele; Perrotta, Rosario Emanuele

    2013-11-01

    Cancer in older people is a common problem worldwide. Among various types of cancer, skin cancers represent an important percentage. The principal risk factors are sun exposure, family history of skin cancer, fair skin color, but also the age plays an important role in the genesis of skin cancers. In older people there are a more prolonged exposure to carcinogenesis and a decreased functionality of reparation mechanisms of the cells so they acquire a selective advantage of growing and proliferating. At the same time age causes alteration in immune system by increasing NK-cells absolute number and decreasing both the endogenous and the lymphokine-induced lytic activities. The anti-tumor immune response is also mediated by the cytotoxic T- lymphocytes and in the elderly a strong reduction of T-cell function has been demonstrated. In elderly patients the diagnosis and the treatment of skin cancers can be different from younger counterpart. For example in older patients with melanoma is important to evaluate Breslow depth while higher mitotic rate has major value in younger patients. Moreover, the treatment should consider the performance status of patients and their compliance.

  14. Eye surgery in the elderly

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    Raczyńska D

    2016-04-01

    Full Text Available Dorota Raczyńska, Leopold Glasner, Ewelina Serkies-Minuth, Magdalena A Wujtewicz, Kamila Mitrosz Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland Abstract: Extending life expectancy is a human achievement. It does however entail problems. Ophthalmic treatments are widely recognized as having a low risk of general complications. A classic example is cataract surgery, considered to be one of the safest and most frequently performed surgical procedures in the world. However, advanced age brings with it risks that should be considered before surgery. Eye operations, as with procedures on other organs, are largely dependent on the quality of surgical tissues. Therefore, the elderly are at increased risk of complications. Improved general health and postoperative follow-up with the use of noninvasive technologies such as optical coherence tomography translate into lower intraoperative risk and better postoperative prognosis. In this review, we discuss the impact of general health on operational prognosis, therapeutic problems, and technical difficulties which a surgeon and anesthesiologist may encounter in the process. We also consider new technology and strategies specifically aimed at treating eye conditions in the elderly. Keywords: eye surgery, eye aging, anesthesiology in ophthalmology, cataract, glaucoma, vitrectomy, age-related macular degeneration

  15. HEALTH EDUCATION TO PROMOTE HEALTHY AGING WITH ELDERLY PATIENTS AT A REFERRAL CENTER FOR SOCIAL ASSISTANCE (CRAS IN SINOP-MT

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    J. O. Iori

    2017-02-01

    Full Text Available Nursing care for the elderly should aim to promote elderly health and reduction of foreseeable risk factors, as well as value and institute measures to the greatest possible degree of autonomy and independence in the elderly in relation to his life and especially about his Cheers. With this view, we carried out a study with 16 members aged from Linkages Strengthening Group of a Social Assistance Reference Center (CRAS, the municipality of Sinop - MT, to enhance understanding of the elderly as the promotion of health through education about risk and protective factors of the most common diseases and health problems among the elderly. We used the action research as a methodological reasons, because this means turning the subject both at the level of thought and in action. The results of this research showed a female predominance in the participation of older age groups, increased participation of older widows with education of 01 years to 04 years. The perception of the elderly as the educational activity performed was satisfactory, reporting that the dynamics of the talks were good, important and promoted new information. It was also found through most of the elderly respondents reported the need for health education activities for this audience. It is concluded that the elderly incorporated into their daily health promotion measures learned in the educational activity, with improvements in quality of life. As well, the need to implement more health education programs for the elderly aimed at promoting healthy aging.

  16. Relations between longitudinal trajectories of subjective financial wellbeing with self-rated health among elderly

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    Giovanni Piumatti

    2017-12-01

    Conclusions: Results suggest that in late life longitudinal negative changes in perceptions of financial wellbeing may occur together with decreases levels of self-reported health. Future research on health inequalities in elderly should pay specific attention to the link between financial wellbeing and health from a self-reported perspective.

  17. The effect of loneliness on malnutrition in elderly population.

    Science.gov (United States)

    Ramic, Enisa; Pranjic, Nurka; Batic-Mujanovic, Olivera; Karic, Enisa; Alibasic, Esad; Alic, Alma

    2011-01-01

    The clinical and epidemiological data show that proper nutrition plays an important role in maintaining health and combating the danger of developing some chronic diseases in the elderly population. Nutrition is an important factor in many physiological and pathological changes that accompany the aging process. More than 50% of elderly patients are suffering from malnutrition which is information that concerns. Due to various factors, older people are potentially vulnerable groups at risk of malnutrition. Loneliness, isolation from society and neglect of parents by children is a big problem to many people in old age. To determine differences in nutritional status of elderly people living alone compared to those who live in family surroundings. The study was conducted in the municipality of Tuzla in 2009-2010, in outpatient family medicine Simin Han. The survey covered a total of 200 elderly subjects (age >65 years). Subject group consisted of 45% of people living alone, and 55% control group consisted of elderly patients who live in traditional family surroundings. Questionnaires used in this study are General geriatric assessment questionnaire and Mini nutritional status. The average age (+/- SD) was 75.4 +/- 6.2 years in subject group, while the same in the control group was 74.9 +/- 5.6 years. In subject group significantly more patients are on the verge of poverty. There are significant differences in the classification of financial status, according to the groups (p = 0.043). Members of subject groups have significantly lower BMI categories (p = 0.03) compared with the control group. In our study, people who live alone are at increased risk of malnutrition (p = 0030), have reduced the number of daily meals, significantly lower daily intake of protein, fruits and vegetables in the diet in relation to persons living in a family environment. Significantly more patients with loss of appetite live alone. According to the existence of self-reported food problems

  18. A Survey of Abuse of the Elderly in Texas.

    Science.gov (United States)

    Anderson, Jeff; And Others

    Many elderly persons suffer abuse and neglect from which they cannot escape. Questions concerning the extent of elder abuse, the kinds of abuse, and underlying factors associated with elder abuse in Texas were explored in a survey of professionals most likely to encounter elder abuse in their work. Questionnaires (1,508) were mailed to agencies…

  19. Middle turbinate angiofibroma in an elderly woman

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    Perić Aleksandar

    2009-01-01

    Full Text Available Background. Angiofibromas are histologically benign vascular tumors, originating from the nasopharynx, near by the area of sphenopalatine foramen. These neoplasms occur typically in male adolescents. Reports of primary extranasopharyngeal angiofibromas have appeared sporadically in the literature in English. We present the first case of an elderly woman with tumor arising from the middle turbinate, diagnosed as angiofibroma. Case report. A 63-year-old female presented with left-sided nasal obstruction and epistaxis. Endoscopic evaluation revealed a polypoid mass arising from the anteroinferior portion of the left middle turbinate. Computed tomography (CT scan showed a soft-tissue opacity that filled the anterior part of the left nasal cavity. After the endoscopic excision of the mass, postoperative pathohistological and immunohistochemical analysis confirmed the diagnosis of an angiofibroma. Two years later, the patient was free of symptoms and without endoscopic evidence of recurrence. Conclusion. Extranasopharyngeal angiofibromas arising from the nasal cavity are extremely rare tumors. Immunohistochemical analysis is very important in all doubtful cases, especially in those with atypical location.

  20. Elder Abuse: The Hidden Problem. A Briefing by the Select Committee on Aging, House of Representatives, Ninety-Sixth Congress, First Session (Boston, Massachusetts, June 23, 1979).

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This briefing by the Congressional Select Committee on Aging was designed to gather information on the physical and psychological abuse of the elderly. A number of witness reports are included, testifying to the seriousness and extent of the problem of elder abuse. It is pointed out that many victims refuse to admit abuse; public discussions of…

  1. The elder physical abuse reflected in judicial authorities in Eskisehir.

    Science.gov (United States)

    Karbeyaz, Kenan; Çelikel, Adnan

    2017-11-01

    Elder abuse is a health and human rights problem that may occur among every race and ethnic group all around the world. This study aims at describing all cases of physical abuse of elderly which have been reported to, and investigated by Eskisehir - a western city of Turkey. Physical abuse incidents above 65 years of age which were evaluated by the Eskisehir Council of Forensic Medicine for expert witness opinion during 5year period between 01.01.2010 and 12.31.2014 are examined in this descriptive, cross-sectional study. 253 cases are found and evaluated in the scope of the study. It is determined that all aggressors are the acquaintance of the victim, and for 114 cases (45.1%) the aggressor is the victim's son. It is found that only investigation procedures of cases are completed, but no protection and rehabilitation program has been issued. In conclusion, it is determined that elder victims are abused by family members and relatives who are mostly the care givers. It is seen that emergency physicians play a great role in the detection of abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Significant unmet oral health needs of homebound elderly adults.

    Science.gov (United States)

    Ornstein, Katherine A; DeCherrie, Linda; Gluzman, Rima; Scott, Elizabeth S; Kansal, Jyoti; Shah, Tushin; Katz, Ralph; Soriano, Theresa A

    2015-01-01

    To assess the oral health status, use of dental care, and dental needs of homebound elderly adults and to determine whether medical diagnoses or demographic factors influenced perceived oral health. Cross-sectional analysis. Participants' homes in New York City. Homebound elderly adults (N = 125). A trained dental research team conducted a comprehensive clinical examination in participants' homes and completed a dental use and needs survey and the Geriatric Oral Health Assessment Index. Participants who reported a high level of unmet oral health needs were more likely to be nonwhite, although this effect was not significant in multivariate analysis. Individual medical diagnoses and the presence of multiple comorbidities were not associated with unmet oral health needs. The oral health status of homebound elderly adults was poor regardless of their medical diagnoses. High unmet oral health needs combined with strong desire to receive dental care suggests there is a need to improve access to dental care for this growing population. In addition to improving awareness of geriatricians and primary care providers who care for homebound individuals, the medical community must partner with the dental community to develop home-based programs for older adults. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  3. A Rare Case of Chronic Diarrhea in an Elderly Male

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    Ming-Jong Bair

    2009-06-01

    Full Text Available Chronic diarrhea is a common condition in older age groups, and many patients do not seek medical attention unless their diarrhea is associated with other symptoms, such as weight loss, gastrointestinal bleeding or abdominal pain. It is a critical condition in the elderly, especially with systemic disease. We report the case of an elderly patient with chronic diarrhea secondary to intestinal capillariasis. Human intestinal capillariasis is a rare parasitosis of the gastrointestinal tract, which may be a fatal disease if early treatment is not given. The clinical hallmarks of capillariasis include chronic diarrhea, abdominal pain, borborygmi, marked weight loss, protein and electrolyte loss, and cachexia. Most patients die from electrolyte loss resulting in heart failure and/or septicemia. Taiwan, particularly in Taitung County, is a Capillaria-prevalent area. Thus, parasitosis must be considered in the differential diagnosis of patients with debilitating chronic diarrhea, especially in the elderly aboriginal population of Taitung County. A careful dietary and travel history is important in any such case; but even in the absence of clear-cut exposure, a parasitic infection should be considered and carefully investigated.

  4. Assessment of risk of falls in elderly living at home

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    Adriana de Azevedo Smith

    Full Text Available ABSTRACT Objective: to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. Method: cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS version 19 was used for statistical analysis. Results: there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001, age (0.054, cognitive status (<0.001 and history of falls (<0.001. All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. Conclusion: female gender, older elderly (over 80 years old, with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.

  5. [Unipedal stance time and fall risk in the elderly].

    Science.gov (United States)

    Domínguez-Carrillo, Luis Gerardo; Arellano-Aguilar, Gregorio; Leos-Zierold, Héctor

    2007-01-01

    We undertook this study to relate unipodal stance time (UST) as a falls indicator in the elderly and to corroborate with UST exercise increments. One hundred sixty eight elderly subjects (age >70 years) with two or more falls during the previous 12 months were compared with 150 similar subjects without falls. UST chronometry and quadriceps and triceps brachialis strength dynamometry were used. Equilibrium and antigravity muscle-strengthening exercise program with 20 work sessions were carried out. Results were analyzed with chi(2), Student's t-test, and Fisher tests. UST of the control group showed 28.84 +/- 4.73 sec (mean +/- SD). The UST sample showed 19.18 +/- 4.24 sec. The test was initially impossible to carry out in 42 cases (p = 0.05). The final evaluation showed 142 cases with 30 sec of UST (p = 0.00001), isometric force increased in 70% and 30%, respectively (p = 0.05). At 6-month follow-up, 53 falls were reported, 29 were in patients who could not accomplish UST measurement on initial evaluation. UST falls in elderly people, and exercise programs increase UST.

  6. Suicidal ideation and attempted suicide in elderly people - subjective experiences.

    Science.gov (United States)

    Gutierrez, Denise Machado Duran; Sousa, Amandia Braga Lima; Grubits, Sonia

    2015-06-01

    We discuss the subjective experiences of elderly people who show suicidal ideation and/or attempts at suicide, based on their own reports. We understand the concept of 'subjective' as referring to intra-psychic experience resulting from social, economic, relationship or biographical conditions. Although the subject is sparsely covered in the literature, it is important, because it is in the field of subjectivity that ideations of, and attempts at, suicide develop and occur until they become a concrete act. Empirical data were collected through semi-structured interviews focusing on: social characterization, portrayal and mode of life, previous mental state, atmosphere of the attempt, effects on the health of the elderly person and family. Based on the analysis of the meanings that emerge, five empirical categories were generated: (1) subject's feeling of being in a non-place; (2) absence of acceptance of losses; (3) suffering due to ingratitude of family members; (4) feeling of uselessness of, and in, life; (5) re-signification of the situations that generate suicide-related conduct. The results point to a fundamental need to incorporate knowledge about the subjective processes into programs for prevention of suicide among the elderly who have ideation of, or attempts at, suicide.

  7. Safety of etanercept in elderly subjects with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Alfredomaria Lurati

    2009-12-01

    Full Text Available Alfredomaria Lurati, Mariagrazia Marrazza, Katia Angela, Magda ScarpelliniFornaroli Hospital, Rheumatology Unit, Magenta, ItalyObjective: To report side effects seen in a clinical cohort of patients aged >65 years with rheumatoid arthritis (RA treated with the tumor necrosis factor-α TNF-α blocker etanercept and to compare the side effects rate with patients aged ≤65 years.Methods: All patients with RA that started etanercept and who were referred to our rheumatology unit from November 2005 to March 2009 were included in this study and prospectively followed to collect side effects related to therapy.Results: One hundred three patients were enrolled: 41 (37 females, 4 males aged >65 years and 62 (40 females, 22 males aged <65 years. In the patients aged >65 years, the safety profile (defined as rate of side effects of etanercept was similar to that in patients aged ≤65 years (P > 0.05 and the survival curves between the groups were similar (P > 0.05.Conclusions: In our three-year experience, the anti-TNFα agent etanercept has been well tolerated and safe in elderly patients. The risk of side effects in these patients was no greater than in subjects aged ≤65 years. However, such inhibitors are associated with various and numerous side effects and elderly patients with RA should be carefully monitored to limit the risk of side effects during anti-TNFα therapy as much as possible.Keywords: anti-TNF therapy, rheumatoid arthritis, elderly

  8. DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

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    Tanushree

    2016-03-01

    Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

  9. FAMILY PRACTICE APPROACH TO ELDERLY PATIENTS

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    Marija Petek Šter

    2004-10-01

    Full Text Available Background. The number of elderly patients, i.e. people over 64 years, is growing. With longer life span the proportion of elderly people will be even higher. Elderly patients are a heterogeneous group of patients with considerable differences in health status, functional capacity, emotions, fears, beliefs and views.Health care of elderly patients in primary care is a responsibility of family doctors. One third of all family practice consultations are in the age group over 64. A consultation in the elderly is different from a consultation in younger patients. The consultation length in those patients is longer and the office visits of elderly are more frequent. If we want to deliver a quality care for the elderly, we have to care for them and manage their illness in psychological, physical, family and social context, which is a core stone of biopsychosocial model of medical practice. Besides medical knowledge and patient participation, all these elements make a foundation of the holistic approach. In elderly a special attention to their attitude towards aging, dying, loneliness and to the fears connected to those issues should be taken into account. Coordination with other services and with patients’ families is also necessary. Family physician is in the best position to recognise abuse, neglection or limitations in patient autonomy.We should be aiming to achieve a connection between the doctor and the patient through continuity between the doctor, the patient and his/her family. Good connection will make management of elderly patients more effective and the patients will accept and follow therapeutic plan.

  10. From sick elderly to super-grandparents. A typology of elderly representations in Romanian video advertising

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    Simona-Nicoleta Vulpe

    2017-12-01

    Full Text Available The aim of this paper was to study the elderly representations in Romanian video advertising in order to identify a typology corresponding to these representations. The research method that I used was the content analysis with a dominant qualitative approach, but also including quantification elements. The commercials that I selected for my analysis promoted health products, banking and insurances and fast moving consumers’ goods (FMCG. The identified typology is composed of five types of elderly representations: Super-Grandparents, Seclusive Elderly, Sick Elderly, Funny Elderly, and High-Tech Elderly. The representation types and their stereotypical content varied depending on the type of product/service that was promoted and on the public addressed by commercials.

  11. Renal histology in the elderly: indications and outcomes.

    LENUS (Irish Health Repository)

    Brown, Catherine M

    2011-06-28

    Background: Renal disease is being increasingly diagnosed in the elderly. However, reports on biopsy-confirmed renal disease in this population are limited. The aim of this study was to give an overview of the most important indications, diagnoses and outcomes of renal biopsies in the elderly in our center. Methods: This was a retrospective review of all elderly renal biopsies over 5 years. Patients were eligible for inclusion if they were aged =65 years and had had a native kidney biopsy performed. The data recorded included age, sex, indications for biopsy, histological diagnoses and outcomes. Results: During this time, 1,372 native renal biopsies were performed. Of these, 236 (17%) were in patients aged =65 years; 150 male (64%) and 86 female (36%). The most common indications for biopsy were acute renal failure and nephrotic syndrome. Common diagnoses included pauci-immune crescentic glomerulonephritis, tubulointerstitial nephritis, membranous nephropathy, IgA nephropathy and chronic thrombotic microangiopathy. Long-term follow-up of 3 years was available for 102 patients; median serum creatinine at the time of biopsy was 427 µmol\\/L (interquartile range 204-702) and at 3 years post biopsy had fallen to 192 µmol\\/L (interquartile range 152-408). Conclusions: In our center, 17% of native kidney biopsies are performed in elderly patients aged =65 years. In our experience, this procedure was safe and had a 97% diagnostic rate. The available follow-up data of patients suggest that renal histology is not only of benefit in diagnosis but also of potential value in terms of prognosis and treatment.

  12. Perineal tap water burns in the elderly: at what cost?

    Science.gov (United States)

    Potter, Michael D E; Maitz, Peter K M; Kennedy, Peter J; Goltsman, David

    2017-11-01

    Burn injuries are expensive to treat. Burn injuries have been found to be difficult to treat in elderly patients than their younger counterparts. This is likely to result in higher financial burden on the healthcare system; however, no population-specific study has been conducted to ascertain the inpatient treatment costs of elderly patients with hot tap water burns. Six elderly patients (75-92 years) were admitted for tap water burns at Concord Hospital during 2010. All costs incurred during their hospitalization were followed prospectively, and were apportioned into 'direct' and 'indirect' costs. Direct costs encompassed directly measurable costs, such as consumables used on the ward or in theatres, and indirect costs included hospital overheads, such as bed and theatre costs. Three males and three females admitted with burns to the buttocks, legs or feet. Total burn surface area (TBSA) ranged from 9-21% (mean 12.8%). Length of stay ranged from 26-98 days (mean 46 days). One patient died, and four required surgical management or grafting. Total inpatient costs ranged from $69 782.33 to $254 652.70 per patient (mean $122 800.20, standard deviation $67 484.46). TBSA was directly correlated with length of stay (P < 0.01) and total cost (P < 0.01). Hot water burns among the elderly are associated with high treatment costs, which are proportional to the size of the burn. The cost of treating this cohort is higher than previously reported in a general Australian burn cohort. © 2016 Royal Australasian College of Surgeons.

  13. Emotions generated by food in elderly French people.

    Science.gov (United States)

    Narchi, I; Walrand, S; Boirie, Y; Rousset, S

    2008-11-01

    Eating behaviour depends partly on food preference, which may be determined by different types of emotions. Among the emotions generated by food, disgust and pleasure are common and can lead to increased and reduced food consumption. We tested the hypothesis that (1) elderly men and women felt different emotions towards food, and (2) low energy intake is related to negative emotions towards food. In February 2004, a convenience sample of elderly participants was recruited locally by telephone. Food intake of 52 elderly people, aged 63-80 years, was monitored throughout each day for one week and made it possible to assign the elderly people to two groups (low and high energy intake from food consumption data). One month later, each of them assessed their likes or dislikes towards 30 food pictures (vegetables, cheeses, fruits, starchy foods, sweets, meat, fish, offal and eggs) using 19 emotional words (eight words with a positive valence: 'to like', 'thrilled', 'satisfaction', 'surprise', 'serene', 'amused', 'pride', 'interest', and 11 other words with a negative valence: 'disgust', 'indifference', 'guilt', 'uneasiness', 'nostalgia', 'impatience', 'doubt', 'frustration', 'embarrassment', 'disappointment' and 'lassitude'. The emotional intensities experienced with the different pictures were analysed by ANOVA for each group (men and women, small and big eaters). There were differences in likes and dislikes between men and women. Both guilty and liking scores towards food were generally higher in women than in men. Small eaters felt more doubt, unease, disappointment and indifference towards food than big eaters. In conclusion, the report of low food intake was related to more negative emotions towards foods that might be associated with the willingness to restrict food intake or to undernutrition.

  14. [Elderly people with visual impairment in The Netherlands].

    Science.gov (United States)

    Limburg, J J; Keunen, J E E; van Rens, G H M B

    2009-09-01

    To estimate the number of elderly people with visual impairment in The Netherlands, now and in the future. Possibilities for intervention are discussed. Estimates are based on a recent report on behalf of Foundation InZicht, ZonMw, in which prevalence data from population-based studies on blindness and low vision and its causes in The Netherlands, western Europe, The United States and Australia are related to the latest demographic data for The Netherlands. Of the 16.4 million Dutch in 2008 2.4 million (14.7%) are 65 years of age and older. Of this last group 155,000 persons are living in nursing homes or residential homes, the others are living in their own homes. In 2008 an estimated 77,000 persons are blind and 234,000 have low vision. Of them 79% is 65 years of age or older. Of the older people in care institutions 20% is blind (32,000) and 22% has low vision (34,000). In 62% of them the visual impairment is treatable or could have been prevented ('avoidable'). Of the older people living independently 1.2% is blind (27,000) and 6.8% has low vision (154,000). In 57% of them the affliction is avoidable. In 2008 247,000 elderly suffer from a visual impairment that could have been treated or prevented in 143,000 (58%) of them. Screening and treatment of elderly in care institutions seems indicated, as is health education to and goal-oriented screening of elderly who live independently.

  15. Suicide in the Elderly – The Hastening of Death

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    Bárbara Pedrosa

    2017-03-01

    Full Text Available Introduction:  Suicidal thoughts are common amongst the elderly. The risk of suicide in people aged 65 or more is the highest in several countries. The lethality of suicide attempts increases with age and the risk of acting on suicidal thoughts is higher. Many are the risk factors that seem to lead to suicidal ideation in this age. Aims: The present review aims to study the characteristics, risk factors and prevention programs concerning elderly suicide. It also aims to raise awareness amongst health care workers for this issue. Methods:  A  literature  review  was  carried out using the Pubmed with the keywords “elderly”, “aging” and “suicide”. Reference of United Nation’s reports and a textbook were also considered. Results:  Suicide  in  the  elder  seems  to  be multifactorial . 46 to 86% of older people who die of suicide presented an affective affective disorder in the previous weeks, namely, depression. Other risk factors are anxiety, male  gender,  higher  education,  obsessive personality  traits,  poor  social  integration in society, adverse life events, especially the death of the spouse, medical condition and neurocognitive dysfunction. Conclusions: Suicide prevention programs for the elder should not focus only on depression but in all the factors abovementioned, promoting the development of the subject’s resilience, positive aging, family and society involvement and also the control of medical comorbidities."

  16. Renal histology in the elderly: indications and outcomes.

    LENUS (Irish Health Repository)

    2012-02-01

    Background: Renal disease is being increasingly diagnosed in the elderly. However, reports on biopsy-confirmed renal disease in this population are limited. The aim of this study was to give an overview of the most important indications, diagnoses and outcomes of renal biopsies in the elderly in our center. Methods: This was a retrospective review of all elderly renal biopsies over 5 years. Patients were eligible for inclusion if they were aged =65 years and had had a native kidney biopsy performed. The data recorded included age, sex, indications for biopsy, histological diagnoses and outcomes. Results: During this time, 1,372 native renal biopsies were performed. Of these, 236 (17%) were in patients aged =65 years; 150 male (64%) and 86 female (36%). The most common indications for biopsy were acute renal failure and nephrotic syndrome. Common diagnoses included pauci-immune crescentic glomerulonephritis, tubulointerstitial nephritis, membranous nephropathy, IgA nephropathy and chronic thrombotic microangiopathy. Long-term follow-up of 3 years was available for 102 patients; median serum creatinine at the time of biopsy was 427 micromol\\/L (interquartile range 204-702) and at 3 years post biopsy had fallen to 192 micromol\\/L (interquartile range 152-408). Conclusions: In our center, 17% of native kidney biopsies are performed in elderly patients aged =65 years. In our experience, this procedure was safe and had a 97% diagnostic rate. The available follow-up data of patients suggest that renal histology is not only of benefit in diagnosis but also of potential value in terms of prognosis and treatment.

  17. WAYFINDING STUDY IN VIRTUAL ENVIRONMENTS: THE ELDERLY VS. THE YOUNGER-AGED GROUPS

    Directory of Open Access Journals (Sweden)

    Seunghae Lee

    2011-07-01

    Full Text Available This study aims to examine the impact of architectural wayfinding aids on wayfinding performances in comparison of the elderly group and the younger aged group. An ambulatory healthcare facility was simulated using Virtual Reality (VR to develop two levels of wayfinding aids for the same environments. The base model included minimal wayfinding aids, and the design model included more wayfinding aids. The VR environment was presented in the form of video in order to test wayfinding performances at three different wayfinding decision points. Results showed that age and wayfinding aids impacted wayfinding performances. The younger-aged group performed wayfinding better compared to the elderly group. Participants who were tested in the design model were more successful in wayfinding compared to the elderly group. The elderly group reported that more salient wayfinding aids such as a big logo and paint colors helped their wayfinding while the younger-aged group reported less salient aids such as door designs as helpful wayfinding aids. When there were minimal wayfinding aids, the elderly participants needed to rely mostly on memory recall by remembering turns or paying close attention. When participants felt that the wayfinding test was difficult, their performances were less successful. Findings in this study suggest that wayfinding design for the elderly should consider the limited ability of recall and therefore, design wayfinding aids more frequently with more salient aids to avoid confusion. The elderly group needed to rely on their limited cognitive ability when there were not enough wayfinding aids, which make them experience difficulties in wayfinding.

  18. Report of a Phase II Study of Clofarabine and Cytarabine in De Novo and Relapsed and Refractory AML Patients and in Selected Elderly Patients at High Risk for Anthracycline Toxicity

    Science.gov (United States)

    Cooper, Barry; Holmes, Houston; Vance, Estil; Berryman, Robert Brian; Maisel, Christopher; Li, Sandy; Saracino, Giovanna; Tadic-Ovcina, Mirjana; Fay, Joseph

    2011-01-01

    Purpose. To determine the efficacy and safety of clofarabine and cytarabine (Ara-C) in adult patients with relapsed or refractory acute myeloid leukemia (AML) and in elderly patients with untreated AML and heart disease. Patients and Methods. Patients with relapsed/refractory AML and older patients for whom there was a concern over toxicity from additional anthracyclines received 5 days of clofarabine, 40 mg/m2 per day i.v. over 1 hour, followed 4 hours later by Ara-C, 1,000 mg/m2 per day i.v. over 2 hours. Results. Thirty patients were enrolled. The median age was 67 years (range, 38–82 years) and 18 (60%) had received at least one prior therapy. Eleven (37%) patients had a history of cardiovascular disease and were considered to be at high risk for anthracycline toxicity. High-risk cytogenetic abnormalities were present in 14 (47%) patients. The overall response rate (complete remission [CR] plus partial remission) was 53%, including a CR in 14 patients (47%). Responses were observed in all cytogenetic risk groups and in patients who had received up to five prior therapies. The median disease-free survival interval was 9.5 months. The 30-day mortality rate was 20% (de novo AML, 8%; relapsed/refractory AML, 28%). Of the 14 patients achieving a CR, half were able to proceed to curative hematopoietic stem cell transplantation. Conclusions. Clofarabine in combination with Ara-C is effective in both untreated and previously treated patients with AML. In addition, it represents a useful remission induction strategy to serve as a bridge to transplantation in older patients with AML. PMID:21273514

  19. Inner happiness among Thai elderly.

    Science.gov (United States)

    Gray, Rossarin Soottipong; Rukumnuaykit, Pungpond; Kittisuksathit, Sirinan; Thongthai, Varachai

    2008-09-01

    This study, based on data collected in 2005 from Chai Nat province, examines the level of happiness of the Thai elderly population and its relationship to various external and internal factors. It was found that mean happiness was slightly above a feeling of "neutral." According to multiple regression analyses, external factors including economic hardship, living arrangements, functional ability, perceived social environment, and consumerism significantly influence the level of happiness. The strongest predictor of happiness is, however, the internal factor-that is, a feeling of relative poverty when compared to their neighbors. Controlling for demographic and all external factors, the respondents who do not feel poor show the highest level of happiness compared to those who feel as poor as or poorer than their neighbors. This is self-interpreted as a feeling of contentment with what one has, which has been influenced by Thai culture, which is pervaded by Buddhism.

  20. Breast cancer in the elderly

    International Nuclear Information System (INIS)

    Baum, M.

    2010-01-01

    As the expectation of life in the Western world increases the incidence of breast cancer rises and more and more of our patients present over the age of 70. The expectation of life amongst women in the UK is now 85 so a fit elderly woman of 70 has many years left for the natural history of breast cancer to express itself Never the less the older the woman with breast cancer the more likely she is to die of co-morbidity. The first point to make therefore is that age alone should not be a determinant of therapy but that should remain a decision based on the stage and biological variables within the primary tumour. In spite of all that there may be a place to compromise on default therapies if the expectation of life of the woman is say less than three years. I will illustrate these points by focussing on three trials with which Fve been actively involved. The first are the trials comparing surgery plus tamoxifen versus surgery alone in women over the age of 70, secondly the TRAGIT trial of intra-operative radiotherapy and thirdly the ATAC trial comparing tamoxifen with arimidex. I will argue that surgery is still required in primary therapy in the elderly whose expectation of life exceeds 3 years but also there is room for a new trial of aromatase inhibitors as sole therapy for women with tumours that express the ER and are say 80 years or more at presentation. I also believe that there is a place for lORT for women with serious co-morbidity and I will argue that there may be an age of transition when tamoxifen might be favoured above aromatase inhibitors as first line adjuvant therapy. (author)

  1. Graduate Students' Reflections on Elder and End-of-Life Care for Prisoners.

    Science.gov (United States)

    Baumann, Steven L; Todaro-Franceschi, Vidette

    2017-07-01

    The focus of this report was graduate nursing students' reflections on elder and end-of-life care for prisoners. The personal reflections of 21 graduate nursing students who attended a presentation by Susan J. Loeb on October 26, 2016 were included in this report. The title of the presentation was "Enhancing End-of-Life Care for Prisoners Through Partnering With the Prison Community." The student essays were synthesized to construct a summary essay, from which four themes were identified: aging in prison, dying in prison, ethical and professional issues in the elder and end-of-life care of prisoners, and ethical and professional issues in research involving elderly and end-of-life care of prisoners. These findings were interpreted from a global perspective in light of two different nursing perspectives: the humanbecoming tradition and the science of unitary human beings.

  2. The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey.

    Science.gov (United States)

    Sooryanarayana, Rajini; Choo, Wan Yuen; Hairi, Noran N; Chinna, Karuthan; Hairi, Farizah; Ali, Zainudin Mohamad; Ahmad, Sharifah Nor; Razak, Inayah Abdul; Aziz, Suriyati Abdul; Ramli, Rohaya; Mohamad, Rosmala; Mohammad, Zaiton Lal; Peramalah, Devi; Ahmad, Noor Ani; Aris, Tahir; Bulgiba, Awang

    2017-09-01

    As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. Cross-sectional study, analysing baseline findings of a cohort of older adults. Kuala Pilah district, Negeri Sembilan state, Malaysia. To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

  3. Dietary habits and physical activity patterns among Slovenian elderly: cross-sectional survey with cluster analysis

    Directory of Open Access Journals (Sweden)

    Joca Zurc

    2015-03-01

    Full Text Available Introduction: Physical activity and a healthy diet are significant predictors of healthy ageing—they help the elderly maintain their physical and mental health, and prevent chronic diseases. Methods: The data for the empirical quantitative survey were collected on the sample of 218 elderly community-dwelling participants (aged 65 years or more, using a structured questionnaire for self-reporting. Data analyses were proceed with the bivariate statistics, and multivariate hierarchical cluster analysis. Results: Most respondents reported good dietary habits (83.1% and a satisfactory physical activity level (60.5%. On average, the elderly eat 3-4 meals per day (59.8% and engage in physical activity at least three times a week (58.6%, with interventions lasting 15 minutes or more (84.4 % and non-organized activity prevailing (96.2%. Ward’s method yielded three clusters with homogenous dietary and physical activity patterns: ‘Health Conscious’ (30.8%, ‘At Risk’ (42.7% and ‘Special Requirements’ (26.5%. Significant differences were identified between clusters and educational level (p = 0.001. Discussion and conclusions: In the future, special attention should be placed on the elderly group with a lower educational level and special dietary and physical activity requirements. Additional studies on representative samples are required for a comprehensive investigation into the lifestyle behaviours of elderly individuals.

  4. Vitamin D and muscle function in the elderly: the elixir of youth?

    Science.gov (United States)

    Girgis, Christian M

    2014-11-01

    Circumstantial evidence suggests that vitamin D deficiency may contribute to age-related changes in skeletal muscle. This review discusses recent clinical trials examining effects of vitamin D on muscle function in the elderly, and poses the important question: can vitamin D reverse muscle ageing? Observational studies report an association between vitamin D and muscle atrophy/weakness in elderly subjects. Interventional studies suggest that frail, elderly subjects may benefit from vitamin D supplementation by displaying reduced falls, improved muscle function and increased muscle fibre size. However, meta-analyses do not report convincing effects of vitamin D in the elderly. This may be because of multiple factors including lack of standardized endpoints for muscle function, variable study design and different doses of vitamin D supplementation amongst these studies. The evidence base is therefore inconsistent. Vitamin D deficiency may exacerbate ageing of skeletal muscle. However, current evidence that vitamin D supplementation reverses age-related muscle dysfunction is equivocal and does not justify stringent vitamin D targets in the elderly. Until these issues are clarified, the safest option is to aim for conservative vitamin D targets that are sufficient for normal calcium homeostasis.

  5. Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors

    Directory of Open Access Journals (Sweden)

    Lílian Varanda Pereira

    2015-10-01

    Full Text Available AbstractOBJECTIVECorrelating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales.METHODA study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS of 11 points and a Verbal Descriptor Scale (VDS of five points were compared in three evaluations: overall, at rest and during movement.RESULTSWomen were more representative (61.4% and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales.CONCLUSIONPain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.

  6. Elderly homicide in Chicago: a research note.

    Science.gov (United States)

    Fazel, Seena; Bond, Mieko; Gulati, Gautam; O'Donnell, Ian

    2007-01-01

    There is a body of knowledge about elderly crime victims, but we know little about the characteristics of elderly perpetrators, especially of homicide. The few studies that have been published are based on small samples and are somewhat dated. In an examination of homicides committed in Chicago over a 31-year period, we compared cases involving perpetrators aged over 60 years (n = 443) with those involving younger perpetrators (n = 24,066). There were a number of significant differences. Elderly killers were more likely to be White and to commit suicide afterwards. Their victims were more likely to be spouses, females, and aged over 60 years. Inter-racial homicide was more common for younger offenders. The low number of homicides involving the elderly is explained by reference to routine activity theory. Copyright 2007 John Wiley & Sons, Ltd.

  7. Flu shots and unvaccinated elderly Medicare beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths...

  8. MANAGEMENT OF DIABETES IN THE ELDERLY

    African Journals Online (AJOL)

    congestive heart failure often co-occur in elderly patients with geriatric conditions such as urinary incontinence and injurious falls.8 Nevertheless, ... complications, although a case for improved diabetes control and the prevention of ...

  9. Immunosuppression in the elderly renal allograft recipient

    DEFF Research Database (Denmark)

    Montero, Nuria; Pérez-Sáez, María José; Pascual, Julio

    2016-01-01

    BACKGROUND: The Elderly are the fastest growing part of kidney transplant recipients. The best immunosuppressive strategy is unknown. METHODS: We performed a systematic search of randomized controlled trials and observational studies focused on safety and efficacy of different immunosuppression...... strategies in elderly kidney recipients. Data extraction and risk of bias evaluation were systematically performed. RESULTS: Ten studies were included: 2 randomized clinical trials and 8 observational. A marginal benefit was found for early renal function with delayed tacrolimus or complete tacrolimus...... receptor antibody induction, calcineurin-inhibitor minimization with MMF and steroid minimization is advisable in the low immunologic risk elderly recipient, considering the increased risk of toxicities, infection and malignancies. In the high immunologic risk elderly recipient, taking into account...

  10. Intelligent monitoring system of bedridden elderly

    Science.gov (United States)

    Dong, Rue Shao; Tanaka, Motohiro; Ushijima, Miki; Ishimatsu, Takakazu

    2005-12-01

    In this paper we propose a system to detect physical behavior of the elderly under bedridden status. This system is used to prevent those elderly from falling down and being wounded. Basic idea of our approach is to measure the body movements of the elderly using the acceleration sensor. Based on the data measured, dangerous actions of the elderly are extracted and warning signals to the caseworkers are generated via wireless signals. A feature of the system is that the senor part is compactly assembled as a wearable unit. Another feature of the system is that the system adopts a simplified wireless network system. Due to the network capability the system can monitor physical movements of multi-patients. Applicability of the system is now being examined at hospitals.

  11. Practical Management of Anaesthesia in the Elderly

    DEFF Research Database (Denmark)

    Strøm, Camilla; Rasmussen, Lars Simon; Steinmetz, Jacob

    2016-01-01

    The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general......, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient. To optimise care, clinicians should be familiar with the typical physiologic...... changes related to ageing and the implications for anaesthetic management. All anaesthetic techniques, methods and agents can be applied, if tailored to the patient's physiologic and pathologic changes. The elderly are more sensitive to anaesthetics, meaning that desired sedative and analgesic effects...

  12. Factors Affecting Hypertension among the Malaysian Elderly

    Science.gov (United States)

    Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Shahar, Suzana; Ng, Chee Kyun; Mun, Chan Yoke

    2016-01-01

    Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR) = 1.54), an increase in body weight (OR = 1.61), and an increase in the blood levels of albumin (OR = 1.51), glucose (OR = 1.92), and triglycerides (OR = 1.27) significantly increased the risk of hypertension in subjects (p Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects. PMID:29367559

  13. Elderly Labor Supply: Work or Play

    National Research Council Canada - National Science Library

    Haider, Steven

    2001-01-01

    .... However, very little research has examined labor market behavior in this population. In this paper, we examine a series of questions in an attempt to better understand why the elderly continue to work...

  14. Cancer Outcomes in Low-Income Elders

    Data.gov (United States)

    U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...

  15. Functional and cognitive decline in hospitalized elderly

    Directory of Open Access Journals (Sweden)

    EUGÉNIA MENDES

    2016-12-01

    Full Text Available ABSTRACT Aim – Understand if functional and cognitive decline is accentuated during hospitalization in elderly patients. Method – It was design a descriptive and correlational study. The Functional Independence Measure (FIM and the Mini-Mental State Examination (MMSE were used. Results – Were evaluated at admission and discharge 51 elderly (75.53 ± 7.16 years, 53% women, admitted in an internal medicine unit with a length of stay of 14.27±6.45 days. For FIM and MMSE were found statistically significant differences with lower scores from admission to discharge. Negative correlations between age and length of stay and the scores of all measures were found. Except for the Cognitive FIM at admission, all elderly residents at home fared better than the institutionalized in all measures. Conclusions – The hospitalization contributes to a greater weakness/frailty of the elderly and is considered high risk for decline in physical fitness and cognitive function.

  16. [Lifestyle of elderly patients with diabetes mellitus].

    Science.gov (United States)

    Fukuoka, Yuki; Yamada, Yuichiro

    2013-11-01

    In elderly people, glucose tolerance is deteriorated and the incidence of diabetes mellitus is increased, due to decreased muscle mass and physical activity, declining pancreatic beta cell function, and other factors. Diabetes mellitus is an important risk factor for arteriosclerosis development in the elderly. Precise diagnosis and adequate treatment are necessary to prevent cerebrovascular and ischemic heart diseases. Elderly patients with diabetes mellitus are characteristically afflicted with more complications, impaired activities of daily living, cognitive function decline, and family environment problems, as compared with young and middle-aged diabetics. Therefore, tailor-made rather than uniform therapy becomes important. Lifestyle modification is the basis of diabetes treatment. Herein, we describe "prevention and management" of diabetes mellitus, focusing on the lifestyles of elderly diabetics.

  17. Historical and current predictors of self-reported health status among elderly persons in Barbados Sucesos del pasado y del presente que determinan el estado de salud, según autonotificación, de las personas de edad en Barbados

    Directory of Open Access Journals (Sweden)

    Ian R. Hambleton

    2005-06-01

    Full Text Available OBJECTIVE: To understand the relative contribution of past events and of current experiences as determinants of health status among the elderly in the Caribbean nation of Barbados, in order to help develop timely public health interventions for that population. METHODS: The information for this prevalence study was collected in Barbados between December 1999 and June 2000 as part of the "SABE project," a multicenter survey in seven urban areas of Latin America and the Caribbean that evaluated determinants of health and well-being in elderly populations (persons 60 and older. We used ordinal logistic regression to model determinants of self-reported health status, and we assessed the relative contribution of historical socioeconomic indicators and of three current modifiable predictor groups (current socioeconomic indicators, lifestyle risk factors, and disease indicators, using simple measures of association and model fit. RESULTS: Historical determinants of health status accounted for 5.2% of the variation in reported health status, and this was reduced to 2.0% when mediating current experiences were considered. Current socioeconomic indicators accounted for 4.1% of the variation in reported health status, lifestyle risk factors for 7.1%, and current disease indicators for 33.5%. CONCLUSIONS: Past socioeconomic experience influenced self-reported health status in elderly Barbadians. Over half of this influence from past events was mediated through current socioeconomic, lifestyle, and disease experiences. Caring for the sick and reducing lifestyle risk factors should be important considerations in the support of the current elderly. In addition, ongoing programs for poverty reduction and increased access to health care and education should be considered as long-term strategies to improve the health of the future elderly.OBJETIVO: Determinar la contribución relativa de sucesos del pasado y experiencias del presente al estado de salud de las

  18. Elderly fall risk prediction using static posturography

    Science.gov (United States)

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity—0.114 x Eyes Closed Vector Sum Magnitude Velocity—2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older

  19. Elderly fall risk prediction using static posturography.

    Science.gov (United States)

    Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; McIlroy, William E

    2017-01-01

    Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older

  20. Elderly fall risk prediction using static posturography.

    Directory of Open Access Journals (Sweden)

    Jennifer Howcroft

    Full Text Available Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP and medial-lateral (ML center of pressure (CoP motion; AP and ML CoP root mean square distance from mean (RMS; and AP, ML, and vector sum magnitude (VSM CoP velocity were calculated. Romberg Quotients (RQ were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24, prospective all fallers (42, prospective fallers (22 single, 6 multiple, and prospective non-fallers (47. Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for

  1. Is somatic comorbidity associated with more somatic symptoms, mental distress, or unhealthy lifestyle in elderly cancer survivors?

    Science.gov (United States)

    Grov, Ellen Karine; Fosså, Sophie D; Dahl, Alv A

    2009-06-01

    The associations of lifestyle factors, somatic symptoms, mental distress, and somatic comorbidity in elderly cancer survivors have not been well studied. This study examines these associations among elderly cancer survivors (age >or=65 years) in a population-based sample. A cross-sectional comparative study of Norwegian elderly cancer survivors. Combining information from The Norwegian Cancer Registry, and by self-reporting, 972 elderly cancer survivors were identified, of whom 632 (65%) had somatic comorbidity and 340 did not. Elderly cancer survivors with somatic comorbidity had significantly higher BMI, more performed minimal physical activity, had more somatic symptoms, used more medication, and had more frequently seen a medical doctor than survivors without somatic comorbidity. In multivariable analyses, unhealthy lifestyle and higher somatic symptoms scores were significantly associated with cancer cases with somatic comorbidity. In univariate analyses those with somatic comorbidity were significantly older, had lower levels of education, higher proportions of BMI >or= 30, less physical activity, poorer self-rated health, higher somatic symptoms score, more mental distress, had more frequently seen a medical doctor last year, and more frequently used daily medication. Our outcome measures of lifestyle, somatic symptoms and mental distress were all significantly associated with somatic comorbidity in elderly cancer survivors, however only lifestyle and somatic symptoms were significant in multivariable analyses. In elderly cancer survivors not only cancer, but also somatic comorbidity, deserve attention. Such comorbidity is associated with unhealthy lifestyles, more somatic symptoms and mental distress which should be evaluated and eventually treated.

  2. Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

    Science.gov (United States)

    Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

    2011-03-01

    Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Feasibility, reliability, and validity of a smartphone based application for the assessment of cognitive function in the elderly.

    Science.gov (United States)

    Brouillette, Robert M; Foil, Heather; Fontenot, Stephanie; Correro, Anthony; Allen, Ray; Martin, Corby K; Bruce-Keller, Annadora J; Keller, Jeffrey N

    2013-01-01

    While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these "next-generation" assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST) in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, psmartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries of cognitive and motor function in the elderly is discussed.

  4. Social workers' roles in addressing the complex end-of-life care needs of elders with advanced chronic disease.

    Science.gov (United States)

    Kramer, Betty J

    2013-01-01

    This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life.

  5. Fall risk in an active elderly population

    DEFF Research Database (Denmark)

    Læssøe, Uffe; Hoeck, Hans C.; Simonsen, Ole

    2007-01-01

    risk can be assessed by testing balance performance. In this study a test battery of physiological parameters related to balance and falls was designed to address fall risk in a community dwelling elderly population. RESULTS: Ninety-four elderly males and females between 70 and 80 years of age were...... assessment in which the physiological performance is evaluated in relation to the activity profile of the individual. Udgivelsesdato: 2007-null...

  6. Acute Kidney Injury in the Elderly

    Science.gov (United States)

    Abdel-Kader, Khaled; Palevsky, Paul

    2009-01-01

    Synopsis The aging kidney undergoes a number of important anatomic and physiologic changes that increase the risk of acute kidney injury (formerly acute renal failure) in the elderly. This article reviews these changes and discusses the diagnoses frequently encountered in the elderly patient with acute kidney injury. The incidence, staging, evaluation, management, and prognosis of acute kidney injury are also examined with special focus given to older adults. PMID:19765485

  7. Elderly Labor Supply: Work or Play

    National Research Council Canada - National Science Library

    Haider, Steven

    2001-01-01

    .... Despite this, we find that the wages of the elderly are low both relative to younger populations and relative to the wages they earned when they themselves were young. Among individuals over the age of 70, we find that changes in health status dominate labor market transitions. Overall. our findings suggest that non- pecuniary considerations play an important role in determining elderly labor supply decisions.

  8. Sharing Elderly Healthcare information on Cloud Computing

    OpenAIRE

    Lu, Fangjie; Khan, Israr

    2012-01-01

    Context: Due to rapid increase in the population of elderly people, sharing healthcare information has become an essential requirement for the development of e-health system. By conducting a research in e-health and cloud computing we have explored the advantages and disadvantages of sharing healthcare information for elderly people through cloud computing. Objectives: The main purpose of this research is to investigate the suitability of cloud computing to share healthcare information. The s...

  9. Anorectal Physiology/Pathophysiology in the Elderly

    OpenAIRE

    Yu, Siegfried W.B.; Rao, SSC

    2014-01-01

    The U.S. elderly population (≥85 years old) is estimated to increase from 5 to 20 million people between the years 2000 to 2050. Among the medical disorders facing the elderly, anorectal problems are not only highly prevalent, but cause significant morbidity and mortality, and have deleterious effects on health care burden and quality of life. These include disorders such as fecal incontinence, fecal impaction with overflow fecal incontinence, chronic constipation, dyssynergic defecation, hem...

  10. Perfil sociodemográfico e estado de saúde auto-referido entre idosas de uma localidade de baixa renda Perfil sociodemográfico y estado de salud auto-referido entre ancianas de una comunidad de escasos recursos Socio-demographic profile and self-reported health status of elderly women in a low-income community

    Directory of Open Access Journals (Sweden)

    Ana Inês Sousa

    2008-12-01

    su condición propia (anciana, mujer y pobre, el grupo ya se encuentra potencialmente en una situación de riesgo y desventaja social en lo referente a otros grupos.The main objective of the present study is to develop a socio-demographic diagnosis to identify the self-perception of the state of health of elderly women in a community of low income in a county of the city of Rio de Janeiro, Brazil. It is a descriptive study, developed in three stages: exploratory focus groups; a Census of the elderly population and a survey with the elderly women identified in the Census. The subjects were 369 elderly women, number that corresponds to 83.5% of the eligible population. Women accounted for 62.8% of the total of the elderly in thecommunity, presenting a disfavorable social condition (49.3% are illiterate, 44.7% are widows, 62.3% have a monthly income of up to a minimum wage and 22,0% reported not having an income at all. Even though 62.0% say they have good health, 80.5% say they have some type of health problem. Due to their condition (elderly, women and poor, the group is already potentially in a situation of risk and social disadvantage compared to other groups.

  11. Factors associated with sarcopenia in institutionalized elderly.

    Science.gov (United States)

    Mesquita, Alice Ferreira; Silva, Emanuelle Cruz da; Eickemberg, Michaela; Roriz, Anna Karla Carneiro; Barreto-Medeiros, Jairza Maria; Ramos, Lílian Barbosa

    2017-03-30

    The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

  12. Health conditions of young and old elderly

    Directory of Open Access Journals (Sweden)

    Cibelle Barbosa Reis

    2016-02-01

    Full Text Available Objective: to evaluate the elderly about the socio-demographic profile and health conditions in the age groups from 60 to 75 years old (“young” elderly and above 76 years (“old” elderly. Methods: this is a cross-sectional study and home based. The data were collected applying a questionnaire based on the model developed by the Older Americans Resources and Services. Results: 118 elderly participated in the study, being 68.6% “young”, 58% illiterate, 85.2% with income less than two minimum wages and 70.4% with non-white skin. The “old” elderly had a higher proportion of loss of the companion (p=0.002, non-communicable chronic diseases (p=0.023 and dependence to perform activities of daily living (p=0.036. Both age groups had low physical activity, excessive consumption of medicaments and chewing problems. Conclusion: the model of health facing the elderly, should not be restricted to treatment of diseases but cover their functional capacity.

  13. EPILEPSY IN ELDERLY PATIENTS (DIAGNOSTIC FEATURES

    Directory of Open Access Journals (Sweden)

    S. A. Gulyaev

    2014-01-01

    Full Text Available Physicians frequently consider that epilepsy is a disease in children and young adults; however, its incidence in elderly patients is not lower and commonly higher than those among children and young people. Among the causes of epilepsy in elderly patients, there is a predominance of acute and chronic cerebral circulatory disorders (50 % of all cases. Other causes of epilepsy (neurodegenerative processes, tumors, etc. are rarely encountered in the elderly. However, there is actually no real pattern of incidence of epilepsy in the elderly since the diversity and features of its clinical manifestations in these patients, as well as difficulties in describing their status make the diagnosis of the disease very hard in this category of patients. Seizures without loss of consciousness, which are especially associated with the development of transient muscle tone disorders and autonomic dysfunction, are commonly regarded as benign vertigo, autonomic or mental disorders. This study has indicated that the development of epilepsy in the elderly, which results from cerebrovascular and neurodegenerative pathology, is not a rare, but relatively common neurological disorder. By taking into account the aging tendency in economically developed countries, the increasing number of elderly patients with epilepsy is an important medical and economic problem that calls for in-depth investigation, timely diagnosis,and treatment.

  14. Renal Transplantation from Elderly Living Donors

    Directory of Open Access Journals (Sweden)

    Jacob A. Akoh

    2013-01-01

    Full Text Available Acceptance of elderly living kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. This is a review of publications in the English language between 2000 and 2013 about renal transplantation from elderly living donors to determine trends and effects of donation, and the outcomes of such transplantation. The last decade witnessed a 50% increase in living kidney donor transplants, with a disproportionate increase in donors >60 years. There is no accelerated loss of kidney function following donation, and the incidence of established renal failure (ERF and hypertension among donors is similar to that of the general population. The overall incidence of ERF in living donors is about 0.134 per 1000 years. Elderly donors require rigorous assessment and should have a predicted glomerular filtration rate of at least 37.5 mL/min/1.73 m2 at the age of 80. Though elderly donors had lower glomerular filtration rate before donation, proportionate decline after donation was similar in both young and elderly groups. The risks of delayed graft function, acute rejection, and graft failure in transplants from living donors >65 years are significantly higher than transplants from younger donors. A multicentred, long-term, and prospective database addressing the outcomes of kidneys from elderly living donors is recommended.

  15. Socioeconomic inequality of overweight and obesity of the elderly in Iran: Bushehr Elderly Health (BEH Program

    Directory of Open Access Journals (Sweden)

    Alireza Raeisi

    2017-01-01

    Full Text Available Abstract Background The objective of this population-based, large sample size study was to investigate the socioeconomic inequality of overweight and obesity among the elderly in Iran. Methods Baseline data of 3000 persons aged ≥60 years who participated in the Bushehr Elderly Health (BEH program was analyzed. Overweight and obesity were defined as a body mass index (BMI equal to or higher than 25 and 30, respectively. Socioeconomic status (SES was measured by an asset index, constructed using principal component analysis, income, education level, and employment status. The Concentration Index and the Lorenz curve were used to illustrate the levels of inequality for overweight and obesity by gender. Results The frequencies among men and women were, respectively, 840 (57.7% and 1131 (73.2%, P < 0.001, for overweight, and 211 (14.7% and 511 (33.7%, P < 0.001, for obesity. There were direct associations between asset index quintiles and both overweight and obesity among both genders (Ps for trend <0.01 except for obesity among men (P for trend = 0.118. The overall Concentration Indices for overweight and obesity were 0.031 (95%CI = 0.016–0.046, P < 0.001 and 0.041 (95%CI = 0.004–0.078, p = 0.028, respectively. Conclusion Findings support the direct relationship between SES and obesity among women as previously reported in developing countries.

  16. An Elderly Employment Model For The Thai Automotive Industry

    Directory of Open Access Journals (Sweden)

    Pornrat Sadangharn

    2017-10-01

    Full Text Available This research aims at studying an elderly employment model for the Thai automotive industry. Mixed methods with a sequential exploratory strategy were utilized. Grounded theory was employed by using in-depth interviews to investigate the characteristics of elderly employment in the Thai automotive industry. For this stage of the research, theoretical and purposive sampling was used to select 32 key informants from four groups of stakeholders: (1 elderly workers, (2 employers or human resource managers, (3 government officers, and (4 academics. The findings were then validated using a quantitative approach with structural equation modelling (SEM. A total of 308 elderly workers and human resource managers were surveyed regarding their opinion about elderly employment. Based on the survey, the elderly employment model in the Thai automotive industry, which is comprised of the approach to elderly employment, elderly employment preparation, and key success factors for elderly employment, was revealed to be a good fit. 

  17. Comparison of oral health status and daily nutrient intake between elders who live alone and elders who live with family: Based on the Korean National Health and Nutrition Examination Survey (KNHANES VI) (2013-2015).

    Science.gov (United States)

    Kim, Eun-Jeong; Jin, Bo-Hyoung

    2018-06-01

    To compare the nutritional factors and oral status of elders living alone and elders living with their families in Korea. Numerous studies have found that the presence of fewer remaining teeth is associated with decreased nutrient intake; however, there is no study comparing the nutritional status and oral status of elders living alone with that of elders living with family based on a nationally representative sample. A sample of 2904 individuals who participated in the sixth Korean National Health and Nutrition Examination Survey was reviewed (65-84 years of age). Living status was defined according to the participants' self-reported questionnaire, and a nutrient intake questionnaire was designed as an open questionnaire and used during the face-to-face interviews. The number of existing teeth was used to determine oral status. A complex-sample general linear analysis and multivariate logistic regression analysis were used to evaluate the association between the number of teeth and nutrient intake among elders living with family and elders living alone after adjusting for confounders. Elders living alone were significantly older and tended to have the following characteristics: women, lower household income, lower educational level, poor perceived health status, non-smokers, non-drinkers and lack of physical activity. Elders living alone had a poorer perceived oral health status, had not received an oral examination in the past year, had chewing problems and had fewer existing teeth (P oral health and nutrient intake status. Participants who had many existing teeth had higher nutrient intake than the participants who had fewer existing teeth. For healthy lives at old age, family support or additional social support for elders living alone should be considered. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  18. Injuries and outcomes associated with traumatic falls in the elderly population on oral anticoagulant therapy.

    Science.gov (United States)

    Boltz, Melissa M; Podany, Abigail B; Hollenbeak, Christopher S; Armen, Scott B

    2015-09-01

    Fall risk for older adults is a multi-factorial public health problem as 90% of geriatric injuries are caused by traumatic falls. The CDC estimated 33% of adults >65 years incurred a fall in 2011, with 30% resulting in moderate injury. While much has been written about overall risk to trauma patients on oral anticoagulant (OAC) therapy, less has been reported on outcomes in the elderly trauma population. We used data from the National Trauma Data Bank (NTDB) to identify the types of injury and complications incurred, length of stay, and mortality associated with OACs in elderly patients sustaining a fall. Using standard NTDB practices, data were collected on elderly patients (≥65 years) on OACs with diagnosis of fall as the primary mechanism of injury from 2007 to 2010. Univariate analysis was used to determine patient variables influencing risk of fall on OACs. Odds ratios were calculated for types of injury sustained and post-trauma complications. Logistic regression was used to determine mortality associated with type of injury incurred. Of 118,467 elderly patients sampled, OAC use was observed in 444. Predisposing risk factors for fall on OACs were >1 comorbidity (p3 complications (p<0.0001); the most significant being ARDS and ARF (p<0.0001). The mortality rate on OACs was 16%. Injuries to the GI tract, liver, spleen, and kidney (p<0.0002) were more likely to occur. However, if patients suffered a mortality, the most significant injuries were skull fractures and intracranial haemorrhage (p<0.0001). Risks of anticoagulation in elderly trauma patients are complex. While OAC use is a predictor of 30-day mortality after fall, the injuries sustained are markedly different between the elderly who die and those who do not. As a result there is a greater need for healthcare providers to identify preventable and non-preventable risks factors indicative of falls in the anti-coagulated elderly patient. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. [Socializing groups as protective factor against depression in elderly people. Barranquilla, Colombia].

    Science.gov (United States)

    Tuesca-Molina, Rafael; Fierro Herrera, Norma; Molinares Sosa, Alexandra; Oviedo Martínez, Fernando; Polo Arjona, Yesid; Polo Cueto, José; Sierra Manrique, Ivan

    2003-01-01

    The depression is a principal problem of public health. The principal aim of this study is to determine the role of the social groups as factor protective in elderly, to evaluate the agreement by American Psychiatric Association Criterions and Hamilton Depression test, and also to determine other socio-cultural risk factors associated with depressive syndrome in elderly. Cross-sectional survey. The sample consisted of 602 elderly people (eligible subjects) were men (223) and women (379) between 60 and 94 years (males and females), residents in the south-west of Barranquilla, Colombia. A previously tested, self answer questionnaire was used, therefore, we needed a report consent. Risk measures: Odds Ratio (OR-95% Confidence intervalue), Kappa test to agreement by the nine criteria of the American Psychiatric Association and Hamilton test so, screening testing. The participation in social groups was a protector factor. (Odds Ratio = 0.5; 95% CI 0.34-0.73, p = 0.001). The rate 29.9% was obtained with prevalence of depression in elderly (21.4%-39.4%) affecting principally males (32.7%). The agreement by Kappa test = 0.63 was very important or good. Sensibility = 56.1% (48.5%-63.4%) Specificity = 0.93% (97.8%-99.8%) and Predictive Positive Value = 97.1% (91.2%-99.3%). This survey was to determine risk factors related to depression in elderly in anyway can be potentially modifiable. The familiar disfunction by moderate and serious, the lack as blindness and deafness, the loneliness, the housingness and low incomes were obtained with risk factors associated to depression. The participation in a social group is a protective factor to depression syndrome in elders. The nine criteria of the American Psychiatric Association to allow the depressed patient exactly as sick even though is not necessary to screening because this test is low sensibility for used in a population elderly.

  20. Scoping review of health promotion and disease prevention interventions addressed to elderly people.

    Science.gov (United States)

    Duplaga, Mariusz; Grysztar, Marcin; Rodzinka, Marcin; Kopec, Agnieszka

    2016-09-05

    The ageing of modern societies remains one of the greatest challenges for health and social systems. To respond to this challenge, we need effective strategies assuring healthy active life for elderly people. Health promotion and related activities are perceived as a key intervention, which can improve wellbeing in later life. The main aim of this study is the identification and classification of such interventions addressed to older adults and elderly. Therefore, the strategy based on the scoping review as a feasible tool for exploring this domain, summarizing research findings and identifying gaps of evidence, was applied. The scoping review relies on the analysis of previous reviews of interventions aimed at older adults (55-64 years old) and elderly persons (65 years and above) assessed for their effectiveness in the framework of a systematic review and/or meta-analysis. The search strategy was based on the identification of interventions reported as health promotion, primary disease prevention, screening or social support. In the analysis, the reviews published from January 2000 to April 2015 were included. The search strategy yielded 334 systematic reviews and/or meta-analyses addressed to target groups of interest, 182 of them assessed interventions belonging to health promotion, 219 to primary prevention, 34 to screening and 35 to social support. The studies focused on elderly (65 years and above) made up 40.4 % of all retrieved reviews and those addressing population of 55 years and above accounted for 24.0 %. Interventions focused on health maintenance and improvement in elderly and older adults represent frequently combined health promotion and disease prevention actions. Many interventions of this type are not addressed exclusively to elderly populations and/or older adults but are designed for the general population. The most common types of interventions addressed to elderly and older adults in the area of health promotion include health