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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. Nutritional Status in Self-Neglecting Elderly

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

    2006-01-01

    Elder self-neglect is the most common, and most compelling form of elder mistreatment. Individuals who cannot provide the basic needs for themselves may develop social, functional, and physical deficits. The CREST project has the goal of systematically characterizing these individuals, and the objective of the study reported here is to characterize aspects of their nutritional status. Self-neglect (SN) subjects referred from Adult Protective Services were recruited and consented. Control (CN) subjects were matched for age, gender, race, and socio-economic status when possible. Reported here are data on 47 SN subjects (age 77 +/- 7, mean +/- SD; body weight 76 kg +/- 26) and 40 CN subjects (77 +/- 7, 79 kg +/- 20). Blood samples were analyzed for indices of nutritional status. SN subjects had higher serum concentrations of homocysteine (p elderly population is at risk with respect to several markers of nutritional status.

  3. 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

  4. Observational measure of elder self-neglect.

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    Iris, Madelyn; Conrad, Kendon J; Ridings, John

    2014-01-01

    The purpose of this study was to improve measurement of elder self-neglect by testing the psychometric properties of the Elder Self-Neglect Assessment (ESNA). Social workers, case managers, and adult protective services providers from 13 Illinois agencies completed a 77-item assessment for 215 clients suffering from self neglect. Analyses used Rasch item response theory and traditional validation approaches to test for dimensionality, model fit, and additional construct validation, resulting in a 62-item assessment. The ESNA met Rasch fit criteria with good internal consistency, item reliability, and construct validity. A 25-item short form also met Rasch criteria. A hierarchy of items associated with severity of abuse was produced by frequency of occurrence. ESNA indicators of self-neglect align into two broad categories: behavioral characteristics and environmental factors, which must be accounted for in a comprehensive evaluation. Theoretical refinements developed using the empirically generated item hierarchy may help to improve assessment and intervention.

  5. 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

    2017-07-13

    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.

  6. 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

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

    Science.gov (United States)

    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

  8. Is pain a significant factor in elder self-neglect?

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    Pickens, Sabrina; Burnett, Jason; Naik, Aanand D; Holmes, Holly M; Dyer, Carmel Bitondo

    2006-01-01

    Pain is a worldwide health concern leading to cognitive impairments, depression, and decline in activities of daily living when poorly controlled. Self-neglect is also a serious public health issue being the most common allegation reported to Adult Protective Services (APS). The purpose of this analysis is to determine whether self-reported pain is associated with validated cases of self-neglect compared with matched controls. This is a cross-sectional study of 80 (APS) validated cases of self-neglect aged 65 years and older and 80 control participants recruited from a geriatric clinic at Harris County Hospital District. Control participants were matched for age, race, gender, and zip code. Both groups were administered the Wong-Baker FACES rating scale and the Mini-Mental State Examination in their homes by a geriatric nurse practitioner and a research assistant. Self-reported pain was noted in 43% of the self-neglect group compared with only 28% in the control group (X2 = 3.85, df = 1, p = .05). This difference became non-significant after stratifying for MMSE scores of 19 or greater (X2 = 3.38, df = 1, p = .066). The self-neglecting elderly also reported significantly higher levels of pain compared with the matched controls (t = 2.5, df = 143, p = .014). This mean difference remained significant after stratifying by MMSE scores of 19 or greater (t = 2.6, df = 124, p = .009). The data provide preliminary support for the relationship between self-reported pain and elder self-neglect. Research is needed to determine whether pain is a causal or associated factor in self-neglect and whether therapeutic intervention can improve the syndrome of self-neglect.

  9. Cross-Sectional Study of the Characteristics of Reported Elder Self-Neglect in a Community-Dwelling Population: Findings from a Population-Based Cohort

    National Research Council Canada - National Science Library

    Dong, Xin-Qi; Simon, Melissa; Evans, Denis

    2010-01-01

    Background: Elder self-neglect is an important public health issue. However, little is known about the characteristics of self-neglect and its association with social factors among community-dwelling populations. Objectives: (1...

  10. 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.

  11. Home care nurses' experiences with and perceptions of elder self-neglect.

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    Johnson, Yvonne O'Connell

    2015-01-01

    Self-neglect is a poorly understood phenomenon evident to home healthcare nurses who describe older adults who self-neglect as disheveled, unkempt individuals living in cluttered, filthy homes. In spite of the concerns nurses report about these individuals and their situations, individuals who self-neglect give no indication there is any reason for concern for their welfare, and in fact some refuse intervention. The purpose of this study was to determine how home healthcare nurses perceive elder self-neglect, their experiences with this phenomenon, and to explore the steps nurses take when self-neglect is suspected.

  12. Elder self-neglect and hospitalization: findings from the Chicago Health and Aging Project.

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    Dong, XinQi; Simon, Melissa A; Evans, Denis

    2012-02-01

    To quantify the relation between reported elder self-neglect and rate of hospitalization in a community population of older adults. Prospective population-based study. Geographically defined community in Chicago. Community dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty-five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder self-neglect and 1.8 ± 3.2 for those with reported elder self-neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39-1.55). Greater severity of self-neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P self-neglect and hospitalization. Reported elder self-neglect was associated with higher rates of hospitalization in this community population. Greater severity of self-neglect was associated with a greater rate of hospitalization. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  13. Association between elder self-neglect and hospice utilization in a community population.

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    Dong, XinQi; Simon, Melissa A

    2013-01-01

    Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8669 participants in the Chicago Health and Aging Project, a subset of 1438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (mild: (HR, 2.12 (1.61-2.79); moderate: (HR, 2.36 (1.95-2.84); severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, -0.27, SE, 0.12, pself-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Prospective study of the elder self-neglect and ED use in a community population.

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    Dong, Xinqi; Simon, Melissa A; Evans, Denis

    2012-05-01

    This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. A prospective population-based study is conducted in a geographically defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6864 participants in the Chicago Health and Aging Project, 1165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3), and for those with reported elder self-neglect, it was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, and cognitive and physical function, older people who self-neglect had significantly higher rates of emergency department utilization (rate ratio, 1.42; 95% confidence interval, 1.29-1.58). Greater self-neglect severity (mild: standardized parameter estimate [PE], 0.27; standard error [SE], 0.04; P self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Prospective Study of the Elder Self-Neglect and Emergency Department Use in a Community Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.; Evans, Denis

    2011-01-01

    Purpose This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population. Methods A prospective population-based study is conducted in a geographically-defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6,864 participants in the Chicago Health and Aging Project, 1,165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization 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 emergency department visits for those without elder self-neglect was 0.6 (1.3) and for those with reported elder self-neglect was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, cognitive and physical function, elders who self-neglect had significantly higher rates of emergency department utilization (RR, 1.42, 95% CI, 1.29–1.58). Greater self-neglect severity (Mild: PE=0.27, SE=0.04, pself-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization. PMID:21411263

  16. The Development of a Conceptual Model for Understanding Elder Self-Neglect

    Science.gov (United States)

    Iris, Madelyn; Ridings, John W.; Conrad, Kendon J.

    2010-01-01

    Purpose: Elder self-neglect (ESN) represents half or more of all cases reported to adult protective services. ESN directly affects older adults and also their families, neighbors, and the larger communities around them. ESN has public health implications and is associated with higher than expected mortality rates, hospitalizations, long-term care…

  17. The Utility of the KELS Test in Substantiated Cases of Elder Self-neglect

    Science.gov (United States)

    Pickens, Sabrina; Naik, Aanand D.; Burnett, Jason; Kelly, P.A.; Gleason, Mary; Dyer, Carmel B.

    2010-01-01

    Purpose Self-neglect is the most prevalent finding among cases reported to Adult Protective Services and is characterized by an inability to meet one’s own basic needs. The Kohlman Evaluation of Living Skills (KELS) has been validated in geriatric populations to assess performance with both instrumental (IADL) and basic activities of daily living (ADL), and as an assessment tool for the capacity to live independently, therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders. Methods This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from Adult Protective Services (APS) as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender and zip code. A geriatric nurse practitioner-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and Mini-Mental State Examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls. Summary of Results The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p=0.025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p=0.013). Conclusion Abnormal results using an in-home KELS test was significantly associated with substantiated cases of self-neglect. These findings suggest that the KELS test has significant utility as part of a comprehensive geriatric assessment to aid clinicians in suspected cases of self-neglect. Implications for Practice There is currently no gold standard

  18. Association of personality traits with elder self-neglect in a community-dwelling population.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2011-08-01

    Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are as follows: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Population-based study conducted from 1993 to 2005 of community-dwelling older adults (N = 9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N = 1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity, and information processing. Logistic and linear regressions were used to assess these associations. In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Neuroticism, extraversion, rigidity, and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders.

  19. Association of Personality Traits with Elder Self-Neglect in a Community Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

    2010-01-01

    Objective Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Methods Population-based study conducted from 1993–2005 of community-dwelling older adults (N=9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N=1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity and information processing. Logistic and linear regressions were used to assess these associations. Results In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Conclusion Neuroticism, extraversion, rigidity and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders. PMID:21788924

  20. Prevalence of elder self-neglect in a Chicago Chinese population: The role of cognitive physical and mental health.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa

    2016-09-01

    The present study examined the cognitive, physical and psychological characteristics associated with elder self-neglect in a USA Chinese older population. The Population Study of Chinese Elderly in Chicago is a population-based epidemiological study of Chinese older adults in the greater Chicago area. In total, 3159 Chinese older adults aged 60 years and older were interviewed from 2011 to 2013. Personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions and inadequate utility. The prevalence of elder self-neglect of all severities was higher among older adults who were with worsening health status, lower cognitive function, lower physical function and more depressive symptoms. Poorer health status (mild self-neglect OR 1.20, 95% CI 1.06-1.35; moderate/severe self-neglect: OR 1.52, 95% CI 1.30-1.77), lower physical function (activities of daily living moderate/severe self-neglect OR 1.09, 95% CI 1.05-1.13; instrumental activities of daily living mild OR 1.04, 95% CI 1.03-1.06; instrumental activities of dailiy living moderate/severe OR 1.06, 95% CI 1.04-1.07), lower cognitive function (mild self-neglect OR 1.05, 95% CI 1.03-1.07; moderate/severe self-neglect OR 1.07, 95% CI 1.04-1.09) and more depressive symptoms (mild self-neglect OR 1.05, 95% CI 1.02-1.07; moderate/severe self-neglect OR 1.08, 95% CI 1.06-1.11) were significantly associated with increased risk for elder self-neglect of all severities. Older adults with lower levels of cognitive, physical, and psychological health were more likely to report elder self-neglect and its phenotypes. Future research is required to examine risk/protective factors associated with elder self-neglect. Geriatr Gerontol Int 2016; 16: 1051-1062. © 2015 Japan Geriatrics Society.

  1. Elder self-neglect is associated with an increased rate of 30-day hospital readmission: findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A

    2015-01-01

    Elder self-neglect is associated with increased morbidity and mortality. The objective of this study is to examine the prospective relationship between reported elder self-neglect and the rate of 30-day hospital readmission in a community population. We conducted a prospective population-based study of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 7,219 participants in the Chicago Health and Aging Project, a subset of 1,228 participants was reported to the social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to the social services agency. The outcome of interest was the annual rate of 30-day hospital readmission calculated from the Center for Medicare and Medicaid System hospitalization data from 1993 to 2009. Poisson regression models were used to assess these relationships. The average annual rate of 30-day hospital readmission for those without elder self-neglect was 0.2 (SD 0.7) and for those with reported elder self-neglect 0.9 (SD 2.8). After adjusting for sociodemographic and socioeconomic characteristics, medical comorbidities, cognitive function, physical function, and psychosocial well-being, elders who self-neglect had a significantly higher rate of 30-day hospital readmission (rate ratio 2.50, 95% confidence interval 2.02-3.10). Greater self-neglect severity [mild: parameter estimate (PE) 1.09, standard error (SE) 0.19, p self-neglect and 30-day hospital readmission was not moderated by medical conditions, cognitive impairment, physical disability, or psychosocial well-being. Reported elder self-neglect was associated with increased rates of 30-day hospital readmission in this community population. Greater self-neglect severity was associated with a greater increase in the rate of 30-day hospital readmission. © 2014 S. Karger AG, Basel.

  2. Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the Population Study of Chinese Elderly in Chicago study.

    Science.gov (United States)

    Dong, XinQi

    2014-12-01

    This study aimed to examine the prevalence of self-neglect and its specific behaviors in an elderly community-dwelling U.S. Chinese population through a population-based cohort study (PINE Study) in the greater Chicago area. Community-dwelling population of older Chinese adults were interviewed from 2011 to 2013 (n = 3,159). The personal and home environment of participants was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented according to self-reported quality of life (QOL). It was found that the prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate to severe self-neglect. Unsanitary conditions (17.0%) was the most prevalent, followed by need for home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and of all types was higher in older adults with fair or poor QOL than in those with good or very good QOL. Poorer QOL was significantly associated with greater risk of self-neglect of all severities (mild self-neglect: odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.26-2.96, P self-neglect: OR = 3.58, 95% CI = 1.79-7.13, P self-neglect is prevalent, especially in elderly adults with poorer QOL. Future research is needed to examine risk and protective factors associated with elder self-neglect. © 2014, Copyright the Author Journal compilation © 2014, The American Geriatrics Society.

  3. Elder Self-Neglect Is Associated with Increased Rate of 30 Day Hospital Readmission: Findings from the Chicago Health and Aging Project

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2014-01-01

    Background Elder self-neglect is associated with increased morbidity and mortality. The objective of this study is to examine the prospective relationship between reported elder self-neglect and rate of 30 day hospital readmission in a community population. Methods Prospective population-based study of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 7,219 participants in the Chicago Health and Aging Project, a subset of 1,228 participants was reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. Outcome of interest was the annual rate of 30 day hospital readmission calculated from the Center for Medicare and Medicaid System hospitalization data from 1993-2009. Poisson regression models were used to assess these relationships. Results The average annual rate of 30 day hospital readmission for those without elder self-neglect was 0.2 (0.7) and for those with reported elder self-neglect was 0.9 (2.8). After adjusting for sociodemographic, socioeconomic, medical commorbidities, cognitive function, physical function, and psychosocial wellbeing, elders who self-neglect had significant higher rate of 30 day hospital readmission (RR, 2.50, 95% CI, 2.02-3.10). Greater self-neglect severity (Mild: PE=1.09, SE=0.19, pself-neglect and 30 day hospital readmission was not moderated by medical conditions, cognitive impairment, physical disability or psychosocial wellbeing. Conclusion Reported elder self-neglect was associated with increased rates of 30 day hospital readmission in this community population. Greater self-neglect severity was associated with a greater increase in the rate of 30 day hospital readmission. PMID:25300509

  4. Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population.

    Science.gov (United States)

    Dong, XinQi

    2016-01-01

    This study aimed to examine the socio-demographic and socioeconomic characteristics associated with prevalence and severity of elder self-neglect in an U.S. Chinese older population. The PINE study is a population-based epidemiological study in the greater Chicago area. In total, 3159 Chinese older adults were interviewed from 2011 to 2013. Elder self-neglect was assessed with systematic observations of a participant's personal and home environment across five domains: hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Elder self-neglect was prevalent among older adults aged 80 years or over (mild self-neglect: 34.6% 95% CI 30.9-38.4; moderate/severe: 15.6% 95% CI 12.8-18.6), men (mild: 28.6% 95% CI 26.1-31.3; moderate/severe: 13.1% 95% CI 11.2-15.1), those with 0-6 years of education (mild: 32.2% 95% CI 29.7-34.9; moderate/severe: 12.6% 95% CI 10.8-14.5), and those with an annual personal income between $5000 and $10,000 (mild: 30.8% 95% CI 28.4-33.2; moderate/severe: 11.8% 95% CI 10.2-13.5). Older age (mild self-neglect: OR 1.02, 95% CI 1.01-1.03; moderate/severe self-neglect: OR 1.02, 95% CI 1.00-1.03) and lower education levels (mild self-neglect: OR 1.06, 95% CI 1.03-1.08; moderate/severe self-neglect: OR 1.07, 95% CI 1.04-1.09) were associated with significantly increased odds of elder self-neglect. Women (moderate/severe self-neglect: OR 0.73, 95% CI 0.58-0.93) had significantly decreased odds of moderate/severe elder self-neglect. No significant association was found between levels of income and overall elder-self-neglect of all severities. Future research is needed to examine risk/protective factors associated with elder self-neglect in U.S. Chinese older populations.

  5. Social networks: a profile of the elderly who self-neglect.

    Science.gov (United States)

    Burnett, Jason; Regev, Tziona; Pickens, Sabrina; Prati, Laura Lane; Aung, Koko; Moore, Jenny; Dyer, Carmel Bitondo

    2006-01-01

    Self-neglect is an independent risk factor for early mortality in older people and has been linked to depression and the occurrence of mental and physical decline. Sound social networks have been shown to slow the process of decline in the elderly, and currently little is known about the social networks associated with elder self-neglect. The aim of this study was to explore the social networks associated with elder self-neglect compared with a matched-control group. Ninety-one Adult Protective Services-validated cases of elder self-neglect were compared on formal and informal social network factors with 91controls matched for age, race, gender, and socio-economic status. Elders in the self-neglect group were significantly less likely to (1) Live with a spouse, (2) Live with others, (3) Have weekly contact with children or siblings, (4) Visit with neighbors and friends and (5) Participate in religious activities. Less adequate social resources related to family, friends, and religious affiliations are significantly associated with elder self-neglect.

  6. Exploring Self-neglect in Older Adults: Preliminary Findings of the Self-Neglect Severity Scale and Next Steps

    OpenAIRE

    Kelly, P Adam; Dyer, Carmel B.; Pavlik, Valory; Doody, Rachelle; Jogerst, Gerald

    2008-01-01

    Despite the public health implications of self-neglect, no tool exists for characterizing this condition. Self-neglecters often have no caregivers or surrogates to interview regarding the neglect, and are often too cognitively impaired to provide valid self-reports. In response to this need, researchers from the Consortium for Research in Elder Self-neglect of Texas (CREST), collaborated with other experts in the field of elder self-neglect to design the Self-neglect Severity Scale (SSS). The...

  7. Elder abuse and self-neglect: "I don't care anything about going to the doctor, to be honest...".

    Science.gov (United States)

    Mosqueda, Laura; Dong, XinQi

    2011-08-01

    Elder mistreatment encompasses a range of behaviors including emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. This article discusses the range of elder mistreatment in community-living older adults, associated factors, and consequences. Although self-neglect is not considered a type of abuse in many research definitions, it is the most commonly reported form of elder mistreatment and is associated with increased morbidity and mortality. The case on which this article is based describes a 70-year-old woman who neglects herself and dies despite multiple contacts with the medical community. Despite significant gaps in research, enough is known to guide clinical practice. This article presents the practical approaches a health care professional can take when a reasonable suspicion of elder mistreatment arises. Public health and interdisciplinary team approaches are needed to manage what is becoming an increasing problem as the number of older adults around the world increases.

  8. The utility of the Kohlman Evaluation of Living Skills test is associated with substantiated cases of elder self-neglect.

    Science.gov (United States)

    Pickens, Sabrina; Naik, Aanand D; Burnett, Jason; Kelly, P A; Gleason, Mary; Dyer, Carmel B

    2007-03-01

    Self-neglect is the most prevalent finding among cases reported to Adult Protective Services (APS) and is characterized by an inability to meet one's own basic needs. The Kohlman evaluation of living skills (KELS) has been validated in geriatric populations to assess performance with both instrumental and basic activities of daily living and as an assessment tool for the capacity to live independently; therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders. This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from APS as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender, and ZIP code. A geriatric nurse practitioner (NP)-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and mini-mental state examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls. The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p = .025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p = .013). Abnormal results using an in-home KELS test were significantly associated with substantiated cases of self-neglect. There is currently no gold-standard measure for identifying capacity with self-care behaviors among cases of self-neglect. As a result, self-neglect may remain unidentified in many clinical settings. The KELS provides clinicians with an objective measure of an individual's capacity and performance with

  9. Elder Self-Neglect in a Community-Dwelling U.S. Chinese Population: Findings from the Population Study of Chinese Elderly in Chicago (PINE) Study

    Science.gov (United States)

    Dong, XinQi

    2014-01-01

    Objectives To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling U.S. Chinese aging population. Design Population-based cohort study. Setting Community-dwelling population of Chinese older adults. Participants 3,159 Chinese older adults in the greater Chicago area interviewed from 2011-2013. Measurements Participant’s personal and home environment was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented across self-reported quality-of-life. Results Prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate/severe self-neglect among Chinese older adults. In terms of specific phenotypes, unsanitary conditions (17.0%) was the most prevalent, followed by need of home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and its phenotypes was higher among older adults with fair or poor quality-of-life as compared to that of older adults with good or very good quality-of-life. Lower quality-of-life was significantly associated with and increased risk for self-neglect of all severities (mild self-neglect: OR 1.93, 95% CI 1.26-2.96, pself-neglect: OR 3.58, 95% CI 1.79-7.13, pself-neglect is prevalent, especially among those with lower levels of quality-of-life. Future research is needed to examine risk/protective factors associated with elder self-neglect. PMID:25439674

  10. 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.

  11. A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A; Fulmer, Terry; Mendes de Leon, Carlos F; Hebert, Liesi E; Beck, Todd; Scherr, Paul A; Evans, Denis A

    2011-06-01

    Self-neglect is the behavior of an elderly person that threatens his or her own health and safety, and it is associated with increased morbidity and mortality. Although report of self-neglect is more common among black older adults, the racial/ethnic differences in mortality remain unclear. The Chicago Healthy Aging Project is a population-based cohort study conducted from 1993 to 2005. A subset of these participants were suspected to self-neglect and were reported to a social services agency. Mortality was ascertained during follow-up and from the National Death Index. Cox proportional hazards models were used to assess the mortality risk. In the total cohort, there were 5,963 black and 3,475 white older adults, and of these, 1,479 were reported for self-neglect (21.7% in black and 5.3% in white older adults). In multivariable analyses with extensive adjustments, the interaction term indicated that impact of self-neglect on mortality was significantly stronger in black than in white older adults (parameter estimate, 0.54, SE, 0.14, p self-neglect, the hazard ratio for black older adults was 5.00 (95% confidence interval, 4.47-5.59) and for white older adults was 2.75 (95% confidence interval, 2.19-3.44). At 3 years after report, the hazard ratios were 2.61 (95% confidence interval, 2.25-3.04) and 1.47 (95% confidence interval, 1.10-1.96) for black older adults and white older adults, respectively. Future studies are needed to qualify the casual mechanisms between self-neglect and mortality in black and white older adults in order to devise targeted prevention and intervention strategies.

  12. Exploring self-neglect in older adults: preliminary findings of the self-neglect severity scale and next steps.

    Science.gov (United States)

    Kelly, P Adam; Dyer, Carmel B; Pavlik, Valory; Doody, Rachelle; Jogerst, Gerald

    2008-11-01

    Despite the public health implications of self-neglect, no tool exists for characterizing this condition. Self-neglecters often have no caregivers or surrogates to interview regarding the neglect and are often too cognitively impaired to provide valid self-reports. In response to this need, researchers from the Consortium for Research in Elder Self-neglect of Texas (CREST) collaborated with other experts in the field of elder self-neglect to design the Self-neglect Severity Scale (SSS). The SSS assesses three domains of self-neglect (hygiene, functioning, and environment) and relies on observational ratings assigned by trained observers. After pilot testing and revision, the SSS was field tested in the homes of subjects who had been reported to and substantiated by Texas Adult Protective Services (APS) as self-neglecting and compared with results of subjects recruited from a local geriatric clinic who were reported to APS but had no history of self-neglect. The first field test demonstrated that the SSS could distinguish elderly self-neglecters from community dwellers who do not self-neglect. The SSS exhibited adequate scale reliability (Cronbach alpha) and correlation with case status. Interrater reliability also appeared adequate, although sensitivity and specificity fell below the conventional acceptable range. Future methods are proposed for refining the SSS to improve its use as the benchmark for identifying elder self-neglect.

  13. 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

  14. A cross-sectional population-based study of elder self-neglect and psychological, health, and social factors in a biracial community.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Beck, Todd; Evans, Denis

    2010-01-01

    Elder self-neglect is an important public health issue; however, its association with psychological, health, and social factors remains unclear. This study aimed to (1) examine the associations between self-neglect severity and psychological, health, and social factors (2) examine the racial/ethnic differences in these associations. We conducted a biracial population-based study in a geographically defined community in Chicago: Chicago Health Aging Project. We identified 1094 persons who had been identified by social services agency as suspected elder self-neglect from 1993 to 2005. Self-neglect severity was assessed on a 0-45 scale. The psychological, health, and social factors were assessed using Center for Epidemiological Studies of Depression (CESD), poor mental health, health status, unhealthy days, poor physical health, days away from usual activities, social network, and social engagement. Linear regression was used to assess associations between self-neglect and psychological, health, and social factors. Interaction terms (Self-neglect x Race) were used to assess the black (non-Hispanic black) and white (non-Hispanic white) differences in these associations. There were significant associations between self-neglect severity with health and social factors. After adjusting for confounders, greater self-neglect severity was associated with lower health status (PE = 0.001, p = 0.002), higher unhealthy days (PE = 0.139, p Self-Neglect x Race) indicates black compared with white older adults, had more days away from usual activities (PE = 0.321, p = 0.045) and lower social engagement (PE = -0.04, p = 0.003). Greater self-neglect severity is associated with lower levels of health and social wellbeing. These associations may be stronger for black than white older adults.

  15. Neglect and Self-Neglect

    Science.gov (United States)

    ... Paveza, G. Neglect in the elderly patient. (1998). Nursing Clinics of North America. 33(3), 457-467. Rathborn-McCuan, E., & Fabian, D.R. (Eds.). (1992). Self-neglecting elders: A clinical dilemma. Westport, CT: Auburn House Home | About NCPEA | Elder ...

  16. Other Safety Concerns and Self-Neglect

    Science.gov (United States)

    ... Center (NAPSRC) Training Research Exploitation Resources Technical Assistance Other Safety Concerns and Self-Neglect Other safety concerns ... APS office for additional information. When To Report Other Safety Concerns and Self-Neglect? If you witness ...

  17. Correlate of self-care and self-neglect among community-dwelling older adults

    Science.gov (United States)

    Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma’rof; Ibrahim, Rahimah

    2014-01-01

    Background: The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. Materials and Methods: A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. Results: The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. Conclusions: The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being. PMID:25949256

  18. Ethical perspectives on self-neglect among older adults.

    Science.gov (United States)

    Mauk, Kristen L

    2011-01-01

    Self-neglect is a serious and growing problem among older adults. A 2004 survey from Adult Protective Services (APS) showed that adults age 60 or older were named in 85,000 reports of self-neglect from 21 states (Naik, Lai, Kunik, & Dyer, 2008; Teaster, Dugar, Mendiondo, Abner, & Cecil, 2006). Although rehabilitation nurses are obligated to uphold the autonomy of older adults and strengthen their independence, dilemmas result when people's poor health behaviors put them or others at risk for negative consequences. When making decisions about nursing actions related to self-neglecting elderly people, the basic principles of autonomy, beneficence, nonmaleficence, and capacity must be considered. The purpose of this article is to discuss major ethical perspectives related to self-neglect among older adults.

  19. The prevalence of elder self-neglect in a community-dwelling population: hoarding, hygiene, and environmental hazards.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A; Mosqueda, Laura; Evans, Denis A

    2012-04-01

    To examine the prevalence of self-neglect and its specific behaviors in a community-dwelling population of older adults. A population-based cohort study conducted between 2007 and 2010 rated participant's personal and home environment, particularly with regard to hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across health-related variables of health status, physical function, and cognitive function. There were 4,627 older adults (1,645 men and 2,982 women). Prevalence of self-neglect in older adults increased with lower health status in both men (4.7% in very good/excellent health, 7.9% in good health, and 14.9% in fair/poor health) and women (4.5% in very good/excellent health, 7.9% in good health, and 10.6% in fair/poor health). For those with ≥3 Katz impairments, the prevalence of self-neglect in older adults was 12.8% in men and 13.8% in women. For those with MMSE (Mini-Mental State Examination) ≤20, the prevalence of self-neglect in older adults was 18.8% in men and 13.6% in women. Self-neglect was clearly prevalent among older adults, especially among those with lower health status and physical and cognitive function.

  20. Reporting elder mistreatment.

    Science.gov (United States)

    Capezuti, E; Brush, B L; Lawson, W T

    1997-07-01

    Elder mistreatment, defined as the abuse and neglect of older persons, includes physical, psychological, and sexual abuse, caregiver and self-neglect, and financial exploitation. Fifty states and the District of Columbia have passed legislation to establish adult protective service (APS) programs. State APS statutes authorize APS agencies to investigate cases of elder mistreatment. Some status fund services to alleviate the abusive or neglectful situation. This article analyzes the critical aspects of state-specific APS legislation affecting nursing practice with older adults and the nurse's role in reporting cases of elder mistreatment.

  1. Self-neglect and neglect of vulnerable older adults: reexamination of etiology.

    Science.gov (United States)

    Choi, Namkee G; Kim, Jinseok; Asseff, Joan

    2009-01-01

    Using assessment and investigation data from the reported APS cases in Texas, this study examines the types of elder self-neglect and neglect, including medical neglect. It then examines the association between self-neglect and neglect and individual economic resources as well as health care and social service programs for the poor. The findings show that elder self-neglect/neglect is, in large part, attributable to frail older adults' and their families' lack of resources to pay for essential goods and services and the inadequate healthcare and other formal support programs for the older adults and their caregivers. This inadequate public policy coverage, rather than individual and intrafamily risk factors per se, needs to be considered as a significant cause of elder self-neglect/neglect.

  2. Community-Based Risk Assessment of Elder Mistreatment and Self-Neglect: Evidence of Construct Validity and Measurement Invariance Across Gender and Ethnicity

    National Research Council Canada - National Science Library

    Jason Burnett; Carmel B. Dyer; James G. Booker; David V. Flores; Charles E. Green; Pamela M. Diamond

    2014-01-01

    Mistreatment and self-neglect among older adults are linked to significantly high mortality rates, but research in this area is hindered by a lack of standardized assessments to identify these circumstances...

  3. Self-neglect and adult safeguarding: findings from research

    OpenAIRE

    Braye, Suzy; Orr, David; Preston-Shoot, Michael

    2011-01-01

    This report was commissioned by the Department of Health (DH) and examines the concept of self-neglect. The relationship between self-neglect and safeguarding in the UK is a difficult one, partly because the current definition of abuse specifies harmful actions by someone other than the individual at risk. Safeguarding Adults Boards’ policies and procedures commonly contain no reference to self-neglect; occasionally they explicitly exclude it or set criteria for its inclusion\\ud \\ud The perce...

  4. Self-Neglect: Ethical Considerations.

    Science.gov (United States)

    Day, Mary Rose; Leahy-Warren, Patricia; McCarthy, Geraldine

    2016-01-01

    Self-neglect is a significant international public health issue. Estimates suggest that there may be over one million cases per year in the United States. Aging populations will put more people at risk of self-neglect. This chapter presents background literature, self-neglect definitions and policy context, risk factors, and a brief overview of research on perspectives of self-neglect from both clients and community health and social care professionals. A case study is presented from the perspective of an individual and is used to explore ethical issues therein. A person-centered assessment within a multidisciplinary team approach is required for building a therapeutic relationship with clients. Capacity is a central issue in the management of responses to self-neglect. Ethical considerations of importance for community health and social care professionals include beneficence and nonmaleficence, autonomy and capacity, and respect for people's rights and dignity. A model of ethical justification is presented to explain dilemmas, challenges, and actions. Competence of professionals, multidisciplinary team working, informed consent, privacy, confidentiality, and best interest are also critical considerations. Effective decision making by an interdisciplinary team of professionals needs to be person-centered and give due consideration to the best interest of self-neglecting clients. The purpose of this chapter is to provide an in-depth discussion and examination of ethical issues and challenges relating to self-neglecting clients.

  5. 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.

  6. [Self-neglect in older adults--a complex problem].

    Science.gov (United States)

    Reesink, Fransje E; Boelaarts, Leo; Weinstein, Henry C

    2009-01-01

    A 76-year-old man presented at the emergency department with functional decline and extreme self-neglect. He died after a few days. The probable cause of death was pneumonia. His family consented to autopsy. Surprisingly, the neuropathological findings showed a tauopathy consistent with fronto-temporal dementia. Self-neglect in the elderly is a common and complex problem associated with high mortality and morbidity. This syndrome requires a thorough workup to detect possible causes. The most common etiologies are neurodegenerative disorders, psychiatric illness and alcohol abuse. It is important to elucidate the cause of self-neglect in order to give the proper treatment and support to the patient and family.

  7. Theory synthesis for self-neglect: a health and social phenomenon.

    Science.gov (United States)

    Gibbons, Susanne W

    2009-01-01

    Self-neglect, best known for its prominent place in the elder mistreatment framework, is a phenomenon associated with a variety of health and social conditions. However, a second, less worrisome group of older adults with chronic disease exhibits similar patterns of nonadherence and inadequate self-care practices and has the potential for progression. The purpose of this theory-validating research was to describe characteristics and behaviors of self-neglect in adults (aged 55 years and older) who reside in the community. This research described characteristics and behaviors of self-neglect in early stages of this phenomenon and described the influence of several variables of significance in the clinical evolution and course of self-neglect in identified cases. A descriptive, exploratory mixed-method design was employed for a comprehensive analysis of the research questions. A convenience sample of seven healthcare providers identified a purposive sample of 20 patient participants. Demographic information, geriatric assessments, and structured interview data were analyzed using content analysis and descriptive statistics. Characteristics and behaviors of self-neglect, before significant deterioration, are described in intentional (n = 9) and nonintentional (n = 11) self-neglect study participants. Fourteen themes emerged and were grouped into five categories. Coping problems appeared to affect operable self-care agency of each self-neglect study participant. The results validate a framework for self-neglect research and practice and indicate a need to consider coping abilities of all patients exhibiting self-neglect.

  8. Assessing Capacity in the Setting of Self-Neglect

    Science.gov (United States)

    Naik, Aanand D.; Pickens, Sabrina; Burnett, Jason; Lai, James M.; Dyer, Carmel Bitondo

    2010-01-01

    Summary Compared to older adults with disabilities and those who autonomously choose to live in squalor; self-neglect syndrome arises from a predicate state of vulnerability in frail older adults. This state of vulnerability is characteristically associated with a decline in decision-making capacity regarding the ability to care for and protect oneself. We developed the COMP Screen to evaluate vulnerable older adults to identify potential gaps in decision-making capacity using a screening tool. A total of 182 older adults were evaluated and consistent declines in cognitive ability and decision-making processes were present in this population. However, there were no significant differences between elders referred for self-neglect and matched older adults. These findings suggest that declines in decision-making processes are not uncommon in vulnerable older adults but traditional conceptualizations of decision-making capacity may be inadequate for differentiating the capacity for self care and protection in elders who self-neglect. PMID:17972661

  9. Prevalence and risk factors for self-neglect among older adults living alone in South Korea.

    Science.gov (United States)

    Lee, Minhong; Kim, Kyeongmo

    2014-01-01

    This study aimed to explore the prevalence of and risk factors for self-neglect among older adults who live alone. Data were obtained through face-to-face interview responses of 1,023 older adults living alone in a metropolitan area in South Korea, selected via stratified random sampling, which considered the population variables gender, age group, and district. Descriptive statistics were used to characterize the prevalence of self-neglect, and hierarchical multiple regression analysis was conducted to identify significant risk factors of self-neglect. At least 22.8% of the participants could be considered to have one form of elder self-neglect. Consistent with previous research, self-neglect was more prevalent in the older people living alone who had higher levels of depressive symptoms or a lack of family social support. Unexpectedly, self-neglect was more prevalent among respondents with higher levels of education and cognitive abilities, lower levels of medical comorbidities, and more children. Additionally, social networks of friends and use of social services (formal social support) did not affect the frequency of self-neglect. The findings have implications for gerontological practice and policy, especially for older people living alone in South Korea.

  10. Is greater self-neglect severity associated with lower levels of physical function?

    Science.gov (United States)

    Dong, XinQi; Mendes de Leon, Carlos F; Evans, Denis A

    2009-06-01

    This study examined the association between severity of self-neglect and physical function in a population of community-dwelling older adults. Participants were older adults (N = 1,094) reported to the Chicago Department on Aging for suspected self-neglect from 1993 to 2005, who also participated in the Chicago Health Aging Project. The primary outcome of physical function was assessed using physical performance tests. Secondary outcomes were assessed using the Katz, Nagi, and Rosow-Breslau scales. Multiple regression models were used to assess these associations. After adjusting for confounders, higher self-neglect severity scores were associated with lower physical performance testing (coefficient = -.062, p = .001). Greater self-neglect severity was also correlated with the reported number of impairments on the Katz, Nagi, and Rosow-Breslau scales (coefficients = .024, .024, and .016, respectively, p = .001). Higher self-neglect severity is associated with lower levels of physical function among older adults.

  11. Adult protective services clients confirmed for self-neglect: characteristics and service use.

    Science.gov (United States)

    Ernst, Joy Swanson; Smith, Charles A

    2011-10-01

    Self-neglect is a complex and inadequately understood phenomenon that accounts for the majority of Adult Protective Services cases. This retrospective, record-based study of the characteristics of 210 older adults who were reported to Adult Protective Services and confirmed for self-neglect revealed that common health problems included nutritional frailty, arthritis, and incontinence. Comparisons based upon length of service showed differences in worker-rated social environment risk, client capacity, and activities of daily living performance. Comparisons of findings with those of other studies of self-neglect underscore the need for systematic research on this population.

  12. 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.

  13. 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.

  14. Prevalence of self-neglect across gender, race, and socioeconomic status: findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A; Evans, Denis A

    2012-01-01

    Self-neglect is the behavior of an elderly person that threatens his/her own health and safety, and it is associated with increased morbidity and mortality. However, the scope of the self-neglect in the community population remains unclear. We examined the prevalence of self-neglect and its specific behaviors of hoarding, hygiene and other environmental hazards in a community-dwelling elderly population. A population-based cohort study conducted from 2007 to 2010 in a single cycle in a geographically defined community of 4 adjacent neighborhoods in Chicago, Ill., USA. Participant's personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across gender, race/ethnicity, education and income levels. There were 4,627 older adults in the cohort. The prevalence of self-neglect and specific personal and environmental hazards varied significantly by race/ethnicity and by levels of education and income. For race/ethnicity, black older adults (men 13.2%; women 10.9%) had a significantly higher prevalence of self-neglect than white older adults (men 2.4%; women 2.6%). For those with less than high school education, the prevalence of the self-neglect was 14.7% in men and 10.9% in women. For those with an annual income of less than USD 15,000, the prevalence of self-neglect was 21.7% in men and 15.3% in women. The prevalence of self-neglect and specific behaviors of hoarding, poor hygiene, and other environmental hazards are higher among black older adults and among those with lower levels of education and income. Copyright © 2011 S. Karger AG, Basel.

  15. Assessing capacity in suspected cases of self-neglect

    OpenAIRE

    Naik, Aanand D; Lai, James M.; Kunik, Mark E.; Dyer, Carmel B.

    2008-01-01

    Self-neglect is a serious and burgeoning public health challenge representing the most common problem faced by Adult Protective Services agencies. Among older adults who are vulnerable to self-neglect, the capacity to make decisions may remain intact. However, the capacity to identify and extract oneself from harmful situations, circumstances, or relationships may be diminished. A key ethical and clinical branch point in identifying older adults at risk for self-neglect involves determining w...

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

    OpenAIRE

    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 ...

  17. Assessing capacity in the setting of self-neglect: development of a novel screening tool for decision-making capacity.

    Science.gov (United States)

    Naik, Aanand D; Pickens, Sabrina; Burnett, Jason; Lai, James M; Dyer, Carmel Bitondo

    2006-01-01

    Compared with older adults with disabilities and those who autonomously choose to live in squalor, self-neglect syndrome arises from a predicate state of vulnerability in frail older adults. This state of vulnerability is characteristically associated with a decline in decision-making capacity regarding the ability to care for and protect oneself. We developed the COMP Screen to evaluate vulnerable older adults to identify potential gaps in decision-making capacity using a screening tool. A total of 182 older adults were evaluated and consistent declines in cognitive ability and decision-making processes were present in this population. However, there were no significant differences between elders referred for self-neglect and matched older adults. These findings suggest that declines in decision-making processes are not uncommon in vulnerable older adults but traditional conceptualizations of decision-making capacity may be inadequate for differentiating the capacity for self-care and protection in elders who self-neglect.

  18. Assessing capacity in suspected cases of self-neglect.

    Science.gov (United States)

    Naik, Aanand D; Lai, James M; Kunik, Mark E; Dyer, Carmel B

    2008-02-01

    Self-neglect is a serious and burgeoning public health challenge representing the most common problem faced by Adult Protective Services agencies. Among older adults who are vulnerable to self-neglect, the capacity to make decisions may remain intact. However, the capacity to identify and extract oneself from harmful situations, circumstances, or relationships may be diminished. A key ethical and clinical branch point in identifying older adults at risk for self-neglect involves determining whether the individual can both make and implement decisions regarding personal needs, health, and safety. The Articulate --> Demonstrate method is a practical and efficient way to screen capacity in the setting of suspected self-neglect. Once self-neglect has been identified, common clinical interventions can be targeted to the diagnosed deficits that foster vulnerability to neglect in older adults.

  19. The mortality of elder mistreatment.

    Science.gov (United States)

    Lachs, M S; Williams, C S; O'Brien, S; Pillemer, K A; Charlson, M E

    1998-08-05

    Although elder mistreatment is suspected to be life threatening in some instances, little is known about the survival of elderly persons who have been mistreated. To estimate the independent contribution of reported elder abuse and neglect to all-cause mortality in an observational cohort of community-dwelling older adults. Prospective cohort study with at least 9 years of follow-up. The New Haven Established Population for Epidemiologic Studies in the Elderly cohort, which included 2812 community-dwelling adults who were older than 65 years in 1982, a subset of whom were referred to protective services for the elderly. All-cause mortality among (1) elderly persons for whom protective services were used for corroborated elder mistreatment (elder abuse, neglect, and/or exploitation), or (2) elderly persons for whom protective services were used for self-neglect. In the first 9 years after cohort inception, 176 cohort members were seen by elderly protective services for verified allegations; 10 (5.7%) of these were for abuse, 30 (17.0%) for neglect, 8 (4.5%) for exploitation, and 128 (72.7%) for self-neglect. At the end of a 13-year follow-up period from cohort inception, cohort members seen for elder mistreatment at any time during the follow-up had poorer survival (9%) than either those seen for self-neglect (17%) or other noninvestigated cohort members (40%) (Pself-neglect (odds ratio, 1.7; 95% confidence interval, 1.2-2.5), when compared with other members of the cohort. Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults.

  20. Self-Neglect: Development and Evaluation of a Self-Neglect (SN-37) Measurement Instrument.

    Science.gov (United States)

    Day, Mary Rose; McCarthy, Geraldine

    2016-08-01

    Self-neglect (SN) is a global phenomenon, largely hidden, poorly defined, and a serious public health issue. It can be intentional or unintentional and depends on the individual's capacity. Creating a safe living environment for self-neglecting adults can present complex ethical challenges. The purpose of this research was to develop and evaluate the psychometric properties of an instrument to measure professional's perceptions of self-neglect. A descriptive cross-sectional design was used in this two-stage study. Stage 1 involved the generation of an item pool (90 items), face and content validity; and pilot testing of the instrument. In stage 2, the questionnaire was posted to a national sample of community health and social care professionals (n=566) across Ireland, with a 60% response (n=339). Exploratory factor analysis (EFA) was conducted using scale development guidelines to identify scales and subscales of the instrument. Construct validity was established using EFA. The result was a 37-item SN instrument, composed of five factors: environment, social networks, emotional and behavioural liability, health avoidance, and self-determinism which explained 55.6% of the total variance. Factor loadings were ≥0.40 for all items on each of the five subscales. Cronbach's alpha (α) for four subscales ranged from 0.83 to 0.89 and one subscale was 0.69. The SN-37 can be used not only to measure SN, but also to develop interventions in practice. Further testing of the SN-37 in primary care settings with diverse populations is recommended.

  1. High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect.

    Science.gov (United States)

    Turner, Anisha; Hochschild, Ann; Burnett, Jason; Zulfiqar, Amber; Dyer, Carmel B

    2012-09-01

    Medication non-adherence can exacerbate disease severity, leading to impairments that interfere with self-care activities in older adults, and, ultimately, death. Elder self-neglect is the most common report to Adult Protective Services (APS) across the USA and is a significant risk factor for early mortality. These individuals often suffer from multiple comorbid diseases that require careful management, but for various reasons they are unwilling or unable to provide themselves with the self-care resources necessary for maintaining health and safety. No studies have assessed whether medication adherence is associated with elder self-neglect. The purpose of this study was to assess and describe medication adherence in this population, as well as evaluate associations between medication adherence and cognitive impairment, depression, physical function, and abilities to perform basic and instrumental activities of daily living (BADLs and IADLs). A cross-sectional study of 100 community-dwelling adults 65 years of age and older with APS-substantiated elder self-neglect were assessed. In-home comprehensive geriatric assessments (CGAs) were completed and included medication reviews. Information on each medication, including the amount taken from the date dispensed, was collected and used to determine adherence. The criteria for non-adherence were taking 110 % of at least one medication. The sample was also split into groups of low adherence (≤29 %), moderate adherence (29-86 %) and high adherence (≥86 %). Scores on the CGA measures Mini-Mental State Examination, Geriatric Depression Scale, Physical Performance Test (PPT) and Kohlman Evaluation of Living Skills were assessed to determine whether cognitive impairment, depression, physical function, and/or ability to perform BADLs and IADLs were associated with non-adherence or low, moderate or high levels of adherence. Twenty-five per cent of the sample was taking more than seven medications daily. The average rate of

  2. 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, health, participatio

  3. Severe self-neglect: an epidemiological and historical perspective.

    Science.gov (United States)

    Poythress, Edward Lee; Burnett, Jason; Naik, Aanand D; Pickens, Sabrina; Dyer, Carmel Bitondo

    2006-01-01

    Older adults with severe self-neglect have multiple deficits in various social, functional and physical domains, and often live insqualor. These individuals often present with poor personal hygiene, domestic squalor and hoarding which results in a threat to their own health as well as personal and public safety. Severe self-neglect occurs along a continuum with older adults often having cognitive and affective disorders compared with younger individuals presenting with psychiatric illnesses. In cases of severe self-neglect with hoarding, evidence has shown this behavior occurs in diverse social strata and not among the wealthy and professionals alone as believed earlier. Due to the multiple conditions associated with severe self-neglect, this population will require an interdisciplinary, multidimensional approach to reduce morbidity and mortality rates including nursing home placement. Research on this group has been limited and is rarely described in the medical and nursing literature. Future research is needed to provide practitioners with effective screening instruments and interventions on cases of severe self-neglect.

  4. Self-neglect in older adults: a primer for clinicians.

    Science.gov (United States)

    Pavlou, Maria P; Lachs, Mark S

    2008-11-01

    Self-neglect in older adults is an increasingly prevalent, poorly understood problem, crossing both the medical and social arenas, with public health implications. Although lacking a standardized definition, self-neglect is characterized by profound inattention to health and hygiene. In light of the aging demographic, physicians of all specialties will increasingly encounter self-neglectors. We outline here practical strategies for the clinician, and suggestions for the researcher. Clinical evaluation should include attention to medical history, cognition, function, social networks, psychiatric screen and environment. The individual's capacity is often questioned, and interventions are case-based. More research is needed in basic epidemiology and risk factors of the problem, so that targeted interventions may be designed and tested. The debate of whether self-neglect is a medical versus societal problem remains unresolved, yet as health sequelae are part of the syndrome, physicians should be part of the solution.

  5. 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,

  6. 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, det

  7. 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, housing situation,

  8. Four subtypes of self-neglect in older adults: results of a latent class analysis.

    Science.gov (United States)

    Burnett, Jason; Dyer, Carmel B; Halphen, John M; Achenbaum, W A; Green, Charles E; Booker, James G; Diamond, Pamela M

    2014-06-01

    To determine whether there are subtypes of elder self-neglect (SN) with different risk factors that can be targeted using medical and social interventions. Cohort study using archived data of Adult Protective Services (APS) substantiated cases of elder SN between January 1, 2004, and December 31, 2008. Houston, Harris County, Texas. Adults aged 65 and older with APS region VI substantiated SN between January 1, 2004, and December 31, 2008 (N = 5,686). Adult Protective Services caseworkers used the Client Assessment and Risk Evaluation (CARE) tool during home investigations, assessing risk of harm in the domains of living conditions, financial status, physical and medical status, mental health, and social connectedness. Latent class analysis was used to identify unique subtypes of elder SN. Four unique subtypes of elder SN were identified, with approximately 50% of individuals manifesting physical and medical neglect problems. Other subtypes included environmental neglect (22%), global neglect (21%), and financial neglect (9%). Older age, Caucasian descent, and mental status problems were more strongly associated with global neglect behaviors. African Americans were more likely to experience financial and environmental neglect than Caucasians and non-white Hispanics. Elder SN consists of unique subtypes that may be amenable to customized multidisciplinary interventions. Future studies are needed to determine whether these subtypes impose differential mortality risks and whether multidisciplinary tailored interventions can reduce SN and prevent early mortality. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  9. 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 training work income and asse

  10. 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.

  11. Frailty in self-neglecting older adults: A secondary analysis.

    Science.gov (United States)

    Lee, Jessica L; Burnett, Jason; Dyer, Carmel B

    2016-01-01

    Self-neglect (SN) and frailty in older adults is associated with increased disability and mortality. Despite these commonalities, there have been no studies objectively assessing frailty in older adults who SN. This secondary analysis classified frailty in N = 37 older adults with Adult Protective Services validated SN using the Fried Frailty Phenotype (FFP) of weight loss, weakness, exhaustion, activity level, and walking speed. Overall, 3% were classified as robust, 62% as prefrail, and 35% as frail. Most (72%) were overweight/obese, with clinically significant decreases in activity level (60%) and walking speed (97%). Compared to the original FFP population, older adults who SN exhibit important differences in frailty phenotypes, and finding that the largest percentage of older adults who SN were prefrail may indicate a critical opportunity for intervening in this population to reduce future functional decline and mortality.

  12. Impairment in Instrumental Activities of Daily Living and the Geriatric Syndrome of Self-Neglect

    Science.gov (United States)

    Naik, Aanand D.; Burnett, Jason; Pickens-Pace, Sabrina; Dyer, Carmel B.

    2008-01-01

    Purpose: We sought to characterize self-neglect definitively as a geriatric syndrome by identifying an association with functional impairment. Design and Methods: We performed a cross-sectional home evaluation of 100 community-living older adults referred by Adult Protective Services for geriatric self-neglect and 100 matched adults from a…

  13. Impairment in Instrumental Activities of Daily Living and the Geriatric Syndrome of Self-Neglect

    Science.gov (United States)

    Naik, Aanand D.; Burnett, Jason; Pickens-Pace, Sabrina; Dyer, Carmel B.

    2008-01-01

    Purpose: We sought to characterize self-neglect definitively as a geriatric syndrome by identifying an association with functional impairment. Design and Methods: We performed a cross-sectional home evaluation of 100 community-living older adults referred by Adult Protective Services for geriatric self-neglect and 100 matched adults from a…

  14. Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability.

    Science.gov (United States)

    Hansen, Marissa C; Flores, David V; Coverdale, John; Burnett, Jason

    2016-01-01

    Self-neglect among older adults results in increased morbidity and mortality rates. Depression is strongly linked to self-neglect and when untreated, severely complicates management of health and functional outcomes. The study aims to identify factors correlated with depression to inform approaches to service recruitment and retention that improve long-term outcomes. The sample included urban community-dwelling older adults (n = 96) 65 years of age and older with Adult Protective Services-substantiated self-neglect. All participants completed a range of validated cognitive, functional, and self-report demographic and clinical measures around health and mental health functioning. A secondary data analysis using multivariable logistic regression revealed that a positive screen for alcohol abuse, low self-rated health, and higher self-reported pain were associated with significantly higher odds of self-reported depression. Further research is needed to understand the temporality between these correlates and depression and to inform prevention and intervention practices for self-neglecting older adults.

  15. Could self-neglect in older adults be a geriatric syndrome?

    Science.gov (United States)

    Pavlou, Maria P; Lachs, Mark S

    2006-05-01

    Self-neglect in older adults is a complex phenomenon characterized by inattention to health and hygiene, typically stemming from an inability or unwillingness to access potentially remediating services. Some aspects of self-neglect clinically resemble geriatric syndromes (e.g., falling, incontinence). The literature on self-neglect was comprehensively reviewed and its quality evaluated in the context of considering its candidacy for a geriatric syndrome. MEDLINE (1966-2004) was searched using self-neglect as a keyword. Using a "snowball" sampling strategy, associated terms (e.g., Diogenes' syndrome) were combined, selecting relevant papers and frequently cited references, assessing each one using specific criteria. Its candidacy for consideration for a geriatric syndrome was assessed based on the quality of data in four domains: multifactorial etiology, shared risk factors with other geriatric syndromes, association with functional decline, and association with increased mortality. The 54 articles reviewed included 24 case series, 13 theoretical articles, 11 observational studies, and six reviews; these were of highly variable methodological quality. The strongest evidence that self-neglect may be a geriatric syndrome includes its often multifactorial etiology, its clear independent association with increased mortality, and the fact that two other geriatric syndromes (cognitive impairment and depression) are risk factors for self-neglect. Self-neglect in older adults is a prevalent problem that appears to have at least some features of a geriatric syndrome. Insofar as the concept of geriatric syndrome has been a useful clinical and research paradigm to create interventions for vulnerable older adults, and no such strategies are available for this vexing and understudied clinical problem, future research is warranted in this area.

  16. Self-reported vaccination in the elderly

    Science.gov (United States)

    Reyes-Ortiz, Carlos; Borda, Miguel German; 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 evaluate by logistic regression models. Results: A total of 73.0% of respondents received influenza, 57.8% pneumococcal and 47.6% tetanus vaccine. Factors independently associated with vaccination included: 1- age (65-74 years had higher odds of receiving vaccinations, compared to 60-64 years); 2- socioeconomic status (SES) (higher SES had lower odds of having influenza and pneumococcal vaccines, compared to those with lower SES); 3- health insurance (those with contributive or subsidized health insurance had higher odds (between 3 and 5 times higher) of having vaccinations, compared to those with no insurance); 4- older adults with better functional status (greater Lawton scores) had increased odds for all vaccinations; 5- older adults with higher comorbidity had increased odds for influenza and pneumococcal vaccinations. Conclusion: Vaccination campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination or vulnerable to reach it such as the disabled elder. PMID:27226661

  17. An analysis of elder abuse rates in Milwaukee County.

    Science.gov (United States)

    Thomson, Mary J; Lietzau, Lauren K; Doty, Megan M; Cieslik, Linda; Williams, Ramona; Meurer, Linda N

    2011-12-01

    The elder abuse and neglect burden in Milwaukee County, Wisconsin, is substantial, with 3384 reports made from 2006 to 2009. Current prevalence estimates are determined from reported cases only and are likely underestimated. Provider awareness of victim and perpetrator characteristics is necessary to increase recognition and response. A cross-sectional analysis of elder abuse and neglect cases reported to the Milwaukee County Department on Aging (MCDA) from 2006 to 2009 was performed to provide a profile of the county's elder abuse burden by victim, perpetrator, and reporter characteristics. Annual reporting trends were identified using Poisson regression analysis. Fifty-eight percent of MCDA reports of abuse were substantiated after investigation. Victims in Milwaukee County tended to be older than 75 (64%), female (64%), and white (62%). Reporting rates to the MCDA were significantly lower in 2009 than 2006. Perpetrators were often adult children (48%) or a spouse (14%). Forty percent of life-threatening cases of self-neglect were due to unfulfilled medical needs. Most reports were made by medical professionals (23%), relatives of the victim (21%), and community agencies (18%). Only 13% of elder abuse victims were placed in nursing homes and assisted living centers; many received services to assist independent living. Although this study is limited to reported cases only, it provides a valuable profile of pertinent elder abuse characteristics in Milwaukee County. Characteristics of vulnerable elders, potential abusers, and investigation outcomes are described to inform clinical practice about this important social issue.

  18. 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.

  19. 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

  20. Does self-neglect occur among older adults with dementia when unsupervised in assisted living? An exploratory, observational study.

    Science.gov (United States)

    Caspi, Eilon

    2014-01-01

    The phenomenon of older adults with dementia who develop behavioral expressions when they are unsupervised in assisted living residences is understudied. This qualitative study aimed to bridge this gap in the literature by focusing on 12 residents in various stages of dementia. Grounded Theory was followed to guide data collection and analysis. Data were collected in two special care units of an assisted living residence for 10 months. Participant observation was the primary data collection strategy. Semistructured interviews with staff and managers and review of clinical records augmented the observation data. While unsupervised, residents exhibited a wide spectrum of negative emotional states, behavioral expressions, functional difficulties, wayfinding difficulties, serious hygiene problems, and safety risks. More than half of the identified incidents represented self-neglectful behaviors. The study highlights the need for enhanced supervision and targeted interventions for residents with dementia who are susceptible to self-neglect.

  1. Medication Regimen Complexity and Low Adherence in Older Community-Dwelling Adults With Substantiated Self-Neglect.

    Science.gov (United States)

    Abada, Sharon; Clark, Leslie E; Sinha, Arup K; Xia, Rui; Pace-Murphy, Kathleen; Flores, Renee J; Burnett, Jason

    2017-06-01

    Determine whether medication regimen complexity predicts medication adherence levels in a sample of community-dwelling adults 65 years and older with Adult Protective Services-substantiated self-neglect. A cross-sectional analysis of baseline data ( N = 31 participants) from a pilot intervention to increase medication adherence among the target group was performed. The Medication Regimen Complexity Index (MRCI) and the 8-item Morisky Medication Adherence Scale (MMAS-8)™ were the primary independent and dependent measures, respectively. A multivariable linear regression analysis, adjusting for potential confounders, was conducted to estimate the association between complexity and adherence. Regimen complexity was high (mean MRCI = 19.6) and adherence was low (mean MMAS = 5.1). Even after controlling for confounders, increased complexity was significantly associated with lower adherence. Older community-dwelling adults who self-neglect have complex medication regimens that contribute to low medication adherence. Medication regimen complexity may be a modifiable contributor to low adherence that can be targeted by future interventions to reduce self-neglect and its consequences.

  2. 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.

  3. 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.

  4. Mandibular Ameloblastoma in an Elderly Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Kokoro Nagata

    2013-01-01

    Full Text Available Ameloblastomas frequently occur in relatively young people, but are rarely seen in people aged 80 years or older. We report a case of mandibular ameloblastoma in an elderly patient with a review of the literature. The patient was a 82-year-old man who noticed swelling of the gingiva approximately 2 weeks prior to his initial visit. Computed tomography showed a radiolucent area with little radiopacity. Internal uniformity was observed at the site, with thinning of cortical bone which lacked continuity in some areas. The excision and curettage were performed under general anaesthesia. No recurrence has been observed 14 months after surgery.

  5. Mandibular Ameloblastoma in an Elderly Patient: A Case Report

    Science.gov (United States)

    Nagata, Kokoro; Shimizu, Kasumi; Sato, Chu; Morita, Hiroshi; Watanabe, Yoshihiro; Tagawa, Toshiro

    2013-01-01

    Ameloblastomas frequently occur in relatively young people, but are rarely seen in people aged 80 years or older. We report a case of mandibular ameloblastoma in an elderly patient with a review of the literature. The patient was a 82-year-old man who noticed swelling of the gingiva approximately 2 weeks prior to his initial visit. Computed tomography showed a radiolucent area with little radiopacity. Internal uniformity was observed at the site, with thinning of cortical bone which lacked continuity in some areas. The excision and curettage were performed under general anaesthesia. No recurrence has been observed 14 months after surgery. PMID:23533821

  6. 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.

  7. 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, Anita

    2017-01-01

    OBJECTIVE: To 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 METHODS

  8. Food Stamp Program Elderly Nutrition Demonstrations: Interim Report on Elderly Participation Patterns

    OpenAIRE

    Scott Cody

    2004-01-01

    To raise participation in the Food Stamp Program by low-income elderly people, USDA implemented the Elderly Nutrition Demonstration in Arizona, Connecticut, Florida, Maine, Michigan, and North Carolina in 2002. Each demonstration used one of three strategies to increase participation: (1) simplifying eligibility requirements for those applying for food stamps, (2) directly assisting applicants with completing the application process, and (3) offering applicants the option of receiving package...

  9. Prevalence of Elder Abuse and Neglect in Seniors with Psychiatric Morbidity - Example from Central Moravia, Czech Republic

    Directory of Open Access Journals (Sweden)

    Jan Luzny

    2012-08-01

    Full Text Available Background: 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.Methods: 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.Results: 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.Conclusion: 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.

  10. Note from Iran: Self-reported elder abuse in Qazvin, 2012.

    Science.gov (United States)

    Oveisi, Sonia; Karimi, Rana; Mahram, Manoochehr

    2014-01-01

    This brief report provides a first look at self-reported instances of elder abuse by a sample of people 60 years and older living in Qazvin, Iran. Six hundred community-dwelling persons, drawn from the registry files of each health center in Qazin, completed questionnaires during April to October 2012. At least 80% of the participants reported experiencing some form of psychological abuse, financial abuse, and/or neglect at least once during a 2-month period. Physical and sexual abuse were rarely reported. Despite a strong Iranian cultural emphasis on respect for elders, the self-reporting of elder abuse, especially psychological abuse, is greater than our expectation. We recommend that health-related policies and programs begin to identify elder abuse and neglect as a first step in prevention.

  11. Paracoccidioidomycosis and cryptococcosis with localized skin manifestations: report of two cases in the elderly*

    Science.gov (United States)

    de Oliveira, Ederson Valei Lopes; de Almeida, Margarete Teresa Gottardo; Turatti, Aline; Gomes, Ciro Martins; Roselino, Ana Maria

    2016-01-01

    Distinct cases of Paracoccidioidomycosis and Cryptococcosis with atypical and localized skin manifestation on the upper limbs of two elderly patients are reported. In the 2nd one, he presented asymptomatic pulmonary cancer; the blood tests for fungal infection were negative, and the etiologic agents were seen in skin biopsy samples. This report emphasizes the importance of the differential diagnosis of infectious diseases in elderly patients. PMID:27192530

  12. Multidisciplinary approach to "accidental" falls in the elderly: a case report.

    Science.gov (United States)

    Galizia, Gianluigi; Testa, Gianluca; Mazzella, Francesca; Cacciatore, Francesco; Ungar, Andrea; Masotti, Giulio; Rengo, Franco; Abete, Pasquale

    2008-06-01

    Falls in the elderly are commonly and often wrongly identified as "accidental". We report a case of an elderly woman admitted to first aid for a trauma due to an accidental fall. Geriatric multidisciplinary evaluation revealed mild cognitive impairment associated with depressive symptoms; both findings made the anamnesis uncertain. Syncope algorithm was applied and "tachy-brady form of sick sinus syndrome" was diagnosed. Differential diagnosis between "accidental" and "apparently accidental" falls in elderly patients is very difficult but a multidisciplinary geriatric evaluation can clarify the correct diagnosis.

  13. Validity of self-reported birthweight among middle-aged and elderly women in the Danish Nurse Cohort Study

    DEFF Research Database (Denmark)

    Wodskou, Pernille M; Hundrup, Yrsa A; Obel, Erik B;

    2010-01-01

    To investigate the validity of self-reported birthweight among middle-aged and elderly women and to identify possible determinants of reporting accuracy.......To investigate the validity of self-reported birthweight among middle-aged and elderly women and to identify possible determinants of reporting accuracy....

  14. 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.

  15. Dysphagia lusorium in elderly:A case report

    Institute of Scientific and Technical Information of China (English)

    Bulent Kantarceken; Ertan Bulbuloglu; Murvet Yuksel; Ali Cetinkaya

    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.

  16. Health care 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 health care professionals' perspectives on elder abuse to achieve a better understanding of the problems of reporting and to generate ideas for improving the detection and reporting 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: preconceptions, assessment, interpretation, systems, and knowledge and education. Participants suggested a reorganization of the external reporting system. More frequent and pragmatic education is necessary to strengthen practical knowledge about elder abuse.

  17. 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.

  18. Elder abuse and oral health care providers: an intervention to increase knowledge and self-perceived likelihood to report.

    Science.gov (United States)

    Sugita, Julie A; Garrett, Mario D

    2012-01-01

    The objective of this study was to ascertain whether a symposium on elder abuse raises the level of knowledge and the self-reported likelihood to report elder abuse among licensed oral health care providers. 130 dentists, hygienists, and assistants voluntarily attended a 4-hour training symposium and completed both pre- and postsurveys testing their level of knowledge. Results by statistical analyses, using repeated measurements, Wilcoxon signed-rank test for nonparametric data, showed increases in awareness of reporting process, knowledge/awareness of elder abuse, knowledge of mandated reporter requirements, and comfort levels with recognizing signs and symptoms of elder abuse and neglect. In conclusion, a symposium can increase the self-reported likelihood of reporting elder abuse.

  19. [Association between tooth root remains and self-reported oral health among the elderly].

    Science.gov (United States)

    Martins, Aline Blaya; Dalberto, Charlene da Silveira; Hugo, Fernando Neves

    2015-12-01

    The presence of tooth root remains is a common clinical finding among elderly patients and may reflect a need for treatment. The scope of this study sought to explore the association between the presence of tooth root remains and self-reported oral health among the elderly. Secondary data from two sanitary districts of Porto Alegre, State of Rio Grande do Sul, were analyzed. A conceptual theoretical model was used in the analysis to assess factors related to self-perceived oral health: gender, age, education, marital status, smoking habit, alcohol consumption, demand for oral health care, participation in community groups, family economic self-sufficiency, oral health service accessed, number of teeth and the presence of tooth root remains. The statistical data were analyzed using Chi-square and Poisson Regression tests (95% CI analysis; α 5%). The sample consisted of 849 elderly individuals with a mean age of 69.7 years (± 7.2); 14.5% of the elderly had tooth root remains and 60.7% reported good self-perceived oral health. According to the hierarchical analysis, the absence of tooth root remains was associated with good oral health perception. The qualification and expansion of health care provided should be considered in order to allow planning actions to ensure the maintenance of good oral health for the elderly.

  20. Rural Community-Dwelling Elders' Reports of Access to Care: Are There Hispanic versus Non-Hispanic White Disparities?

    Science.gov (United States)

    Borders, Tyrone F.

    2004-01-01

    Consumer reports can provide useful information about the dimensions of access in need of improvement for particular population subgroups. To determine if there are Hispanic versus non- Hispanic white disparities in rural elders' reports of their health care access. A telephone survey was conducted among 2,097 rural community-dwelling elders in…

  1. Elder abuse and neglect: an overview.

    Science.gov (United States)

    Gorbien, Martin J; Eisenstein, Amy R

    2005-05-01

    The dramatic growth of the American elderly population has great implications for our health care system. The "demographic imperative" that has fueled the awareness of the needs of older adults has a major impact on issues related to social welfare, justice, and economics. There are 45 million people over the age of 60 and 3 million over the age of 85. Those over age 85 represent the fastest growing segment of the elderly population. With this trend comes a segment of the population that is at risk for abuse, neglect, or self-neglect. We are challenged to be aware of the many faces of elder mistreatment and to understand it in the broader context of domestic violence. All health care professionals working with older adults need to become familiar with the recognition, treatment, and prevention of elder abuse and neglect.

  2. The Bet Tzedek legal services model: how a legal services model addresses elder abuse and neglect.

    Science.gov (United States)

    Morris, Janet R

    2010-07-01

    Bet Tzedek, Hebrew for the "House of Justice," provides free legal assistance to older adults in Los Angeles County. Their civil attorneys work alongside prosecutors and service providers for the elderly as members of multidisciplinary teams to assist older adults with complicated elder abuse and neglect cases. Case examples demonstrate how civil attorneys collaborate with the Los Angeles County Elder Abuse Forensic Center to address financial abuse, real estate fraud, and self-neglect issues. Cooperation among the courts, Bet Tzedek, and other county agencies has resulted in more user-friendly processes to expedite filing of conservatorships and elder abuse restraining orders.

  3. Xanthomatous hypophysitis associated with autoimmune disease in an elderly patient: A rare case report

    Directory of Open Access Journals (Sweden)

    Masahiro Oishi

    2016-01-01

    Conclusion: To the best of our knowledge, this patient is the oldest of reported patients diagnosed with XH. Steroid therapy may be effective to XH temporarily. XH should be considered when diagnosing pituitary cystic lesions in elderly patients with autoimmune disease.

  4. An Evaluation of the Nutrition Services for the Elderly. Volume II. Analytic Report.

    Science.gov (United States)

    Kirschner Associates, Inc., Albuquerque, NM.

    This document is part of a five-volume nationwide study of Nutrition Service operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. This volume contains the analytic report, which presents the major findings of the evaluation. Chapter 1 gives a report…

  5. An Evaluation of the Nutrition Services for the Elderly. Volume III. Descriptive Report.

    Science.gov (United States)

    Kirschner Associates, Inc., Albuquerque, NM.

    This document is part of a five-volume nationwide study of Nutrition Services operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. A descriptive report is contained in this volume, which presents non-selective and preliminary analysis of the data base…

  6. Hydroxychloroquine-associated hyperpigmentation mimicking elder abuse.

    Science.gov (United States)

    Cohen, Philip R

    2013-12-01

    Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed drug-associated black and blue pigmentation of her skin. The dyschromia was misinterpreted by her clinician as elder abuse and Adult Protective Services was notified. The family was eventually cleared of suspected elder abuse. A skin biopsy of the patient's dyschromia confirmed the diagnosis of hydroxychloroquine-associated hyperpigmentation. Hyperpigmentation of skin, mucosa, and nails can be observed in patients treated with antimalarials, including hydroxychloroquine. Elder abuse is a significant and underreported problem in seniors. Cutaneous findings can aid in the discovery of physical abuse, sexual abuse, and self-neglect in elderly individuals. However, medication-associated effects, systemic conditions, and accidental external injuries can mimic elder abuse. Therefore, a complete medical history and appropriate laboratory evaluation, including skin biopsy, should be conducted when the diagnosis of elder abuse is suspected.

  7. [Images of aging in the field of health care for the elderly. Findings and recommendations in the Sixth National Social Report on the Situation of the Elderly].

    Science.gov (United States)

    Berner, F

    2011-08-01

    This paper is based on the Sixth National Social Report on the Situation of the Elderly, published in November 2010, that deals with the images of aging that exist in society. The aim of this paper is to describe how the commission that wrote the Sixth National Social Report on the Situation of the Elderly evaluates the role of images of aging in the field of health care and to specify the need for change that the commission identifies with respect to images of aging. The paper consists of four parts. A general introduction is followed by a discussion of some important aspects of images of aging, including a description of central assumptions and concepts of the expert commission. The main part is then the analysis of images of aging in the field of health care for the elderly. Finally, the recommendations of the expert commission in order to promote an adjustment of health care to an aging society are presented.

  8. 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.

  9. Tubulointerstitial Nephritis and Uveitis Syndrome in an Elderly Man: Case Report and Literature Review.

    Science.gov (United States)

    Lei, Wen-Hui; Xin, Jun; Yu, Xue-Ping; Li, Jie; Mao, Ming-Feng; Ji, Jian-Song; Wu, Chui-Fen; Zhu, Chao-Yong; Jin, Lie

    2015-11-01

    Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease of unknown etiology defined by the combination of tubulointerstitial nephritis, uveitis, and biochemical abnormalities. It has been reported that TINU mainly affects adolescents and young women. Here we reported a special case regarding a 60-year-old man with acute renal failure due to TINU syndrome documented by renal biopsy.We present a rare case of an elderly patient, who had been suffering from a fever for 2 weeks, characterized by sudden onset and resolving spontaneously, and accompanied by extreme fatigue, loss of appetite, and shivering. Renal biopsy showed a tubulointerstitial nephritis, with polymorphonuclear infiltration and acute tubulitis. In the outpatient clinic, he was diagnosed with idiopathic bilateral anterior uveitis 1 month ago. Ophthalmological examination revealed anterior asymptomatic bilateral uveitis. Human leukocyte antigen (HLA) typing (HLA-DQA1*0101/0201 and HLA-DQB1*0303/0503) was found which supported the suspect of TINU syndrome. The patient was treated with oral prednisone (1 mg/kg) and continued for 8 weeks on tapering doses. Serum creatinine normalized within 3 and 6 months later renal function also recovered completely.This case highlights that TINU syndrome is probably an underdiagnosed disease responsible for some cases of idiopathic anterior uveitis in elderly male patients. It is of critical importance to be aware of this syndrome by nephrologist and ophthalmologists in this special population. Further studies are needed to elucidate clinical characteristic and pathogenesis of TINU syndrome in elderly population.

  10. Gliomatosis cerebri presenting as rapidly progressive dementia and parkinsonism in an elderly woman: a case report

    Directory of Open Access Journals (Sweden)

    Duron Emmanuelle

    2008-02-01

    Full Text Available Abstract Introduction Dementia is one of the most important neurological disorders in the elderly. Dementia of tumoral origin is rare and parkinsonism of neoplastic origin is unusual. We herein report a case of gliomatosis cerebri, a very rare brain tumor seldom affecting the elderly, which presented as rapidly progressive dementia and parkinsonism. Case presentation An 82-year-old woman very rapidly developed progressive dementia and akineto-rigid parkinsonism. Brain CT scan was normal. Cerebral magnetic resonance imaging (MRI with gadolinium injection highlighted a diffuse tumor-related infiltration involving both lobes, the putamen, the pallidum, the substantia nigra, and the brainstem, corresponding to the specific description and definition of gliomatosis cerebri. Conclusion This atypical presentation of a gliomatosis cerebri, and the infiltration of the substantia nigra by the tumor, merits attention.

  11. Burning Tongue as Initial Presentation of Celiac Disease in an Elderly Woman: A Case Report.

    Science.gov (United States)

    Sherman, Andrea; Zamulko, Alla

    2016-06-01

    There are few reports in the literature where celiac disease presents with tongue manifestations, although atypical presentations of celiac disease are not uncommon. This case report highlights an atypical presentation of celiac disease in an elderly female. Our patient presented to clinic with complaints of a burning tongue for the past two years as well as occasional loose stools and fatigue. Work-up revealed iron deficiency anemia, zinc deficiency and an abnormal celiac panel. Complete symptom improvement was noted by 10 weeks into the initiation of a gluten free diet. Celiac disease can present at any age and should be considered as a differential in findings of malabsorption and gastrointestinal symptoms.

  12. Prevalence, seriousness and reporting of work-related violence in the Danish elderly care.

    Science.gov (United States)

    Sharipova, Muborak; Borg, Vilhelm; Hogh, Annie

    2008-12-01

    A survey study (paper and pencil) among staff of elderly care institutions in 36 Danish municipalities (n = 9949) was conducted in 2005 with a response rate of 78%. The majority of the participants of the study were women (96%). The paper presents the prevalence, perpetrators, seriousness (self-rated seriousness, injuries, sick leave and type of violence) of work-related physical violence towards care workers in the Danish elderly care and the frequency of reporting the incidents to the safety organization. The findings show that every fourth caregiver was exposed to violence in 2005. Care personnel working in nursing homes and integrated institutions had the highest prevalence of violence (40%) and were also most often (10%) exposed to violence. Clients were most often (>90% of cases) the perpetrators. The most frequent types of violence were hitting (63%) and scratching/pinching (63%). Being held (32%) or kicked (27%) was also mentioned as frequent types of violence; use of weapon, throwing or hitting with a hard objects were more seldom. Nearly 1/3 of the exposed respondents rated at least one incident as very serious. There were significant associations between self-rated seriousness and type of violence, injuries and sick leave. The incidents were, in particular when perpetrators were clients, often rated as not serious. Only 22% of the victims of violence reported the violent incidents to the safety organizations. Reports of violent incidents were significantly associated with frequency of exposure, type of violence, physical injury, sick leave and perpetrators. The more frequent and most serious cases were reported most often and cases where the perpetrators were clients were reported less often than when perpetrators were others. It has been suggested that underreporting of violence occurs because it is time consuming, lacks supervisory support, because it won't make any difference, because it is part of the job, and also because there is a tendency to

  13. 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. 

  14. The violence against the elderly in films

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    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.  

  15. Self-Reported Sleep Disturbance among African-American Elderly: The Effects of Depression, Health Status, Exercise, and Social Support.

    Science.gov (United States)

    Bazargan, Mohsen

    1996-01-01

    Investigates prevalence, correlates, and self-reported difficulties in initiating and maintaining sleep for a sample of 998 black elderly subjects. The majority (68.3%) of the sample had no trouble falling asleep. Over 14.5% of men and 23.6% of women reported sleep latencies exceeding 30 minutes. Almost 13% reported less than 4 hours of sleep a…

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

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    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.

  17. Management of biofilm control in an elderly patient suffering from rheumatoid arthritis: a case report.

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    Nardi, G M; Sabatini, S; Lauritano, D; Denisi, C; Grassi, F R

    2013-01-01

    The increase in the average age of the population forces dentists and dental hygienists to deal with clinical scenarios typical of the elderly. In old people deep changes present both in systemic and oral health. These changes affect the anatomical and functional integrity of many tissues, such as the mouth. Impairment of patients' oral hygiene becomes manifested by local infections and promotes the pathogenesis of periodontal diseases. There is also a significant increase in autoimmune diseases, which are defined as disorders of the immune system that result in abnormal immune responses. Among the autoimmune diseases of medical interest we report a case of rheumatoid arthritis (RA) strictly related to periodontal disease.

  18. Familial aortic coarctation: a rare cause of refractory hypertension in the elderly: a case report.

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    Lara-Rojas, Carmen M; Bernal-Lopez, M Rosa; Lopez-Carmona, M Dolores; Gomez-Huelgas, Ricardo

    2015-01-01

    We report the first case of late presentation of familial aortic coarctation, a rare cause of hypertension. Diagnosis of familial aortic coarctation in the elderly is exceptional, given that in the absence of endovascular or surgical repair patients do not usually survive beyond 50 years of age. Our case concerns a 72-year-old woman with hypertension of long evolution, control of which improved markedly after endovascular repair of the coarctation. Her son had undergone surgery for repair of aortic coarctation at the age of 23 years.

  19. 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.

  20. Gastric Dilation due to a Neuroleptic Agent in an Elderly Patient: A Case Report

    Science.gov (United States)

    Parent, V.; Popitean, L.; Loctin, A.; Camus, A.; Manckoundia, P.

    2014-01-01

    Neuroleptics may cause side effects, some of which are little known. We describe here a case of gastric dilation related to treatment with a neuroleptic in an elderly man. To our knowledge, such a case has never been reported in the literature. A 76-year-old man, living in a nursing home, was hospitalized for general weakness and abdominal pain. He had dementia with behavioral disorders treated with cyamemazine, a sedative and anxiolytic neuroleptic. Given a clinical suspicion of intestinal occlusion, an abdominopelvic computerized tomography scan was performed before the patient was admitted to our hospital. This computerized tomography scan did not show intestinal occlusion and there was no mention of gastric dilation in the computerized tomography scan report. Thus, acute gastroenteritis was suspected. The usual medications were stopped and symptomatic treatment for gastroenteritis was started. Quickly, his clinical state and biological parameters returned to normal and his usual treatment, including cyamemazine, was started again. The next day, the digestive symptoms, except for obstipation, reappeared. The abdominal X-ray showed gastric dilation without intestinal occlusion. The neuroleptic was stopped again and symptoms vanished the next day. This report underlines all of the necessary precautions and surveillance around drug prescription, especially in elderly persons. PMID:25161671

  1. Gastric Dilation due to a Neuroleptic Agent in an Elderly Patient: A Case Report

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    V. Parent

    2014-01-01

    Full Text Available Neuroleptics may cause side effects, some of which are little known. We describe here a case of gastric dilation related to treatment with a neuroleptic in an elderly man. To our knowledge, such a case has never been reported in the literature. A 76-year-old man, living in a nursing home, was hospitalized for general weakness and abdominal pain. He had dementia with behavioral disorders treated with cyamemazine, a sedative and anxiolytic neuroleptic. Given a clinical suspicion of intestinal occlusion, an abdominopelvic computerized tomography scan was performed before the patient was admitted to our hospital. This computerized tomography scan did not show intestinal occlusion and there was no mention of gastric dilation in the computerized tomography scan report. Thus, acute gastroenteritis was suspected. The usual medications were stopped and symptomatic treatment for gastroenteritis was started. Quickly, his clinical state and biological parameters returned to normal and his usual treatment, including cyamemazine, was started again. The next day, the digestive symptoms, except for obstipation, reappeared. The abdominal X-ray showed gastric dilation without intestinal occlusion. The neuroleptic was stopped again and symptoms vanished the next day. This report underlines all of the necessary precautions and surveillance around drug prescription, especially in elderly persons.

  2. Massive right atrial myxoma with dyspnea at rest in an elderly patient: A case report

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    Romanović Radoslav

    2015-01-01

    Full Text Available Introduction. Primary heart tumors are extremely rare and myxoma is the most common type of these tumors. Although intraatrial presentation is a predilection place, right atrial localization is atypical. The symptom triad is characteristic in the clinical presentation of the tumor: embolic complication, intracardiac blood flow obstruction and systemic manifestations like elevated erythrocyte sedimentation rate, fever, anemia, body weight loss. Case report. We presented an elderly female patient with massive myxoma in the right atrium, 77 × 44 mm in diameter, which filled the entire right atrium and spread into the right ventricle, causing the tricuspid valve obstruction and dyspnea. It was visualized by transthoracic echocardiography and small and insignificant pericardial effusion was also seen. After surgical removal of the tumor, the patient remained without any symptoms and pericardial effusion. Conclusion. Tumors of the right heart have to be considered in the differential diagnosis of unexplained dyspnea in elderly patients. Transthoracic echocardiography is certainly necessary and mostly available diagnostic tool that can be of great help in diagnosing heart tumor as well as planning cardiac surgery, as it provides in most cases excellent visualization of the tumor and its relationship with other parts of the heart.

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

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    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.

  4. Elderly kendo (Japanese fencing) player with Kienböck's disease in one wrist and Preiser's disease in the other wrist: a case report.

    Science.gov (United States)

    Iwasaki, Norimasa; Masuko, Tatsuya; Funakoshi, Tadanao; Minami, Akio

    2010-01-01

    Elderly patients suffering from avascular necrosis of a carpal bone in both wrists are extremely rare. We report a case of an elderly kendo (Japanese fencing) competitor who sustained Preiser's disease in the left hand following the occurrence of Kienböck's disease in the right hand. The current case demonstrates the importance of raising awareness of these diseases as potential sports-related problems in the elderly.

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

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    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.

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

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    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.

  7. Elder abuse: a call to action.

    Science.gov (United States)

    Bird, P E; Harrington, D T; Barillo, D J; McSweeney, A; Shirani, K Z; Goodwin, C W

    1998-01-01

    An estimated 2 million people a year are victims of elder abuse, which ranges from neglect and mistreatment to physical abuse. By the year 2020, a full 22% of the population will be aged 65 or older. This demographic explosion demands that we identify and protect those at risk. To investigate the incidence of elder abuse or neglect (EAN) and to determine clinician awareness of associated risk factors, we conducted a 1-year retrospective review of thermally injured patients aged 60 or older. Data included age, total body surface area burned, mechanism of injury, length of hospital stay, mortality, abuse or neglect risk factors, and referral to the appropriate social agency. We found that our elderly patients (n = 28) were poorly screened for EAN. While 64% to 96% of patients were screened for cognitive impairment, overall health, and financial resources, none were screened for risk factors of emotional isolation. None of the patient's caregivers, including any spouses, roommates, or guardians, were screened for risk factors of substance abuse, familial violence, dependency needs, or external stresses. With the use of available data, we were able to place 11 patients on the following levels of abuse or neglect: 1) low risk for abuse; 2) self-neglect; 3) neglect; and 4) abuse. By this scale, 7 patients (64%) were victims of self-neglect, 3 patients (27%) were victims of neglect, and 1 patient (9%) was a victim of abuse. Adult Protective Services intervened in 2 cases. Recognizing that all cases of EAN should be preventable, we cannot accept the socioeconomic impact of this entity. The 11 patients identified as victims of neglect, self-neglect, or abuse accounted for 135 hospital days and 8 fatalities. Before we can address EAN, health care personnel must be made aware of the problem and routine screening for risk factors must be implemented. The true incidence of EAN is likely underestimated because health care providers have difficulty recognizing its features. A

  8. The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment

    Science.gov (United States)

    Guercio, Brendan; Donovan, Nancy J.; Munro, Catherine E.; Aghjayan, Sarah L.; Wigman, Sarah E.; Locascio, Joseph J.; Amariglio, Rebecca E.; Rentz, Dorene M.; Johnson, Keith A.; Sperling, Reisa A.; Marshall, Gad A.

    2015-01-01

    Background Apathy is a common neuropsychiatric symptom in Alzheimer’s disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD. Objective To compare the three AES sub-scales—subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C)—over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly). Methods Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia. Results Fifty seven MCI and 18 CN subjects (ages 53–86) were followed for 1.4±1.2 years and 0.7±0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male sex. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the clinician-reported AES (AES-C) best predicted transition from MCI to AD dementia. Conclusion In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. Self-reported AES scores may be more sensitive than informant and clinician-report when subjects are CN, but less reliable if subjects have MCI. Moreover, the clinician-reported AES sub-scale predicted progression from MCI to AD dementia. PMID:26401564

  9. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

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    van Weert Henk C

    2010-01-01

    Full Text Available Abstract Background Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizziness reported by elderly patients in family practice, to describe their final diagnoses as recorded by the family physician, and to compare the clinical characteristics of dizzy patients with those of non-dizzy patients. Methods Data were obtained from the Second Dutch National Survey of General Practice, a prospective registration study which took place over a 12-month period in 2001. We developed a search strategy consisting of 15 truncated search terms (based on Dutch synonyms for dizziness, and identified all patients aged 65 or older who visited their family physician because of dizziness (N = 3,990. We used the mid-time population as denominator to calculate the prevalence and incidence, and for group comparisons we used the Student's t and Chi-square test, and logistic regression analysis. Results The one-year prevalence of dizziness in family practice in patients aged 65 or older was 8.3%, it was higher in women than in men, and it increased with age. In patients aged 85 or older the prevalence was similar for men and women. The incidence of dizziness was 47.1 per 1000 person-years. For 39% of the dizzy patients the family physicians did not specify a diagnosis, and recorded a symptom diagnosis as the final diagnosis. Living alone, lower level of education, pre-existing cerebrovascular disease, and pre-existing hypertension were independently associated with dizziness. Conclusions Dizziness in family practice patients increases with age. It is more common in women than in men, but this gender difference disappears in the very old. Because a large proportion of dizzy elderly patients in family practice remains undiagnosed, it would be

  10. 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.

  11. [Criminal behavior and police records: self-reports from elderly individuals].

    Science.gov (United States)

    Kunz, F

    2011-02-01

    As a consequence of demographic changes the crime rates of our society are increasingly influenced by the behavior of older age groups in the population. Hence, both the description and explanation of crime at advanced ages are gaining in importance. As almost no relevant self-report data are available, a regionally representative mail survey among 49 to 81-years-olds was conducted which gathered self-reports on criminal behavior, potentially explanatory variables and previous police records. Almost 50% of respondents reported that they had committed at least 1 out of 14 types of offences at least once since turning 50 years old. Younger cohorts were noticeably more crime prone than older ones, both at the present and in the past. Out of all offences asked about, driving under the influence of alcohol (DUI) was the primary behavior that showed up among the respondents. Apart from the DUI offence crime committed by the elderly is mainly characterized by fraud and property crimes in situations of everyday life by people who are well integrated and economically secure. Main predictors of criminal behavior at advanced ages are the individual sex and social learning mechanisms. The vast majority of people who have been repeatedly recorded by the police throughout their lives perpetuate criminal activities until higher ages. The proportion of offenders whose first police record took place after their 50(th) birthday is 56% which is much lower than estimates derived from official crime data.

  12. Daily newspaper reporting on elderly care in Sweden and Finland: a quantitative content analysis of ethnicity- and migration-related issues

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    Sandra Torres

    2014-11-01

    Full Text Available Media representations are important sources of information especially about contexts that people have limited access to (such as the one we address here, that is, elderly care. Representations of this also give us an insight into how ethnicity-, culture-, and migration-related issues are regarded. This article aims to shed light on media representations related to the nexus of elderly care, ethnicity, and migration in Sweden and Finland, given that the two countries have similar elderly care regimes but different migration regimes. The study uses quantitative content analysis to analyze all of the daily newspaper articles on elderly care that have touched upon these issues and have been published in one major newspaper in each country between 1995 and 2011 (N=347. In this article, we present the topics that these newspaper articles discuss; the elderly care actors that the articles focus on (i.e. whether the focus has been on elderly care recipients, elderly care providers or informal caregivers; the ethnic backgrounds of those who expressed themselves in the articles (i.e. whether the focus has been on the ethnic majority or on ethnic minorities; and the type of explanatory frameworks used in the daily press reporting in question. The article problematizes the media representations of ethnicity- and migration-related issues within the Swedish and Finnish elderly care sectors that the analysis has unveiled in relation to the debate on the challenges that the globalization of international migration poses to the elderly care sector.

  13. Decreased warfarin effects in elder with recurrent Clostridium difficile infection during fidaxomicin therapy: a case report

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    Antonio Riccardo Buonuomo

    2015-03-01

    Full Text Available Clostridium difficile infection is a disease with increasing incidence, particularly in high‑riskpatients such as the elderly, immunocompromised patients, etc.We report an unexpected decrease of International Normalized Ratio (INR response to warfarin during a first recurrence of Clostridium difficile infection (CDI treated with fidaxomicin. The patient, an old man who has prosthetic heart valves on anticoagulation therapy with warfarin, was treated with an association of vancomycin plus metronidazole for a first episode of CDI. Patient remained symptom‑free for few days and then he presented with recurrent diarrhea. A retreatment with vancomycin and metronidazole didn’t resolve symptoms of CDI, therefore he underwent fidaxomicin treatment for 10 days, with rapid resolution of diarrhea. In the meantime, warfarin effects diminished, and only with increases of dosage INR therapeutic range was achieved few days after discontinuing fidaxomicin. According to product information, fidaxomicin doesn’t interfere with warfarin. The authors highlight the different plausible mechanisms to explain the association between the unexpected decreased effect of warfarin and factors that could have influenced such event. The frequent update of product information through good pharmacovigilance practices could help clinicians in the management of unexpected events.http://dx.doi.org/10.7175/cmi.v9i1.953

  14. Diagnostic laparoscopy for pneumatosis intestinalis in a very elderly patient: A case report

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    Shuhei Ito

    2017-09-01

    Conclusion: Diagnostic laparoscopy may be a useful option for definitively ruling out the lethal conditions associated with pneumatosis intestinalis in frail elderly patients with severe conditions in the emergency setting.

  15. 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

  16. An Official American Thoracic Society Workshop Report: Evaluation and Management of Asthma in the Elderly.

    Science.gov (United States)

    Skloot, Gwen S; Busse, Paula J; Braman, Sidney S; Kovacs, Elizabeth J; Dixon, Anne E; Vaz Fragoso, Carlos A; Scichilone, Nicola; Prakash, Y S; Pabelick, Christina M; Mathur, Sameer K; Hanania, Nicola A; Moore, Wendy C; Gibson, Peter G; Zieman, Susan; Ragless, Betina B

    2016-11-01

    Asthma in the elderly (>65 yr old) is common and associated with higher morbidity and mortality than asthma in younger patients. The poor outcomes in this group are due, in part, to underdiagnosis and undertreatment. There are a variety of factors related to aging itself that affect the presentation of asthma in the elderly and influence diagnosis and management. Structural changes in the aging lung superimposed on structural changes due to asthma itself can worsen the disease and physiologic function. Changes in the aging immune system influence the cellular composition and function in asthmatic airways. These processes and differences from younger individuals with asthma are not well understood. Phenotypes of asthma in the elderly have not been clearly delineated, but it is likely that age of onset and overlap with chronic obstructive pulmonary disease impact disease characteristics. Physiologic tests and biomarkers used to diagnose and follow asthma in the elderly are generally similar to testing in younger individuals; however, whether they should be modified in aging has not been established. Confounding influences, such as comorbidities (increasing the risk of polypharmacy), impaired cognition and motor skills, psychosocial effects of aging, and age-related adverse effects of medications, impact both diagnosis and treatment of asthma in the elderly. Future efforts to understand asthma in the elderly must include geriatric-specific methodology to diagnose, characterize, monitor, and treat their disease.

  17. Primary shortening of the forearm and Sauvé-Kapandji for severely comminuted fractures of the distal forearm in elderly patients: a case report.

    Science.gov (United States)

    Goorens, Chul Ki; Geurts, Ghislain; Goubau, Jean F

    2013-01-01

    We report a case of an elderly female who sustained a severely comminuted distal radial and ulnar fracture, treated by shortening of the forearm, combined with a primary Sauvé-Kapandji procedure and volar plating of the distal radius.

  18. Intraoral Vertical Ramus Osteotomy Improved the Stomatognathic Function in an Elderly Patient with Mandibular Protrusion:A Case Report

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    Ishihara,Yoshihito

    2010-10-01

    Full Text Available This article reports the successful surgical-orthodontic treatment of an elderly patient with dentofacial deformity and signs and symptoms of temporomandibular disorder (TMD. The patient was a 63-year-old woman with a concave profile due to mandibular protrusion. To correct skeletal deformities, the mandible was posteriorly repositioned by employing intraoral vertical ramus osteotomy (IVRO following presurgical orthodontic treatment. After active treatment for 31 months, the facial profile was significantly improved and satisfactory occlusion was achieved. In addition, TMD symptoms of clicking sounds on the left side and difficulty in mouth opening were resolved. Regarding the findings of magnetic resonance imaging, anterior disc displacement in the opening phase was improved in the temporomandibular joint on the left side. Furthermore, stomatognathic functions were also improved without any aggravation of age-related problems. In conclusion, surgical repositioning of the mandible using IVRO leads to both morphological and functional improvements even in elderly patients.

  19. 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

  20. Hepatic adenoma in an elderly male patient: A rare case report

    Directory of Open Access Journals (Sweden)

    Ravi Swami, Nimbargi RC, Karandikar MN, Jagdale KA

    2014-04-01

    Full Text Available Hepatocellular adenomas are usually affect females in their 3rd and 4th decades of life. Uses of oral contraceptives use or anabolic steroids have been blamed for this. This is rare in old age and in an elderly male presented with hepatic adenoma. Such cases are difficult to diagnose on fine needle aspiration cytology and can cause under or over diagnosis. Here we present a rare case of hepatic adenoma in an elderly male with both cytological as well as histopathology features of adenoma.

  1. Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh.

    Science.gov (United States)

    Ferdous, Tamanna; Cederholm, Tommy; Razzaque, Abdur; Wahlin, Ake; Nahar Kabir, Zarina

    2009-07-01

    To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community-living elderly persons aged 60 years or more (60-92 years; 69 +/- 7 years). Mobility, activities of daily living (ADL), performance tests, handgrip strength, the Mini Nutritional Assessment (MNA) and a structured questionnaire were used to assess physical function, nutritional status, socioeconomic status and health status, respectively. Descriptive and linear hierarchical regression analyses were applied. Seven per cent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties in performing one or more items in the performance tests. According to the MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants than well-nourished participants reported limited mobility, impaired ADL and difficulties in the performance tests. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socioeconomic and health status differences. Good nutritional status is important for the physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation.

  2. Elder Abuse and Substance Abuse

    Science.gov (United States)

    ... Culture in Elder Abuse Mental capacity, consent, and undue influence The relationship between elder abuse and substance abuse ... older person's financial resources and to wield significant ... financially or, in the case of illegal drug use, less likely to report. ...

  3. High Blood Pressure and Self-Reported Systemic Hypertension in Elderly Enrolled in the Family Health Strategy Program.

    Science.gov (United States)

    Oliveira, E C T; de Menezes, T N; de Olinda, R A

    2017-06-01

    This study aimed to determine the prevalence of high blood pressure (HBP), self-reported hypertension, and associated factors among in elderly enrolled in the Family Health Strategy (FHS) Program. This is a cross-sectional study with in elderly enrolled in the FHS Program of Campina Grande/Paraíba/Brazil. This study determined the prevalence of HBP and self-reported hypertension and their associations with demographic, socioeconomic variables, lifestyle, and number of self-reported morbidities. Three blood pressure measurements were performed, and the average value was used for analysis. To control possible confounding factors, data were modeled by the method of linear models generalized with Poisson log modeling to determine prevalence ratios and confidence intervals. The SPSS 22.0 statistical application was used, and 5% significance level was adopted. High prevalence of HBP (80.9%) was observed, which was associated with the number of self-reported morbidities, both in the univariate and multivariate analyses. High prevalence of self-reported hypertension (66.4%) was also observed. In the final model, positive association between hypertension and demographic and socioeconomic variables and lifestyle was verified. Monitor hypertension should be a priority action given its association with genetic, social and behavioral conditions presented by individuals.

  4. Self-Reported Cancer Screening among Elderly Medicare Beneficiaries: A Rural-Urban Comparison

    Science.gov (United States)

    Fan, Lin; Mohile, Supriya; Zhang, Ning; Fiscella, Kevin; Noyes, Katia

    2012-01-01

    Purpose: We examined the rural-urban disparity of screening for breast cancer and colorectal cancer (CRC) among the elder Medicare beneficiaries and assessed rurality's independent impact on receipt of screening. Methods: Using 2005 Medicare Current Beneficiary Survey, we applied weighted logistic regression to estimate the overall rural-urban…

  5. Short report : Chronic medical conditions and life satisfaction in the elderly

    NARCIS (Netherlands)

    Jelicic, M; Kempen, GIJM

    1999-01-01

    The aim of this study was to examine the effect of chronic disease on life satisfaction in community dwelling elderly. A total of 5279 research participants, mean age 69.57 (SD = 8.04) yrs, were asked to judge their life satisfaction on the Seven Point Satisfaction Rating Scale. They were also admin

  6. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    Maarsingh, O.R.; Dros, J.; Schellevis, F.G.; van Weert, H.C.; Bindels, P.J.; van der Horst, H.E.

    2010-01-01

    Background: Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizzin

  7. Dizziness reported by elderly patients in family practice: Prevalence, incidence, and clinical characteristics

    NARCIS (Netherlands)

    O.R. Maarsingh (Otto); J. Dros (Jacquelien); F.G. Schellevis (François); H.C. van Weert (Henk); P.J.E. Bindels (Patrick); H.E. van der Horst (Henriette)

    2010-01-01

    textabstractBackground: Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and inciden

  8. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics.

    NARCIS (Netherlands)

    Maarsingh, O.R.; Dros, J.; Schellevis, F.G.; Weert, H.C. van; Bindels, P.J.; Horst, H.E. van der

    2010-01-01

    Background: Although dizziness in elderly patients is very common in family practice, most prevalence studies on dizziness are community-based and include a study population that is not representative of family practice. The aim of this study was to investigate the prevalence and incidence of dizzin

  9. Self-Reported Cancer Screening among Elderly Medicare Beneficiaries: A Rural-Urban Comparison

    Science.gov (United States)

    Fan, Lin; Mohile, Supriya; Zhang, Ning; Fiscella, Kevin; Noyes, Katia

    2012-01-01

    Purpose: We examined the rural-urban disparity of screening for breast cancer and colorectal cancer (CRC) among the elder Medicare beneficiaries and assessed rurality's independent impact on receipt of screening. Methods: Using 2005 Medicare Current Beneficiary Survey, we applied weighted logistic regression to estimate the overall rural-urban…

  10. Short report : Chronic medical conditions and life satisfaction in the elderly

    NARCIS (Netherlands)

    Jelicic, M; Kempen, GIJM

    1999-01-01

    The aim of this study was to examine the effect of chronic disease on life satisfaction in community dwelling elderly. A total of 5279 research participants, mean age 69.57 (SD = 8.04) yrs, were asked to judge their life satisfaction on the Seven Point Satisfaction Rating Scale. They were also

  11. 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.

  12. Spinal cord compression due to undiagnosed thoracic meningioma following lumbar surgery in an elderly patient: a case report.

    Science.gov (United States)

    Knafo, S; Lonjon, G; Vassal, M; Bouyer, B; Lonjon, N

    2013-12-01

    As spinal surgery in elderly patients is becoming increasingly frequent, comorbidities likely to be decompensated after such procedures must be kept in mind. We report here the case of an 82-year-old woman who presented rapidly progressive spinal cord compression following lumbar surgery for radiculopathy. Investigations showed a thoracic intradural extramedullary compressive lesion, which after removal turned out to be a meningioma. We suggest that radiculopathy and non-specific degenerative modifications partially masked this lesion, and that lumbar surgery caused this acute neurological deterioration. Therefore, we advice caution in older patients among whom such ambiguous clinical presentation is frequent. Copyright © 2013. Published by Elsevier Masson SAS.

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

    Science.gov (United States)

    Lee, Wan; Park, Yong-Chan; Kim, Myoung-Hyoun; Choi, Moon-Ki; Yoon, Jung-Hoon

    2016-01-01

    Fibrous dysplasia (FD) is an uncommon skeletal disorder in which normal bone is replaced by abnormal fibro-osseous 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. PMID:28035304

  14. Cardiac fibrosis in the elderly, normotensive athlete: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Harle Lindsey

    2008-03-01

    Full Text Available Abstract Background Cardiac fibrosis occurs with normal aging, but the extent of this process and its effect on cardiac function is unknown. Fibrosis in the nonhypertensive elderly patient is thought to be due to decreased degradation, and not increased deposition, of collagen. The cause of this decreased degradation is unknown. Athletes commonly develop cardiac hypertrophy, and recent evidence has linked long-term physical activity to the development of interstitial myocardial fibrosis. Whether this exercise-induced fibrosis occurs regularly, or only in genetically predisposed individuals, is unknown. Case presentation We present the case of an elderly, nonhypertensive athlete who died suddenly of sepsis. Autopsy demonstrated foci of fibrosis throughout the right and left ventricle and significant narrowing of the left ventricular cavity. The findings may be secondary to aging, athletic activity or an undiagnosed medical condition. Conclusion The true incidence and importance of age- and exercise-associated myocardial fibrosis is an area for future research.

  15. Diving bradycardia of elderly Korean women divers, haenyeo, in cold seawater: a field report.

    Science.gov (United States)

    Lee, Joo-Young; Lee, Hyo-Hyun; Kim, Siyeon; Jang, Young-Joon; Baek, Yoon-Jeong; Kang, Kwon-Yong

    2016-01-01

    The purpose of the present field study was to explore diving patterns and heart rate of elderly Korean women divers (haenyeo) while breath-hold diving in cold seawater. We hypothesized that the decreasing rate in heart rate of elderly haenyeos during breath-hold diving was greater and total diving time was shorter than those of young haenyeos from previous studies. Nine haenyeos participated in a field study [68 ± 10 yr in age, ranged from 56 to 83 yr] at a seawater temperature of 10 to 13 °C. Average total diving time including surface swimming time between dives was 253 ± 73 min (155-341 min). Total frequency of dives was 97 ± 28 times and they dived 23 ± 8 times per hour. All haenyeos showed diving bradycardia with a decreased rate of 20 ± 8% at the bottom time (101 ± 20 bpm) when compared to surface swimming time (125 ± 16 bpm) in the sea. Older haenyeos among the nine elderly haenyeos had shorter diving time, less diving frequencies, and lower heart rate at work (p<0.05). These reductions imply that haenyeos voluntarily adjust their workload along with advancing age and diminished cardiovascular functions.

  16. 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

  17. Elder abuse in residential long-term care: an update to the 2003 National Research Council report.

    Science.gov (United States)

    Castle, Nicholas; Ferguson-Rome, Jamie C; Teresi, Jeanne A

    2015-06-01

    A synthesis of the last decade of literature on elder abuse in residential long-term care (i.e., Nursing Homes and Assisted Living) is discussed. Presented are definitions of abuse, theoretical and conceptual models, prevalence rates of abuse, outcomes and costs, and sources of abuse. The synthesis represents an update to the literature in the influential 2003 National Research Council report. We identify many of the same issues and concerns exist that were surfaced in this prior report. Many theoretical and conceptual models need further elaboration. Conflicting definitions of abuse are pervasive. Rates of abuse are generally inaccurate, and probably under-reported. However, we also identify progress in many areas. An increase in empirical studies that exist in this area (although very few in Assisted Living). Other forms and types of abuse have also been identified as important, such as resident-to-resident abuse. These areas are discussed, along with potential suggestions for additional research.

  18. Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Paola Di Carlo

    2014-01-01

    Full Text Available Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB and posaconazole (PSO and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients.

  19. The assessment of ADL among frail elderly in an interview survey : Self-report versus performance-based tests and determinants of discrepancies

    NARCIS (Netherlands)

    Kempen, GIJM; Steverink, N; Ormel, J; Deed, DJH

    1996-01-01

    The impact of three sociodemographic, two cognitive, rico affective, and four personality measures on the discrepancies between self-reported and performance-based ADL in a sample of 753 frail elderly is studied by means of multiple regression analyses. Underestimation (i.e., lower self-reported lev

  20. 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.

  1. Imatinib-induced decompensated heart failure in an elderly patient with chronic myeloid leukemia: case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Hai-Hong Ran; Ran Zhang; Xue-Chun Lu; Bo Yang; Hui Fan; Hong-Li Zhu

    2012-01-01

    Because it is safe and well tolerated, imatinib is a standard first-line therapy for chronic myeloid leukemia (CML). Although there have been sporadic reports of imatinib-induced cardiotoxicity, including left ventricle (LV) dysfunction and heart failure, the evidence for it is contradictory. Here, we reported a case of an 88-year-old male patient with CML developed decompensated heart failure following imatinib therapy. Four days after the initiation of imatinib, the patient developed orthopnea, edema and a pleural effusion accompanied by abdominal distension, nausea and vomiting. The chest X-ray film showed an enlarged cardiac profile. The echocardiogram demonstrated a decreased LV ejection fraction and enlarged left-side cardiac chambers. B-type natriuretic peptide concentrations were markedly increased. The patient recovered soon after the withdrawal of imatinib and introduction of comprehensive therapy for heart failure. Imatinib-induced cardiotoxicity in elderly patients is a potentially serious complication that merits further evaluation.

  2. The advantages and disadvantages of ITC, ITE and BTE hearing aids: diary and interview reports from elderly users.

    Science.gov (United States)

    May, A E; Upfold, L J; Battaglia, J A

    1990-10-01

    The advantages and disadvantages of in-the-canal (ITC), in-the-ear (ITE) and behind-the-ear (BTE) hearing aids for elderly aid users were examined. Two hundred and forty four clients were randomly assigned to one of the three aid types from seven hearing aid manufacturers. The clients' perceived help from their fitting, and the degree of difficulty they encountered over a range of listening situations and environments were rated using a daily diary and a structured interview. Findings indicated that for elderly clients there were no large practical advantages for one aid type over another. While ITC and ITE aids were rated more highly than BTE's in background noise, all three aid types were rated as relatively poor in background noise as well as in groups, in the wind, when using the telephone and in the localisation of sound. All three aid types were rated equally and well for performance in one-to-one conversation in quiet, and for listening to television and radio. Hours of use and reasons for non-use are presented, as are clients' reports on cosmetic issues, manipulative ease and overall satisfaction level with their aids.

  3. 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.

  4. Laparoscopic repair of Morgagni hernia with composite mesh in an elderly woman: Report of a case.

    Science.gov (United States)

    Ikarashi, Masahito; Matsuda, Minoru; Murayama, Isao; Fujii, Masashi; Takayama, Tadatoshi

    2015-05-01

    A 78-year-old woman was admitted to another hospital with vomiting. Chest X-ray showed an abnormal shadow in the lower right lung field, and CT indicated a Morgagni hernia containing the stomach and transverse colon. The patient was transferred to our hospital and underwent laparoscopic surgery. After the hernia contents were repositioned into the abdominal cavity, we repaired the hernia orifice with a prosthetic mesh to achieve a tension-free repair. There were no complications after the surgery, and there has been no recurrence. The patient has remained free of clinical symptoms since 10 months after the surgery. Laparoscopic repair with a prosthetic mesh for Morgagni hernia is a simple and safety procedure for elderly patients.

  5. 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.

  6. 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

  7. 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 ...

  8. Vertigem no idoso: relato de caso Vertigo in elderly: a case report

    Directory of Open Access Journals (Sweden)

    Marcelle Alpino Levandowski

    2008-12-01

    Full Text Available TEMA: investigar a vertigem em paciente idosa com vários comprometimentos sistêmicos e avaliar a efetividade terapêutica para o tratamento da vertigem Posicional Paroxística Benigna (VPPB. PROCEDIMENTOS: estudo de caso longitudinal de paciente do sexo feminino com vertigem submetido à terapia fonoaudiológica com exercícios de habituação vestibular. RESULTADOS: no período de seis meses, observou-se melhora no quadro vertiginoso da paciente. CONCLUSÃO: a reabilitação vestibular com exercícios de habituação vestibular mostrou eficácia no tratamento da VPPB da paciente.BACKGROUND: to investigate the vertigo in elderly woman with several systemic commitments and evaluate treatment effectiveness for Benign Paroxysmal Positional Vertigo (BPPV. PROCEDURES: longitudinal clinical study of a female patient with vertigo submitted to speech and hearing therapy with vestibular habituation exercises. RESULTS: after six months the patient had clinical improvement. CONCLUSION: vestibular rehabilitation with vestibular habituation exercises showed effectiveness in the treatment of this patient with BPPV.

  9. Postflight balance control recovery in an elderly astronaut: a case report

    Science.gov (United States)

    Paloski, William H.; Black, F. Owen; Metter, E. Jeffrey

    2004-01-01

    OBJECTIVE: To examine the sensorimotor adaptive response of a 77-year-old man exposed to the gravito-inertial challenges of orbital space flight. STUDY DESIGN: Prospective case study with retrospective comparisons. SETTING: NASA Neurosciences Laboratory (Johnson Space Center) and Baseline Data Collection Facility (Kennedy Space Center). PRIMARY PARTICIPANT: One 77-year-old male shuttle astronaut. INTERVENTION: Insertion into low Earth orbit was used to remove gravitational stimuli and thereby trigger sensorimotor adaptation to the microgravity environment. Graviceptor stimulation was reintroduced at landing, and sensorimotor readaptation to the terrestrial environment was tracked to completion. MAIN OUTCOME MEASURES: Computerized dynamic posturography tests were administered before and after orbital flight to determine the magnitude and time course of recovery. RESULTS: The elderly astronaut exhibited balance control performance decrements on landing day; however, there were no significant differences between his performance and that of younger astronauts tested on the same shuttle mission or on previous shuttle missions of similar duration. CONCLUSIONS: These results demonstrate that the physiological changes attributed to aging do not necessarily impair adaptive sensorimotor control processes.

  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. 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

  12. 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.

  13. Self-maintenance Habits and Preferences in Elderly (SHAPE): reliability of reports of self-care preferences in older persons.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Jensen, Barbara

    2007-02-01

    Self-care preferences can be used in designing programs of care. Yet little has been documented concerning the self-care habits and preferences of older adults. This study assessed the reliability of reports of self-care preferences and their importance among older adults using the Self-maintenance Habits and Preferences in Elderly (SHAPE) instrument. Twenty community-dwelling seniors completed the SHAPE questionnaire twice within a one- to two-week interval. Percent agreement, both exact and close/partial, was computed to assess the reliability of preference content, and intra-class correlations (ICCs) were used for preference importance. Test and subject factors affecting reliability were also investigated. Exact agreement rate for item content was 73%, and that for close/partial agreement was 93%. Mean ICC for item importance was 0.72. Reliability was greater for dichotomous items than for either ordinal or categorical questions. Reliability of item content varied with number of response options and importance reliability varied with age and IADL status. Information from SHAPE about self-care preferences can be used to plan services for seniors and to individualize care for older persons, especially those transitioning to new living environments or those receiving home care.

  14. Nonconvulsive status epilepticus in the elderly associated with newer antidepressants used at therapeutic doses: A report of three cases

    Directory of Open Access Journals (Sweden)

    Go Taniguchi

    2015-01-01

    All three patients were male and were 73 years of age or older. One patient was recently diagnosed with temporal lobe epilepsy and treated with low-dose lamotrigine. In all patients, newer antidepressants were initiated because of depressive symptoms. After titrating to therapeutic doses (paroxetine 20 mg/day, sertraline 50 mg/day, and combination of sertraline 50 mg/day and mirtazapine 30 mg/day in one patient each, impaired consciousness appeared. Electroencephalography (EEG showed generalized slow waves with intermittent spike–slow-wave complexes. Intravenous injection of antiepileptic drugs improved EEG findings and clinical symptoms. After discontinuance of the abovementioned antidepressants, NCSE did not recur in any of patients. These reports raise the question of whether the newer antidepressants, like classic antidepressants, might also induce NCSE in the elderly, even when used at therapeutic doses. Physicians should consider monitoring for possible NCSE when using newer antidepressants in patients who may have low drug tolerability. Active continuous video-EEG monitoring is essential when behavioral and psychological symptoms or change in consciousness level is suspected.

  15. Self-reported difficulty in climbing up or down stairs in nondisabled elderly.

    Science.gov (United States)

    Verghese, Joe; Wang, Cuiling; Xue, Xiaonan; Holtzer, Roee

    2008-01-01

    To examine clinical and functional correlates of self-reported difficulty in climbing up or climbing down stairs in older adults. Cross-sectional survey. Community sample. Older adults (N=310; mean age, 79.7 y; 62% women), without disability or dementia. Not applicable. Clinical and functional status as well as activity limitations (able to perform activities of daily living [ADLs] with some difficulty). Of the 310 subjects, 140 reported difficulties in climbing up and 83 in climbing down stairs (59 both). Self-reported difficulty in climbing up stairs was associated with hypertension, arthritis, and depressive symptoms. Difficulty in climbing up stairs was also associated with poor balance and grip strength as well as neurologic gait abnormalities. Subjects with difficulty climbing down stairs had more falls. Both activities were associated with leg claudication, fear of falling, non-neurologic gait abnormalities, and slow gait. Examined individually, self-reported difficulty climbing down stairs captured a wider spectrum of ADL limitations than climbing up stairs. However, combined difficulty in both phases of stair climbing had a stronger association with activity limitations (vs no difficulty; odds ratio, 6.58; 95% confidence interval, 3.35-12.91) than difficulty in any one phase alone. Self-reported difficulty in climbing up and down stairs revealed commonalities as well as differences in related clinical correlates. Difficulty in both climbing up and down stairs should be separately assessed to better capture clinical and functional status in older adults.

  16. ANALYSIS OF REPORTS ABOUT 384 ELDERLY CASES OF ACCIDENTAL INJURY IN COMMUNITY%384例社区老年人意外伤害报告分析

    Institute of Scientific and Technical Information of China (English)

    薛锦花

    2011-01-01

    [Objective] To understand the characteristics and causes of accidental injury of the elderly in community, in order to provide bases for preventing the occurrence of accidental injuries. [Methods] Retrospectively summarized the reports about 384 elderly cases of accidental injury in community. [Results] Homes and roads were the main sites for injury accidents; falling down and falling in accidental injuries were the main reasons for the elderly; accidental injury easily leaded to fractures of the elderly. [Conclusion] Physical characteristics of the elderly easily lead to accidental injury; improving the environment and facilities, preventing falls and preventing osteoporosis are the focuses in preventing accidental injuries; it should establish and improve accident prevention network.%[目的]了解社区老年人意外伤害的特点与原因,为防范意外伤害的发生提供依据. [方法]回顾性总结某社区卫生服务中心从2007年6月~2009年12月的384例社区老年人意外伤害报告. [结果]家中和公路是老年人发生意外伤害的主要场所;跌倒、坠落是老年人意外伤害的主要原因;老年人意外伤害易导致骨折.[结论]老年人的身体特点易导致意外伤害;改善环境设施、预防跌倒、预防骨质疏松症是防范意外伤害的重点;应建立健全意外伤害防护网络.

  17. 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.

  18. Impact of self-reported symptoms of allergic rhinitis and asthma on sleep disordered breathing and sleep disturbances in the elderly with polysomnography study

    Science.gov (United States)

    Kim, Sae-Hoon; Won, Ha-Kyeong; Moon, Sung-Do; Kim, Byung-Keun; Chang, Yoon-Seok; Kim, Ki-Woong; Yoon, In-Young

    2017-01-01

    Background Sleep disordered breathing (SDB) and sleep disturbances have been reported to be associated with allergic rhinitis and asthma. However, population-based studies of this issue in the elderly are rare. Objective To investigate the impact of self-reported rhinitis and asthma on sleep apnea and sleep quality using polysomnography in an elderly Korean population. Methods A total of 348 elderly subjects who underwent one-night polysomnography study among a randomly selected sample were enrolled. Study subjects underwent anthropometric and clinical evaluations. Simultaneously, the prevalence and co-morbid status of asthma and allergic rhinitis, and subjective sleep quality were evaluated using a self-reported questionnaire. Results Ever-diagnosis of allergic rhinitis was significantly more prevalent in subjects with SDB compared with those without SDB. Subjects with an ever-diagnosis of allergic rhinitis showed a higher O2 desaturation index and mean apnea duration. Indices regarding sleep efficiency were affected in subjects with a recent treatment of allergic rhinitis or asthma. Waking after sleep onset was longer and sleep efficiency was lower in subjects who had received allergic rhinitis treatment within the past 12 months. Subjects who had received asthma treatment within the past 12 months showed significantly lower sleep efficiency than others. Conclusion Our study indicates that a history of allergic rhinitis is associated with increased risk of SDB in the elderly. Sleep disturbance and impaired sleep efficiency were found in the subjects who had received recent treatment of allergic rhinitis or asthma. Physicians should be aware of the high risk of sleep disorders in older patients with respiratory allergic diseases. PMID:28245272

  19. Inlfuencing Factors of Self-reported Disability among the Elderly%老年人自报残疾的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    黄庆波; 陈洁茹; 张旭; 陈功

    2015-01-01

    Objective Data from China Health and Retirement Longitudinal Study in 2011 was used in this paper to examine the influencing factors associated with self-reported disability among the elderly. Results from multivariate logistic regression models showed that increased age, male, less education, rural registered household, unemployment, poor housing condition, with chronic disease and less participation in social intercourse are emerged as influencing factors associated with higher self-reported disability prevalence among the elderly after controlling for socio-demographic characteristics. Therefore, the elderly have a higher prevalence of self-reported disability. Policies related to disability should pay more attention to these elderly people who are male, in lower social economic status and with less engagement in social intercourse, in order to reduce the prevalence of disability.%通过借助中国健康与养老追踪调查2011年数据中对老年人自报残疾的影响因素进行分析。结果显示,年龄越大、男性、受教育水平越低、农业户口、未工作、住房条件越差、有慢性病、社交活动频率越低的老年人自报残疾的可能性越高。相关残疾政策应给予这部分老年群体特别是高龄老人和患有慢性病的老人更多的关注,并采取实际措施予以扶持和帮助。以降低其残疾发生率。

  20. Achromobacter Xylosoxidans Bloodstream Infection in Elderly Patient with Hepatocellular Carcinoma: Case Report and Review of Literature.

    Science.gov (United States)

    Raghuraman, Kausalya; Ahmed, Nishat H; Baruah, Frincy K; Grover, Rajesh K

    2015-01-01

    Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidans was isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  1. Achromobacter Xylosoxidans bloodstream infection in elderly patient with Hepatocellular Carcinoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kausalya Raghuraman

    2015-01-01

    Full Text Available Achromobacter xylosoxidansis a nonfermentative Gram-negative organism, known to cause opportunistic infection in humans. We report a case of septicemia in a 76-year-old male patient with underlying hepatocellular carcinoma due to A. xylosoxidans, which showed a different antimicrobial susceptibility pattern from what is usually reported. From aerobic blood culture of the patient, A. xylosoxidanswas isolated which was found to be sensitive to amoxicillin-clavulanic acid, piperacillin-tazobactam, ceftazidime, cefoperazone-sulbactam, meropenem, minocycline, tigecycline, and trimethoprim/sulfamethoxazole. The patient recovered with amoxicillin-clavulanic acid treatment, which was given empirically to the patient. The present case highlights the possible role of amoxicillin-clavulanic acid for treatment of bloodstream infection with A. xylosoxidans.

  2. 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.

  3. ECT associated musical hallucinations in an elderly patient: a case report

    OpenAIRE

    2006-01-01

    Abstract Electro Convulsive Therapy (ECT) is a medical treatment for severe mental illness in which small, carefully controlled electricity is applied to the brain. This electric stimulation is done in conjunction with anesthesia and muscle relaxant medications to produce a mild generalized seizure. This is used to treat a variety of psychiatric disorders. This is most effective in the treatment of severe depression providing a rapid relief. We report and discuss an unusual presentation of a ...

  4. ECT associated musical hallucinations in an elderly patient: a case report

    Directory of Open Access Journals (Sweden)

    Wildgoose Keith

    2006-08-01

    Full Text Available Abstract Electro Convulsive Therapy (ECT is a medical treatment for severe mental illness in which small, carefully controlled electricity is applied to the brain. This electric stimulation is done in conjunction with anesthesia and muscle relaxant medications to produce a mild generalized seizure. This is used to treat a variety of psychiatric disorders. This is most effective in the treatment of severe depression providing a rapid relief. We report and discuss an unusual presentation of a ninety three year old lady with a diagnosis of Major Depressive Disorder, Recurrent, Severe with Psychotic features (296.34 who experienced musical hallucinations whilst she was treated on ECT. Clinically there was an inverse relationship between the biological symptoms of depression and musical hallucination during the ECT management. Though similar reports have never been reported earlier, we noticed a good association between the initiation of ECT and musical hallucination in our patient. The patient stopped experiencing musical hallucinations and improved of her biological symptoms of depression completely after the full course of ECT.

  5. ECT associated musical hallucinations in an elderly patient: a case report.

    Science.gov (United States)

    Janakiraman, Raguraman; Wildgoose, Keith; Seelam, Kalyan

    2006-08-04

    Electro Convulsive Therapy (ECT) is a medical treatment for severe mental illness in which small, carefully controlled electricity is applied to the brain. This electric stimulation is done in conjunction with anesthesia and muscle relaxant medications to produce a mild generalized seizure. This is used to treat a variety of psychiatric disorders. This is most effective in the treatment of severe depression providing a rapid relief. We report and discuss an unusual presentation of a ninety three year old lady with a diagnosis of Major Depressive Disorder, Recurrent, Severe with Psychotic features (296.34) who experienced musical hallucinations whilst she was treated on ECT. Clinically there was an inverse relationship between the biological symptoms of depression and musical hallucination during the ECT management. Though similar reports have never been reported earlier, we noticed a good association between the initiation of ECT and musical hallucination in our patient. The patient stopped experiencing musical hallucinations and improved of her biological symptoms of depression completely after the full course of ECT.

  6. Special Section: Educating Elderly Caregivers.

    Science.gov (United States)

    Epstein, Bernice A.; And Others

    1990-01-01

    Four articles in this special section report on (1) Arizona curriculum for home-based caregivers of the elderly in rural communities (Epstein, Koenig); (2) educational programs for nursing home caregivers (Marsden); (3) extension programs for helping low-income elderly with money management (Koonce); and (4) energy education for the elderly…

  7. Hydroxychloroquine-Associated Hyperpigmentation Mimicking Elder Abuse

    OpenAIRE

    Cohen, Philip R

    2013-01-01

    Background Hydroxychloroquine may result in cutaneous dyschromia. Older individuals who are the victims of elder abuse can present with bruising and resolving ecchymoses. Purpose The features of hydroxychloroquine-associated hyperpigmentation are described, the mucosal and skin manifestations of elder abuse are reviewed, and the mucocutaneous mimickers of elder abuse are summarized. Case Report An elderly woman being treated with hydroxychloroquine for systemic lupus erythematosus developed d...

  8. 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.

  9. EVENTRATION OF DIAPHRAGM COMPLICATED BY GASTRIC VOLVULUS IN ELDERLY FEMALE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kedarnath

    2014-04-01

    Full Text Available We report a 64 year old female who presented with epigastric pain and intractable vomiting not respond to treatment and we were not able to pass nasogastric tube. Chest x –ray shows eventration of left sided hemi diaphragm, upper gastro intestinal contrast study conform the diagnosis of gastric volvulus. Plication of left hemidiaphragm with anterior gastropexy was performed through an abdominal approach. Postoperatively the patient's symptoms improved. Acute gastric volvulus carries a mortality rate of 42–56%, secondary to gastric ischemia, perforation or necrosis.1 Emergency physicians should have suspicion about gastric volvulus when treating patients with abdominal pain and persistent vomiting. The patient should go for surgical consultation as early as possible.

  10. 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.

  11. 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.

  12. [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.

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

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    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.

  14. Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report.

    Science.gov (United States)

    Dhingra, Kunaal; Prakash, Shobha

    2012-06-01

    Drug-influenced gingival overgrowth is an unaesthetic overgrowth of gingiva principally associated with intake of drugs like phenytoin, cyclosporin A and nifedipine. Its occurrence in both dentate and edentulous regions of oral cavity is poorly understood. This report highlights clinical and histological description, aetiology and management of gingival overgrowth in a partially edentulous (non-denture wearer) 60-year-old female patient with epilepsy on phenytoin and phenobarbital drugs from past 7 years. Patient's intraoral examination revealed lobulated and fibrotic consistency gingival overgrowth around teeth and on partially edentulous ridges of upper and lower arches along with generalised tooth mobility. Under medical consultation, full mouth extraction, surgical excision of overgrowth followed by complete denture rehabilitation and replacement of combination drugs with sodium valproate were accomplished. Histologically, the lesion showed fibro-epithelial hyperplasia. Clinical results after 6 months demonstrated almost complete resolution of gingival overgrowth. The findings of present case suggest that gingival overgrowth can occur even in partially edentulous ridges (not exposed to denture wear) that could be due to persistence of gingival overgrowth, which may not resolve completely following tooth extraction or occurs because of incorporation of specific subpopulation of gingival fibroblasts in alveolar ridge mucosa. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  15. Self-reported predictors of depressive symptomatology in an elderly population with type 2 diabetes mellitus: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Balkrishnan Rajesh

    2007-08-01

    Full Text Available Abstract Background The prevalence of depression increases among the elderly with chronic medical conditions like diabetes. Hence, the purpose of this study was to determine predictors of depressive symptomatology in Medicare enrolled elderly population with type 2 diabetes mellitus. Methods A prospective cohort study was conducted by administrating health risk assessment questionnaire to elderly (≥65 years with type 2 diabetes. Responses were linked with administrative claim's data. Data were obtained from elderly with type 2 diabetes who were enrolled in Medicare Health Maintenance Organization (HMO in southeastern United States. The instrument collected information related to demographics, health status, medication use, and healthcare service utilization prior to enrollment. Responses were combined with the administrative claims data of HMO to obtain information on actual utilization of healthcare resources. The Short Form Center for Epidemiologic Studies Depression scale was used to assess depressive symptoms. Multivariable logistic regression analyses were conducted to determine predictor variables. Results Of 792 respondents, about 17% had depressive symptoms. Almost 96% of patients were using 1 or more antidiabetic medications. Overall, increased risk of depression was associated with lower health related quality of life (HRQoL (OR: 0.97; 95% CI: 0.96–0.98 and higher impairments in instrumental activities of daily living (IADLs (OR: 1.31; 95% CI: 1.14–0.52 in elderly patients. Poor health related quality of life (OR: 0.97, 95%CI: 0.95–0.99 was associated with higher risk of depression in patients on insulin therapy. Conclusion Impairments in daily activities and lower HRQoL were predictors of depressive symptomatology in elderly with diabetes. Determinants of depression varied according to pharmacotherapeutic class of antidiabetic medications.

  16. 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.

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

    Science.gov (United States)

    Ozten, Eylem; Tufan, Ali Evren; Cerit, Cem; Sayar, Gökben Hızlı; Ulubil, Irem Yalug

    2013-01-10

    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. 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. 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 etiology and that atypical antipsychotics may help in the management of primary delusional

  18. 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

  19. Feasibility of using quadriceps-strengthening exercise to improve pain and sleep in a severely demented elder with osteoarthritis – a case report

    Directory of Open Access Journals (Sweden)

    Richards Kathy

    2002-10-01

    Full Text Available Abstract Background Osteoarthritis (OA of the knee, which is prevalent among older adults in nursing homes, causes significant pain and suffering, including disturbance of nocturnal sleep. One nonpharmacologic treatment option is quadriceps-strengthening exercise, however, the feasibility of such a treatment for reducing pain from OA in severely demented elders has not been studied. This report describes our test of the feasibility of such an exercise program, together with its effects on pain and sleep, in a severely demented nursing home resident. Case presentation The subject was an elderly man with severe cognitive impairment (Mini-Mental Status Exam score 4 and knee OA (Kellgren-Lawrence radiographic grade 4. He was enrolled in a 5-week, 10-session standardized progressive-resistance training program to strengthen the quadriceps, and completed all sessions. Pain was assessed with the Western Ontario and MacMaster OA Index (WOMAC pain subscale, and sleep was assessed by actigraphy. The patient was able to perform the exercises, with a revision to the protocol. However, the WOMAC OA pain subscale proved inadequate for measuring pain in a patient with low cognitive functioning, and therefore the effects on pain were inconclusive. Although his sleep improved after the intervention, the influence of his medications and the amount of daytime sleep on his nighttime sleep need to be considered. Conclusions A quadriceps-strengthening exercise program for treating OA of the knee is feasible in severely demented elders, although a better outcome measure is needed for pain.

  20. Effectiveness of an Innovative Pulsed Electromagnetic Fields Stimulation in Healing of Untreatable Skin Ulcers in the Frail Elderly: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Fabio Guerriero

    2015-01-01

    Full Text Available Introduction. Recalcitrant skin ulcers are a major burden in elderly patients. Specifically, chronic wounds result in significant morbidity and mortality and have a profound economic impact. Pulsed electromagnetic fields (PEMFs have proved to be a promising therapy for wound healing. Here we describe the first reported case of an innovative PEMF therapy, Emysimmetric Bilateral Stimulation (EBS, used to successfully treat refractory skin ulcers in two elderly and fragile patients. Case Presentation. Two elderly patients developed multiple chronic skin ulcerations. Despite appropriate treatment, the ulcers showed little improvement and the risk of amputation was high. Both patients underwent daily EBS therapy and standard dressing. After few weeks of treatment, major improvements were observed and all ulcers had healed. Conclusion. In patients with refractory ulceration, EBS therapy may be of real benefit in terms of faster healing. This case supports the supportive role for PEMFs in the treatment of skin ulceration in diabetes and is suggestive of a potential benefit of EBS in this clinical condition.

  1. [Acromegaly: multifaceted clinical presentation of a rare disease of the elderly. Report of two cases with long-term follow-up].

    Science.gov (United States)

    Foppiani, Luca; Del Monte, Patrizia; Ruelle, Antonio; Marugo, Alessandro; Bernasconi, Donatella

    2006-04-01

    We report two cases of acromegaly in elderly patients. Both patients had markedly invasive GH-secreting macroadenomas, which caused hugely increased circulating GH levels (over 90 ng/ml). The first patient, 79 year-old, presented with goitre and severe osteoarthrosis, refused surgery and was treated with various somatostatin analogues (ultimately accompanied by cabergoline), without satisfactory control of the disease. The second patient, 67-year-old, presented with symptoms secondary to hypopituitarism, which had been previously misdiagnosed. These symptoms resolved with the appropriate substitutive therapy, which led to a significant improvement in her condition. However, two transphenoidal operations, radiotherapy and long-term somatostatin agonist therapy were required to control GH hypersecretion satisfactorily. The authors wish to underline that acromegaly is a rare but not negligible disorder in the elderly, which can affect the whole body functions and cause severe morbidities. In the two cases presented somatostatin agonists alone were not able to control the tumoral hypersecretion adequately. The prompt discovery (usually through a simple clinical evaluation) of this disease in the elderly, confirmed by hormonal and morphological evaluation, together with a multidisciplinary (medical, surgical, radiotherapeutic) approach can improve their quality of life and increase life expectancy.

  2. [Two elderly case reports of renal excretion type drug poisoning caused by dehydration that was due to poor eating in home care].

    Science.gov (United States)

    Ibata, Takeshi; Hinokiyama, Hiromi; Nakashita, Chisako; Mito, Saori; Doi, Seiko; Shiki, Satomi; Hata, Akiko; Sato, Miyuki; Komuro, Ryutaro; Iijima, Hohei

    2010-12-01

    The elderly patients are susceptible to acute renal failure due to dehydration or infection. Therefore, the drug should be administered with caution. We report two cases of acute renal failure from dehydration that led to a subsequent drug poisoning. Case 1: An 85-year-old woman with a history of colorectal cancer surgery was admitted to our emergency department for appetite loss and weakness. Because she was given a normal amount of drugs under the condition of poor oral intake, she was hospitalized by digitalism. Case 2: A 72-year-old woman was admitted to our emergency department for disturbance of consciousness and appetite loss. The medication given by a staff in geriatric health services facility appeared to have caused a pilsicainide poisoning. As the elderly patients were given a normal amount of drugs under the poor oral intake condition, blood levels of renal excretion type drug had increased in both cases. Medication management for the elderly should be comprehensively considered the background of the individual.

  3. 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

  4. What is Elder Abuse?

    Science.gov (United States)

    ... Strategic Plan Federal Initiatives Career Opportunities Contact Us Administration on Aging (AoA) What is Elder Abuse? What ... Elder Justice & Adult Protective Services Elder Justice Coordinating Council Prevention of Elder Abuse, Neglect and Exploitation (Title ...

  5. Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department: implications for selection of clinical outcome measures

    DEFF Research Database (Denmark)

    Nielsen, Louise Møldrup

    2016-01-01

    moderate (r = 0.53). The correlation between the Barthel-20 and the 30s-CST was fair (r = 0.45). The correlation between Barthel-20 and the AMPS process was non-significant. The results were affected by high ceiling effect (Barthel-20). Conclusion Self-reported and performance-based measures seem to assess......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......). Methods Participants were 61 patients aged 65 years and above admitted to an ED. The self-reported measure used was the Barthel-20; the performance-based measures were Timed Up and Go (TUG); 30s-Chair Stand Test (30s-CST) and Assessment of Motor and Process Skills (AMPS) with the two scales; motor...

  6. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database.

    Science.gov (United States)

    Liabeuf, Sophie; Gras, Valérie; Moragny, Julien; Laroche, Marie-Laure; Andrejak, Michel

    2014-01-01

    To report a series of cases of ulceration of the oral mucosa linked to direct contact with ferrous sulfate in elderly patients. The first case report concerns the occurrence of widespread oral ulceration in an 87-year-old woman with Alzheimer's disease. The ulceration extended from the side of the tongue to the floor of the mouth. No clear explanation was found and various local treatments were ineffective. Once it was realized that the ferrous sulfate tablets (given as an iron supplement) were crushed prior to administration (due to the patient's deglutition disorder), withdrawal of this treatment led to rapid resolution of the ulceration. Nine other cases of oral ulcerations associated with ferrous sulfate were identified in the French National Pharmacovigilance Database. All but one of the patients were over 80 years of age and the youngest patient (a 54-year-old) had dysphagia associated with facial paralysis. Only two other reports of oral ulceration due to ferrous sulfate have been published to date. Mucosal toxicity of ferrous sulfate (which is probably related to oxidative stress) has previously been reported for the hypopharynx, the esophageal lumen, and (after inhalation of a tablet) the tracheobronchial tree. The mucosal toxicity of ferrous sulfate must be taken into account when deglutition disorders are present (as in elderly patients) and appropriate pharmaceutical formulations (such as syrups) should be administered to at-risk patients. The use of iron salts other than ferrous sulfate could be considered.

  7. MOBILITY DEVICES FOR THE ELDERLY

    Directory of Open Access Journals (Sweden)

    Minoru KAMATA

    2006-01-01

    Full Text Available The authors propose the use of micro-electric vehicles called “silver vehicles” (SV as mobility devices for older drivers who have difficulty driving automobiles. Previous reports have described research on characteristics of the elderly, proposed the SV concept and evaluated it in townmobility field tests. This report addresses feasibility of the SV concept and issues of town planning through a follow-up study of characteristics of the elderly three years later, long-term in-use testing of SV-comparable production vehicles, and investigations of elderly driver characteristics and trailing behavior in mixed traffic situations.

  8. Is 2 weeks of antibiotic therapy enough to treat elderly patients with nontyphoid Salmonella bacteremia? A case report of fatal endovascular infection.

    Science.gov (United States)

    Chen, Po-Lin; Tsai, Liang-Miin; Kan, Chung-Dann; Ko, Wen-Chien

    2014-08-01

    Nontyphoid Salmonella (NTS) can cause invasive diseases in the elderly. Notably, the most feared complication of NTS bacteremia is endovascular infection. The risk factors for infected aortic aneurysm include old age and atherosclerosis. Extended use of antimicrobial therapy (> 2 weeks) for NTS bacteremia should be considered for those who demonstrate the risk factors for endovascular infection, even when a metastatic focus is clinically elusive. Herein, we report the case of a 75-year-old patient with diabetes mellitus, hypertension, chronic kidney disease, and myocardial infarction who died of an infected aortic aneurysm despite 3 weeks of antibiotic therapy that was administered to treat the initial NTS bacteremia.

  9. Is the Concept of Delirious Mania Valid in the Elderly? A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Pramudith M. Maldeniya

    2013-01-01

    Full Text Available Delirious mania has been well recognized in the published literature and in the clinic. Over the years there has been refinement of understanding of its clinical features, course, and treatment. The literature suggests that delirious mania should be considered in individuals who present with a constellation of sudden onset delirium, mania, and psychosis. However, delirious mania is not recognized under a formal classification system nor are there any formal guidelines for its treatment. We, as such, question if the concept of delirious mania in the elderly is valid. We present a case of an elderly man with marked features of delirium with minimal manic or psychotic features who had a previous diagnosis of bipolar I disorder. On thorough clinical assessments no identifiable cause of his delirium was found. We therefore considered his presentation to be more likely due to delirious mania. Electroconvulsive therapy was considered and offered to which he responded very well. We invite the reader to consider whether delirious mania is a valid concept in the elderly, where features of delirium may be more prominent than manic or psychotic features.

  10. 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.

  11. Correlates of patient satisfaction with physician visit: Differences between elderly and non-elderly survey respondents

    Directory of Open Access Journals (Sweden)

    Anderson Roger T

    2007-11-01

    Full Text Available Abstract Background Few studies document differences in patient satisfaction with physicians in the elderly (≥ 65 years and compare it to non-elderly ( Methods A cross-sectional survey study on a convenience sample of 20,901 patients rated their recent visit to a physician through a web-based survey. Survey included validated questions based on aspects of physician care practice such as "friendliness", wait times and time spent with doctor. These scales were then used to measure patient satisfaction with physician. Statistical analysis involved pair-matching of non-elderly patients with elderly patients (both cohorts, n = 507 each using propensity scores. Results Even though elderly and non-elderly patients had similar waiting times, elderly patients gave higher physician satisfaction scores than non-elderly patients (all p Conclusion Increased patient satisfaction ratings of the non-elderly were associated more strongly with shorter waiting times than in the elderly. However overall, elderly patients reported similar waiting times and better physician satisfaction scores. Similarly, higher physician satisfaction in non-elderly patients were more strongly associated with increased time spent with physician than in the elderly patients.

  12. The Nonutilization of Special Transport Services by the Elderly in Urban Areas: A Case Study of Washington, D.C. Final Report and Executive Summary.

    Science.gov (United States)

    Lyons, Deborah L.; Lipowitz, Isaac

    Improving the mobility of older adults has been a major goal of transportation programs and policies for the elderly at both the federal and local levels. To examine reasons why eligible elderly individuals in urban areas do not use available special transport services, 140 elderly persons in the Washington, D.C. area were surveyed on the extent…

  13. Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly.

    Science.gov (United States)

    Morena, Marion; Jaussent, Audrey; Chalabi, Lotfi; Leray-Moragues, Hélène; Chenine, Leila; Debure, Alain; Thibaudin, Damien; Azzouz, Lynda; Patrier, Laure; Maurice, Francois; Nicoud, Philippe; Durand, Claude; Seigneuric, Bruno; Dupuy, Anne-Marie; Picot, Marie-Christine; Cristol, Jean-Paul; Canaud, Bernard

    2017-03-15

    Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration. The primary outcome was intradialytic tolerance (day 30-day 120). Secondary outcomes included health-related quality of life, cardiovascular risk biomarkers, morbidity, and mortality. During the observational period for intradialytic tolerance, 85% and 84% of patients in high-flux hemodialysis and online hemodiafiltration arms, respectively, experienced at least one adverse event without significant difference between groups. As exploratory analysis, intradialytic tolerance was also studied, considering the sessions as a statistical unit according to treatment actually received. Over a total of 11,981 sessions, 2,935 were complicated by the occurrence of at least one adverse event, with a significantly lower occurrence in online hemodiafiltration with fewer episodes of intradialytic symptomatic hypotension and muscle cramps. By contrast, health-related quality of life, morbidity, and mortality were not different in both groups. An improvement in the control of metabolic bone disease biomarkers and β2-microglobulin level without change in serum albumin concentration was observed with online hemodiafiltration. Thus, overall outcomes favor online hemodiafiltration over high-flux hemodialysis in the elderly.

  14. Treatment of unstable intertrochanteric fractures of the femur through hip arthroplasty in the elderly:A report of 56 cases

    Directory of Open Access Journals (Sweden)

    Chuan-lin DU

    2011-12-01

    Full Text Available Objective To investigate the treatment effect of hip arthroplasty for unstable intertrochanteric fractures of the femur in the elderly.Methods Fifty-six elderly patients(25 males and 31 females,aged 75 to 92 years with mean of 83 years with unstable intertrochanteric fractures hospitalized from January 2005 to June 2010 were involved in the present study.According to the Evan’s fracture classification,22 cases were classified as type III,24 as type IV,and 10 as type V.All the patients received bone-cement type hip arthroplasty,and the treatment effects,perioperative complications,and follow-up results were observed.Results The operation was completed successfully for all patients.The postoperative complications included,two cases of deep venous thrombosis,two cases of transient psychotic disorder,and two cases of pseudomembranous colitis,all of which,were cured via symptomatic treatment.Three patients have had complications with pulmonary embolism and two with fractures around the prosthesis four months after discharge.Two patients died of pulmonary infection and multiple organ failure,respectively.The Harris hip score were excellent for the 21 cases and good for 26 cases.The excellent and good rating was 83.9% after six months from operation.No joint infection or dislocation occurred during the follow-up period of 12 to 20 months(mean of 16 months.Conclusion Hip arthroplasty has been proven to be an effective treatment for unstable intertrochanteric fractures in the elderly with less surgery trauma and complications.It also allowed early ambulation and improved the quality of life of the patients.

  15. 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

  16. Cross-cultural validation of the Falls Efficacy Scale International (FES-I) using self-report and interview-based questionnaires among Persian-speaking elderly adults.

    Science.gov (United States)

    Baharlouei, Hamzeh; Salavati, Mahyar; Akhbari, Behnam; Mosallanezhad, Zahra; Mazaheri, Masood; Negahban, Hossein

    2013-01-01

    FES-I has been designed to assess fear of falling (FoF). The purpose of this study was to establish the Persian-language version of the FES-I and to assess its psychometric properties under different modes of administration: self-report and interview-based. Participants included 191 elderly people aged over 60 who were mostly community dwelling. With an interval of 14 days, 97 volunteers completed the questionnaire in the retest session. To evaluate the construct validity, we assessed the ability of the FES-I to discriminate people based on gender, level of education, number of falls and FoF. The correlation with the Short Form of Health Survey (SF-36), Timed Up and Go (TUG) and Functional Reach Test (FRT) was also determined to test validity. Internal consistency was excellent in both self-report (0.93) and interview (0.92) versions. All intra-class correlations (ICCs) were above 0.70 with the highest reliability obtained for the condition where the interview based FES-I was used in both test and retest sessions. The strength of correlation between the FES-I and TUG varied based on mode of administration: moderate for interview and high for self-report mode. The FES-I had a higher correlation with the SF-36 subscales of physical health than subscales of mental health. The FES-I had the ability to discriminate the participants based on gender, educational level, and number of falls and FoF. In conclusion, both interview and self-report versions of the FES-I demonstrated acceptable measurement properties to assess FoF in Iranian elderly persons.

  17. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database

    Directory of Open Access Journals (Sweden)

    Liabeuf S

    2014-04-01

    Full Text Available Sophie Liabeuf,1–3 Valérie Gras,1 Julien Moragny,1 Marie-Laure Laroche,4 Michel Andrejak1,3On behalf of the French National Network of Pharmacovigilance Centers1Regional Pharmacovigilance Center, Division of Clinical Pharmacology, Amiens University Medical Center and Jules Verne University of Picardy, Amiens, France; 2Clinical Research Centre, Clinical Pharmacology Division, Amiens University Medical Center and the Jules Verne University of Picardy, Amiens, France; 3INSERM U1088, Amiens, France; 4Regional Pharmacovigilance Center, Department of Pharmacology, Toxicology and Pharmacovigilance, Limoges University Medical Center, Limoges, FranceObjective: To report a series of cases of ulceration of the oral mucosa linked to direct contact with ferrous sulfate in elderly patients.Case summary: The first case report concerns the occurrence of widespread oral ulceration in an 87-year-old woman with Alzheimer’s disease. The ulceration extended from the side of the tongue to the floor of the mouth. No clear explanation was found and various local treatments were ineffective. Once it was realized that the ferrous sulfate tablets (given as an iron supplement were crushed prior to administration (due to the patient’s deglutition disorder, withdrawal of this treatment led to rapid resolution of the ulceration. Nine other cases of oral ulcerations associated with ferrous sulfate were identified in the French National Pharmacovigilance Database. All but one of the patients were over 80 years of age and the youngest patient (a 54-year-old had dysphagia associated with facial paralysis.Discussion: Only two other reports of oral ulceration due to ferrous sulfate have been published to date. Mucosal toxicity of ferrous sulfate (which is probably related to oxidative stress has previously been reported for the hypopharynx, the esophageal lumen, and (after inhalation of a tablet the tracheobronchial tree.Conclusion: The mucosal toxicity of ferrous

  18. 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.

  19. Elder abuse: speak out for justice.

    Science.gov (United States)

    Olson, Jenna M; Hoglund, Barbara A

    2014-01-01

    It is estimated that 1 in 10 older adults experience abuse, but only 1 in 5 to as little as 1 in 24 cases are reported. Elder abuse is expected to increase as the population ages. Nurses are in a prime position to identify, assess, manage, and prevent elder abuse. This article explores elder abuse and its prevalence, potential causes, and risk factors offering case studies, assessment tools, resources, and interventions.

  20. 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.

  1. 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.

  2. Identifying and Evaluating Elder Abuse and Neglect

    Directory of Open Access Journals (Sweden)

    Aygul Kissal

    2009-08-01

    Full Text Available Elder abuse and neglect have been put into agenda because of the increasing number of elderly people, changing family and socio-cultural structure, worsening of the economic conditions in recent years. Abuse and neglect has been considered as a critical and complex subject which affects the health of elderly people and their life quality. Health professionals are a central position to reveal, manage and prevent elder abuse. For this reason, They need to know the reason, risk-factor and findings of abuse. Health professionals who support elder-especially nurse- shouldn’t only deal with this subject but also they should be educated about diagnosing, reporting and attempting. This paper’s aim is to inform people about the evaluation of risk-factors, findings and prevention of elder abuse and neglect and to increase sensitivity. [TAF Prev Med Bull 2009; 8(4.000: 357-364

  3. How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden

    OpenAIRE

    Bravell, Marie Ernsth; Westerlind, Bjorn; Midlöv, Patrik; Ostgren, Carl-Johan; Borgquist, Lars; Lannering, Christina; Molstad, Sigvard

    2011-01-01

    Knowledge about the need for care of elderly individuals in community dwellings and the factors affecting their needs and support is limited. The aim of this study was to characterize the frailty of a population of elderly individuals living in community dwellings in Sweden in relation to co-morbidity, use of drugs, and risk of severe conditions such as malnutrition, pressure ulcers, and falls. In 2008, 315 elderly individuals living in community dwellings were interviewed and examined as par...

  4. Burn treatment in the elderly.

    Science.gov (United States)

    Keck, M; Lumenta, D B; Andel, H; Kamolz, L P; Frey, M

    2009-12-01

    The population of elderly patients is expected to rise continuously over the next decades due to global demographic changes. The elderly seem to be most vulnerable to burns and their management remains undoubtedly a challenge. A clear age margin for elderly patients is not yet defined, but most studies adhere to the inclusion of patients 65 years and above, but the general condition and social situation must be taken into account. The understanding of the physiological basis of aging and its related pathophysiological changes has only marginally influenced treatment and decision making in elderly burn patients. When looking at treatment regimens currently applied in elderly burn patients, the discussion of standards in intensive care as well as surgical strategies is ongoing. However, trends towards a moderate, non-aggressive resuscitation approach and careful inclusion of key parameters like physiological age, pre-burn functional status and premorbid conditions, seem to be useful guidelines for interdisciplinary treatment decisions. Once ordered for surgical treatment, the amount of body surface area operated in one session should be adapted to the general status of the patient. Even if older burn victims have a reported higher mortality rate than younger patients, improved therapeutic options have contributed to a reduced mortality rate even in the elderly over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive rehabilitation program. This review will give an overview of the current literature and will draw attention to specific topics related to this important subpopulation of burn patients.

  5. Chemotherapy for metastatic seminoma in elderly patients

    NARCIS (Netherlands)

    Rentinck, MEM; Nieboer, P; Sleijfer, DT; Gietema, JA; Van der Graaf, WTA

    2003-01-01

    Testicular germ cell tumours are rarely diagnosed in the elderly. In view of the high cure rate of these tumours, even in elderly patients treatment with chemotherapy and/or radiotherapy should be considered. In this report we describe two older patients with metastatic testicular seminoma. Both

  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. Sphingobacterium spiritivorum bacteremia due to cellulitis in an elderly man with chronic obstructive pulmonary disease and congestive heart failure: a case report.

    Science.gov (United States)

    Hibi, Arata; Kumano, Yuka

    2017-09-30

    Sphingobacterium spiritivorum is a glucose non-fermenting Gram-negative rod, formerly classified as one of the Flavobacterium species. It is characterized by a large number of cellular membrane sphingophospholipids. Sphingobacterium species are ubiquitous and isolated from natural environments, such as soil and water. However, they rarely cause infections in humans. Only a limited number of cases have been reported in elderly and immunocompromised patients with underlying diseases and predisposing factors. An 80-year-old Japanese man with chronic obstructive pulmonary disease and congestive heart failure visited the Kariya Toyota General Hospital, Aichi, Japan with the chief complaint of fever accompanied by chills and left leg pain. At initial presentation, he was distressed and dyspneic. He was febrile (38.8 °C), and his left foot was swollen with reddening and tenderness. We diagnosed him as having cellulitis, and he was hospitalized for antibiotic therapy. Initially, he was treated with intravenously administered cefazolin, but after the isolation of a glucose non-fermenting Gram-negative rod from blood cultures, we decided to switch cefazolin to intravenously administered meropenem on day 4, considering the antibiotic resistance of the causative organism. The causative organism was identified as S. spiritivorum on day 6. His condition gradually stabilized after admission. Meropenem was switched to orally administered levofloxacin on day 12. He was discharged on day 16 and treated successfully without any complications. Although S. spiritivorum is rare, with limited cases isolated from cellulitis, it should be considered as a causative organism in elderly and immunocompromised patients with cellulitis. Blood cultures are the key to correct diagnosis and appropriate treatment.

  8. Recurrent neck abscesses due to cervical tuberculous lymphadenopathy in an elderly woman post-splenectomy: a case report

    Directory of Open Access Journals (Sweden)

    Niblock Aaron L

    2011-12-01

    Full Text Available Abstract Introduction There are approximately 7000 new cases of tuberculosis every year in the UK, the majority of which are pulmonary. Approximately 5% affect the lymph nodes in immunocompetent patients. Scrofula is an old term used to describe lymph nodes of the neck infected with tuberculosis Case presentation In the elderly population, growing neck lumps are always treated as red flags until a diagnosis is confirmed. Here, the case of an 89-year-old Caucasian woman is presented. She was reluctant to seek medical help as she feared the cause was sinister and did not want surgical intervention. Conclusion It is difficult to culture tuberculosis from superficial swabs, resulting in a high proportion of false negative results. Where there is a high degree of clinical suspicion for tuberculosis, it is important to consider a biopsy with culture. Patients over the age of 65 have waning immunity and are therefore a vulnerable group for acute infections as well as the re-activation of indolent organisms. Post-splenectomy patients are at a major disadvantage during sepsis and when a cellular immune response is required, such as when faced with a Mycobacterium tuberculosis infection. Scrofula is treated with a similar regime as pulmonary tuberculosis and has a near 100% success rate.

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

    OpenAIRE

    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

    2016-01-01

    Introduction 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 a...

  10. 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

  11. Discrepancies between self-reported years of education and estimated reading level among elderly community-dwelling African-Americans: Analysis of the MOAANS data.

    Science.gov (United States)

    O'Bryant, Sid E; Lucas, John A; Willis, Floyd B; Smith, Glenn E; Graff-Radford, Neill R; Ivnik, Robert J

    2007-03-01

    The influence of education on cognition has received a great deal of attention in the literature. Although there is general consensus regarding the importance of education on cognitive functioning, the extent to which self-reported level of education corresponds to true educational attainment remains unclear, especially in ethnic minority populations where equal access to education has not always been available. Several investigators have suggested that reading skill may serve as a quantitative estimate of true education experience. Among African-Americans, however, research has shown that self-reported educational level consistently over predicts estimated reading level. The current study analyzed the discrepancy between self-reported years of education completed and estimated reading level in a sample of community-dwelling, elderly African-Americans participating in Mayo's Older African Americans Normative Studies (MOAANS) (Lucas, J.A., Ivnik, R.J., Willis, F.B., Ferman, T.J., Smith, G.E., Parfitt, F.C., Petersen, R.C., & Graff-Radford, N.R. (2005). Mayo's Older African Americans Normative Studies: Normative data for commonly used clinical neuropsychological measures. The Clinical Neuropsychologist, 19, 162-183). In this sample, 29% of the participants read at a level that was 3 or more years below what would be expected based on self-report of education attained. This study also sought to evaluate the extent to which this discrepancy fluctuated as a function of demographic variables such as location of schooling (urban, suburban, rural; North vs. South), parental education and literacy, and percentage of segregation in schooling. Implications of these results are discussed, as are areas for further inquiry.

  12. A Warning Index Used in Prescreening for Alzheimer’s Disease, Based on Self-Reported Cognitive Deficits and Vascular Risk Factors for Dementia in Elderly Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Toshioki Matsuzawa

    2012-01-01

    Full Text Available Background/Aims. Diabetes might increase the risk of Alzheimer’s disease (AD. For detecting dementia, it is typical to obtain informants’ perceptions of cognitive deficits, but such interviews are usually difficult in routine care. We aimed to develop a model for predicting mild to moderate AD using a self-reported questionnaire and by evaluating vascular risk factors for dementia in elderly subjects with diabetes. Methods. We recruited 286 diabetic and 155 nondiabetic elderly subjects. There were 25 patients with AD and 261 cognitively normal individuals versus 30 with AD and 125 normal subjects, respectively. Each participant answered subjective questions on memory deficits and daily functioning. Information on vascular risk factors was obtained from clinical charts, and multivariate logistic regression was used to develop a model for predicting AD. Results. The predicted probabilities used in screening for AD in diabetic subjects constituted age, education, lower diastolic blood pressure, subjective complaints of memory dysfunction noticeable by others, and impaired medication, shopping, and travel outside a familiar locality. Receiver operating characteristic analysis revealed a satisfactory discrimination for AD specific for diabetic elderly subjects, with 95.2% sensitivity and 90.6% specificity. Conclusion. This is the first useful index that can prescreen for AD in elderly subjects with diabetes.

  13. Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Anirudh Rao

    Full Text Available 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 study design quality in the nephrology literature.Systematic literature review.European and North American, Pre-dialysis Chronic Kidney Disease (CKD cohort studies.Studies assessing the association between CKD and mortality in the elderly (>65 years published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE.Time period before and after the publication of the STROBE statement.Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS, Scottish Intercollegiate Guidelines Network (SIGN and Critical Appraisal Skills Programme (CASP tools.37 papers (11 Pre & 26 Post STROBE were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0 vs 83% (IQR, 78.4-84.9, p = 0.05. There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9, SIGN (Manuscript SIGN score 83.3 and CASP (Manuscript CASP score 91.7 tools.Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting.This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort

  14. Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

    Science.gov (United States)

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

    2016-01-01

    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 study design quality in the nephrology literature. Systematic literature review. European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Time period before and after the publication of the STROBE statement. Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0) vs 83% (IQR, 78.4-84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting. This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort

  15. Effects of Chronic Exercise on Severity, Quality of Life and Functionality in an Elderly Parkinson’s Disease Patient: Case Report

    Science.gov (United States)

    Lattari, Eduardo; Pereira-Junior, Pedro Paulo; Neto, Geraldo Albuquerque Maranhão; Lamego, Murilo Khede; Moura, Antonio Marcos de Souza; de Sá, Alberto Souza; Rimes, Ridson Rosa; Manochio, João Paulo; Arias-Carrión, Oscar; Mura, Gioia; Nardi, Antonio E; Machado, Sergio

    2014-01-01

    Exercise produces potential influences on physical and mental capacity in patients with neuropsychiatric disorders, and can be made a viable form of therapy to treat Parkinson’s disease (PD). We report the chronic effects of a regular physical exercise protocol on cognitive and motor functions, functional capacity, and symptoms in an elderly PD patient without dementia. The patient participated of a program composed of proprioceptive, aerobic and flexibility exercises, during 1 hour, three days a week, for nine months. Patient used 600 mg of L-DOPA daily, and 1 hour prior to each exercise session. Assessment was conducted in three stages, 0-3, 3-6 and 6 to 9 months, using percentual variation to the scales Hoehn and Yahr, Mini-Mental State Examination (MMSE), Parkinson Activity Scale (PAS), Beck Depression Inventory (BDI), and Unified Parkinson's Disease Rating Scale (UPDRS-III). Reassessment showed clear changes in clinical parameters for Hoehn and Yahr (4 to 2.5), MMSE (14 to 22), PAS (13 to 29), BDI (9 to 7) and UPDRS-III (39 to 27) at the end of 9 months. According to our data, exercise seems to be effective in promoting the functional capacity and the maintenance of cognitive and motor functions of PD patients. Regular exercise protocols can be implemented as an adjunctive treatment for reducing the severity of PD. PMID:25419223

  16. Primary Primitive Neuroectodermal Tumor of the Conus Medullaris in an Elderly Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    H. Shimosawa

    2011-05-01

    Full Text Available Primary spinal primitive neuroectodermal tumors (PNETs are very rare conditions. Most of these tumors occur in children and young adults. A 63-year-old man with a primary spinal PNET in the conus medullaris from the L1 to L2 level is presented in this report. The optimal treatment of primary spinal PNETs is yet unknown. Surgical resection, radiation therapy, and chemotherapy have been advocated for the treatment of spinal PNET based on PNETs at other sites. However, the outcome is very poor. There are a few reports of cases with long-term survival and no recurrence. In these patients, en bloc resections were performed.

  17. Utilization of health promotion resources and control of health condition among healthy elderly people

    OpenAIRE

    Kuwajima, Daisuke

    2011-01-01

    In Japan, the world’s most rapidly aging country, health promotion services are often provided for elderly people, especially frail elderly and disabled people. However, in 2010, more than 60% of elderly people considered themselves to be “healthy” (Cabinet Office, white paper on aging society, 2010). It is therefore also necessary to enhance services for health promotion among these healthy elderly people. Previous studies have reported the needs of healthy elderly people with respect to hea...

  18. North Carolina's Elderly Population: A Distributional Analysis. Department of Sociology and Anthropology Progress Report Soc. 61, 1975.

    Science.gov (United States)

    Clifford, William B.; Faulkner, Gary L.

    Analyzing selected data on North Carolina's aged population (65 and over), this report utilizes U.S. Census figures, providing tabular data on the migration of the aged and the distribution of the aged population by residence in North Carolina and the U.S. and by North Carolina counties (rural and urban places). Major findings reveal that North…

  19. Conservation among Elderly Women.

    Science.gov (United States)

    Hughston, George A.; Protinsky, Howard O.

    1979-01-01

    The majority of 63 elderly women were able to pass tests in the conservation of mass (98 percent), volume (100 percent), and surface area (65 percent). These results conflict with previous research about Piagetian abilities of elderly people. (RL)

  20. The Report-AGE project: a permanent epidemiological observatory to identify clinical and biological markers of health outcomes in elderly hospitalized patients in Italy.

    Science.gov (United States)

    Bustacchini, Silvia; Abbatecola, Angela Marie; Bonfigli, Anna Rita; Chiatti, Carlos; Corsonello, Andrea; Di Stefano, Giuseppina; Galeazzi, Roberta; Fabbietti, Paolo; Lisa, Rosamaria; Guffanti, Enrico E; Provinciali, Mauro; Lattanzio, Fabrizia

    2015-12-01

    Italy is expected to experience the largest growth in persons ≥65 years (>20% by 2020). This demographic shift allows for geriatric research on predictive clinical and biological markers of outcomes related to frailty, re-hospitalization and mortality. To describe rationale and methods of the Report-AGE study project of acute care patients in Italian National Research Center on Aging (INRCA) research hospitals. Report-AGE study is a large observational study on health conditions and outcomes of hospitalized elderly patients (≥65 years). The primary objective of the study is to create a high-level data resource of demographics, comprehensive geriatric assessments, clinical and diagnostic information, as well as biological and molecular markers in all older patients admitted to INRCA Hospitals. Assessments in physical and nutritional parameters, co-morbid health conditions, and associations with frailty parameters are ongoing in older hospitalized adults following an acute event. Study collection began in September 2011. Up to date, there are 3479 patients ≥65 years (mean age: 85 ± 7years) with 1543 men and 1936 women enrolled. Data have been recorded regarding functional and clinical parameters before, during hospital admission and at discharge. Data collection for primary outcome analyses related to re-hospitalization and mortality is estimated for September 2016. This study aims at collecting precise clinical data, comprehensive geriatric assessment, risk factors, and biological data from acute care patients. Data will also be used to identify mechanisms underlying frailty in this specific population. This study provides a descriptive epidemiological collection of the health conditions of older in-patients.

  1. 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

    ). Methods Participants were 61 patients aged 65 years and above admitted to an ED. The self-reported measure used was the Barthel-20; the performance-based measures were Timed Up and Go (TUG); 30s-Chair Stand Test (30s-CST) and Assessment of Motor and Process Skills (AMPS) with the two scales; motor...... moderate (r = 0.53). The correlation between the Barthel-20 and the 30s-CST was fair (r = 0.45). The correlation between Barthel-20 and the AMPS process was non-significant. The results were affected by high ceiling effect (Barthel-20). Conclusion Self-reported and performance-based measures seem to assess...

  2. 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

  3. Glioblastoma care in the elderly.

    Science.gov (United States)

    Jordan, Justin T; Gerstner, Elizabeth R; Batchelor, Tracy T; Cahill, Daniel P; Plotkin, Scott R

    2016-01-15

    Glioblastoma is common among elderly patients, a group in which comorbidities and a poor prognosis raise important considerations when designing neuro-oncologic care. Although the standard of care for nonelderly patients with glioblastoma includes maximal safe surgical resection followed by radiotherapy with concurrent and adjuvant temozolomide, the safety and efficacy of these modalities in elderly patients are less certain given the population's underrepresentation in many clinical trials. The authors reviewed the clinical trial literature for reports on the treatment of elderly patients with glioblastoma to provide evidence-based guidance for practitioners. In elderly patients with glioblastoma, there is a survival advantage for those who undergo maximal safe resection, which likely includes an incremental benefit with increasing completeness of resection. Radiotherapy extends survival in selected patients, and hypofractionation appears to be more tolerable than standard fractionation. In addition, temozolomide chemotherapy is safe and extends the survival of patients with tumors that harbor O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation. The combination of standard radiation with concurrent and adjuvant temozolomide has not been studied in this population. Although many questions remain unanswered regarding the treatment of glioblastoma in elderly patients, the available evidence provides a framework on which providers may base individual treatment decisions. The importance of tumor biomarkers is increasingly apparent in elderly patients, for whom the therapeutic efficacy of any treatment must be weighed against its potential toxicity. MGMT promoter methylation status has specifically demonstrated utility in predicting the efficacy of temozolomide and should be considered in treatment decisions when possible. Cancer 2016;122:189-197. © 2015 American Cancer Society.

  4. Cognitive Health of the Elderly

    Directory of Open Access Journals (Sweden)

    Moumita Maity

    2014-05-01

    Full Text Available A substantial proportion of the world’s elderly population resides in the developing countries. It is noted that there has been an increase in longevity for these elderly and as a consequence their health profiles have changed. For example, it has been observed that increased longevity led to higher prevalence of age related neurological disorder like dementia. In India, community based studies on cognitive impairment and associated lifestyle factors are very few and such studies in the eastern part of the country is virtually lacking. In view of the above, a comparative profile of cognitive function between rural and urban elderly of West Bengal, India, has been reported in the present study. The study has also been purported to identify the role of socio-demographic factors on cognitive function. A structured demographic questionnaire was used for collection of socio-demographic data and MMSE [1] was canvassed for collection of data on cognitive function from a sample of urban and a rural elderly population. The study sample includes 381 elderly of both sexes, taken from both urban (176 and rural (205 settings in the Indian State of West Bengal with an age range of 65 to 79 years (mean age 70.6 years. Results of the study indicate that the cognitive impairment is significantly higher among the rural elderly than their urban counterparts, irrespective of sex. The results also demonstrate that more adversities in cognitive function occur in female gender, irrespective of area of residence. Multinomial logistic regression model reveal that age, sex, marital status, self earning, family earning, family size and number of living children are the important predictors of cognitive impairment in the study population.

  5. Special considerations for nutritional studies in elderly.

    Science.gov (United States)

    Riobó Serván, Pilar; Sierra Poyatos, Roberto; Soldo Rodríguez, Judith; Gómez-Candela, Carmen; García Luna, Pedro Pablo; Serra-Majem, Lluis

    2015-02-26

    The elderly population is increasing and it is well documented that may present some health problems related to nutritional intake. Both mental and physical impairments in the elderly may need specific adaptations to dietary assessment methods. But all self-report approaches include systematic and random errors, and under-reporting of dietary energy intake is common. Biomarkers of protein intake, as 24 hours urinary Nitrogen, may not be useful in elderly patients because of incontinence problems. Some micronutrients, like vitamin B12, have special importance in the elderly population. Also, measurement of fluid intake is also critical because elderly population is prone to dehydration. A detailed malnutrition status assessment should be included in the geriatric dietary history, and assessment. Body mass index (BMI) is not useful in the elderly, and it is important to evaluate functional status. Gait speed, handgrip strength using hand dynamometry can be used. Body Shape Index (ABSI) appears to be an accurate measure of adiposity, and is associated with total mortality. Further research is needed to clarify the best and simple methods to accurately estimate food and beverage fluid intake in the elderly population, and to evaluate nutritional and hidration status.

  6. Sclerosing Mesenteritis as a Cause of Abdominal Mass and Discomfort in an Elderly Patient: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Farzana Nawaz Ali

    2010-01-01

    Full Text Available Sclerosing mesenteritis is a rare benign process that involves inflammation, fat necrosis, and fibrosis of the mesentery. The disease poses great diagnostic challenge due to its nonspecific clinical and diagnostic findings. We report the case of a 75-year-old man who presented with vague abdominal discomfort associated with an intra-abdominal mass. With suspicion of a bowel carcinoid tumor on computed tomography scans, the patient underwent diagnostic laparoscopy. A diagnosis of sclerosing mesenteritis was made on histological examination. The patient's symptoms responded to a combination of immunosuppressive drugs, with no interval change in the size of the mass on radiological examination after fifteen months.

  7. Pleomorphic liposarcoma of the pectoralis major muscle in an elderly man: Report of a case and review of literature

    Directory of Open Access Journals (Sweden)

    Sezer Atakan

    2009-01-01

    Full Text Available Primary liposarcoma of the pectoral major muscle is extremely rare. We report a case of liposarcoma of the pectoral major muscle which was treated with surgical excision and postoperative radiotherapy. A 70-year-old man admitted with left-sided painless progressively growing breast mass. Radiological investigation revealed liposarcoma of the pectoralis major muscle. The patient was treated by surgical removal. Pathological diagnosis was pleomorphic liposarcoma. The patient had postoperative radiotherapy and free of disease for 9 months. Surgical excision and postoperative radiotherapy is the most favored treatment strategy. Careful follow-up is mandatory for detecting recurrences.

  8. Frenectomy for improvement of a problematic conventional maxillary complete denture in an elderly patient: a case report.

    Science.gov (United States)

    Al Jabbari, Youssef S

    2011-12-01

    Maxillary labial and buccal frena are considered as normal anatomic structures in the oral cavity. However, they may exist intraorally as a thick broad fibrous attachment and/or become located near the crest of the residual ridge, thus interfering with proper denture border extension resulting in inferior denture stability, retention and overall patient satisfaction. This case report highlights the importance of clinical examination and treatment planning which may mandate preprosthetic surgery prior to fabrication of a new conventional complete denture. Adequate patient satisfaction with conventional complete dentures can be significantly increased after frenectomy.

  9. Asthma in the elderly: Current understanding and future research needs--a report of a National Institute on Aging (NIA) workshop.

    Science.gov (United States)

    Hanania, Nicola A; King, Monroe J; Braman, Sidney S; Saltoun, Carol; Wise, Robert A; Enright, Paul; Falsey, Ann R; Mathur, Sameer K; Ramsdell, Joe W; Rogers, Linda; Stempel, David A; Lima, John J; Fish, James E; Wilson, Sandra R; Boyd, Cynthia; Patel, Kushang V; Irvin, Charles G; Yawn, Barbara P; Halm, Ethan A; Wasserman, Stephen I; Sands, Mark F; Ershler, William B; Ledford, Dennis K

    2011-09-01

    Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.

  10. [Sleep health education for elderly people].

    Science.gov (United States)

    Miyazaki, Soichiro; Nishiyama, Akiko

    2015-06-01

    Successful aging is characterized by minimal age-associated loss of the physiological functions of sleep and circadian clock. Sleep health education is necessary to have normal, quality nighttime sleep and full daytime alertness. Elderly people show changes of sleep parameters, accompanied by increased napping. Many studies have reported that daytime sleepiness or napping in elderly people could have potentially serious effects such as dementia and life-style related diseases. The main topics of sleep health education for elderly people are as follows: Right knowledge of sleep mechanism, understanding the bad influence of excessive napping, the effects of light on the circadian rhythm and negative effects of caffeine, alcohol and television.

  11. Acute exogenous lipoid pneumonia caused by accidental kerosene ingestion in an elderly patient with dementia: a case report.

    Science.gov (United States)

    Gotanda, Hiroshi; Kameyama, Yumi; Yamaguchi, Yasuhiro; Ishii, Masaki; Hanaoka, Yoko; Yamamoto, Hiroshi; Ogawa, Sumito; Iijima, Katsuya; Akishita, Masahiro; Ouchi, Yasuyoshi

    2013-01-01

    Acute exogenous lipoid pneumonia is an uncommon condition caused by aspiration of oil-based substances, occurring mainly in children. Here, we report the case of an 83-year-old patient with Alzheimer's disease who presented with coughing and hypoxia. The diagnosis of acute exogenous lipoid pneumonia caused by accidental kerosene ingestion was made on the basis of the patient's clinical history, and typical radiological and cytological findings. The patient's cognitive impairment and an unsafe environment, in which the patient's 91-year-old husband stored kerosene in an old shochu bottle, were responsible for the accidental ingestion. Acute exogenous lipoid pneumonia should be considered in the differential diagnosis for acute respiratory disorders in the rapidly aging population. © 2013 Japan Geriatrics Society.

  12. Stress-induced cardiomyopathy following infection of the upper respiratory tract in an elderly female patient: A case report

    Science.gov (United States)

    Ding, Huaiyu; Huang, Rongchong; Shi, Xiaoli; Wu, Baolin

    2016-01-01

    Stress-induced cardiomyopathy (SIC), also known as takotsubo cardiomyopathy (TTC), is a relatively newly-described condition, which has been increasingly reported in the literature. It is characterized by acute onset of symptoms and electrocardiogram changes mimicking myocardial infarction, with transient but completely reversible left ventricular (LV) dysfunction. SIC commonly occurs following physical or emotional stress. The present study discusses the case of a 68-year-old female patient who had suffered from infection of the upper respiratory tract for 10 days before admission to the hospital with symptoms of chest stuffiness and dyspnea that persisted for 2 days. Coronary angiography showed normal coronary artery function, while LV angiography demonstrated systolic apical ballooning. Based on these observed characteristics, the patient was diagnosed with SIC and was successfully treated. PMID:27882121

  13. 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.

  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 CHADS2 score 3.2±1.2, mean CHA2DS2-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. 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......: the study showed a high prevalence of detrimental life style factors including smoking, excessive alcohol consumption and physical inactivity in elderly Danish men. Except for diabetes and respiratory disease, chronic diseases were underreported and in particular erectile dysfunction and osteoporosis were...

  16. Ageism and death: effects of mortality salience and perceived similarity to elders on reactions to elderly people.

    Science.gov (United States)

    Martens, Andy; Greenberg, Jeff; Schimel, Jeff; Landau, Mark J

    2004-12-01

    The present research investigated the hypotheses that elderly people can be reminders of our mortality and that concerns about our own mortality can therefore instigate ageism. In Study 1, college-age participants who saw photos of two elderly people subsequently showed more death accessibility than participants who saw photos of only younger people. In Study 2, making mortality salient for participants increased distancing from the average elderly person and decreased perceptions that the average elderly person possesses favorable attitudes. Mortality salience did not affect ratings of teenagers. In Study 3, these mortality salience effects were moderated by prior reported similarity to elderly people. Distancing from, and derogation of, elderly people after mortality salience occurred only in participants who, weeks before the study, rated their personalities as relatively similar to the average elderly person's. Discussion addresses distinguishing ageism from other forms of prejudice, as well as possibilities for reducing ageism.

  17. Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report.

    Science.gov (United States)

    Ueda, Junji; Yoshida, Hiroshi; Makino, Hiroshi; Maruyama, Hiroshi; Yokoyama, Tadashi; Hirakata, Atsushi; Akagi, Ichiro; Watanabe, Manabu; Uchida, Eiichi; Uchida, Eiji

    2016-01-01

    The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.

  18. Chronic subdural hematoma in elderly patient with EDTA-dependent pseudothrombocytopenia recently treated with aspirin and warfarin: case report.

    Science.gov (United States)

    Tosa, Masato; Fujita, Hiroshi; Ishihama, Yumiko; Nishimura, Shigeko; Ide, Takafumi

    2014-01-01

    A 78-year-old man who had a history of myocardial and cerebral infarction and who was treated with aspirin and warfarin, presented with left chronic subdural hematoma. Cerebral computed tomography showed severe brain compression of hematoma with midline shift, indicating the need for emergent surgery. The hematology and clotting tests upon admission revealed severe thrombocytopenia (platelet count, 1.3 × 10(4)/μL) with normal clotting activity. Because platelet aggregation was evident in the smear, we re-examined the patient for hematology using tubes that contained heparin, showing also low platelet count (2.3 × 10(4)/μL). The day on admission, we performed irrigation and drainage of the chronic subdural hematoma through single burr-hole craniostomy. During surgery, we used 10 units of platelet concentrates (PCs) for the reason that the patient was taking aspirin and coagulopathy derived from low platelet count could not be excluded. After surgery, we re-evaluated the hematology of the blood stored in tubes that contained ethylenediaminetetraacetic acid (EDTA) with or without kanamycin (KM). Treatment with KM dissociated EDTA-induced platelet aggregation and revealed platelet counts with highest accuracy (no KM treatment, 1.3 × 10(4)/μL; KM treatment, 15.2 × 10(4)/μL). This phenomenon is called EDTA-Dependent Pseudothrombocytopenia (PTCP) defined as falsely low platelet counts reported by automated hematology analyzers due to platelet aggretgation. Awareness of the phenomenon will enable neurosurgeons to manage patients with PTCP appropriately and clinical laboratory especially in emergency hospital is recommended to prepare for the hematological tubes being added KM in routine analysis, resulting in preventing mistaken diagnosis.

  19. 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.…

  20. Perceived health, life satisfaction, and cardiovascular risk factors among elderly Korean immigrants and elderly Koreans.

    Science.gov (United States)

    Sin, Mo-Kyung; Chae, Young-Ran; Choe, Myoung-Ae; Murphy, Patrick; Kim, Jeungim; Jeon, Mi-Yang

    2011-03-01

    Acknowledging that changes in sociocultural environment influence health status, the purpose of this study was to compare perceived health, life satisfaction, and cardiovascular health in elderly Korean immigrants and elderly Koreans. In this cross-sectional study, a convenience sample of 88 elderly Korean immigrants and 295 elderly Koreans 65 and older were recruited from Korean communities in the United States and Korea. Respondents' perceived health was measured by self-assessment; life satisfaction was self-assessed using a dichotomous scale of general satisfaction with life; and cardiovascular health status was surveyed by self-report of major diagnosed cardiovascular risk factors (i.e., hypertension, hyperlipidemia, diabetes mellitus) and body mass index measurement for obesity. Despite having better perceived health and life satisfaction, elderly Korean immigrants also had higher prevalence of cardiovascular risk factors. The findings provide health care providers with useful information for effective health assessment of minority immigrants.

  1. Social and Psychological Status of the American Indian Elderly: Past Research, Current Advocacy, and Future Inquiry.

    Science.gov (United States)

    Manson, Spero M.; Pambrun, Audra M.

    1979-01-01

    Examined past efforts to improve the Indian elderly's quality of life, summarized mental health issues, critically reviewed relevant literature, and reported results from a needs assessment survey of Indian elderly. Journal availability: see RC 503 481. (DS)

  2. Perceived Stress and Elder Abuse: A Population-Based Study of Adult Protective Services Cases in Chicago.

    Science.gov (United States)

    Roepke-Buehler, Susan K; Dong, XinQi

    2015-09-01

    To characterize the relationship between perceived stress and Adult Protective Services (APS) elder abuse cases in a population-based sample. Cross-sectional. Chicago. community-dwelling, older adults (N = 8,558; mean age 74 ± 7, 62% female, 64% African American). Perceived Stress Scale (PSS), APS database linkage. Bivariate and adjusted analyses showed that perceived stress was significantly higher in APS clients than in participants without any APS interaction for various subtypes of abuse (e.g., abuse from a perpetrator and self-neglect). This relationship was strongest for those with a confirmed history of abuse from a perpetrator, with a medium-large effect size (t = -5.8, P < .001, Cohen D = -0.6). Those in the highest stress tertile had a likelihood of having confirmed history of abuse from a perpetrator that was nearly three times as great as that of those in lower stress tertiles (odds ratio = 2.7, 95% confidence interval = 1.2-6.2). Analyses of individual PSS items revealed a robust relationship between distress items and APS involvement. Items reflecting coping were inconsistently associated with elder abuse. Clients of APS have higher levels of perceived stress, and abuse from a perpetrator strengthens this relationship. Therefore, victims of abuse from a perpetrator may be at the highest risk of stress-related consequences and should be targeted for intervention efforts that enhance empowerment and effective coping strategies. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  3. Functional limitations related to foot pain in the elderly

    Directory of Open Access Journals (Sweden)

    Fabiana Maria Rodrigues Lopes de Oliveira

    2015-09-01

    Full Text Available Objective: to investigate the association between foot pain and functional disability in the elderly. Methods: descriptive study conducted among the elderly attended in a geriatric outpatient clinic of a university hospital. The sample consisted of 114 elderly who reported foot pain. Data was collected through subsidized interview, using structured instrument, covering demographic variables and the Manchester Foot Pain and Disability Index in Elderly and the Mini Mental State Examination. Results: there was a high incidence of foot pain among women and young elderly as well as significant inability to perform certain daily activities. Conclusion: it is identified the need for special attention to the health of elderly reporting foot pain, since this tends to restrict daily activities, causing decreased quality of life, immobilization and possible episodes of falls.

  4. How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden.

    Science.gov (United States)

    Ernsth Bravell, Marie; Westerlind, Björn; Midlöv, Patrik; Östgren, Carl-Johan; Borgquist, Lars; Lannering, Christina; Mölstad, Sigvard

    2011-01-01

    Knowledge about the need for care of elderly individuals in community dwellings and the factors affecting their needs and support is limited. The aim of this study was to characterize the frailty of a population of elderly individuals living in community dwellings in Sweden in relation to co-morbidity, use of drugs, and risk of severe conditions such as malnutrition, pressure ulcers, and falls. In 2008, 315 elderly individuals living in community dwellings were interviewed and examined as part of the SHADES-study. The elderly demonstrated co-morbidity (a mean of three diseases) and polypharmacy (an average of seven drugs). More than half the sample was at risk for malnutrition, one third was at risk for developing pressure ulcers, and nearly all (93%) had an increased risk of falling and a great majority had cognitive problems. Age, pulse pressure, body mass index, and specific items from the modified Norton scale (MNS), the Downton fall risk index (DFRI), and the mini nutritional assessment (MNA-SF) were related to different outcomes, defining the need for care and frailty. Based on the results of this study, we suggest a single set of items useful for understanding the need for care and to improve individual based care in community dwellings.

  5. [Musical hallucinations in the elderly].

    Science.gov (United States)

    Assal, Frédéric

    2003-01-01

    Musical hallucinations (MH) are probably more frequent in the elderly than those reported in the literature. We will illustrate the clinical findings of MH with 3 personal cases. The differential diagnosis and the diagnostic tools relevant in clinical practice will be presented as well as the pathogenesis of deafferentiation-induced MH. MH can be considered as a phenomenon of neuronal plasticity and also serve as a model to understand neuronal networks involved in mental representation of music and hallucinations in general.

  6. The elderly patients' dignity

    DEFF Research Database (Denmark)

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

    2007-01-01

    This study shows how care providers in hospital practice perceive the elderly patient's dignity as a core value in health promoting care towards the elderly. Fifteen focus group interviews were conducted with care providers who told about their nursing practice experience. The interviews were...... analysed using a phenomenological hermeneutical approach. The results disclose that when caring for the elderly patient's health potential, care providers saw dignity as the core value of health. Dignity was found to capture three themes: autonomy, identity, and worthiness. These themes reflect...... 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...

  7. The perceived life stressors among elderly Chinese immigrants: are they different from those of other elderly Americans?

    Science.gov (United States)

    Lee, A A; Ellenbecker, C H

    1998-03-01

    This is a descriptive study examining the perceived life stressors among elderly Chinese immigrants and comparing their stressors to those experienced by other elderly Americans. Lazarus and Folkman's stress theory and Roy's adaptation model were used as the theoretical basis for this study. Based on this framework, it was predicted that elderly Chinese immigrants would report more life stressors than elderly Americans, because they experience a changing cultural environment along with the aging process. The sample was a convenience sample of 30 elderly people from two Chinese churches in one northeastern metropolitan city. Participants were asked to describe a stressful event that they had experienced within the past month. Data were collected by a bilingual (Chinese and English) interviewer using open-ended questions. The research design was based on Manfredi and Pickett's (1987) research exploring the stressors among elderly Americans, and those research results provide the comparison data for this study. The findings suggest that the amount and sources of stress reported by elderly Chinese immigrants are different from those reported by other elderly Americans. Additional studies are needed to identify the coping strategies used by elderly Chinese immigrants. These findings have implications for gerontologists, policy makers, community healthcare providers, and the Chinese immigrant population.

  8. A Report to an Investigation in Elderly People's Life%关于老年人晚年生活的调查报告

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Our country has entered the aging society. To build a harmonious society, we launched an investigation in elderly peo-ple's life from income, daily care, spiritual solace and health care, hoping provides families and governments some reference to solve the problems of elderly people.%  我国已经进入老龄化社会,为构建和谐的老龄化社会,本文从经济情况、生活照顾、精神生活及健康保健等方面对南京市部分老年人的晚年生活现状展开了调查研究,希望能为家庭、社会解决好老人生活问题提供参考。

  9. 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.

  10. A report on the health assessment of an elderly woman%1例老年妇女健康评估的报告

    Institute of Scientific and Technical Information of China (English)

    翟红霞; 李彦斌; 任丽萍; 李月梅

    2004-01-01

    为发现当代老年人存在的健康问题和他们的健康需要,对一位澳洲老年妇女实施了全方位的评估,包括系统的护理问诊和一次彻底的体格检查.结果表明通过全方位的评估,可以做出正确的护理诊断和护理计划.通过此次评估发现老年人存在许多不正常的生理和心理上的改变,对此需要特殊的心理和身体护理,包括特殊的皮肤护理、日常生活护理和疾病护理.%In order to find out the elderly people's health care issues and their needs,we conducted a holistic health assessment on an elderly wom en,the holistic health assessments include a thorough interview and physical examination.The results were identified as the following: an accurate nursing diagnosis and nursing care plan were made by the thorough assessment,it indicated that elderly peoples do have physical and psychological changes,and they need special nursing care with their impaired skin integrity and the activities of daily living (ADLS) and their medical problems.

  11. Self-reported reading and writing skills in elderly who never attended school influence cognitive performances: results from the Coyoacán cohort study.

    Science.gov (United States)

    Mokri, H; Avila-Funes, J A; Le Goff, L; Ruiz-Arregui, L; Gutierrez Robledo, L M; Amieva, H

    2012-07-01

    Beyond the well-known effect of educational level on cognitive performances, the present study investigates the specific effect of literacy acquisition independently of education. A sample of 175 unschooled elderly participants was selected from a larger Mexican population-based cohort study. The sample of 175 subjects who never went to school was divided in two groups: 109 who never acquired literacy skills and 66 who declared having acquired reading and writing abilities. Cognitive performances on commonly used tests (mini mental state examination, Isaacs set test, free and cued selective reminding test and clock-drawing test) were compared between the two groups taking into account several potentially confounding factors. The participants with reading and writing skills performed better than their counterparts in most tests, even though no difference was observed for the Isaacs Set Test and the delayed recall of the free and cued selective reminding test. Writing and reading skills in elderly people with no formal education influence performances in very commonly used test. Not only educational level but also literacy acquisition should be taken into account when conducting cognitive assessment in very low educated elderly people.

  12. Malnutrition among the elderly.

    OpenAIRE

    Rauscher, C.

    1993-01-01

    Nutrition is a significant determinant of health. Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems. Understanding the risk factors for malnutrition helps physicians assess and manage the condition. Primary care physicians are in an excellent position to screen, educate, and manage their elderly malnourished patients.

  13. Malnutrition among the elderly.

    OpenAIRE

    1993-01-01

    Nutrition is a significant determinant of health. Undernutrition presenting as malnutrition is a serious health concern for frail elderly people with many health problems. Understanding the risk factors for malnutrition helps physicians assess and manage the condition. Primary care physicians are in an excellent position to screen, educate, and manage their elderly malnourished patients.

  14. [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).

  15. Assessment of older adults' satisfaction with adult protective services investigation and assistance.

    Science.gov (United States)

    Booker, James G; Breaux, Mary; Abada, Sharon; Xia, Rui; Burnett, Jason

    2017-05-12

    This study examined elder self-neglect client satisfaction with services provided by an Adult Protective Services (APS) program. A total of 77 community-dwelling older adults with APS-substantiated self-neglect responded to the standardized and widely used 8-item Client Satisfaction Questionnaire. Approximately 75% of the participants reported being satisfied with the overall services. They felt that the services provided were responsive to their need(s) and helped them deal with their problem(s). Greater than 80% responded that they would refer a friend, would utilize APS in the future if necessary, and were at least satisfied with the amount of help received. The extent to which their needs were met received the lowest satisfaction scores. Future studies are needed to examine elder self-neglect client satisfaction in relation to specific services.

  16. 老年抑郁症者5-羟色胺再摄取抑制剂撤药反应(附3例报告)%Pay more attention to withdrawal symptoms of selective serotonin reuptake inhibitors in elderly depressed patients (Three Cases Reports)

    Institute of Scientific and Technical Information of China (English)

    郑辉; 陈晓燕; 刘谦; 秦明照

    2013-01-01

    Objective To emphasis on unawareness of withdrawal symptoms of selective serotonin reuptake inhibitors (SSRIs) in elderly depressed patients by reporting 3 cases. Methods Withdrawal symptoms of SSRIs in three elderly depressed patients were analyzed and the relevant literature were reviewed. Results Three cases of elderly patients with varying degrees of mental and physical symptoms related to withdrawal of SSRIs were described. The withdrawal symptoms of paroxetine in patients were more evidentthan other SSRIs. Conclusion Elderly patients with depression have a higher incidence of withdrawal phenomenon of SSRIs. The withdrawal phenomenon has great impact on elder patients. Physicians who prescribe SSRIs should be aware of this special condition in elder depressed patients.%目的 探讨老年患者5-羟色胺(5-HT)再摄取抑制剂(SSRIs)撤药反应.方法 结合文献对3例老年抑郁症患者SSRIs撤药反应进行分析.结果 3例老年患者均出现不同程度的与SSRIs撤药相关的精神及躯体症状,其中以停用帕罗西汀患者症状较为明显.结论 老年抑郁症患者SSRIs撤药反应发生率较高,影响较大,应引起非精神科医生高度重视.

  17. 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.

  18. 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

  19. 1989 Review Conference on New Electronic Technologies for the Elderly: Issues and Projects. Report of an Aspen Institute Conference (5th, Queenstown, Maryland, March 8-10, 1989). Communications and Society Forum Report #11.

    Science.gov (United States)

    Bollier, David

    This document presents summaries of conference presentations which attempted to assess how computer and communications technologies can be harnessed to meet the special needs of elderly people. Each of the eight sessions of the conference opened with experts discussing their respective research projects and electronic technologies: their origins,…

  20. Nurses knowledge and attitudes regarding nutrition in the elderly.

    Science.gov (United States)

    Endevelt, R; Werner, P; Goldman, D; Karpati, T

    2009-06-01

    Nurses in the community are in contact with the elderly at different levels of care. The aim of this study was to assess nurses' knowledge and attitudes regarding nutritional-care for the elderly, and the impact of their attitude on the quality of assessment-care they provide to this growing population in need of nutritional-care. A structured questionnaire was distributed by mail to 600 nurses working in Maccabi-Health-Care-Services (MHS). The questionnaire assessed different aspects of elderly nutrition. The vast majority (91%) of the participants reported treating elderly in their practice. Religious nurses and the nurses with an individual orientation specialty reported more positive attitudes about nutritional-care for the elderly than others did (p=0.05). Nurses with a bachelor's degree had better attitudes than registered nurses about the importance of nutrition for the elderly (p nurses were found to be more knowledgeable than older ones (p nurses perceived nutrition as influencing different health conditions, and 85% pointed to the importance of feeding at the end of life. Nurses working in the community recognize the impact of proper nutrition on elderly patients' health, but need more training in screening for nutritional problems in the elderly.

  1. Asthma in the Elderly

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2009-01-01

    Full Text Available Bronchial asthma is a common problem with enormous medical and economics impacts. It is an inflammatory disease of the airways associated with intermittent episodes of bronchospasm. Asthma is not uncommon in the elderly patients. Prevalence of asthma is similar in older and younger adults. Asthma in the elderly patient is underdiagnosed because of false perceptions by both patient and physician. The high incidence of comorbid conditions in the elderly patient makes the diagnosis and management more difficult. Correct diagnosis is demonstrated with spirometry. The goals of asthma treatment are to achieve and maintain control of symptoms and to prevent development of irreversible airflow limitation. Asthma drugs are preferably inhaled because this route minimizes systemic absorption and, thus, improves the ratio of the therapeutic benefit to the potential side-effects in elderly patients.

  2. Thrombolysis in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Santiago Herrero; Jose Antonio Lapuerta-Irigoyen

    2007-01-01

    The elderly population consists of those over age 75 years and appears to represent the fastest-growing segment of the population.Intravenous thrombolytic therapy (TT) is the most common strategy for the treament of acute myocardial infarction (AMI) in many parts of the world. However, TT carries a higher risk of intra-cranial hemorrhage (ICH) in the elderly patients. Primary percutaneous transluminal coronary angioplasty and stenting (PCI) represents an important alternative in these elderly individuals with contraindications to TT. In developing countries, or in areas without availability of primary PCI, TT remains the only therapeutic modality. Dedicated randomized trials are needed to provide a comprehensive understanding of AMI management in the elderly group.

  3. Anticoagulation in the Elderly

    Directory of Open Access Journals (Sweden)

    Helia Robert-Ebadi

    2010-12-01

    Full Text Available Management of anticoagulation in elderly patients represents a particularly challenging issue. Indeed, this patient population is at high thromboembolic risk, but also at high hemorrhagic risk. Assessment of the benefit-risk balance of anticoagulation is the key point when decisions are made about introducing and/or continuing such treatments in the individual elderly patient. In order to maximise the safety of anticoagulation in the elderly, some specific considerations need to be taken into account, including renal insufficiency, modified pharmacodynamics of anticoagulants, especially vitamin K antagonists, and the presence of multiple comorbidities and concomitant medications. New anticoagulants could greatly simplify and possibly increase the safety of anticoagulation in the elderly in the near future.

  4. [Solitude in the elderly].

    Science.gov (United States)

    Delisle, I

    1998-11-01

    Elderly people who are deprived of the warmth of human contact are at the risk of turning inward. For the very old, an atmosphere such as this can become psychologically catastrophic and lead to depressive syndromes such as extreme sadness, a desire to do nothing, sleep problems and even dementia. An in-depth analysis of the environment of the elderly inspires readers to address care objectives and interventions that will minimize and prevent these negative consequences.

  5. 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.

  6. Health-Seeking Behavior Among the Elderly.

    Science.gov (United States)

    Bausell, R. Barker

    1986-01-01

    Compared persons 65 years of age or older (N=177) to younger adults (n=997) with respect to compliance with 20 recommended health-seeking behaviors. Overall, the elderly group reported greater compliance with these behaviors, attributed more importance to their value, but perceived themselves as having less control over their future health.…

  7. PATHWAYS TO INSTITUTIONAL CARE FOR ELDERLY ...

    African Journals Online (AJOL)

    User

    African Journal of Social Work, 7(1), June 2017 .... Basing on this theory, the elderly's past social life brought out reasons for them .... reported lack of close family due to death or unmaintained or severed relationships. .... wishing to be repatriated are assisted by their respective countries' Ambassadors, who first locate their.

  8. Perceptions of familial caregivers of elder adults.

    Science.gov (United States)

    Sayles-Cross, S

    1993-01-01

    This study investigated perceptions of 139 familial caregivers of elder adults to answer the question "Is there a significant relationship between appraisal, social distance and the cost of caring for an elder family member?" The cost of caring was analyzed in five dimensions (personal-social restrictions, physical-emotional health, value, care recipient as provocateur and economic cost). Caregivers reported concern for their well-being, feelings of disgust/anger, high social distance and coping by accepting and holding back. Not only were significant relationships found, but caregivers emerged as an at-risk population.

  9. Management of hepatocellular carcinoma in the elderly

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Mean age of hepatocellular carcinoma (HCC) patients hasbeen progressively increasing over the last decades andageing of these patients is becoming a real challenge inevery day clinical practice. Unfortunately, internationalguidelines on HCC management do not address thisproblem exhaustively and do not provide any specific recommendation. We carried out a literature search inMEDLINE database for studies reporting on epidemiology,clinical characteristics and treatment outcome of HCCin elderly patients. Available data seem to indicatethat in elderly patients the outcome of HCC is mostlyinfluenced by liver function and tumor stage rather thanby age and the latter should not influence treatmentallocation. Age is not a risk for resection and olderpatients with resectable HCC and good liver functioncould gain benefit from surgery. Mild comorbiditiesdo not seem a contraindication for surgery in agedpatients. Conversely, major resection in elderly, evenwhen performed in experienced high-volume centres,should be avoided. Both percutaneous ablation andtransarterial chemoembolization are not contraindicatedin aged patients and safety profile of these proceduresis acceptable. Sorafenib is a viable option for advancedHCC in elderly provided that a careful evaluation ofconcomitant comorbidities, particularly cardiovascularones, is taken into account. Available data seem tosuggest that in either elderly and younger, treatment isa main predictor of outcome. Consequently, a nihilisticattitude of physicians towards under- or no-treatment ofaged patients should not be longer justified.

  10. Violence on the elderly and Social Work

    Directory of Open Access Journals (Sweden)

    Maria Irene Lopes Carvalho

    2011-09-01

    Full Text Available Violence and abuse of the elderly won expression and visibility across the increase of the number of people aged 65 or over in the total population of developed countries. However, this issue is not only explained by the increase in the elderly population and the longevity, but also by the awareness that the problem exists, especially of professionals working in the social and health area. In this article we first identify the notions of violence upon the elderly statements by international organizations (OMS, EU and some studies in this area. Besides this problematisation, we present the known categories of violence and risk indicators. Here is some statistical data on the phenomenon in Portugal and some guidelines for policies in this area. Secondly, we present the result of a inquiry instrument applied to social work professionals, whose aim was to assess the perception of the risk categories of violence over the elderly. You must create educational programs and prevention campaigns for the general public can identify the signs of abuse and report situations, train health professionals and social area with responsibility to protection of the elderly and introduce guidelines that homogenizing the procedures, develop home care programs to improve the procedures of informal caregivers and develop systems for monitoring and evaluating the quality of care for older people, especially the long-term.

  11. The prevalence of elder abuse and neglect: a systematic review

    National Research Council Canada - National Science Library

    Cooper, Claudia; Selwood, Amber; Livingston, Gill

    2008-01-01

    to perform a systematic review of studies measuring the prevalence of elder abuse or neglect, either reported by older people themselves, or family and professional caregivers or investigated using objective measures...

  12. Bisphosphonate therapy and osteonecrosis of the jaw complicated with a temporal abscess in an elderly woman with rheumatoid arthritis: a case report.

    Science.gov (United States)

    Manzon, Licia; Ettorre, Evaristo; Viscogliosi, Giovanni; Ippoliti, Stefano; Filiaci, Fabio; Ungari, Claudio; Fratto, Giovanni; Agrillo, Alessandro

    2014-01-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse drug reaction described as the progressive destruction and death of bone tissue of the mandible or maxilla, in the course of bisphosphonate therapy. Orally administered bisphosphonates, widely used for the treatment of osteoporosis, are rarely associated with BRONJ. Instead, the risk greatly increases whether the patient is concomitantly taking steroid and/or immunosuppressant agents. The aims of this paper are to briefly discuss the evidence of the associations between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors such as the presence of rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. In particular, we present the case of an elderly woman with BRONJ suffering from rheumatoid arthritis, with a recent dental extraction and with a very unusual complication: a temporal abscess, who was successfully treated.

  13. Share A Fare: a user-side subsidy transportation program for elderly and handicapped persons in Kansas City, Missouri. Final report, May 1977-December 1978

    Energy Technology Data Exchange (ETDEWEB)

    Dorosin, E.; Phillips, J.

    1979-07-01

    Documentation of the Share A Fare, Kansas City, Missouri's user-side subsidy transportation broken project for elderly and handicapped persons, during its first 20 months of operation is presented. The project was designed and implemented by the city; it is totally funded from a 1/2 cent city sales tax designated for transportation purposes. Transportation service is provided by profit and not-for-profit carriers and by city owned and operated vans. The operation of the project is described and key features and their impacts on program success are identified. Data are presented on project design and planning; operating characteristics; and on the project's impact on service providers, users, and city sponsor.

  14. [Disability among elderly women in Brazil].

    Science.gov (United States)

    Parahyba, Maria Isabel; Veras, Renato; Melzer, David

    2005-06-01

    To estimate disability rates and explore associations, identifying the most significant socioeconomic markers associated with the prevalence of mobility disability among elderly women. National mobility disability rates were estimated based on information from the 1998 National Household Survey (PNAD), conducted by the Instituto Brasileiro de Geografia e Estatística. The present study analyzes the elderly women population, totaling 16,186 subjects. Logistic regression models were constructed considering 'difficulty walking 100 meters' as the dependent variable. The prevalence of markers of mild, moderate and severe disability was greater among women, and increased with age. In logistic regression analysis, markers most strongly associated with increased prevalence of mobility disability were age, gender, low schooling, and low income. Rural residence was also associated with reduced prevalence. Our results suggest potential risk factors for the development of functional decline in elderly women, given that the associations encountered were consistent with those reported by other studies in the literature.

  15. Depression Treatment Patterns among Elderly with Cancer

    Directory of Open Access Journals (Sweden)

    Patricia A. Findley

    2012-01-01

    Full Text Available Little is known about cancer treatment patterns among the elderly as depression and cancer in this older population have not been well explored. This study seeks to fill a gap in the literature by using data from the Medicare Current Beneficiary Survey from years 2000–2005 to examine depression treatment patterns among elderly diagnosed with both cancer and depression. Depression treatments examined include antidepressants with and without psychotherapy. We found that of those with both cancer and depression, 57.7% reported antidepressant use only, 19.7% received psychotherapy with or without antidepressants, and 22.6% had no depression treatment. We found those with greater comorbidity, of a minority race, with lower levels of education, and living in rural areas were less likely to receive treatment for depression. These findings highlight the need to address disparities in the treatment of depression in the elderly population with cancer.

  16. Screening Tool for Older Persons' Appropriate Prescriptions for Japanese: Report of the Japan Geriatrics Society Working Group on "Guidelines for medical treatment and its safety in the elderly".

    Science.gov (United States)

    Kojima, Taro; Mizukami, Katsuyoshi; Tomita, Naoki; Arai, Hiroyuki; Ohrui, Takashi; Eto, Masato; Takeya, Yasushi; Isaka, Yoshitaka; Rakugi, Hiromi; Sudo, Noriko; Arai, Hidenori; Aoki, Hiroaki; Horie, Shigeo; Ishii, Shinya; Iwasaki, Koh; Takayama, Shin; Suzuki, Yusuke; Matsui, Toshifumi; Mizokami, Fumihiro; Furuta, Katsunori; Toba, Kenji; Akishita, Masahiro

    2016-09-01

    In 2005, the Japan Geriatrics Society published a list of potentially inappropriate medication that was an extract from the "Guidelines for medical treatment and its safety in the elderly 2005." The 2005 guidelines are due for a revision, and a new comprehensive list of potentially inappropriate medications is required. A total of 15 diseases, conditions and special areas related to their clinical care were selected. We originated clinical questions and keywords for these 15 areas, carried out a systematic review using these search criteria, and formulated guidelines applying the Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. If we did not find good evidence despite the drug being clinically important, we looked for evidence of efficacy and for disease-specific guidelines, and incorporated them into our guidelines. We selected 2098 articles (140 articles per area), and extracted another 186 articles through a manual search. We further added guidelines based on disease entity and made two lists, one of "drugs to be prescribed with special caution" and the other of "drugs to consider starting," primarily considering individuals aged 75 years or older or those who are frail or in need of special care. New lists of potentially inappropriate medications and potential prescribing omissions called "Screening Tool for Older Person's Appropriate Prescriptions for Japanese" were constructed. We anticipate that future studies will highlight more evidence regarding the safety of high-quality drugs, further improving the provision of appropriate medical care for the elderly. Geriatr Gerontol Int 2016: 16: 983-1001. © 2016 Japan Geriatrics Society.

  17. Structuring the STD prevention work in the elderly: educational workshops

    OpenAIRE

    Vanessa Lopes Munhoz Afonso; Filomena Neves Pereira Vieira Adduci; Zenaide Azevedo Criado de Oliveira; Eurides da Silva Gonçalves Machado; Alexandre Ferreira; Elisabete Silva Notari; Regina Garcia do Nascimento; Paulo Sérgio Pelegrino

    2016-01-01

    Background and Objectives: Report educational experiences orienting the elderly population about sexuality and prevention of sexually transmitted diseases. Case description: A professional experience report of STD prevention group in the elderly at a specialized clinic. The educational gerontology was used as a methodology in the production of workshops held from November/2012 to December/2014 to service users. The workshops entitled “Tenda da Sabedoria”, “Baile dos Idosos” and “Roda de Conve...

  18. Opportunistic hearing screening in elderly inpatients

    Directory of Open Access Journals (Sweden)

    Krishan Ramdoo

    2014-04-01

    Full Text Available Objective: To determine the prevalence of occult hearing loss in elderly inpatients, to evaluate feasibility of opportunistic hearing screening and to determine subsequent provision of hearing aids. Materials and methods: Subjects (>65 years were recruited from five elderly care wards. Hearing loss was detected by a ward-based hearing screen comprising patient-reported assessment of hearing disability and a whisper test. Subjects failing the whisper test or reporting hearing difficulties were offered formal audiological assessment. Results: Screening was performed on 51 patients aged between 70 and 95 years. Of the patients, 21 (41% reported hearing loss and 16 (31% failed the whisper test. A total of 37 patients (73% were referred for audiological assessment with 17 (33% found to have aidable hearing loss and 11 were fitted with hearing aids (22%. Discussion: This study highlights the high prevalence of occult hearing loss in elderly inpatients. Easy two-step screening can accurately identify patients with undiagnosed deafness resulting in significant proportions receiving hearing aids. Key sentences Approximately 14% of the elderly population use hearing aids despite a reported prevalence of deafness in up to 55%. The use of hearing aids is associated with an improvement in physical, emotional, mental and social well-being. An easy screening test for hearing loss consists of patient-reported hearing loss and a whisper test. Opportunistic screening of elderly inpatients resulted in referral of 73% of screened patients for formal audiology. Of the screened patients, 22% were provided with hearing aids.

  19. 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

  20. Riskiness in the Elderly: Attitudes of Young and Elderly Adults.

    Science.gov (United States)

    Feldstein, Jerome H.; Feldman, Barbara

    Risk-taking attitudes and behaviors among young and elderly adults were investigated. Elderly subjects, from both a nursing home and the community, and college students responded to choice dilemmas involving aged central characters. Each subject responded twice, once under "self" instructions, and once as the "average elderly person" would…

  1. 老年人外源性类脂质肺炎14例%Report of 14 cases of exogenous lipoid pneumonia in the elderly

    Institute of Scientific and Technical Information of China (English)

    谭政; 许小毛; 杨菁菁; 柯会星

    2016-01-01

    Objective To investigate the clinical characteristics of exogenous lipoid pneumonia and to explore the characteristics of the elderly with the disease.Methods 14 cases of elderly patients with exogenous lipoid pneumonia in Beijing Hospital were analyzed.Results Among the 14 patients(7 male and 7 female),main symptoms included dyspnea (50.0 %),cough (35.7 %),and the common signs were crackles (28.6 %) and wet rales (21.4 %).For exogenous lipoid pneumonia,the most common causes of inhalation of lipoid substances included chronic constipation,nasal cavity diseases such as rhinitis (35.7%).Some of elderly dementia patients may wrong inhale lipoid substances(21.4 %).X ray or CT features of exogenous lipoid pneumonia showed a tumor-like mass or lesions (42.9%)and the exudative plaque (64.3%),both of which were easily misdiagnosed as tumor.All of the 14 cases(100%) were misdiagnosed as "pneumonia" or "lung tumor",and finally confirmed by pathological diagnosis.Among the 14 cases,2 cases were diagnosed by cytopathology of bronchial alveolar lavage fluid or by transbronchial lung biopsy,10 cases were diagnosed by invasive examination methods like lobe resection,and 2 cases were confirmed by autopsy.At present,there is still a lack of effective treatment methods for exogenous lipoid pneumonia.Conclusions Due to the basal disease(such as constipation)action,the elderly may easily have access to exogenous lipoid pneumonia with atypical symptoms,might have more serious manifestations than younger adults,and may have X ray or CT imaging similar to lung cancer or pneumonia.So it is often misdiagnosed.If the patients cannot be timely diagnosed and the causes cannot be removed,it is likely to cause chronic interstitial fibrosis or death.Clinicians must increase the awareness of,and take into account the possibility of lipoid pneumonia,especially meeting the elderly patients with dry cough and dyspnea,rales or crackles and X-ray or CT tumor-like imaging as main

  2. Meals for the Elderly

    Science.gov (United States)

    1977-01-01

    NASA is drawing upon its food-preparation expertise to assist in solving a problem affecting a large segment of the American population. In preparation for manned space flight programs, NASA became experienced in providing astronauts simple, easily-prepared, nutritious meals. That experience now is being transferred to the public sector in a cooperative project managed by Johnson Space Center. Called Meal System for the Elderly, the project seeks to fill a gap by supplying nutritionally balanced meal packages to those who are unable to participate in existing meal programs. Many such programs are conducted by federal, state and private organizations, including congregate hot meal services and home-delivered "meals on wheels." But more than 3.5 million elderly Americans are unable to take advantage of these benefits. In some cases, they live in rural areas away from available services; in others, they are handicapped, temporarily ill, or homebound for other reasons. Meal System for the Elderly, a cooperative program in which the food-preparation expertise NASA acquired in manned space projects is being utilized to improve the nutritional status of elderly people. The program seeks to fill a gap by supplying nutritionally-balanced food packages to the elderly who are unable to participate b existing meal service programs.

  3. 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....

  4. 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…

  5. Elder Care Comes of Age.

    Science.gov (United States)

    Herndon, Mary D.

    1995-01-01

    A discussion of elder care looks at the extent to which government and employers are addressing the issue, how elder care affects the work performance of and productivity of employed caregivers, and how human resource professionals can respond effectively to the needs of both employee and employer as these needs relate to the issue of elder care.…

  6. 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.

  7. 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.

  8. Structuring the STD prevention work in the elderly: educational workshops

    Directory of Open Access Journals (Sweden)

    Vanessa Lopes Munhoz Afonso

    2016-01-01

    Full Text Available Background and Objectives: Report educational experiences orienting the elderly population about sexuality and prevention of sexually transmitted diseases. Case description: A professional experience report of STD prevention group in the elderly at a specialized clinic. The educational gerontology was used as a methodology in the production of workshops held from November/2012 to December/2014 to service users. The workshops entitled “Tenda da Sabedoria”, “Baile dos Idosos” and “Roda de Conversa”addressed the sexuality of the elderly, knowledge about transmission and how to prevent it. Actions are always accompanied by the distribution of educational materials, condoms and referrals to testing users for Hepatitis B and C, HIV and syphilis. The group noticed satisfaction of the elderly, interest and effective participation through learning in a simple and enjoyable way. It was also possible to identify elderly interested in multiplying the knowledge with peers and family. Conclusions: The participatory educational process promotes strengthening of elderly network support, enabling an active channel of communication between staff and users, offering subsidies appropriated to prevention work and treatment of diseases. Keywords: Health of the Elderly; Health Education; Communicable Disease Prevention; Health Promotion.

  9. Learning from other lands. Caring for elderly demented Koreans.

    Science.gov (United States)

    Lee, H; Kim, S; You, K S

    1997-09-01

    The aims of the study reported here were to describe the socio-demographic characteristics of caregivers of demented elders in Korea and their care recipients and to compare the positive and negative meanings and outcomes of the caregiving experiences of caregivers who had admitted their elderly demented relative to a nursing home (G1: n = 24) and caregivers still caring for their elderly demented relatives at home (G2: n = 30). Most caregivers were female (80%), married (89%), and related to the care receiver as daughter-in-law (39%), daughter (22%), wife (15%), son (13%), or neighbor (6%). Social class differences were found between the home care and nursing home groups: the upper classes were significantly more likely to have placed their demented elder in a nursing home, whereas the low social classes were more likely to keep taking care of their demented elder at home instead of placing them in a nursing home. Caregivers who had admitted their relative to a nursing home (G1) reported significantly more difficulties from disturbed sleep, disrupted children's studies, and limited personal life when they were caring for the elder at home (p care group (G2) had significantly greater satisfaction in serving as a model for their children and practicing religion (p care receiver than those who have placed their demented elder in a nursing home, although the difference in this case was not significant.

  10. 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.

  11. Bisphosphonate therapy and osteonecrosis of the jaw complicated with a temporal abscess in an elderly woman with rheumatoid arthritis: a case report

    Directory of Open Access Journals (Sweden)

    Manzon L

    2014-08-01

    Full Text Available Licia Manzon,1 Evaristo Ettorre,1 Giovanni Viscogliosi,1 Stefano Ippoliti,1 Fabio Filiaci,2 Claudio Ungari,2 Giovanni Fratto,1 Alessandro Agrillo2 1Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, 2Department of Odontology and Maxillofacial Surgery, “Sapienza” University, Rome, Italy Abstract: Bisphosphonate-related osteonecrosis of the jaw (BRONJ is an adverse drug reaction described as the progressive destruction and death of bone tissue of the mandible or maxilla, in the course of bisphosphonate therapy. Orally administered bisphosphonates, widely used for the treatment of osteoporosis, are rarely associated with BRONJ. Instead, the risk greatly increases whether the patient is concomitantly taking steroid and/or immunosuppressant agents. The aims of this paper are to briefly discuss the evidence of the associations between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors such as the presence of rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. In particular, we present the case of an elderly woman with BRONJ suffering from rheumatoid arthritis, with a recent dental extraction and with a very unusual complication: a temporal abscess, who was successfully treated. Keywords: bisphosphonate-related osteonecrosis of the jaw, BRONJ, adverse reaction, steroidsA Letter to Editor has been received and published for this article

  12. [Ruptured Aneurysm of the Sinus of Valsalva Accompanied with a Bicuspid Aortic Valve in an Elderly Man;Report of a Case].

    Science.gov (United States)

    Murase, Toshifumi; Tamura, Susumu; Ohzeki, Yasuhiro; Ebine, Kunio

    2017-09-01

    The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve. An aneurysm originating from the anterior sinus of Valsalva had ruptured into the right ventricular outflow tract. The ruptured aneurysm and VSD were repaired by patch closure through the right ventricular outflow tract. Additionally, the aneurysm of the sinus of Valsalva was repaired with direct closure through aortotomy. The insufficient bicuspid aortic valve was replaced with a bioprosthetic valve. After the operation, heart failure improved promptly, and he was making satisfactory progress in his recovery.

  13. Waist circumference, BMI and the prevalence of self-reported diabetes among the elderly of the United States and six cities of Latin America and the Caribbean.

    Science.gov (United States)

    Barceló, A; Gregg, E W; Pastor-Valero, M; Robles, S C

    2007-12-01

    Using data from the Salud Bienestar y Envejecimiento (SABE) project and the U.S. National Health and Nutrition Examination Survey (NHANES 1999-2004), we examined the prevalence of obesity and diagnosed diabetes among older adults in the Americas; we also examined the association of age, sex, level of education, weight status, waist circumference, smoking, and race/ethnicity with diabetes among older adults. The prevalence of diagnosed diabetes was highest in the US Blacks and Mexican Americans, followed by Bridgetown and Mexico City (22% for each) and lowest in Santiago, Montevideo, Havana, and US Whites (13-15%). Diagnosed diabetes was significantly associated with BMI among participants from Bridgetown, Sao Paulo, and the three US ethnic groups, while it was associated with waist circumference in all sites except Mexico City. Our findings suggest major geographical and ethnic variation in the prevalence of diagnosed diabetes among older adults. Waist circumference was more consistently associated with the prevalence of diagnosed diabetes than BMI. Higher prevalences of diabetes are found among the elderly of African or Mexican descent in the United States and in other countries of the Americas when compared to the prevalence among whites in the United States and in other Latin American countries with populations of predominant Western European descent.

  14. Elderly poverty and Supplemental Security Income.

    Science.gov (United States)

    Nicholas, Joyce; Wiseman, Michael

    2009-01-01

    In the United States, poverty is generally assessed on the basis of income, as reported in the Current Population Survey's (CPS's) Annual Social and Economic Supplement (ASEC), using an official poverty standard established in the 1960s. The prevalence of receipt of means-tested transfers is underreported in the CPS, with uncertain consequences for the measurement of poverty rates by both the official standard and by using alternative "relative" measures linked to the contemporaneous income distribution. The article reports results estimating the prevalence of poverty in 2002. We complete this effort by using a version of the 2003 CPS/ASEC for which a substantial majority (76 percent) of respondents have individual records matching administrative data from the Social Security Administration on earnings and receipt of income from the Old-Age, Survivors, and Disability Insurance and Supplemental Security Income (SSI) programs. Adjustment of the CPS income data with administrative data substantially improves coverage of SSI receipt. The consequence for general poverty is sensitive to the merge procedures employed, but under both sets of merge procedures considered, the estimated poverty rate among all elderly persons and among elderly SSI recipients is substantially less than rates estimated using the unadjusted CPS. The effect of the administrative adjustment is less significant for perception of relative poverty than for absolute poverty. We emphasize the effect of these adjustments on perception of poverty among the elderly in general and elderly SSI recipients in particular.

  15. [Anaemia in the elderly].

    Science.gov (United States)

    Leischker, Andreas Herbert; Fetscher, Sebastian; Kolb, Gerald Franz

    2016-07-01

    In the elderly, even mild anaemia leads to significantly decreased quality of life and reduced survival rate. Therefore even mild anaemias should be worked up especially in the elderly. More than 75 % of all anaemias have a specific and treatable cause.Differential diagnosis of anaemia in the elderly is much more challenging compared to the differential diagnosis in younger patients: in older patients often more than one dysfunction is responsible for the anaemia simultaneously. Many routine laboratory parameters are changed by ageing and are therefore only of limited value for diagnosis of anaemia. Soluble transferinreceptor and hepcidin are two parameters feasible for differential diagnosis of the causes of anaemia in the elderly.The most common cause of iron deficiency anaemia in the elderly is gastrointestinal bleeding. Many causes for gastrointestinal bleeding -like angiodysplasia of the colon - can readily be treated with endoscopic therapy. For this reason, colonoscopy is part of the standard workup for elderly patients with iron-deficient anaemia (IDA) if no contraindications exist.Therapy of anaemia is based on the specific cause or the causes. In IDA, the first step other than causal treatment is to replace iron orally. If this is not tolerated because of side effects or does not lead to a sufficient rise in the haemoglobin level, intravenous iron replacement therapy is indicated. Folic acid deficiency is generally treated orally, whereas vitamin B12 deficiency is generally treated by the parenteral - preferably subcutaneous - route. In anaemia due to chronic renal failure and anaemia due to myelodysplastic syndromes, the underlying cause must be treated, furthermore erythropoiesis-stimulating agents can be indicated. © Georg Thieme Verlag KG Stuttgart · New York.

  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. Physical Activity in Elderly

    Science.gov (United States)

    Tirpakova, Veronika; Sedliak, Milan; Kern, Helmut; Mayr, Winfried; Hamar, Dušan

    2015-01-01

    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. PMID:26913164

  19. 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.......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....

  20. Physical Activity in Elderly.

    Science.gov (United States)

    Cvecka, Jan; Tirpakova, Veronika; Sedliak, Milan; Kern, Helmut; Mayr, Winfried; Hamar, Dušan

    2015-08-24

    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.

  1. 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. 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 concern...... ‘what is care?’ and redirects us to new sites 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...

  2. Homocystiene Profile in Elderly

    Directory of Open Access Journals (Sweden)

    Ola A. Hafiz1, Sarah A.Hamza1,Walaa W. Aly1,Wessam E.Saad2, Ahmed K.Mortagy1

    2013-01-01

    Full Text Available Background: Homocysteine (Hcy is a sulfurated amino acid an elevated homocysteine level is a marker for a pathogenic process as well as a cause of pathology. Method: it is across sectional study conducted on 91 elderly participants 60 years and older selected from geriatric outpatient clinic and geriatric inpatient departmentthey underwent comprehensive geriatric assessment, and homocysteine (Hcy level in blood by Enzyme Immunoassay (EIA. Results: homocysteine not significantly related to age, sex and functional status. Also mean Hcy level is 15.4 μmol/liter. Conclusion: further studies to evaluate Hcy level in elderly with different ages are recommended.

  3. Stereotypes of the elderly in magazine advertisements 1956-1996.

    Science.gov (United States)

    Miller, P N; Miller, D W; McKibbin, E M; Pettys, G L

    1999-01-01

    The globalization of American culture is increasing as various media target an international market. This article reports the results of a study examining trends in the stereotyping of the elderly in print advertisements appearing from 1956 to 1996 in U.S. magazines. Results show that the percentage of elderly portrayals in print ads has decreased. There has been relatively little overall stereotyping of elderly, with only 4 percent of the sample depicting negative stereotypes. Nevertheless, there has been an increasing percentage of negative stereotypes and a decreasing percentage of positive stereotypes. Results are analyzed in relationship to marketing trends and the social impact on aging.

  4. 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.

  5. Intergenerational Exchange of Resources and Elderly Support in Rural China.

    Science.gov (United States)

    Lin, Zhiyong; Pei, Xiaomei

    2016-07-01

    This study examines how parental investments on children affect elderly support, and how this effect is contingent on emotional closeness or parental authority. Data collected from 770 elderly parents residing in rural China were analyzed. We gathered dichotomous data for (a) whether parents invested on their children via financial or instrumental means (i.e., parental investments) and (b) whether parents reported closeness to their children (i.e., emotional closeness) and whether children respected them (i.e., parental authority). We examined the relation between these variables and children's elderly support (financial, instrumental, and emotional). We tested models in two ways, one examining the direct effect of investments, and another testing the interactions between investments and closeness or authority. We first found that investments were not directly associated with elderly support, although the closeness and authority were. Additionally, the association between investments and support was found within parents who reported authority or closeness with their children.

  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. 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

  8. Nutrition in the elderly.

    Science.gov (United States)

    Pirlich, M; Lochs, H

    2001-12-01

    Malnutrition is more common in elderly persons than in younger adults. Ageing itself, however, neither leads to malabsorption nor to malnutrition with the exception of a higher frequency of atrophic gastritis in older persons. Malnutrition in elderly people is therefore a consequence of somatic, psychic or social problems. Typical causes are chewing or swallowing disorders, cardiac insufficiency, depression, social deprivation and loneliness. Undernutrition is associated with a worse prognosis and is an independent risk factor for morbidity and mortality. Awareness of this problem is therefore important. For the evaluation of nutritional status, it must be remembered that most normal values are derived from younger adults and may not necessarily be suitable for elderly persons. Suitable tools for evaluating the nutritional status of elderly persons are e.g. the body mass index, weight loss within the last 6 months, the Mini Nutritional Assessment (MNA) or the Subjective Global Assessment (SGA). An improvement in the nutritional status can be achieved by simple methods such as the preparation of an adequate diet, hand feeding, additional sip feeding or enteral nutrition.

  9. Lucas Cranach the Elder

    NARCIS (Netherlands)

    Heydenreich, Gunnar

    2007-01-01

    This study provides the first exhaustive description of the materials, techniques and studio practices of Lucas Cranach the Elder. The author describes the characteristic elements of the painter's production, drawing on results of technical examination, as well as an evaluation of documentary source

  10. Hardiness among Elderly Women.

    Science.gov (United States)

    Wagnild, Gail; Young, Heather

    Hardiness has been defined as a mediator in life stress and, within the health/illness context, has been conceptualized as a personality characteristic. This study used a descriptive exploratory design to examine the concept of hardiness among elderly women. The Stress, Appraisal, and Coping model developed by Lazarus and Folkman (1986) was the…

  11. Lucas Cranach the Elder

    NARCIS (Netherlands)

    Heydenreich, Gunnar

    2007-01-01

    This study provides the first exhaustive description of the materials, techniques and studio practices of Lucas Cranach the Elder. The author describes the characteristic elements of the painter's production, drawing on results of technical examination, as well as an evaluation of documentary

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

    OpenAIRE

    Rosamaria Rodrigues Garcia; Vanessa Lopes Munhoz Afonso; Carolina Menezes Sinato; Filomena Neves Pereira Vieira Adduci; Regina Garcia do Nascimento; Francisco Souza do Carmo; Paulo Sérgio Pelegrino

    2015-01-01

    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 strateg...

  13. Price indexes for pharmaceuticals used by the elderly

    OpenAIRE

    Thomas, Joseph; Schondelmeyer, Stephen

    1992-01-01

    The analysis presented in this report was undertaken to identify those drug entities that account for a significant proportion of the retail expenditures for prescription drugs used by the elderly. Commercial data bases were used to develop fixed weight Laspeyres price indexes based specifically on drugs used in the elderly population. The indexes provide the capability to analyze price trends for drug groupings that are not possible with the producer price index (PPI) or the Consumer Price I...

  14. Challenges in the management of oral ulceration in elderly patients

    Directory of Open Access Journals (Sweden)

    Nanan Nur'aeny

    2015-12-01

    Full Text Available Background: Oral ulceration can be experienced by anyone, including those who are elderly. Various trigger factors can occur in elderly patient, but the main thing to consider is the degenerative factors that affect the occurrence of some medical problems. Handling oral ulceration in elderly patients should be done carefully and holistically otherwise the improvement is only temporary and can reappear or even be worse. Purpose: In this paper we will discuss two different case reports of elderly female patients and both having some oral ulceration. Cases: First case of recurrent oral ulceration experienced by 58 years old patient, and second case is concerning a 77 years old patient with chronic oral ulceration and also having some medical problems. Aphthous like ulcers (ALU is a diagnosis for recurrent oral ulceration associated with systemic condition, and usually started after adolescent age. Elderly or geriatric condition itself is a special condition that contribute to the degree of a disease. Cases management: Both patients given non pharmacology and pharmacology therapies. The non pharmacology therapy includes communication, information, and education, also oral hygiene instruction. Steroid as anti-inflammatory drugs had an important role in healing process, beside other medication. Conclusion: Oral ulceration in elderly patients with or without a medical problems becomes a challenging thing to handle due to the complexity of their condition. As a dentist we have more careful to arrange the treatment plans for elderly patients when combine with some therapy related systemic disease.

  15. [How the Congolese young people consider their elderly].

    Science.gov (United States)

    Bikouta, Firmin; Bileckot, Richard; Cauli, Marie; Massamba, Honorine; Puisieux, François

    2015-12-01

    The traditional image of the African family that has long grant a place of choice to the elderly does match maybe any more the reality of today. The WHO report on violence and health 2002 and some studies carried out in other African countries suggest that elder abuse also exists in sub-Saharan Africa. To describe how the young Congolese adults consider their elderly and mistreatments that can result. A cross sectional study was realized between January and April, 2008 with 300 youth and adults aged 15 to 55 years (203 ≤ 25 years old), living in Brazzaville or in Pointe-Noire. The sample of 300 people was constituted according to the method of non-probability sampling. The data collection was made on the ground by state employees of the Ministry of Health, social affairs and family by means of a pre-established questionnaire containing open and closed questions. Youth and adults have contrasted and contradictory representations of the elderly. In 70% of the cases they said have good relationships with the elderly and qualified them as wise persons and as models but, conversely, more than 50% of them found them unwanted and disturbing. Witchcraft accusations are frequent with often serious consequences. Social transformations dispossess little by little the elderly people of their status and their prerogatives in Congo-Brazzaville. They come along with a change of look and behavior of the young adults towards them. Elder abuse in Congo-Brazzaville is an underestimated problem insufficiently denounced and fought.

  16. Chronic daily headache in the elderly.

    Science.gov (United States)

    Özge, Aynur

    2013-12-01

    Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the "aging world" continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body.

  17. Self-perceived health in institutionalized elderly.

    Science.gov (United States)

    Jerez-Roig, Javier; Souza, Dyego Leandro Bezerra; Andrade, Fabienne Louise Juvêncio Paes de; Lima, Bartolomeu Fagundes de; Medeiros, Rafaela Jordânia de; Oliveira, Nayara Priscila Dantas de; Cabral, Sadote Macêdo; Lima, Kenio Costa

    2016-11-01

    This study aimed to verify health self-perception, its prevalence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted in 10 Long-Term care Institutions for the Elderly (LTIE) in the city of Natal (Northeast Brazil), between October and December 2013. Sociodemographic variables were analyzed, along with institution-related and health state variables. Descriptive and bivariate analyses were carried out (Chi-squared test, Fisher's exact test or linear trend Chi-squared test), as well as multivariate analysis (logistic regression). The final sample consisted of 127 elderly. The prevalence of negative self-perceived health was 63.19% (CI 95%: 55.07-70.63), and was associated with weight loss (PR: 1.54; CI 95%: 1.19-1.99), rheumatic disease (PR: 1.46; CI 95%: 1.05-2.01) and not-for-profit LTIE (PR: 1.37; CI 95%: 1.03-1.83), adjusted by sex. More than half of the elderly reported negative self-perceived health, which was associated with weight loss, rheumatic disease and type of institution. Actions must be developed to promote better health conditions in LTIE, such as nutrition consulting and physical therapy, to improve quality of life.

  18. The Elderly: Teacher's Manual. Value Reasoning Series.

    Science.gov (United States)

    Main, John, Ed.

    The complex moral issues of dealing with elderly people are delineated in this manual for teachers responsible for changing the attitudes of young people toward this subject. Six major themes are considered: (1) attitudes toward the elderly; (2) the elderly in our society; (3) problems of the elderly; (4) the elderly and the work force; (5) the…

  19. Safe and comfortable assistance for elderly during lie-to-sit transition

    Science.gov (United States)

    Pervez, Aslam; Ryu, Jeha

    2010-01-01

    While assisting elderly in mobility tasks (such as walking, sit-to-stand, and lie-to-sit etc.) the elderly and robots work cooperatively and remain in continuous physical contact during the task. In order to realize a safe and comfortable assistance to elderly, the natural motion patterns of the elderly during a particular task should be respected and augmented by the robot. This paper is focused on designing robot motion paths that accommodate the natural movement patterns of elderly and are based on modeling the caregivers' actions reported in the biomechanics and elder-care literature. As an example, one such motion path for lie-to-sit and sit-to-stand activities is implemented on SpiderBot-II and experimental results are reported in the paper. Proposed motion path is compared with conventional motion path by evaluating through quantitative safety and comfort indices for mobility assistance robots.

  20. High Cancer Burden in Elderly Chinese, 2005–2011

    Directory of Open Access Journals (Sweden)

    Shugang Li

    2015-09-01

    Full Text Available Objective: Cancer risk increases with age, creating a challenge for the Chinese health system. To inform public health policy and research, we evaluated the cancer burden in elderly Chinese. Methods: Based on the published Chinese Cancer Registry Annual Report or related literature and the China Population and Employment Statistics Yearbooks, we estimated the cancer burden of elderly Chinese, who were representative of the Chinese population. We calculated the cancer incidence, cancer-related mortality, potential years of life lost (PYLL, and disability-adjusted life years (DALYs in 2005–2011 by age, sex, district (rural, urban, and calendar year using national cancer registry, publication, and census data. The relative ratios (RRs were determined between the elderly (≥60 years and young (<60 years. Results: Cancer incidence and related mortality in the elderly were 8.47 and 13.96 times, respectively, those in the young. The PYLL and DALY rates of the elderly were 1.63 and 5.00 times, respectively, those in the young. The PYLL and DALY rates for elderly men and rural districts were higher than for elderly women and urban districts. The RRs for male sex and rural districts were higher than for female sex and urban districts. RRs increased sharply from 2005 to 2011. Conclusions: The cancer burden in elderly Chinese was higher in men and rural districts than in women and urban districts, which creates considerable challenges for the Chinese health care system. Comprehensive measures for cancer prevention and treatment in the elderly are needed.

  1. 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

  2. Crohn's Disease Defined in Three Elderly Disters

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    2005-01-01

    Full Text Available Three elderly sisters presented with symptomatic Crohn's disease. All had ileocolic involvement, and granulomatous inflammation was documented in endoscopic biopsies or surgically resected intestinal specimens. The present report documents the unusual occurrence of very late phenotypical expression of familial ileocolic Crohn's disease. The observations presented here reflect a possible gene-based predisposition to Crohn's disease or, alternatively, disease clustering related to a commonly shared environmental factor.

  3. 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.

  4. Neurosurgery and elderly: analysis through the years.

    Science.gov (United States)

    Chibbaro, Salvatore; Di Rocco, F; Makiese, O; Mirone, G; Marsella, M; Lukaszewicz, A C; Vicaut, E; Turner, B; Hamdi, S; Spiriev, T; Di Emidio, P; Pirracchio, R; Payen, D; George, B; Bresson, D

    2010-04-01

    The aging of the population in westernized countries constitutes an important issue for the health systems struggling with limited resources and increasing costs. Morbidity and mortality rates reported for neurosurgical procedures in the elderly vary widely. The lack of data on risk benefit ratios may result in challenging clinical decisions in this expanding group of patients. The aim of this paper is to analyze the elderly patients cohort undergoing neurosurgical procedures and any trend variations over time. The medical records of elderly patients (defined as an individual of 70 years of age and over) admitted to the Neurosurgical and Neuro-ICU Departments of a major University Hospital in Paris over a 25-year period were retrospectively reviewed. The analysis included: (1) number of admissions, (2) percentage of surgically treated patients, (3) type of procedures performed, (4) length of hospital stay, and (5) mortality. The analysis showed a progressive and significant increase in the proportion of elderly presenting for neurosurgical elective and/or emergency procedures over the last 25 years. The number of procedures on patients over 70 years of age increased significantly whereas the mortality dropped. Though the length of hospital stay was reduced, it remained significantly higher than the average stay. The types of procedures also changed over time with more craniotomies and endovascular procedures being performed. Age should not be considered as a contraindication for complex procedures in neurosurgery. However, downstream structures for postoperative elderly patients must be further developed to reduce the mean hospital stay in neurosurgical departments because this trend is likely to continue to grow.

  5. 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

  6. Threats and violence in Swedish community elderly care.

    Science.gov (United States)

    Josefsson, Karin; Ryhammar, Lars

    2010-01-01

    Violence in elderly care has been reported on a global scale. The aim of this study was to describe nurses' perceptions of threats and violence, directed at themselves and other staff in community elderly care. Another aim was to describe nurses' access to prevention measures for handling threats and violence. A questionnaire was answered by registered nurses (RNs) (n=213) in community elderly care. Data was analyzed by SPSS. The results showed that nurses had experienced high-degree indirect threats (48%), direct threats of violent acts (40%) and violent acts (40%). Forty-five percent of the nurses had witnessed violence and threats toward other staff. Twenty percent of the nurses stated to have access to education in managing threats and violence. The conclusions were that violence occurred frequently in community elderly care, as perceived by nurses, as well as that community authority should increase staff education for handling violence.

  7. Quality of life of elderly people with impaired physical mobility

    Directory of Open Access Journals (Sweden)

    Juliana Maria de Paula

    2014-01-01

    Full Text Available This is an integrative review, which aimed at identifying the available evidence about the knowledge on the quality of life of the elderly with impaired physical mobility between 2001 and 2011. Data collection happened in the LILACS, MEDLINE and COCHRANEdatabases. After analytical reading of works, we selected 16 articles for analysis in two thematic categories: quality of life and personal satisfaction, and quality of life and functional capacity. The mobilitylimitations, pain and emotional well-being in the elderly can be attributed to chronic conditions, negatively affecting the quality of life; and the elderly who report a decreased quality of life, are those with a higher degree of dependence, influencing social participation and well-being. We suggest the nurse’s performance in research on interventions that allow improving the quality of life of the elderly with impaired physical mobility.

  8. An unusual case of chronic prostatitis caused by Haemophilus influenzae in an elderly Saudi patient: A case report and literature review

    Science.gov (United States)

    Al-Mohizea, Maha M.; Alotaibi, Fawzia E.

    2014-01-01

    Haemophilus influenzae has been reported on rare occasions as the cause of prostatitis and urinary tract infections. Here, we report a rare case of chronic prostatitis in a 52-year-old male with benign prostatic hypertrophy and discuss the possible underestimation of the true incidence of H. influenzae in genitourinary infections. This organism was identified only by its growth on chocolate agar, a medium that is not commonly used for urine cultures. PMID:25374472

  9. An unusual case of chronic prostatitis caused by Haemophilus influenzae in an elderly Saudi patient: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Maha M Al-Mohizea

    2014-01-01

    Full Text Available Haemophilus influenzae has been reported on rare occasions as the cause of prostatitis and urinary tract infections. Here, we report a rare case of chronic prostatitis in a 52-year-old male with benign prostatic hypertrophy and discuss the possible underestimation of the true incidence of H. influenzae in genitourinary infections. This organism was identified only by its growth on chocolate agar, a medium that is not commonly used for urine cultures.

  10. [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.

  11. [Catatonia in the elderly].

    Science.gov (United States)

    Chiba, Yuhei; Odawara, Toshinari

    2013-10-01

    Catatonia is a syndrome characterized by mutism, stupor, immobility, negativism, posturing, stereotypy, and echophenomena. Not only patients with schizophrenia, but also patients with general medical disease, mood disorder, and substance-related disorder exhibit catatonia. In the patients with catatonia, it is recommended to examine whether they have a general medical disease. We present two catatonic elder patients. Case 1 exhibited catatonia with vascular dementia, and was revealed to have anti-phospholipid antibody syndrome. Case 2 exhibited catatonia with dementia with Lewy bodies, and was revealed to have Hashimoto's encephalopathy. The first recommended treatment for catatonia is benzodiazepines. In case of benzodiazepine resistance or malignant catatonia, it should be considered electroconvulsive therapy, but it needs to be carefully implemented for elder patients.

  12. 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...... patients did not show an increased but rather a lower mortality rate although it was not statistically significant. Consistent with a slower than normal aging, they were also physically and cognitively better functioning than controls. Because incident tremors beyond 70 y of age show worse aging parameters...

  13. 糖尿病患者合并肾损害3例及相关文献复习%Elder Diabete Mellitus Patients with Kidney disease:Three Cases Report and Review of Literature

    Institute of Scientific and Technical Information of China (English)

    王昱; 鲍晓荣

    2012-01-01

    Objective:To investigate the clinilal characteristics of kidney disease in elder patients with diabete mellitus. Methods: By reporting three cases of diabete mellitus patients that were performed renal biopsy. Results: The diagnosis of the patients are diabetic nephropathy, IgA nephropathy, diabetic nephropathy coexisted with membranous nephropathy, which were confirmed by renal biopsy. Conclusion:Patients with diabete mellitus may present various kinds of clinical manifestation,and performing renal biopsy positively may improve the detection rate of non diabetic renal disease.%目的:探讨老年糖尿病患者合并肾损害的临床特点.方法:报道我科3例糖尿病行肾活检患者的临床资料.结果:3例患者经肾活检分别诊断为糖尿病肾病、糖尿病肾病合并IgA肾病、糖尿病肾病合并膜性肾病.结论:糖尿病合并肾损害可有多种表现,对可疑糖尿病人群积极肾活检可能提高非糖尿病肾脏病变检出率.

  14. Conditions of Elderly Chinese Women

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    ACCORDING to the fourth national census in 1990, the population of women over the age of 60 had reached 51 million. With the increasing population of elderly people, the number of elderly women is becoming larger and larger The number of women who are 80 or more. is twice that of men over age 80. The problems of elderly women are attracting public attention. The information given in this article mainly comes from the 1990 national census except where noted otherwise.

  15. Osteoporosis in Elderly

    Directory of Open Access Journals (Sweden)

    Mehmet Ilkin Naharci

    2012-08-01

    Full Text Available Osteoporosis is a disorder that affects commonly the people above 65 years, impairs the functional status, decreases the life quality, and increases mortality and cost. Lateral screening of vertebra or displaying of proximal femur with DEXA is gold standard method for the evaluation of diagnosis and fracture risk in elderly subjects. Physical examination for the analysis of risk factors of falling and laboratory methods for the diagnosis of secondary osteporosis were used. While increasing muscle strength and balance, exercise programs, calcium and vitamin D supplement are helpful in the prevention of falling. As anti-osteoporotic drugs, aleandronat, risedronat, and strontium ranelat have anti-fracture efficiencies for both hip and vertebra fracture. It is considered that the making of periodically routine health examination is important for early diagnosis and treatment in elderly people. In routine examination of elderly subject, it would be helpful that declaring of actions to be done for the prevention of osteoporosis development, if occured, the stopping of progression, and the prevention of falling as part of health training. [TAF Prev Med Bull 2012; 11(4.000: 471-482

  16. Medication adherence in the elderly

    Directory of Open Access Journals (Sweden)

    Angela Frances Yap, BSc (Pharm (Hons

    2016-06-01

    Full Text Available Medication adherence is a crucial component in the treatment of chronic diseases. In the elderly, clinicians are faced with a unique set of problems associated with adherence that they may not have been adequately trained for. In this paper, we demonstrate the importance of medication adherence in the elderly through a case study. The different factors affecting medication adherence in the elderly are highlighted: patient, medication, health care providers, health care system, and socioeconomic factors. Lastly, we have proposed various ways to address these factors. In doing so, clinicians can better understand the problems that the elderly face, thus achieving better therapeutic outcomes.

  17. The prevalence of malnutrition and its related factors among the elderly of Bojnourd, 2014

    Directory of Open Access Journals (Sweden)

    Seyyed Hamid Nabavi

    2015-04-01

    Full Text Available Background: Nutrition plays a very important role in the health and disease of the elderly, and malnutrition is an obstacle to increasing the quality of life of the elderly. This study was conducted to assess malnutrition and its related factors among the elderly of Bojnourd in 2014. Methods: This study was descriptive cross-sectional. The study population included all the elderly of Bojnourd, among whom 120 elderly were recruited by cluster sampling method. Data were collected using interviews, observation and questionnaires by referring to the homes, hospitals and elderly care centers. In this study, Mini Nutritional Assessment (MNA was used. Data analysis was performed by chi-square test. Results: The mean age of elderly was 71.73±9.70 years. 56.7% of the samples were men and 43.3% were women. 30% of the elderly had a good nutrition, 62.2% of them were at the risk of the malnutrition and 7.5% were malnourished. The results showed that mal malnutrition significantly more seen in female gender, low level of education, smoking single status, staying in nursing home than those hospitalized or are active in community, but no significant difference was reported between age and socioeconomic status. Conclusion: Given the high prevalence of malnutrition in the elderly, and possibility of malnutrition among the elderly, further attempts are required to be made to improve the quality of life and to reduce illness and disability in this population.

  18. 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.

  19. [The issue of tuberculosis in the elderly in Japan].

    Science.gov (United States)

    Toyota, Makoto; Sasaki, Yuka

    2010-12-01

    , 139 cases were studied. There were 63 elderly cases in the 139. In the elderly TB patients, there were many cases of death and moving out, so the clinical results were poor. Some cases take much time to move out. It is important to inform doctors and people who care for the elderly that the elderly are under high risk of tuberculosis, to consider treatment for latent tuberculosis infection of high risk groups of tuberculosis, and that experts in tuberculosis, local doctors, health care center and geriatric facilities have close relation. (5) Problems and measures of tuberculosis in elderly group: Masahiro ABE (National Hospital Organization Ehime National Hospital) The percentage of the aged is high among all of tuberculosis patients, especially in the country compared to the city. I reported problems concerning tuberculosis treatment and ward management for elderly patients. During the hospitalization, the management of underlying diseases and new complications besides tuberculosis treatment is critical. Dysphagia features particularly make difficult to take anti-TB drugs and nutritional state worse. The rehabilitation of swallowing functions is effective to improve these conditions. To make discharge support more helpful, the support system, including regional cooperation path is expected to advance more widely and deeply.

  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. Diabetes auto-referido em idosos: prevalência, fatores associados e práticas de controle Self-reported diabetes in the elderly: prevalence, associated factors, and control practices

    Directory of Open Access Journals (Sweden)

    Priscila Maria Stolses Bergamo Francisco

    2010-01-01

    Full Text Available O objetivo do estudo foi avaliar a prevalência de diabetes auto-referido em idosos, identificando fatores associados, conhecimento e práticas quanto às opções de tratamento. Trata-se de estudo transversal de base populacional, com amostra estratificada por conglomerados e em dois estágios, em municípios do Estado de São Paulo, Brasil. Dos 1.949 idosos, 15,4% referiram diabetes. O índice de massa corporal e a prática de exercício físico estiveram associados à doença. Houve diferença entre diabéticos e não diabéticos quanto à auto-avaliação da saúde, internação, morbidade auto-referida nos últimos 15 dias, e relato das seguintes doenças: hipertensão, anemia, doença renal e cardiovascular. Não houve desigualdade em relação à renda familiar per capita quanto à visita ao médico/serviço de saúde, à participação em grupos de discussão e às práticas de controle da doença. O estudo sugere a importância de mudanças comportamentais, como estratégias de prevenção e controle da doença e suas complicações, bem como a necessidade de oferta de intervenções educativas com ampliação da cobertura de cuidados aos diabéticos.The aim of the study was to assess the prevalence of self-reported diabetes in the elderly, identifying associated factors, knowledge, and practices related to treatment options. This was a cross-sectional population-based study with stratified clustered two-stage sampling in six municipalities in the State of São Paulo, Brazil. Among the 1,949 elderly, 15.4% presented self-reported diabetes. Body mass index and exercising were statistically associated with diabetes. There was a significant difference between diabetics and non-diabetics in terms of self-rated health, hospitalization, self-reported illness in the previous two weeks, and report of the following diseases: hypertension, anemia, chronic kidney disease, and heart disease. In terms of per capita family income, there was no

  2. 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.

  3. Recurrent urosepsis and cardiogenic shock in an elderly patient with pheochromocytoma.

    Science.gov (United States)

    Khoo, Joan Joo-Ching; Au, Vanessa Shu-Chuan; Chen, Richard Yuan-Tud

    2011-01-01

    Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.

  4. 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.

  5. Leisure Activity Participation of Elderly Individuals with Low Vision.

    Science.gov (United States)

    Heinemann, Allen W.

    1988-01-01

    Studied low vision elderly clinic patients (N=63) who reported participation in six categories of leisure activities currently and at onset of vision loss. Found subjects reported significant declines in five of six activity categories. Found prior activity participation was related to current participation only for active crafts, participatory…

  6. 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.

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

    OpenAIRE

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

    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.

  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. Children's Attitudes toward the Elderly

    Science.gov (United States)

    Jantz, Richard K.; And Others

    1977-01-01

    A study measured children's attitudes toward and knowledge of older people in American society. Findings indicate that children have little general knowledge of the elderly and very complex, mixed attitudes toward older persons. Ways are suggested in which schools can inculcate positive attitudes toward all people, including the elderly.…

  10. 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 cons

  11. 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...

  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. [Sleep disturbance in the elderly].

    Science.gov (United States)

    Mori, A

    1990-01-01

    Sleep structure is qualitatively and quantitatively changed by aging. The elderly usually go to bed in early evening and wake up in early morning, and they also take several naps in the day time. The polyphasic sleep is one of the typical sleep patterns found in the elderly. Comparing the sleep of the elderly with that of young adults by the method of polysomnography, the characteristics of the sleep of the elderly are in the prolongation of sleep latency, shortening of total sleep time, increase of Stage W and Stage 1, decrease of Stage 3 and 4, and also decrease of Stage REM and the advance of REM phase. Insomnia is a frequently observed symptom in the elderly. The so-called psychophysiological insomnia due to transient psychological or situational stress is common in the elderly. However, insomnia following the mental disturbance (depression), chronic use of drug or alcohol, dementia (vascular or Alzheimer type) are also important in the elderly. Sleep apnea syndrome is recently found as an important cause of insomnia. Concerning the treatment and prevention of insomnia, it is necessary to exclude the causes of insomnia, to improve the environmental conditions and to keep the regular rhythm of sleep-wake cycle. It is also important to carefully select and use the adequate hypnotics considering the pharmacokinetics and adverse effects of the drugs in the elderly.

  14. Common chronic health problems and life satisfaction among Macau elderly people

    Directory of Open Access Journals (Sweden)

    Sydney X.X. Hu

    2016-12-01

    Conclusion: Lowest life satisfaction was reported among Macau elderly people living with mobility related chronic medical illness. Policies and practices should pay more attention to mobility related health problems or issues of elderly people, such as eye health and neuromuscular weaknesses.

  15. 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 M

  16. [The impact of frailty on the oral care behaviour and dental service use of elderly people

    NARCIS (Netherlands)

    Niesten, D.; Sanden, W.J.M. van der; Gerritsen, A.E.

    2015-01-01

    In order to explore how the level of frailty and various frailty factors affect the dental service use and oral self-care behaviour of frail elderly people, 51 frail elderly people were interviewed. Additional information on age, gender, living situation, prosthetic status, self-reported health and

  17. Leptospirosis in elderly patients.

    Science.gov (United States)

    Gancheva, Galya Ivanova

    2013-01-01

    Leptospirosis is a re-emerging zoonosis with broad clinical spectrum and high mortality in severe forms. The aim of this study was to analyze clinical manifestations, laboratory findings, epidemiological data, and management in elderly patients with leptospirosis. Toward that end, we performed a descriptive analysis of 15 leptospirosis elderly cases (age 60-78 years) treated at the Clinic of Infectious Diseases of University Hospital - Pleven (1976-2012). Patients were serologically confirmed by microscopic agglutination test. Twelve cases (80%) presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes) was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%), hemorrhagic diathesis (13/87%), vomiting (11/73%), abdominal pain (10/67%), myalgia (7/47%) and hypotension (7/47%) also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1±24.1mmol/L) and serum creatinine (mean 347.6±179.8μmol/L). Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6±210.7μmol/L) and slightly elevated aminotransferases (ASAT mean 125.8±61.6IU/L; ALAT mean 131.3±126.5IU/L). Five cases (33%) had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment.

  18. Leptospirosis in elderly patients

    Directory of Open Access Journals (Sweden)

    Galya Ivanova Gancheva

    2013-10-01

    Full Text Available Leptospirosis is a re-emerging zoonosis with broad clinical spectrum and high mortality in severe forms. The aim of this study was to analyze clinical manifestations, laboratory findings, epidemiological data, and management in elderly patients with leptospirosis. Toward that end, we performed a descriptive analysis of 15 leptospirosis elderly cases (age 60-78 years treated at the Clinic of Infectious Diseases of University Hospital - Pleven (1976-2012. Patients were serologically confirmed by microscopic agglutination test. Twelve cases (80% presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%, hemorrhagic diathesis (13/87%, vomiting (11/73%, abdominal pain (10/67%, myalgia (7/47% and hypotension (7/47% also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1 ± 24.1 mmol/L and serum creatinine (mean 347.6 ± 179.8 µmol/L. Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6 ± 210.7 µmol/L and slightly elevated aminotransferases (ASAT mean 125.8 ± 61.6 IU/L; ALAT mean 131.3 ± 126.5 IU/L. Five cases (33% had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment.

  19. Understanding suicide in the elderly.

    Science.gov (United States)

    Zanni, Guido R; Wick, Jeannette Y

    2010-02-01

    One suicide occurs every 16 minutes. Intentionally killing oneself is distinctly human; other species don't commit suicide. Suicide is an exceedingly complex phenomenon stemming from intolerable stress and the inability to cope. Elders tend to plan their suicides well, choose means of killing themselves that are more violent than younger people do, and are less likely to survive the attempt than others. Numerous factors increase risk for elder suicide: recent bereavement, pain, chronic illness, hopelessness, and despair. Identifying and treating depression early is essential to avoid tragedy. Regardless, many elders are treated with anxiolytics and analgesics in lieu of antidepressants, and some medications may increase suicide risk. Consultant pharmacists need to be aware that suicide is a serious concern for elders. When depression seems to be worsening in an elder, aggressive action is needed.

  20. Overlap syndrome of dementia, depression and delirium in elderly patients: a report of 16 cases%老年患者痴呆、抑郁、谵妄、重叠临床分析

    Institute of Scientific and Technical Information of China (English)

    张宁; 姜珊; 刘晓红; 康琳; 朱鸣雷; 王秋梅

    2015-01-01

    Objective To analyze the clinical characteristics and prognosis of the overlap syndrome of dementia,depression and delirium coexistence in two or three of them (the 2D's or 3D's) in elderly patients,in order to raise awareness.Methods Clinical data of 16 patients aged >65 years diagnosed with the 2D's or 3D's admitted to Peking Union Medical College Hospital from 2010 to 2014 were analyzed and relevant literatures were reviewed.Results Patients with the 2D's or 3D' s accounted for 10% of the elderly demented patients and 3% of the elderly depressive patients.16 patients [11 females and 5 males,median age 82 years and mean age (80±6) years] were enrolled,with 7 cases of dementia with depression,6 cases of delirium superimposed on dementia,2 cases of the 3D's,and 1 case of coexisting depression and incident delirium.The Charlson comorbidity index of the 16 patients was (3.0± 1.5).(4.0± 1.6) kinds of geriatric syndromes were found,and the most common were falls (62%),sleep disorders (56%),frailty (50%),polypharmacy (43 %),and malnutrition (37%).Disability was identified in 14 (88%) patients on admission.Delirium was observed in 9 patients (56 %),with 7 cases of hyperactive delirium and 2 cases of hypoactive delirium.Coexisting underlying dementia was identified after episodes of delirium in 6 cases.16 patients all received corresponding intervention during hospitalization period.During a mean follow-up period of (15±13) months,62 % of the patients had more impaired physical function (ADL score reduction≥ 1),and 43% of the patients had more impaired cognitive function (MMSE score reduction≥3).Two patients were transferred to long-term care facilities and one patient died during follow-up.The readmission rate was 50% within 1 year after discharge.Conclusions The domestic report of overlap syndrome of dementia,depression and delirium is rare.Patients with the coexistence of the 2D's or 3D's are more commonly combined with geriatric

  1. [Breast cancer in elderly].

    Science.gov (United States)

    Diab, Sami G

    2007-10-01

    The question of the breast cancer in elderly is enlightened by two constituted epidemiological data bases in the United-States: the data basis of San Antonio and the SEER (Surveillance Epidemology and End Results) which represent a follow-up of 26% of the American population. The listed data allow an approach of the clinical and biological constituents according to the age of the disease as well as the factors of comorbidity. The informations relative to the therapeutic choices are more fragmentary and must be developed first and foremost during the programs. double dagger.

  2. Dysphagia in the elderly.

    Science.gov (United States)

    Khan, Abraham; Carmona, Richard; Traube, Morris

    2014-02-01

    Dysphagia, or difficulty swallowing, is a common problem in the elderly. Based on the initial clinical history and physical examination, the dysphagia is assessed as either primarily oropharyngeal or esophageal in origin. Most oropharyngeal dysphagia is of neurologic origin, and management is coordinated with a clinical swallow specialist in conjunction with an ear, nose, and throat (ENT) physician if warning signs imply malignancy. Several structural and functional esophageal disorders can cause dysphagia. If a patient has likely esophageal dysphagia, a video barium esophagram is a good initial test, and referral to a gastroenterologist is generally warranted leading to appropriate treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Anemia in the Elderly

    OpenAIRE

    Sparling, Terence G.

    2013-01-01

    As the population ages, increasing attention has become focused on the prevalence of anemia in elderly individuals. Anemia occurs in more than 10% of individuals who are older than the age of 65 years, and it increases to more than 50% in individuals who are older than the age of 80 years. Although the anemia is typically mild and unlikely to result in symptoms, it is uniformly associated with increased morbidity and mortality as assessed in large cohort studies. Anemia is an independent pred...

  4. Diffuse large B-cell non-Hodgkin lymphoma involving the unilateral carotid space in an elderly man: A case report

    Science.gov (United States)

    Chen, Bo; Zou, Chunying; Wu, Jianqing

    2017-01-01

    An 84-year-old man presented with a history of repeated syncope and decreased heart rate and blood pressure over the last month. On physical examination, a mass sized ~3×3 cm was palpable in the left submandibular area; the mass was hard, poorly mobile, without tenderness or local skin irritation. The computed tomography angiography examination revealed a soft tissue mass in the neck, at the level of the left carotid bifurcation and above. The left common carotid artery bifurcation and internal and external carotid artery segment were embedded in the mass, and there were multiple enlarged lymph nodes in the left neck. The diagnosis of diffuse large B-cell non-Hodgkin lymphoma was confirmed by a percutaneous biopsy of the left submandibular mass. To the best of our knowledge, this is the first reported case of non-Hodgkin lymphoma involvign the carotid space. PMID:28123742

  5. Diffuse large B-cell non-Hodgkin lymphoma involving the unilateral carotid space in an elderly man: A case report.

    Science.gov (United States)

    Chen, Bo; Zou, Chunying; Wu, Jianqing

    2017-01-01

    An 84-year-old man presented with a history of repeated syncope and decreased heart rate and blood pressure over the last month. On physical examination, a mass sized ~3×3 cm was palpable in the left submandibular area; the mass was hard, poorly mobile, without tenderness or local skin irritation. The computed tomography angiography examination revealed a soft tissue mass in the neck, at the level of the left carotid bifurcation and above. The left common carotid artery bifurcation and internal and external carotid artery segment were embedded in the mass, and there were multiple enlarged lymph nodes in the left neck. The diagnosis of diffuse large B-cell non-Hodgkin lymphoma was confirmed by a percutaneous biopsy of the left submandibular mass. To the best of our knowledge, this is the first reported case of non-Hodgkin lymphoma involvign the carotid space.

  6. Anciano que cuida a anciano Elderly caring for elderly

    Directory of Open Access Journals (Sweden)

    Maria João Costa Pacheco

    2007-09-01

    Full Text Available El envejecimiento es un proceso complejo, continuo, irreversible y dinámico al que la población portuguesa no es ajena. Con la longevidad, los ancianos son cada vez menos autónomos, más dependientes de cuidados de terceros, y estos cuidados aparecen, cada vez más, proporcionados por otro anciano. Actualmente los enfermeros deben dar una atención especial a este fenómeno para suministrar un apoyo mejor a los cuidadores ancianos que cuidan a otros ancianos, también ellos personas con problemas geriátricos. Deberán proporcionar una mayor dedicación a la adquisición y mantenimiento de este papel para promover la autonomía y minimizar la dependencia del anciano cuidado.Aging is a complex process, continuous and irreversible, a phenomenon to which Portuguese population is not stranger. With longevity the elderly becomes less autonomous, depending on the case of others, starting to emerge a growing number of elderly much more elderly, many of them taking care of another elder. In the present nurses should give special attention to this phenomenon in order to provide better support to the elderly caregivers of the elderly, who also have geriatrics problems, proving a greater satisfaction in the acquisition and maintenance of this role and in this way promoting self-governing and minimizing the dependency of the cared elder.

  7. Elder Abuse: The Status of Current Knowledge.

    Science.gov (United States)

    Pedrick-Cornell, Claire; Gelles, Richard J.

    1982-01-01

    Discusses problems of definition of elderly abuse. Examines data and research on the rates of elderly abuse and factors found related to elderly abuse. Critiques theories developed to explain the abuse of the elderly. Presents recommendations for research and practice. (RC)

  8. 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.

  9. Vertigo and dizziness in the elderly

    Directory of Open Access Journals (Sweden)

    Lara eFernandez

    2015-06-01

    Full Text Available 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 nonspecific 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.

  10. 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.

  11. Death and dying anxiety among elderly Arab Muslims in Israel.

    Science.gov (United States)

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

    2010-04-01

    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 differences based on religiosity. Death anxiety was related to gender and education for elderly living in the community, but social support and self-esteem were additional correlates for those living in nursing homes. The results of this study indicate that fostering a sense that one has a supportive social and familial network is important in decreasing death and dying anxiety among elderly Arab people. It would also be beneficial to provide information and knowledge that might relieve some of the anxiety they experience.

  12. Review of the efficacy and safety of fesoterodine for treating overactive bladder and urgency urinary incontinence in elderly patients.

    Science.gov (United States)

    Wagg, Adrian; Oelke, Matthias; Angulo, Javier C; Scholfield, David; Arumi, Daniel

    2015-02-01

    Overactive bladder (OAB) is a common condition, with prevalence rates increasing with advancing age. Symptoms of OAB, including urgency urinary incontinence (UUI), are associated with various co-morbidities in elderly individuals (e.g., falls and fractures, functional impairment, and depression). The current mainstay of pharmacological therapy for OAB is antimuscarinic agents. Until recently, few studies had specifically evaluated the efficacy and safety of antimuscarinics in the treatment of OAB symptoms in elderly patients. This review summarises available evidence from the medical literature on the efficacy and safety of fesoterodine in elderly patients with OAB symptoms, including UUI. The data from unique placebo-controlled fesoterodine trials of elderly and vulnerable elderly patients, together with age-stratified data from post hoc analyses of fesoterodine trials, demonstrate that treatment with fesoterodine 4 or 8 mg results in statistically and clinically significant improvements in OAB symptoms and patient-reported outcomes in many elderly patients. The data indicate that the efficacy of fesoterodine in elderly patients is comparable with that in younger patients. Fesoterodine is generally well tolerated in elderly and vulnerable elderly patients, with low rates of urinary retention and little evidence of central nervous system events or impaired cognition. The data support a favourable benefit-to-risk ratio for fesoterodine in elderly and medically complex vulnerable elderly patients with OAB.

  13. 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...

  14. Patterns of chronic benzodiazepine use in the elderly

    Directory of Open Access Journals (Sweden)

    Vanessa Sgnaolin

    Full Text Available Abstract Background In several countries, prevalence studies demonstrate that chronic use of BZD in the elderly population is very high. This scenario has reached pandemic proportions for decades and is an important public health problem. Objectives To examine the independent association between chronic benzodiazepine use in depression, anxiety and bipolar disorder, as well as other clinical and sociodemographic factors. Methods This cross-sectional study was developed from a population-based survey and conducted from March, 2011 to December, 2012 using a random sample of 550 elderly people who were enrolled in the Family Health Strategy in Porto Alegre, Brazil. Data was collected from identifying epidemiological and health data (sociodemographic, self-perception health, self-reported diseases, smoking, alcohol and pharmacotherapeutic evaluation and from the diagnoses of mood and anxiety disorders. Results Elderly patients diagnosed with depression, anxiety, concomitant depression/anxiety and bipolar disorders, and those who were using antidepressants have a higher risk of benzodiazepine use. Individuals who self-reported drinking alcohol had a lower risk of benzodiazepine use. Discussion Benzodiazepines are often used by the elderly for long periods, which has a direct impact on the treatment of mood and anxiety disorders and on vulnerable groups such as the elderly, who may be unnecessarily taking these drugs.

  15. Datura stramonium poisoning misdiagnosed with stroke:report of one elderly patient%误诊为脑卒中的老年曼陀罗中毒一例

    Institute of Scientific and Technical Information of China (English)

    卢士云; 徐俊

    2015-01-01

    Datura stramonium is a category of freely branching herb and all parts of the plant are poi-sonous,which contain essential components of hyoscyamine,atropine and tropane alkaloids.Mild Datura stra-monium intoxication typically leads to mouth and throat dryness,dysphagia,mydriasis,delirious speech,hal-lucination and tachycardia,etc.Severe patients may present with coma,spasm and even death induced by res-piration and circulatory failure.We reported one elderly patient intoxicated by Datura stramonium.The patient was admitted to hospital with a sudden disturbance of consciousness.The patient had a medical history of hy-pertension.Head CT scan revealed relatively low density of the right temporal lobe.Considering the high risk of cerebral vascular and circulatory system diseases for the aged population,the patient was primarily diagnosed with stroke and received corresponding therapy.However,no significant efficacy was achieved.After further inquiry of medical history,it was comfirmed that the patient had taken medicinal wine soaked with Datura stra-monium seed to release arthralgia two hours before onset.Considering the possibility of Datura stramonium in-toxication,the patient was administered with 0.5 mg of neostigmine via intramuscular injection and relevant symptoms were gradually mitigated.The patient was eventually diagnosed with Datura stramonium poisoning. Consequently,the possibility of Datura stramonium poisoning should be considered for elderly patients with ini-tial symptoms of consciousness disorder and a medical history of hypertension.Explicit inquiry of medical histo-ry and different necessary examinations should be fully performed to avoid the misdiagnosis of acute cerebrovas-cular events.%曼陀罗为草本茄科植物,全株有毒,其主要成分是莨菪碱、阿托品及东莨菪碱等生物碱,中毒后轻者主要表现为口、咽喉发干,吞咽困难,瞳孔散大、谵语幻觉、心率增快等,严重者可发生昏迷、抽搐

  16. Balance disorders in the elderly: epidemiology and functional impact.

    Science.gov (United States)

    Lin, Harrison W; Bhattacharyya, Neil

    2012-08-01

    To quantify the prevalence and determine the impact of dizziness and balance disorders in the elderly. Cross-sectional analysis of a national database. The balance problems survey module of the 2008 National Health Interview Survey was examined, and cases of reported dizziness or balance problems in persons ≥65 years old were identified. The prevalence of balance disorders and associated symptoms and their impacts on self-reported functional limitations were determined. The related impact on daily activities for elderly persons with balance problems was quantified. Sex-based differences in balance problems were determined. Among 37.3 ± 0.9 million elderly persons (mean age, 74.4 ± 0.1 years; 56.9% ± 0.9% female), 7.0 ± 0.2 million persons (19.6% ± 0.7%) reported a problem with dizziness or balance in the preceding 12 months. Balance problems included difficulty with unsteadiness (68.0%), walking on uneven surfaces (54.8%), vertigo (30.1%), and faintness (29.6%). Prescription medication triggered the balance problem in 18.7%. Among the 50.0% of elderly persons with balance problems who sought care, 85.6%, 30.3%, 23.9%, and 16.8% saw a general practitioner, internist, neurologist, or otolaryngologist, respectively. Of this group, 27.4% reported that balance problems specifically prevented them from participating in activities including exercise (61.2%), social events (45.8%), and driving (47.1%). Females were more likely to experience balance problems than males (21.0% vs. 17.7%, P = .025). Approximately one in five elderly persons experiences annual problems with dizziness or balance. Given the significant prevalence and negative effect of balance problems on daily activities in the elderly, balance disorders merit special attention, particularly in the face of an aging population. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  17. Economic crises and the elderly.

    Science.gov (United States)

    Backes-Gellner, Uschi; Schneider, Martin R

    2012-01-01

    Economic crises in the last decades have swept elderly workers more than younger workers out of employment. But now the tide is turning. In affluent societies, elderly workers will have more opportunities of being employed in meaningful and well-paid jobs than ever before. On account of demographic changes, fewer (younger) workers will be around, and most of the reasons that in the past have induced employers to lay off older rather than younger workers will disappear. Future employment strategies will have to focus more on an optimal age mix and on benefitting from the full potential of the elderly. Copyright © 2011 S. Karger AG, Basel.

  18. Renal Cancer in the Elderly.

    Science.gov (United States)

    González León, Tania; Morera Pérez, Maricela

    2016-01-01

    The increase of the aging population corresponds with the rise of renal cancer in elderly patients. The distinction between functional and chronological age, quality of life, and survival estimate are important issues, among others, that should be considered in the management of renal cancer in elderly patients. We made this review with the purpose of synthesizing the most updated criteria regarding indications and outcomes of the different therapeutic options in the management of elderly patients with renal cancer, beginning from the physiologic considerations that characterize them, their capacity to tolerate different therapeutic possibilities, and the prognosis of the patients' risks and comorbidity assessment.

  19. Nutritional situation of elderly nursing home residents.

    Science.gov (United States)

    Pauly, L; Stehle, P; Volkert, D

    2007-02-01

    Malnutrition in institutionalized elderly is of individual and public concern since it negatively affects health outcome and quality of life and is often preventable. Over the past years several studies have examined the prevalence of malnutrition in institutionalized elderly and reported greatly diverse results. The purpose of the present literature review is to give an overview of the current knowledge about the nutritional situation of institutionalized elderly having specific regard to the prevalence of protein-energy malnutrition and nutrition-related problems. Based on a literature search and additional articles from the files of the authors, observational studies with relatively unselected populations reporting figures for the prevalence of malnutrition and/or the prevalence of nutrition-related problems (e. g. poor appetite, chewing or swallowing problems, eating dependency or poor intake) and published between 1990 and 2006 were considered. Relevant information was extracted and compiled. A total of 42 eligible studies with 41 to 6832 participants were found. BMI was the most frequently used parameter for nutritional assessment with mean values mostly between 21 and 24 kg/m(2). Eight studies applied a cut-off value of 20 kg/m(2) and reported between 10% and 50% low values. Weight loss was reported in 7 studies with prevalence rates between 5 and 41%, reduced serum albumin (malnutrition was observed in 2 to 38% and a risk of malnutrition in 37 to 62%. Nutritional problems were reported in 17 studies, again with great variability between the studies. In physically and mentally capable study populations malnutrition was relatively unfrequent. Prevalence rates were highest in studies with great proportions of disabled and severely impaired residents. It can be concluded that malnutrition is generally widespread in institutionalized elderly. Prevalence rates vary according to the parameters and cut-off values used for nutritional assessment and according to the

  20. Symptoms of craniomandibular disorder among elderly people.

    Science.gov (United States)

    Ow, R K; Loh, T; Neo, J; Khoo, J

    1995-06-01

    This study investigated the subjective symptoms of craniomandibular disorder and the restriction in maximal mandibular opening of 891 elderly Singaporean citizens. A distribution of 22% of subjects (20% of the women and 26% of the men) reported subjective symptoms of craniomandibular disorders. The most common single symptom reported was occasional to frequent clicking sounds from the temporomandibular joints (in 15% of subjects). The other single symptoms were reported only occasionally in 2-6% of subjects. Nineteen per cent of the subjects had some restriction in maximal interincisal opening (30-39 mm) and about 1% of subjects were severely restricted in maximal opening (less than 30 mm). Subjectively evaluated limitation of wide mandibular opening was recorded for only 2% of the subjects. Background factors included general musculo-skeletal problems (54%), perceived fair to poor general health (29%), headaches (33%), work-related stress (24%), oral parafunctional clenching (4%) and grinding activity (4%). This paper confirms earlier reports that the subjective signs and symptoms of craniomandibular disorder tend to diminish in elderly people.

  1. Robot Games for Elderly

    DEFF Research Database (Denmark)

    Hansen, Søren Tranberg

    2011-01-01

    in a number of countries is under pressure. Development of new types of technology which can secure self-sustainability and life quality for elderly has been suggested as way to diminish some of the problems caused by an ageing society. It has been shown that even a small amount of physical activity can...... 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...

  2. Hypertension in the Elderly

    Directory of Open Access Journals (Sweden)

    Blas Gil-Extremera

    2012-01-01

    Full Text Available Background. The incidence of hypertension in the Western countries is continuously increasing in the elderly population and remains the leading cause of cardiovascular and morbidity. Methods. we analysed some significant clinical trials in order to present the relevant findings on those hypertensive population. Results. Several studies (SYST-EUR, HYVET, CONVINCE, VALUE, etc. have demonstrated the benefits of treatment (nitrendipine, hydrochrotiazyde, perindopril, indapamide, verapamil, or valsartan in aged hypertensive patients not only concerning blood pressure values but also the other important risk factors. Conclusion. Hypertension is the most prevalent cardiovascular disorder in the Western countries, and the relevance of receiving pharmacological treatment of hypertension in aged patients is crucial; in addition, the results suggest that combination therapy—nitrendipine plus enalapril—could have more benefits than those observed with the use of nitrendipine alone.

  3. 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

  4. The Report about Nutritional Status in Elderly Maintenance Hemodialysis Patients in Hechi City%河池市城区老年维持性血液透析患者营养状态报告

    Institute of Scientific and Technical Information of China (English)

    陆丹宇

    2014-01-01

    目的:研究河池市城区老年维持性血液透析患者营养状态以及影响因素。方法:选择河池市人民医院血液透析中心中,维持性血液透析老年患者45例(65岁以上,老年组)和非老年患者43例(65岁以下,对照组),评估患者营养状态并进行比较。结果:老年组的物理指标测量结果和生化指标测量结果均低于对照组(P65 years old,the elderly group)and 43 non elderly patients(<65 years old,the control group)among the maintenance hemodialysis patients were selected,the nutritional status of patients were assessed and compared. Result:Physical index and biochemical measurements results in the elderly group were lower than the control group(P<0.05),while the ultra sensitive CRP and dialysis adequacy of Kt/V were(3.6 ± 8.4)mg/L and(1.4 ± 0.2)in the elderly group,which were significantly higher than those of the control group (P<0.05);protein and calorie intake for the elderly group were(0.7 ± 0.2)g/(kg·d)and(102.5 ± 11.4)kJ/(kg·d),which were lower than the control group(P<0.05). Conclusion:The nutritional status is poor in elderly maintenance hemodialysis patients,which is influenced by inflammation and protein deficiency,so improve the nutritional status of elderly patients according to influencing factors.

  5. 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

  6. Prevalence of Insomnia and Factors Associated with it Among the Elderly People of Sarangdanda VDC in Panchthar District

    OpenAIRE

    Raj Kumar Subedi

    2011-01-01

    Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies report that the different forms of insomnia like Difficulty Initiating Sleep (DIS), Difficulty Maintaining Sleep (DMS) and Non-Restorative Sleep (NRS) are common among the elderly that are associated to many factors. The objective of the study was to measure the prevalence of insomnia and the factors associated to it among the elderly people. A cross-sectional study was conducted among 142 elderly pe...

  7. Therapy in the elderly hypertensive

    Directory of Open Access Journals (Sweden)

    Peter A Meredith

    2002-03-01

    Full Text Available The number of people over the age of 65 years continues to increase. In most societies blood pressure (BP increases with age and elevated levels of BP are common in the elderly. The elderly are also a high-risk group for cardiovascular (CV disease, which is the leading cause of death in most developed countries. Several intervention trials have confirmed lower CV disease risk in hypertensive patients aged into their early eighties when treated with a variety of antihypertensive drugs. Whilst there is some limited evidence to suggest that β-blockers may not be as effective as thiazide diuretics in reducing coronary heart disease (CHD or total mortality in the elderly, the combination of the two agents and thiazides alone appear to be as effective as newer agents, such as angiotensin-converting enzyme inhibitors (ACE-I and calcium antagonists. There was no evidence from these trials that BP reduction in the elderly was associated with any deleterious effects. Whilst the benefits of treating the elderly hypertensive are well established, some issues remain to be clarified, particularly in relation to treating the very elderly and the potential benefits beyond BP control that may be afforded by newer antihypertensive agents.

  8. Therapy in the elderly hypertensive

    Directory of Open Access Journals (Sweden)

    Peter A Meredith

    2002-03-01

    Full Text Available The number of people over the age of 65 years continues to increase. In most societies blood pressure (BP increases with age and elevated levels of BP are common in the elderly.The elderly are also a high-risk group for cardiovascular (CV disease, which is the leading cause of death in most developed countries. Several intervention trials have confirmed lower CV disease risk in hypertensive patients aged into their early eighties when treated with a variety of antihypertensive drugs. Whilst there is some limited evidence to suggest that -blockers may not be as effective as thiazide diuretics in reducing coronary heart disease (CHD or total mortality in the elderly, the combination of the two agents and thiazides alone appear to be as effective as newer agents, such as angiotensin-converting enzyme inhibitors (ACE-I and calcium antagonists. There was no evidence from these trials that BP reduction in the elderly was associated with any deleterious effects.Whilst the benefits of treating the elderly hypertensive are well established, some issues remain to be clarified, particularly in relation to treating the very elderly and the potential benefits beyond BP control that may be afforded by newer antihypertensive agents.

  9. An Anglo-French Summer School for Elders.

    Science.gov (United States)

    Shea, Peter; Tidmarsh, Mannes

    1981-01-01

    Reports on an international program involving a bilingual summer school program for the elderly. Curriculum topics included aspects of British and French cultural and social life, the role of grandparents, self-help, and health maintenance. Topics were taught via lecture/discussion, tourist visits, and physical/recreative activities. (CT)

  10. A Peer Educator Approach to Nutrition for the Elderly.

    Science.gov (United States)

    Shannon, Barbara M.; And Others

    1983-01-01

    Describes a nutrition education program for the elderly in which 22 older adults were recruited and trained as peer educators to create interest in nutrition and serve as liaisons between peers and sound sources of nutrition information. Participants (N=933) reported that sessions were interesting and provided useful information. (Author/JAC)

  11. 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…

  12. 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.)

  13. Elder Fraud and Financial Exploitation: Application of Routine Activity Theory.

    Science.gov (United States)

    DeLiema, Marguerite

    2017-03-10

    Elder financial exploitation, committed by individuals in positions of trust, and elder fraud, committed by predatory strangers, are two forms of financial victimization that target vulnerable older adults. This study analyzes differences between fraud and financial exploitation victims and tests routine activity theory as a contextual model for victimization. Routine activity theory predicts that criminal opportunities arise when a motivated offender and suitable target meet in the absence of capable guardians. Fifty-three financial exploitation and fraud cases were sampled from an elder abuse forensic center. Data include law enforcement and caseworker investigation reports, victim medical records, perpetrator demographic information, and forensic assessments of victim health and cognitive functioning. Fraud and financial exploitation victims performed poorly on tests of cognitive functioning and financial decision making administered by a forensic neuropsychologist following the allegations. Based on retrospective record review, there were few significant differences in physical health and cognitive functioning at the time victims' assets were taken, although their social contexts were different. Significantly more fraud victims were childless compared with financial exploitation victims. Fraud perpetrators took advantage of elders when they had no trustworthy friends or relatives to safeguard their assets. Findings support an adapted routine activity theory as a contextual model for financial victimization. Fraud most often occurred when a vulnerable elder was solicited by a financial predator in the absence of capable guardians. Prevention efforts should focus on reducing social isolation to enhance protection.

  14. Factors Associated With Leisure Participation Among the Elderly Living in Long-term Care Facilities

    Directory of Open Access Journals (Sweden)

    Li Li

    2010-06-01

    Conclusion: Based on the self-reported interests, health status and level of cognitive skill of elderly residents, long-term care facilities should arrange appropriate leisure activities to prevent depression and to improve quality of life.

  15. Low zinc status: a new risk factor for pneumonia in the elderly?

    Science.gov (United States)

    Barnett, Junaidah B; Hamer, Davidson H; Meydani, Simin N

    2010-01-01

    Low zinc status may be a risk factor for pneumonia in the elderly. This special article reviews the magnitude of the problem of pneumonia (its prevalence, morbidity, and mortality) in the elderly, pneumonia's etiology, and the dysregulation of the immune system associated with increasing age. In addition, recent evidence from the literature is presented demonstrating that low zinc status (commonly reported in the elderly) impairs immune function, decreases resistance to pathogens, and is associated with increased incidence and duration of pneumonia, increased use and duration of antimicrobial treatment, and increased overall mortality in the elderly. Inadequate stores of zinc might, therefore, be a risk factor for pneumonia in the elderly. Randomized, double-blind, controlled studies are needed to determine the efficacy of zinc supplementation as a potential low-cost intervention to reduce morbidity and mortality due to pneumonia in this vulnerable population.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Epilepsy in the elderly: restrictions, fears, and quality of life.

    Science.gov (United States)

    May, T W; Pfäfflin, M; Brandt, C; Füratsch, N; Schmitz, B; Wandschneider, B; Kretz, R; Runge, U; Geithner, J; Karakizlis, H; Rosenow, F; Kerling, F; Stefan, H

    2015-03-01

    Due to demographic change and high incidence of epilepsy in elderly, the number of elderly with epilepsies is increasing. However, only few studies investigated the impact of epilepsy on quality of life (QoL). We investigated how epilepsy affects different aspects of QoL dependent on the age of the patients and the age of onset of epilepsy. In a multicenter, cross-sectional study, three patient groups were recruited from five centers: Group A1: 45 elderly (≥65 years.) with late onset of epilepsy (≥65 years), group A2: 51 elderly (≥65 years.) with early-onset, long-lasting epilepsy (≤50 years), group B: 41 young adults (≤50 years) with epilepsy. Statistical analysis of differences between groups was performed using generalized linear models. Elderly with late-onset epilepsy (group A1) had a significantly lower seizure frequency, were treated with less anti-epileptic drugs (AEDs), and reported a better tolerability of AED treatment, but had more comorbidities compared with groups A2 and B. After adjusting for seizure frequency, tolerability of AEDs and comorbidity, young adults (group B) reported the highest overall QoL, whereas patients of group A1 and A2 did not differ significantly. Epilepsy-related fears, especially fears of stigmatization, were significantly higher in elderly with long-lasting epilepsy compared with groups A1 and B. Seizure-related variables, tolerability of AEDs and comorbidity have a stronger impact on QoL and on restrictions due to epilepsy than age, age at onset of epilepsy or duration of epilepsy. However, some results indicate group-specific patterns of impairment and epilepsy-related fears. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Screening for elder mistreatment in dental and medical clinics

    Science.gov (United States)

    Strauss, Shiela; Russell, Stefanie; Singh, Geetika; Blankenship, Jamie; Vemula, Roja; Caceres, Billy; Valenti, Michael; Sutin, David

    2011-01-01

    Objective Elder mistreatment (EM) is a potentially fatal and largely unrecognised problem in the United States. The purpose of this study was to determine the prevalence of EM in busy clinics and specifically, we report on the feasibility of screening for EM as well as the appropriate instrumentation for screening. Background Data Prevalence estimates for elder mistreatment vary, but recent data from a national sample of community-residing adults over age 60 indicate that 11.4% of older adults report some form of elder mistreatment (1). There is a paucity of research related to screening in dental and medical clinics to understand the prevalence in such practice settings. Methods A cross-sectional study from January 2008 to March 2009. We enrolled 241 patients at two clinics: a medical clinic (N=102) and the dental clinics (N=139). A mini-mental status exam was conducted with a minimum of 18 or better for inclusion. An elder mistreatment screen was next used (EAI-R for medical, HS-EAST for dental). Results For the 241 patients, we were able to compare data from the EAI-R with the HS-EAST. This pilot work demonstrates the feasibility of screening for EM in busy clinics and we documented patient enrolment of 20% in the medical clinics, and 66% in dental clinics. Patients are willing to answer extremely-sensitive questions related to elder mistreatment, and are also willing to use computer technology for interviewing. Conclusion Dental and medical clinics are important practice venues to screen for elder mistreatment. PMID:22225431

  19. A influência da estrutura de um grupo na linguagem escrita de idosos: um estudo de caso The influence of group structure in the written language of elderly subjects: a case report

    Directory of Open Access Journals (Sweden)

    Paulo Penha de Souza Filho

    2011-09-01

    Full Text Available Este estudo tem como objetivo analisar o papel de um grupo de idosos no desenvolvimento de atividades voltadas à escrita de uma das participantes desse grupo, que se consolidou em função de uma Oficina de Linguagem. Trata-se de um relato de caso que partiu de um paradigma interpretativo, o qual inclui subjetividade, interesses, emoções e valores pessoais. Foram realizadas análises da transcrição da entrevista semi-estruturada realizada com uma integrante de 85 anos de uma Oficina de Linguagem, situada em Curitiba. Para a entrevistada, a Oficina é um ambiente que a engrandece, pois se sente incentivada, acolhida pelo grupo e consegue expor fatos de sua vida por meio da escrita. Foi sua participação no grupo que, segundo seus próprios relatos, despertou-lhe desejo e coragem para relembrar, reorganizar e traduzir suas histórias em palavras para serem lidas por outros. Pode-se perceber a estreita relação entre o vínculo que a entrevistada estabelece com o grupo e as suas possibilidades de produções escritas. Participar do mesmo vem gerando mudanças e transformações na forma de a entrevistada se relacionar com suas produções escritas que são elaboradas durante a organização de relatos de suas histórias de vida no e para o grupo.The aim of this study was to analyze the role of an elderly group in the development of writing activities directed to one of the participants of this group, which was consolidated after a Language Workshop. This case report was based on an interpretative paradigm, which includes subjectivity, interests, emotions, and personal values. Transcription analyses of the semi-structured interview conducted with a n 85-year-old member of a Language Workshop from Curitiba (PR, Brazil, were performed. To the interviewee, the Workshop is an empowering environment, that makes her feel encouraged and welcome in the group, and that allow her to expose life facts through writing. It was her participation in the

  20. 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

    2017-02-03

    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.

  1. Determinants of life satisfaction among Japanese elderly women attending health care and welfare service facilities.

    Science.gov (United States)

    Onishi, Chiemi; Yuasa, Kyoko; Sei, Masako; Ewis, Ashraf A; Nakano, Takuro; Munakata, Hokuma; Nakahori, Yutaka

    2010-02-01

    Prolonged life expectancy must be recognized as an excellent achievement of modern medicine, but not all the elderly people are satisfied with their lives. Life satisfaction is a multi-dimensional issue that depends on many objective and subjective characteristics. In this study, we aimed at investigating the factors affecting life satisfaction of 314 elderly Japanese women attending in 28 elderly-care and welfare facilities at Tokushima Prefecture, Japan. Our results indicated that elderly subjects with depression tendencies always show significantly lower degrees of life satisfaction than others who are not depressed (pelderly women who shared decision for their living place and whose opinions were considered for daily life decisions reported significantly more life satisfaction levels than others. We conclude that elderly life satisfaction is affected by various determinants however, with different influencing weight. Life satisfaction of elderly people, with or without dementia, is greatly affected by their mood status and share in decision making. Avoiding elderly people depressive mood, sharing them in various daily decisions, considering their opinions, and allowing them to decide their elderly-care facility placement are crucial determinants for their life satisfaction and essential for their coping, adaptation, well-being and successful aging.

  2. 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

  3. 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.

  4. Clock drawing performance in cognitively normal elderly.

    Science.gov (United States)

    Hubbard, Emily J; Santini, Veronica; Blankevoort, Christiaan G; Volkers, Karin M; Barrup, Melissa S; Byerly, Laura; Chaisson, Christine; Jefferson, Angela L; Kaplan, Edith; Green, Robert C; Stern, Robert A

    2008-05-01

    The Clock Drawing Test (CDT) is a common neuropsychological measure sensitive to cognitive changes and functional skills (e.g., driving test performance) among older adults. However, normative data have not been adequately developed. We report the distribution of CDT scores using three common scoring systems [Mendez, M. F., Ala, T., & Underwood, K. L. (1992). Development of scoring criteria for the Clock Drawing Task in Alzheimer's Disease. Journal of the American Geriatrics Society, 40, 1095-1099; Cahn, D. A., Salmon, D. P., Monsch, A. U., Butters, N., Wiederholt, W. C., & Corey-Bloom, J. (1996). Screening for dementia of the Alzheimer type in the community: The utility of the Clock Drawing Test. Archives of Clinical Neuropsychology, 11(6), 529-539], among 207 cognitively normal elderly. The systems were well correlated, took little time to use, and had high inter-rater reliability. We found statistically significant differences in CDT scores based on age and WRAT-3 Reading score, a marker of education quality. We present means, standard deviations, and t- and z-scores based on these subgroups. We found that "normal" CDT performance includes a wider distribution of scores than previously reported. Our results may serve as useful comparisons for clinicians wishing to know whether their patients perform in the general range of cognitively normal elderly.

  5. Protection of vulnerable adults: an interdisciplinary workshop.

    Science.gov (United States)

    Day, Mary Rose; Bantry-White, Eleanor; Glavin, Pauline

    2010-09-01

    This paper reports on the development, delivery, content and student evaluation of a comprehensive elder abuse and self-neglect workshop for public health nursing and social work students.The workshop provided an interdisciplinary shared learning experience for the students to prepare them for their critical role in safeguarding vulnerable adults. The aim of the workshop was to increase knowledge, awareness and understanding of roles and responsibilities and critical practice problems in the prevention and management of elder abuse and self-neglect. The shared learning approach provided clarity on roles and responsibility, valuing and respecting the contribution of each team member. The importance of building communication and trust with team members and clients was seen as critical. Through case studies and group discussion, assessment and practice skills were developed and awareness heightened on the complexity of the critical practice problems and ethical issues.

  6. Falls prevention for the elderly.

    Science.gov (United States)

    Balzer, Katrin; Bremer, Martina; Schramm, Susanne; Lühmann, Dagmar; Raspe, Heiner

    2012-01-01

    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. 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. 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. Out of 12,000 references retrieved by literature searches, 184 meet the inclusion criteria. However, to a variable degree the validity of their

  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. Quality of life in elderly heart failure patients

    Institute of Scientific and Technical Information of China (English)

    Kathleen L. Grady; Kathleen Halvey

    2006-01-01

    Quality of life (QOL), as a relevant area of research in the understanding of heart failure (HF) patient outcomes, has been increasingly studied during the last two decades. The purposes of this review article are to (1) describe QOL in older adults with HF, (2)identify and critique research designed to test interventions to improve QOL, (3) identify gaps in the literature, and (4) provide recommendations for future research. Seventeen studies describing QOL in older adults with HF were identified. Elderly HF patient QOL has been reported to be fair to poor and is worse as compared to a healthy control group. Furthermore, there is some evidence that suggests that QOL is better in older adults than younger adults and worse in women (both older and younger) than in men, although these findings are not consistent across studies. Predictors of QOL and its dimensions in older HF patients included demographic, clinical, and psychosocial variables. Sixteen interventional studies were identified that reported QOL as an outcome in older adults. Findings among randomized clinical trials (RCTs) to improve QOL outcomes in elderly HF patients do not allow strong conclusions about the benefits of the interventions. It must be noted, though, that while not all studies reported improvements in QOL (either significant or as a trend),no studies reported deterioration in QOL with randomization to an intervention versus control. These studies were limited by several methodological issues. While there has been some research of QOL in this elderly cohort, it is paramount that we address methodological issues and thereby improve the scientific rigor of our research, continue to explore QOL in elderly HF patients, and design intervention trials for elders at risk for poor QOL.

  9. Sagittal plane center of mass movement strategy and joint kinetics during sit-to-walk in elderly fallers.

    Science.gov (United States)

    Chen, Tzurei; Chang, Chien-Chi; Chou, Li-Shan

    2013-08-01

    Biomechanical studies have shown that the horizontal center of mass momentum at seat-off during sit-to-walk is reduced among elderly adults. However, the underlying mechanism of this phenomenon is still lacking. The purpose of this study was to examine differences in center of mass movement strategies and lower extremity joint kinetics in the elderly during sit-to-walk. Fifteen healthy young adults, fifteen healthy elderly adults (70 years or older) and fifteen elderly fallers performed Timed Up and Go test. Biomechanical data collected from sit-to-walk phase of Timed Up and Go test were analyzed. Outcome measures included center of mass-ankle inclination angles, hip, knee and ankle joint moments, and ground reaction forces of the stance limb. Results reported here are from 10 participants in each group due to missing force place data. Elderly fallers adopted a movement strategy that included a posterior foot placement at seat-off, a longer duration, and a shorter initial step length. When compared to healthy individuals, elderly fallers demonstrated a greater ankle plantarflexor moment at seat-off. Increased ankle plantarflexor moment in elderly fallers could be a movement strategy to improve stability during sit-to-walk and may be related to the reduced ankle dorsiflexor strength commonly reported in elderly fallers. Results of this study enhance our understanding on the underlying mechanisms of the altered sit-to-walk movement and could aid in developing effective screening and rehabilitation programs to prevent falling in the elderly. © 2013.

  10. Carotid angioplasty and stenting in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Kadkhodayan, Yasha [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Cross, DeWitte T.; Moran, Christopher J. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Derdeyn, Colin P. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurology, St. Louis, MO (United States)

    2007-11-15

    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.)

  11. Sexual Harassment towards Newcomers in Elder Care

    DEFF Research Database (Denmark)

    Krøjer, Jo; Lehn-Christiansen, Sine; Nielsen, Mette Lykke

    2014-01-01

    focusing on the relation between elderly citizens in need of care and their professional caregivers. In this article, we argue that sexual harassment from the elderly toward newcomers in elder care should also be seen as an effect of institutional practices. Based upon a Foucauldian-inspired notion...

  12. Attribution, the Attractiveness Stereotype, and the Elderly.

    Science.gov (United States)

    Johnson, Douglas F.; Pittenger, John B.

    1984-01-01

    Tests the applicability of the physical attractiveness stereotype to perceptions of the elderly. In the first study, college-age and elderly observers rated the attractiveness of faces of elderly people. In the second study, subjects rated faces at three levels of attractiveness on personality, success in life experiences, and occupational…

  13. Attribution, the Attractiveness Stereotype, and the Elderly.

    Science.gov (United States)

    Johnson, Douglas F.; Pittenger, John B.

    1984-01-01

    Tests the applicability of the physical attractiveness stereotype to perceptions of the elderly. In the first study, college-age and elderly observers rated the attractiveness of faces of elderly people. In the second study, subjects rated faces at three levels of attractiveness on personality, success in life experiences, and occupational…

  14. Two Principles of good elderly care

    DEFF Research Database (Denmark)

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

    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...

  15. Belief Discrepancy Reasoning in the Elderly.

    Science.gov (United States)

    Enright, Robert D.; And Others

    1983-01-01

    Examined the development of belief discrepancy reasoning, or how people evaluate disagreeing others, with 44 college and elderly respondents. Results showed the elderly were significantly lower in belief discrepancy reasoning and higher in dogmatism than the college sample. The elderly sample did not evidence intolerance, but rather relativism.…

  16. Influenza vaccination in the elderly.

    Science.gov (United States)

    Smetana, Jan; Chlibek, Roman; Shaw, Jana; Splino, Miroslav; Prymula, Roman

    2017-07-14

    Seasonal influenza is a prevalent and serious annual illness resulting in widespread morbidity and economic disruption throughout the population; the elderly and immunocompromised are particularly vulnerable to serious sequelae and mortality. The changing demographics worldwide to an aging society have important implications for public health policy and pharmaceutical innovations. For instance, primary prevention via immunization is effective in reducing the burden of influenza illness among the elderly. However, the elderly may be insufficiently protected by vaccination due to the immunosenescence which accompanies aging. In addition, vaccine hesitancy among the younger populations increases the likelihood of circulating infectious diseases, and thus concomitant exposure. While it is clear that the development of more immunogenic vaccines is an imperative and worthy endeavor, clinical trials continue to demonstrate that the current influenza vaccine formulation remains highly effective in reducing morbidity and mortality when well matched to circulating strains.

  17. [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.

  18. Psychiatric disorders in the elderly.

    Science.gov (United States)

    Skoog, Ingmar

    2011-07-01

    Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality.

  19. [Stress incontinence in elderly women].

    Science.gov (United States)

    Loertzer, H; Schneider, P

    2013-06-01

    Stress incontinence is one of the major challenges in geriatric medicine. This is becoming more apparent in routine urology practice with the demographic changes in the population. A thorough diagnosis for a correct treatment of stress incontinence is as important in elderly women as it is in younger patients. This includes assessing the risk factors of incontinence and obesity, parturition, pelvic surgery and changes in hormone levels are risk factors usually found in elderly women. These are the main reasons why this patient group is most frequently affected. Treatment options do not differ significantly from these of younger women. Lifestyle modification, weight loss and supervised pelvic floor training are the mainstays of conservative therapy and surgical treatment should only be considered after these options have been exhausted. In these cases minimally invasive surgical techniques offer clear advantages especially for elderly often multimorbid women.

  20. Cancer Surgery in the Elderly

    Science.gov (United States)

    Kowdley, Gopal C.; Merchant, Nishant; Richardson, James P.; Somerville, Justin; Gorospe, Myriam; Cunningham, Steven C.

    2012-01-01

    The proportions both of elderly patients in the world and of elderly patients with cancer are both increasing. In the evaluation of these patients, physiologic age, and not chronologic age, should be carefully considered in the decision-making process prior to both cancer screening and cancer treatment in an effort to avoid ageism. Many tools exist to help the practitioner determine the physiologic age of the patient, which allows for more appropriate and more individualized risk stratification, both in the pre- and postoperative periods as patients are evaluated for surgical treatments and monitored for surgical complications, respectively. During and after operations in the oncogeriatric populations, physiologic changes occuring that accompany aging include impaired stress response, increased senescence, and decreased immunity, all three of which impact the risk/benefit ratio associated with cancer surgery in the elderly. PMID:22272172

  1. Cancer Surgery in the Elderly

    Directory of Open Access Journals (Sweden)

    Gopal C. Kowdley

    2012-01-01

    Full Text Available The proportions both of elderly patients in the world and of elderly patients with cancer are both increasing. In the evaluation of these patients, physiologic age, and not chronologic age, should be carefully considered in the decision-making process prior to both cancer screening and cancer treatment in an effort to avoid ageism. Many tools exist to help the practitioner determine the physiologic age of the patient, which allows for more appropriate and more individualized risk stratification, both in the pre- and postoperative periods as patients are evaluated for surgical treatments and monitored for surgical complications, respectively. During and after operations in the oncogeriatric populations, physiologic changes occuring that accompany aging include impaired stress response, increased senescence, and decreased immunity, all three of which impact the risk/benefit ratio associated with cancer surgery in the elderly.

  2. FACTORS ANALYZE ABOUT WILLINGNESS OF ELDERLY TO STAY IN ELDERLY FOLK HOME

    Directory of Open Access Journals (Sweden)

    I Ketut Sudiana

    2017-07-01

    Full Text Available Introduction : Moving to the new house is not easy for the elderly, especially moving to the elderly folk home. A lot of elderly refuse to stay in the elderly folk home. Some conditions which make the elderly give their willingness to stay in the elderly hostels such as economic status, family condition, and self desire. But that factors are unclear until now. The aim of this study was to analyze factors related to willingness for elderly living in the elderly hostels. Method : Design used in this study was cross sectional. The population were all of the elderly live in elderly folk home Hargo Dedali Surabaya. Samples were taken using purposive sampling and there were 20 respondents. Data were collected using structured questionnaire and then analyzed using Spearman’s rho test and logistic regression test with level of significance α≤ 0.05. Result : Result showed that the dominant factor of willingness of elderly living in the eladerly folk home was self desire with level of significance ρ=0.02, followed by economic status (ρ=0.031 and than family condition (ρ=0.032. Analysis : It can be concluded that self desire was the major factor related to willingness of elderly living in the elderly folk home. Discussion : Further studies should be appraising how far the motivation appear from the elderly until they decided to live in the elderly folk home.

  3. Detecting elder abuse and neglect: assessment and intervention.

    Science.gov (United States)

    Hoover, Robert M; Polson, Michol

    2014-03-15

    Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is expected to increase. Although the U.S. Preventive Services Task Force found insufficient evidence that screening for elder abuse reduces harm, physicians in most states have professional and legal obligations to appropriately diagnose, report, and refer persons who have been abused. Screening or systematic inquiry can detect abuse. A detailed medical evaluation of patients suspected of being abused is necessary because medical and psychiatric conditions can mimic abuse. Signs of abuse may include specific patterns of injury. Interviewing patients and caregivers separately is helpful. Evaluation for possible abuse should include assessment of cognitive function. The Elder Abuse Suspicion Index is validated to screen for abuse in cognitively intact patients. A more detailed two-step process is used to screen patients with cognitive impairment. The National Center on Elder Abuse website provides detailed, state-specific reporting and resource information for family physicians.

  4. APOE genotype influences functional status among elderly without dementia

    Energy Technology Data Exchange (ETDEWEB)

    Albert, S.M.; Jacobs, D.M.; Stern, Y. [Gertrude H. Sergievsky Center, New York, NY (United States)] [and others

    1995-12-18

    The presence of apolipoprotein-{epsilon}4 (APOE-{epsilon}4) significantly increases the risk of Alzheimer`s disease (AD). The association between APOE-{epsilon}4 status and functional abilities was explored further in a multicultural sample of community-dwelling, nondemented elders. The sample was limited to cognitively-intact, community-dwelling elders, who were free of stroke or other neurologic disability. In 218 elders who met research criteria, the presence of APOE-{epsilon}4 was associated with poorer functional status, apart from the effects of neuropsychological performance, gender, age, and education (OR = 2.5, 95% CI: 1.3, 4.9). In 158 subjects without an APOE-{epsilon}4 allele, 50% reported no functional limitation; in the 60 subjects with an {epsilon}4 allele, only 28% reported no functional limitation (P < .01). The relationship was not explained by the distribution of co-morbidities. The association between poorer function and the presence of an APOE-{epsilon}4 allele was evident in each ethnic group. In path analyses, the presence of an APOE-{epsilon}4 allele was associated with decreased functional ability in non-demented elders not simply through an association with poorer cognitive status, but also independently. These results suggest that the APOE-{epsilon}4 genotype is associated with functional deficit in people with normal neuropsychological profiles. 29 refs., 1 fig., 3 tabs.

  5. 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 ...... of the challenges, when dealing with the aged surgical population with emphasis on postoperative cognitive changes....... 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...

  6. 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.

  7. Symptoms of mental impairment among elderly adults and their effects on family caregivers.

    Science.gov (United States)

    Deimling, G T; Bass, D M

    1986-11-01

    Research that has examined the relationship between caregiving stress and elders' symptoms of mental impairment has focused primarily on cognitive incapacity. This research expands the symptoms of mental impairment to include caregivers' reports of problems in elders' social functioning and the presence of disruptive behavior, in addition to the traditional measure of cognitive incapacity. Results from a study of 614 families living with and caring for an impaired elder show cognitive incapacity to have a less important direct effect on caregiving stress than disruptive behavior and impaired social functioning. Cognitive incapacity does have an important indirect effect through its influence on disruptive behavior and social functioning.

  8. Elder mistreatment in U.S. residential care facilities: the scope of the problem.

    Science.gov (United States)

    Phillips, Linda R; Guo, Guifang; Kim, Haesook

    2013-01-01

    Many in the United States believe elder mistreatment in long-term care is serious and widespread, but until recently few studies focused on the problem. This study was designed to describe the scope of mistreatment in assisted living facilities (ALFs) in Arizona during a 3-year period. Findings showed that receiving citations for elder mistreatment was relatively rare. However, analysis of narrative reports from only 7% of facilities showed 598 allegations of mistreatment in complaint investigations, of which 372 (62.2%) were substantiated and given citations for something other than mistreatment. Results show that elder mistreatment in ALFs is seriously underidentified, even by state inspectors.

  9. A poetry program for the very elderly-Narrative perspective on one therapeutic model.

    Science.gov (United States)

    Wexler, Marvin

    2014-03-01

    The focus of this report is a poetry program that the author has been conducting at a nursing home/short-stay rehabilitation facility for the past three and a half years. The program involves reading poetry to groups of very elderly residents who have significant mental and/or physical disabilities. This article includes a description of the program and the author's observations of its beneficial effects. Poetry readings were also given to individual seniors who have significant dementia. The therapeutic value of the program to the elders and to the person reading the poetry to the elders is discussed.

  10. 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

  11. Vertigo in Elderly – Common but Complicated

    Directory of Open Access Journals (Sweden)

    N. S Neki

    2017-01-01

    Full Text Available Dizziness and its subtype vertigo are common complaints occurring in all age groups after teenage but, it become a major health problem in elderly because of the frequency with which it affects the elder population and leads to direct and indirect consequences. Causes of vertigo in the elderly are not totally different from young population but to some extent they are different too. In elderly, the causation of dizziness and vertigo is interplay multiple factors, so its diagnosis and management differs from other age groups. This review is aimed at highlighting the special aspects of dizziness and vertigo in the elderly.

  12. Acid peptic disease in the elderly.

    Science.gov (United States)

    Linder, J D; Wilcox, C M

    2001-06-01

    GERD and peptic ulcer disease are important diseases in the elderly. GERD presents similarly in the elderly and the young, although elderly patients may have less severe symptoms yet more severe mucosal disease and a higher prevalence of BE. Although the prevalence of H. pylori is falling, the elderly remain at risk for peptic ulcer because of the widespread use of NSAIDS. The presentation of peptic ulcer disease in the elderly can be subtle and atypical when compared with younger patients, leading to a delay in diagnosis. Because of comorbidity in the aged, peptic ulcer disease and its complications result in increased morbidity and mortality rates.

  13. Reduced health-related quality of life in elders with frailty: a cross-sectional study of community-dwelling elders in Taiwan.

    Directory of Open Access Journals (Sweden)

    Cheng-Chieh Lin

    Full Text Available PURPOSE: Exploring the domains and degrees of health-related quality of life (HRQOL that are affected by the frailty of elders will help clinicians understand the impact of frailty. This association has not been investigated in community-dwelling elders. Therefore, we examined the domains and degree of HRQOL of elders with frailty in the community in Taiwan. METHODS: A total of 933 subjects aged 65 years and over were recruited in 2009 from a metropolitan city in Taiwan. Using an adoption of the Fried criteria, frailty was defined by five components: shrinking, weakness, poor endurance and energy, slowness, and low physical activity level. HRQOL was assessed by the short form 36 (SF-36. The multiple linear regression model was used to test the independent effects of frailty on HRQOL. RESULTS: After multivariate adjustment, elders without frailty reported significantly better health than did the pre-frail and frail elders on all scales, and the pre-frail elders reported better health than did the frail elders for all scales except the scales of role limitation due to physical and emotional problems and the Mental Component Summary (MCS. The significantly negative differences between frail and robust elders ranged from 3.58 points for the MCS to 22.92 points for the physical functioning scale. The magnitude of the effects of frail components was largest for poor endurance and energy, and next was for slowness. The percentages of the variations of these 10 scales explained by all factors in the models ranged from 11.1% (scale of role limitation due to emotional problems to 49.1% (scale of bodily pain. CONCLUSIONS: Our study demonstrates that the disabilities in physical health inherent in frailty are linked to a reduction in HRQOL. Such an association between clinical measures and a generic measure of the HRQOL may offer clinicians new information to understand frailty and to conceptualize it within the broader context of disability.

  14. Recognition and perception of elder abuse by prehospital and hospital-based care providers.

    Science.gov (United States)

    Rinker, Austin G

    2009-01-01

    The purposes of this study were to evaluate the extent of exposure, knowledge and attitudes of prehospital care providers (PCPs) and hospital care providers (HCPs) to elder abuse and neglect. A 20-question survey was designed to determine the providers' perception, knowledge and ability to identify patients that were potential victims of elder abuse and/or neglect. The surveys were distributed at four Maryland statewide conferences during 2006. A total of 645 surveys were distributed at the start of the individual conferences and 400 completed surveys were returned. Of the respondents, 272 (68.2%) were PCP (emergency medical services=EMSs) and 127 (31.8%) were HCP. During the past 12 months, 51.3% of those surveyed did not have reason to suspect any patients were exposed to abuse or neglect, although 60.5% admitted little or no contact with the elderly. In an attempt to determine respondent's ability to recognize potential abuse and neglect patients, scenario-type questions were used. Respondents believed a decubital ulcer (bedsore) was a positive indicator (83.5%) of abuse/neglect and 92.8% indicated that the elderly could suffer from injuries similar to "shaken-baby syndrome". When questioned about skin bruises as a possible indicator of abuse, only 69.3% of the respondents identified it as a possible sign of abuse. Seventy-one percent of respondents indicated that burns are not common in the elderly and could be another sign of elder abuse. One-in-three providers indicated they would suspect other reasons (dementia, depression, etc.) for the report of a sexual assault in an elderly patient. Eighty-nine percent of providers were aware that healthcare providers in the State of Maryland are required to report suspected elder and vulnerable patient abuse and/or neglect to law enforcement or social services' agencies. When asked to define elder abuse as a medical or social problem, 25.0% of providers stated that it was a social problem. Over 95% of the providers

  15. [Managing infarctions in elderly people].

    Science.gov (United States)

    Luquel, Laurence

    2015-03-01

    Coronary disease is frequent and serious after the age of 80. The management of the elderly person's care depends on whether or not there is associated multiple pathology. After a global geriatric assessment, revascularisation techniques can also be used in this context. Caution must however be taken when introducing a pharmacological treatment.

  16. Opioid use in the elderly.

    NARCIS (Netherlands)

    Wilder-Smith, O.H.G.

    2005-01-01

    Pain treatment in the elderly is an important challenge to Western societies due to increasing numbers of old persons, their higher incidence of pain, and their greater susceptibility to adverse effects of pain medication. We provide an overview of the factors liable to influence opioid action in

  17. 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...

  18. Studying Emotions in the Elderly

    NARCIS (Netherlands)

    Kremer, Stefanie; Uijl, den Louise

    2016-01-01

    This chapter provides an overview of our current understanding of emotions and their measurement in older people. The first part briefly reviews our current understanding of both "the elderly" in general and various facets of emotional aging, such as emotional experiences, emotion regulation, emo

  19. Opioid use in the elderly.

    NARCIS (Netherlands)

    Wilder-Smith, O.H.G.

    2005-01-01

    Pain treatment in the elderly is an important challenge to Western societies due to increasing numbers of old persons, their higher incidence of pain, and their greater susceptibility to adverse effects of pain medication. We provide an overview of the factors liable to influence opioid action in th

  20. Increased Challenge with the Elderly.

    Science.gov (United States)

    Wilson, Helen

    Research has shown that too little stress or stimulation can increase health risks. To determine the effectiveness of mild stimulation on the depression levels and feelings of self-worth of the elderly, 24 withdrawn nursing home residents participated in a non-judgemental 6-month art expression group. Half the group were assigned to a control…

  1. Gerodontology - Orodental care for elderly

    Directory of Open Access Journals (Sweden)

    Vinay Kumar Bhardwaj

    2012-01-01

    Full Text Available Changing demographics, including an increase in life expectancy and the growing numbers of elderly, has recently focused attention on the need for geriatric dental care. Ageing affects oral tissues in addition to other parts of the human body, and oral health (including oral mucosa, lips, teeth and associated structures, and their functional activity is an integral component of general health. Oral disease can cause pain, difficulty in speaking, mastication, swallowing, maintaining a balanced diet, not to mention aesthetical considerations and facial alterations leading to anxiety and depression. Certain strategies should be adopted for improving oral health of the elderly, including the management and maintenance of oral conditions, which are necessary for re-establishing effective masticatory function. Oral health is often neglected in the elderly and oral diseases associated with aging are complex, adversely affecting the quality of life. Although majority of oral health problems are not usually associated with mortality, nearly more than half of the deaths due to oral cancer occur at an age of 65 years plus. This review of geriatric dentistry, which is dedicated to geriatric physicians, geriatric dentist and specialists in oral medicine, emphasizes on age-related oral changes in elderly patients and efforts to summarize the effects of aging in hard and soft oral tissues.

  2. Male Osteoporosis in the Elderly

    OpenAIRE

    Patrizia D’Amelio; Giovanni Carlo Isaia

    2015-01-01

    Osteoporosis is now recognized as an important public health problem in elderly men as fragility fractures are complicated by increased morbidity, mortality, and social costs. This review comprises an overview of recent findings in pathophysiology, diagnosis, and treatment of male osteoporosis, with particular regard to the old population.

  3. Recurrent Urosepsis and Cardiogenic Shock in an Elderly Patient with Pheochromocytoma

    OpenAIRE

    Joan Joo-Ching Khoo; Vanessa Shu-Chuan Au; Richard Yuan-Tud Chen

    2011-01-01

    Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrate...

  4. Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

    OpenAIRE

    2013-01-01

    Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in ...

  5. [association Between Insomnia Symptoms, Daytime Napping, And Falls In Community-dwelling Elderly].

    OpenAIRE

    Pereira,Alexandre Alves; Ceolim, Maria Filomena; Neri,Anita Liberalesso

    2015-01-01

    This study focused on associations between insomnia symptoms, daytime napping, and falls in community-dwelling elderly, using a population-based cross-sectional design and probability sample with 689 community-dwelling elders. The protocol consisted of self-reported and physical performance variables. The study used univariate and multivariate logistic regression analysis with statistical significance set at p < 0.05. Prevalence rates for insomnia symptoms and daytime napping were 49.9% (n = ...

  6. 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

  7. Health care practice patterns for balance disorders in the elderly.

    Science.gov (United States)

    Roberts, Daniel S; Lin, Harrison W; Bhattacharyya, Neil

    2013-10-01

    Characterize health care practice patterns for balance disorders in the elderly. Cross-sectional analysis of national health care survey. Balance disorder cases in patients aged ≥65 years were extracted from the 2008 National Health Interview Survey. Records were analyzed for health professionals seen, diagnostic testing ordered, diagnoses given, and treatments offered. Relationships between diagnostic success, imaging studies, and specialty providers seen were compared. Among 7.02 ± 0.22 million elderly persons reporting a balance problem, 50.0% (3.44 ± 0.16 million) saw a health professional, and 35.8% saw ≥3 providers; 59.6% of elderly patients reported a diagnosed cause for the balance problem. The most common causes were medication side effects (11.3%), inner ear infection (11.0%), heart disease (8.6%), and loose ear crystals (7.9%). Imaging studies had been obtained in 56.7% (2.00 ± 0.11 million cases). Among 24.3% of patients receiving some form of treatment, 61.7% had been taking prescription medication, most commonly diuretic agents (36.5%), anxiolytic agents (25.1%), and meclizine (21.4%). Seeing an otolaryngologist or neurologist was associated with a higher but similar rate of diagnostic imaging studies (70.1%, P = .029 and 78.5%, P balance disorder (61.5% with imaging vs. 56.9% without, P = .265). Despite a high prevalence of balance problems in the elderly, a significant proportion do not come to a clear diagnosis. There is a noteworthy rate of prescription medication utilization in this population. Given an increasingly aging population, attention needs to be given to balance problems in the elderly to optimize diagnosis and health care utilization. 2b. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  8. 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

  9. [Dignified social support for elderly institutionalised adults in Medellín, 2008].

    Science.gov (United States)

    Cardona-Arango, Doris; Estrada-Restrepo, Alejandro; Chavarriaga-Maya, Lina M; Segura-Cardona, Angela M; Ordoñez-Molina, Jaime; Osorio-Gómez, Jorge J

    2010-06-01

    Analysing the social support provided for elderly institutionalised adults being cared for in Elderly Welfare Centres (Centros de Bienestar del Anciano de Medellín) in Medellin during 2008. This was a cross-sectional descriptive study (primary information source) which addressed some characteristics related to the social support being received by 273 elderly people institutionalised in 37 social welfare centres. Univariate and bivariate analysis was applied to the data. The institutionalised people were mostly single or widowed women aged between 65 and 84 who had received primary and secondary education; most were affiliated to the contributory health regimen. Loneliness, health problems and family decision were the main causes for them having become institutionalised. They were visited by their children and other relatives and such support was rated as being satisfactory; however, more than half of them had feelings of loneliness and one sixth claimed to be humiliated and insulted by their loved ones. It should be noted that a few of them reported being mistreated by their caregivers. Institutionalised elderly adults performed recreational activities, were satisfied with the support received from friends, with cohabitation and the pertinent institution. Social support networks were strong within the institution (i.e. Elderly Welfare Centres); the elderly seemed to receive greater abuse from family members and cohabitants than institutional caregivers. Loneliness generally leads elderly adults to become institutionalised; however, once having entered an institution (being partly motivated by little family contact and average satisfaction with friends and the institution itself) their neglect and social vulnerability becomes evident.

  10. Quality of life evaluation of frail elderly in Campinas, São Paulo

    Directory of Open Access Journals (Sweden)

    Flávia Regina de Andrade Varela

    2015-10-01

    Full Text Available Summary Objective: describe the quality of life of frail elderly assisted by the Centro de Referência à Saúde do Idoso (CRI, Campinas, São Paulo, Brazil. Methods: the convenience sample included 122 frail elderly being treated from January 2010 to July 2011, out of a total of 668 frail elderly who were referred to the CRI after application of the brief evaluation form of the elderly, recommended by Ministry of Health, which identifies the elderly with some degree of frailty. Descriptive observational study collected data through sociodemographic questionnaire and quality of life questionnaires: WHOQOL-BREF, WHOQOLOLD and SF-36. Results: the study included 122 frail elderly. Of these, 74.6% (91 were female, mean age 73 years, 46.7% (57 were married, 51.6% (63 had less than 3 years of schooling and 87.7% (107 reported income of one to four minimum wages. The mean total score of the WHOQOL-BREF was 56.6, the WHOQOL-OLD 57.6 and SF-36 Physical Component Summary 34.5 and Mental Component Summary 43.6. Conclusion: knowledge of the impairment profile of quality of life among frail elderly is, therefore, essential for planning health care to this population.

  11. 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.

  12. 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.

  13. Clinical features, comorbidity, and cognitive impairment in elderly bipolar patients

    Science.gov (United States)

    Rise, Ida Vikan; Haro, Josep Maria; Gjervan, Bjørn

    2016-01-01

    Introduction Data specific to late-life bipolar disorder (BD) are limited. Current research is sparse and present guidelines are not adapted to this group of patients. Objectives We present a literature review on clinical characteristics, comorbidities, and cognitive impairment in patients with late-life BD. This review discusses common comorbidities that affect BD elders and how aging might affect cognition and treatment. Methods Eligible studies were identified in MedLine by the Medical Subject Headings terms “bipolar disorder” and “aged”. We only included original research reports published in English between 2012 and 2015. Results From 414 articles extracted, 16 studies were included in the review. Cardiovascular and respiratory conditions, type II diabetes, and endocrinological abnormalities were observed as highly prevalent. BD is associated with a high suicide risk. Bipolar elderly had an increased risk of dementia and performed worse on cognitive screening tests compared to age-matched controls across different levels of cognition. Despite high rates of medical comorbidity among bipolar elderly, a systematic under-recognition and undertreatment of cardiovascular disease have been suggested. Conclusion There was a high burden of physical comorbidities and cognitive impairment in late-life BD. Bipolar elderly might be under-recorded and undertreated in primary medical care, indicating that this group needs an adapted clinical assessment and specific clinical guidelines need to be established. PMID:27274256

  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. Normal spirometry values in healthy elderly: the Rotterdam Study.

    Science.gov (United States)

    Loth, Daan Willem; Ittermann, Till; Lahousse, Lies; Hofman, Albert; Leufkens, Hubert Gerardus Maria; Brusselle, Guy Gaston; Stricker, Bruno Hugo

    2013-04-01

    Although many different reference values for spirometry are available from various studies, the elderly are usually underrepresented. Therefore, our objective was to assess reference values in a sample of healthy participants from a prospective population-based cohort study, including a large proportion of elderly. We included spirometry measurements of healthy, never smokers, from the Rotterdam Study and excluded participants with respiratory symptoms or prescriptions for respiratory medication. Age- and height-specific curves for the 5th (lower limit of normal) and the 50th (median) percentile of Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), and the ratio (FEV1/FVC) were calculated by quantile regression models. The group of healthy elderly study subjects consisted of 1,125 individuals, with a mean age of 68 years, ranging from 47 to 96 years of age. Sex stratified equations for the median and the lower limit of normal were calculated adjusted for age and height. In this study, we report age- and height-dependent reference limits for FEV1, FVC, and FEV1/FVC in a large population, and prediction equations for the lower limit of normal and median values for a sample containing a large proportion of healthy elderly.

  16. 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

  17. Pharmacological Effects of Antihypertensive Drugs in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Alsu I. Abdrahmanova

    2016-11-01

    Full Text Available Introduction. The incidence of arterial hypertension (AH increases. Only 23% of Russian patients monitor their blood pressure. This affects the incidence of complications, the quality and duration of life. The largest number of deaths related to the irrational pharmacotherapy of hypertension occurs in the older age group. Methods. We have carried out a review of publications in scientific and medical literature, the analysis of the current state of views on the incidence, pathogenesis, and peculiarities of the treatment of hypertension in elderly patients. Results. An isolated systolic arterial hypertension (ISAH, typical of the elderly people, is associated with a reduction in the elasticity of the arterial walls. The reaction of the elderly to the medicines is largely determined by the severity of age-related changes. We have considered four factors influencing the effect of drugs such as absorption, distribution, metabolism and excretion of drugs. Discussion. Treatment in elderly patients is aimed at reducing the symptoms and compensating the disturbed functions. It is necessary to be able to detect that symptoms in the structure that affect quality of life and require therapeutic intervention. Physiological aging processes lead to changes in the pharmacokinetics and pharmacodynamics of drugs. The therapeutic effect is affected by changes in absorption, distribution volume, metabolism and excretion of drugs. In this connection there is an increased amount of drug in the bloodstream. Final Report. Knowing the geriatric aspects of cardiology is an important element of knowledge of a modern doctor.

  18. 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.

  19. Perception of elderly men about health and primary health care

    Directory of Open Access Journals (Sweden)

    Camila Polisello

    2014-09-01

    Full Text Available Objective: to understand the perceptions of elderly men about the following themes: “Health”, “Family Health Unit” and “Groups of Health Approaches”. Methods: exploratory and descriptive survey with a qualitative approach, using a convenience sample. Participants were selected from a list of elderly men who used the health unit. A semi-structured interview was designed for data collection. The data were analyzed based on a thematic analysis orientation. Results: eleven men were interviewed. They showed a wide conception of health, considering biopsychosocial factors in their descriptions, as well as a good relationship with the Family Health Unit, where they go for medical appointments and to join health prevention and promotion groups. The participants reported that they did not undergo as many preventive activities as women. They evaluated Groups of Health Approaches as beneficial, with positive implications for health and for life. However some participants have group models from other contexts, especially from the work setting, which do not match the models recommended for Groups of Health Approaches. Conclusion: as the participants are elderly and have more available time and a greater relationship with the unit, they are able to engage in more activities of promotion and prevention at the Family Health Unit. This study also showed that the health unit and the groups act as protective factors for this population; elderly men favor receiving care and engaging in social relations. However, factors associated with gender still hinder a better health care for men.

  20. 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.

  1. [Immune system and rheumatic diseases in the elderly].

    Science.gov (United States)

    Schirmer, Michael

    2016-06-01

    Impairments of the immune system play an important role in all immun-mediated rheumatic diseases. Recently, the following news were reported: · Early aging of the immune system with thymus insufficiency has now been reported for both patients with rheumatoid arthritis and axial spondyloarthritis, without prethymic lack of progenitors at least in rheumatoid arthritis.. · For giant cell arteritis, the most frequent vasculitis in the elderly, an increased expression of IL-17A in temporal artery biopsies coincides with good prognosis and reponse to glucocorticoids.. · Concerning immunosenescence in systemic lupus erythematosus, BAFF appears to have an important role for relapses after B-cell depletion.. For the future it can be anticipated that the use of unified classification criteria for rheumatic diseases (as with the new 2012 EULAR / ACR classification criteria for polymyalgia rheumatica) will ensure better comparability of immunological studies also in the elderly.

  2. Balance control in elderly people with osteoporosis.

    Science.gov (United States)

    Hsu, Wei-Li; Chen, Chao-Yin; Tsauo, Jau-Yih; Yang, Rong-Sen

    2014-06-01

    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. Copyright © 2014. Published by Elsevier B.V.

  3. 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.

  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. Comparing Levels of Depression in Healthy Active and Inactive Elders versus Those with Knee Osteoarthritis Disease

    Directory of Open Access Journals (Sweden)

    Amir Shams

    2016-04-01

    Full Text Available Knee osteoarthritis can have negative effects on the physical and mental conditions, social and family relations, general health and positive feelings of elders. For example, severe limitation of motion and increased depression, which are results of this disease, can have negative impacts on elders. The purpose of this study was to compare the levels of depression in healthy active and inactive elders versus those with knee osteoarthritis disease. Two hundred and twenty (220 elders with knee osteoarthritis disease (110 active and 110 inactive patients and 220 healthy elders (110 active and 110 inactive were voluntarily selected, and they filled the questionnaire about elders’ personal characteristics, physical activity and depression levels. Four groups had differences with respect to education, age and gender. The results of chi-square test revealed that women with knee osteoarthritis disease had increased levels of depression compared to men with the same condition (p<0.05. Older patients had increased levels of depression and educated elders reported lower levels of depression. The results of the one way analysis of variance (ANOVA revealed that there exist a significant difference in depression scores of healthy active and healthy inactive elders and those with knee osteoarthritis disease. The results of Tukey’s test revealed that healthy active elder had lower depression scores compared to inactive elders with knee osteoarthritis disease. Carrying out exercises and physical activities can help improve the health state of patients with knee osteoarthritis problem and can also improve the elders’ mental condition and thus decrease their pain and depression.

  6. 老年患者腹腔镜手术后谵妄23例临床分析%Clinical analysis of postoperative delirium in elderly patients undergoing laparoscopic surgery: a report of 23 cases

    Institute of Scientific and Technical Information of China (English)

    潘孟; 赫军; 陆世锋; 左江伟; 李敏朋; 廖轲; 许斌; 范芳; 俞渊

    2013-01-01

    目的:探讨老年患者腹腔镜手术后发生谵妄的原因、处理及预防措施.方法:回顾分析2008年1月至2012年12月腹腔镜手术后出现谵妄症状的23例老年患者的临床资料.结果:23例患者中,19例症状较轻,经吸氧,使用氟哌啶醇、氟哌利多、奥氮平、氯丙嗪等药物对症治疗后24 h内好转;4例症状较重,予以改善脑循环及补充营养等支持疗法,并辅以心理治疗,1周内症状消失.无一例死亡.结论:老年患者行腹腔镜手术后发生的急性谵妄早期发现、诊断并治疗,对其术后早日康复具有重要意义.%Objective:To study the reason,treatment and prevention methods of postoperative delirium in elderly patients undergoing laparoscopic surgery.Methods:A retrospective analysis was made on clinical data of 23 elderly patients who suffered from postoperative delirium after laparoscopic surgery from Jan.2008 to Dec.2012.Results:Nineteen patients who had mild symptoms of postoperative delirium recovered in 24 h after oxygen inhalation and medical treatment,such as haloperidol,olanzapine,droperidol and chlorpromazine,and were discharged smoothly.4 patients with severe symptoms underwent supportive therapy (improving the cerebral circulation,nutritional supplement and so on) associated with psychotherapy,their symptoms disappeared in one week.No death occurred.Conclusions:Early detection,diagnosis and treatment has an important significance in speedy recovery of acute delirium in elderly patients after laparoscopic surgery.

  7. Abusir: from Pliny the Elder to Google Maps

    CERN Document Server

    Sparavigna, Amelia Carolina

    2011-01-01

    Abusir, the House of Osiris, is the name given to an Egyptian necropolis of the Old Kingdom period. This site is a part of a huge area, from Giza to Dahshur, rich of archaeological remains and covered by many pyramids. The paper is reporting concisely some archaeological studies on Abusir. We start from the description given by Pliny the Elder and end proposing the use of Google Maps.

  8. Measuring elderly dysphagic patients' performance in eating--a review

    DEFF Research Database (Denmark)

    Hansen, Tina; Kjaersgaard, Annette; Faber, Jens

    2011-01-01

    Purpose. This review aims to identify psychometrically robust assessment tools suitable for measuring elderly dysphagic patients' performance in eating for use in clinical practice and research. Method. Electronic databases, related citations and references were searched to identify assessment...... criteria concerning the study design, the statistics used for the psychometric evaluation and the reported values. Results. Eight of fourteen identified assessment tools met the inclusion criteria. Three assessment tools were specific to dementia, two were specific to stroke and three targeted a range...

  9. Home accidents amongst elderly people: A locality study in Scotland

    OpenAIRE

    Gilhooly, M; Banks, P.; Barrett, W.; Wales, A.; Caldwell, S.; Macdonald, C.(Department of Physics and Astronomy, University of Sheffield, Sheffield, United Kingdom); Dunleavy, K

    2007-01-01

    Aim The aim of this locality study was to collect information on reported and unreported accidents amongst elderly people living in one locality in Scotland. Method Postal Survey- A postal questionnaire was sent to 3,757 men and women aged 65+ years living in one locality. The questionnaire asked respondents to indicate how many accidents they had experienced in the past twelve months, plus to indicate type and location. Information was gathered on living arrangements, ethnicity,...

  10. Basal cell carcinomas in elderly patients treated by cryotherapy.

    Science.gov (United States)

    Chiriac, Anca; Mihaila, Doina; Foia, Liliana; Solovan, Caius

    2013-01-01

    Basal cell carcinoma is a malignant skin tumor with high incidence in our country, especially in rural areas, on sun-exposed skin (particularly on the face) in elderly patients. We present three cases of basal cell carcinoma with good results with cryotherapy. This report aims to outline and to prove that in some difficult situations, a simple, inexpensive, easy-to-perform procedure with no contraindications and with minimal side effects (erythema, mild pain) can be applied and resolve such cases.

  11. Multimicronutrient supplementation and asymptomatic urinary tract infections in the elderly

    Directory of Open Access Journals (Sweden)

    Paul Boekitwetan

    2016-02-01

    Full Text Available As human life expectancy continues to increase, developing countries are reporting higher percentages of elderly in their respective populations. The defense mechanisms of the elderly are reduced due to several factors, such as increased susceptibility to infection, specifically urinary tract infection (UTI. A randomised, placebo-controlled, double-blind trial was conducted to assess whether multimicronutrient supplementation is effective in reducing UTIs in older people in the community. A total of 261 elderly who lived in Mampang Prapatan district, South Jakarta, were randomised to daily multimicronutrient supplementation or control groups. The primary outcomes were the incidence of asymptomatic UTI, the organisms responsible for UTIs and the results of sensitivity tests on UTI microorganisms. UTI was defined as culture-positive urine yielding a single species of organisms in numbers greater than 104 cfu/mL urine specimen. At base-line 19.5% of the elderly had UTI, namely 23.7% patients in the MMN group and 16.7% in the control group, but the difference was not statistically significant (p=0.158. Escherichia coli was the most common microorganism, isolated in 20.7% of the MMN group and 17.5% of the control group. After six months of supplementation, UTI in the MMN group decreased by 40.6% compared with only 14.4% in the control group. The numbers of E. coli also declined by 64.3% in the MMN group compared to 37.8% in the control group. This study has confirmed the beneficial effect of multimicronutrient supplementation on UTI in the elderly.

  12. Restless Legs Syndrome in a Nigerian Elderly Population.

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    Fawale, Michael B; Ismail, Ishaq Alani; Mustapha, Adekunle F; Komolafe, Morenikeji A; Adedeji, Tewogbade A

    2016-07-15

    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. 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. 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. 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. © 2016 American Academy of Sleep Medicine.

  13. Nutritional status and functional capacity of hospitalized elderly

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    Leandro-Merhi Vânia A

    2009-11-01

    Full Text Available Abstract Background The nutritional status of the aging individual results from a complex interaction between personal and environmental factors. A disease influences and is influenced by the nutritional status and the functional capacity of the individual. We asses the relationship between nutritional status and indicators of functional capacity among recently hospitalized elderly in a general hospital. Methods A cross-sectional study was done with 240 elderly (women, n = 127 and men, n = 113 hospitalized in a hospital that provides care for the public and private healthcare systems. The nutritional status was classified by the MNA (Mini Nutritional Assessment into: malnourished, risk of malnutrition and without malnutrition (adequate. The functional autonomy indicators were obtained by the self-reported Instrumental Activity of Daily Living (IADL and Activity of Daily Living (ADL questionnaire. The chi-square test was used to compare the proportions and the level of significance was 5%. Results Among the assessed elderly, 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. All the IADL and ADL variables assessed were significantly more deteriorated among the malnourished individuals. Among the ADL variables, eating partial (42.9% or complete (12.9% dependence was found in more than half of the malnourished elderly, in 13.4% of those at risk of malnutrition and in 2.5% of those without malnutrition. Conclusion There is an interrelationship between the nutritional status of the elderly and reduced functional capacity.

  14. Geriatric assessment in elderly patients with prostate cancer.

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    Terret, Catherine; Albrand, Gilles; Droz, Jean Pierre

    2004-03-01

    As a result of demographic evolution, oncologists will treat more and more elderly patients with prostate cancer. Aging is frequently associated with the coexistence of several medical complications that can increase the complexity of cancer treatment decision-making. Unfortunately, clinical oncologists need to be more familiar with the multidimensional assessment of elderly patients. To acquire this skill, we implemented a multidimensional geriatric assessment program at our cancer center. This instrument prospectively assessed 60 elderly patients with prostate cancer. Herein, we describe geriatric aspects detected in our patient sample and report treatment options proposed to elderly patients with prostate cancer at different disease stages. The minimal comprehensive geriatric assessment (mini-CGA) procedure revealed that 66% of our patient population was dependent in one or more of the Katz Activities of Daily Living and 87% were dependent in 1 or more of the Lawton Instrumental Activities of Daily Living; all patients had significant comorbidity according to the Cumulative Illness Rating Scale-Geriatrics, 75% having at least one severe comorbidity. We identified 19 cases of drug interaction. We also observed that half of these patients had a risk of falling and some physical disability; 45% had cognitive disorders requiring more investigation; one third had depressive symptoms. Finally, 65% of the patients were either malnourished or at risk of malnutrition. Many of these problems were unknown before the mini-CGA processing and may interfere with cancer and cancer treatment. Thus, the correct management of elderly patients with cancer requires comprehensive geriatric assessment as well as relevant disease staging at diagnosis. This approach will help us to propose the most appropriate treatment with the main aim of preserving quality of life.

  15. Gender differences, polypharmacy, and potential pharmacological interactions in the elderly

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    Carina Duarte Venturini

    2011-01-01

    Full Text Available OBJECTIVE: This study aims to analyze pharmacological interactions among drugs taken by elderly patients and their age and gender differences in a population from Porto Alegre, Brazil. METHODS: We retrospectively analyzed the database provided by the Institute of Geriatric and Gerontology, Porto Alegre, Brazil. The database was composed of 438 elderly and includes information about the patients' disease, therapy regimens, utilized drugs. All drugs reported by the elderly patients were classified using the Anatomical Therapeutic and Chemical Classification System. The drug-drug interactions and their severity were assessed using the Micromedex® Healthcare Series. RESULTS: Of the 438 elderly patients in the data base, 376 (85.8% used pharmacotherapy, 274 were female, and 90.4% of females used drugs. The average number of drugs used by each individual younger than 80 years was 3.2±2.6. Women younger than 80 years old used more drugs than men in the same age group whereas men older than 80 years increased their use of drugs in relation to other age groups. Therefore, 32.6% of men and 49.2% of women described at least one interaction, and 8.1% of men and 10.6% of women described four or more potential drug-drug interactions. Two-thirds of drug-drug interactions were moderate in both genders, and most of them involved angiotensin-converting enzyme inhibitor, non-steroidal anti-inflammatory, loop and thiazide diuretics, and β-blockers. CONCLUSION: Elderly patients should be closely monitored, based on drug class, gender, age group and nutritional status.

  16. OT Clicking - digital and social inclusion of the elderly

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    Kátia Vanessa Pinto de Meneses

    2017-06-01

    Full Text Available Introduction: The implementation of strategies of digital inclusion and physical, cognitive and social activities has a positive effect on the preservation of the physical and cognitive abilities and quality of life of the elderly. Objective: To report the experience of establishing and developing a university extension project called “OT Clicking”, describing its characteristics, goals, and academic and community contributions. Method: The “OT Clicking” project was created in 2011 to promote social and digital inclusion of the elderly by means of computer workshops, cognitive stimulation workshops, hands-on activities, and socialization activities. The activities were developed in a long-term care facility. The elderly were evaluated every six months. Workshops and assessments were performed by students of the occupational therapy course at the University of Brasilia under the guidance of teachers of the physiotherapy and occupational therapy departments. Results: Two hundred and fifty four senior citizens actively attended 11 computer workshops, eight cognitive stimulation workshops, five hands-on activities, and two socialization activities. Teachers, fellow students, and volunteers participated, enabling the development of a research project and conference presentations. The project’s attendance and production suggest that the activities serve the interests of the elderly, bring new perspectives of social participation, and open a field for practice and research. Conclusion: “OT Clicking” is a viable example of extension project which includes teachers, students and the community, configuring a space for learning, socialization, and social and digital inclusion of the elderly, allowing connection between university teaching, research and extension.

  17. Anthropometric measures and nutritional status in a healthy elderly population

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    Duque-López María

    2007-01-01

    Full Text Available Abstract Background Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people. Methods The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI, body circumference (arm, waist, hip and calf, waist to hip ratio (WHR, elbow amplitude and knee-heel length. Results Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p Conclusion Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.

  18. Exercise efficiency is reduced by mitochondrial uncoupling in the elderly.

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    Conley, Kevin E; Jubrias, Sharon A; Cress, M Elaine; Esselman, Peter

    2013-03-01

    A reduction in exercise efficiency accompanies ageing in humans. Here we evaluated the impact of changes in the contractile-coupling and mitochondrial-coupling efficiencies on the reduction in exercise efficiency in the elderly. Nine adult (mean, 38.8 years old) and 40 elderly subjects (mean, 68.8 years old) performed a cycle ergometer test to measure O2 uptake and leg power output up to the aerobic limit ( ). Reduced leg power output per unit O2 uptake was reflected in a drop in delta efficiency (εD) from 0.27 ± 0.01 (mean ± SEM) in adults to 0.22 ± 0.01 in the elderly group. Similar declines with age were apparent for both the leg power output at and the ATP generation capacity (ATPmax) determined in vivo using (31)P magnetic resonance spectroscopy. These similar declines resulted in unchanged contractile-coupling efficiency values (εC) in the adult (0.50 ± 0.05) versus the elderly group (0.58 ± 0.04) and agreed with independent measures of muscle contractile-coupling efficiency in human quadriceps (0.5). The mitochondrial-coupling efficiency calculated from the ratio of delta to contractile-coupling efficiencies in the adults (εD/εC = 0.58 ± 0.08) corresponded to values for well-coupled mitochondria (0.6); however, εD/εC was significantly lower in the elderly subjects (0.44 ± 0.03). Conversion of ATPmax per mitochondrial volume (ATPmax/Vv[mt,f]) reported in these groups into thermodynamic units confirmed this drop in mitochondrial-coupling efficiency from 0.57 ± 0.08 in adults to 0.41 ± 0.03 in elderly subjects. Thus, two independent methods revealed that reduced mitochondrial-coupling efficiency was a key part of the drop in exercise efficiency in these elderly subjects and may be an important part of the loss of exercise performance with age.

  19. Toxic epidermal necrolysis (TEN) in elderly patients.

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    Honari, S; Gibran, N S; Heimbach, D M; Gibbons, J; Pharmd; Cain, V; Engrav, L H

    2001-01-01

    Toxic epidermal necrolysis (TEN) is a severe exfoliative disease of the skin and mucous membranes that results in high mortality. As the elderly population increases, the number of elderly patients with TEN can also be expected to increase. Elderly patients with comparably sized burn wounds usually have a poor prognosis. Our purpose was to determine whether elderly TEN patients exhibit similarly high mortality. A retrospective review was conducted of 52 patients treated for TEN from October 1991 through September 1998. Eleven patients were older than 65 years. All patients were treated according to our TEN protocol. Eight of 11 patients recovered, and 3 died. The mean total body surface area (TBSA) involvement for the patients who recovered was 24%, compared with 66% for the nonsurvivors. The survival rate for elderly patients (73%) compares well with that for those younger than 65 years (89%). Therefore, we propose that we should be aggressive in treating elderly patients with TEN.

  20. Elderly people's interaction with advanced technology.

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    Blažun, Helena; Vošner, Janez; Kokol, Peter; Saranto, Kaija; Rissanen, Sari

    2014-01-01

    Aging of population is an inevitable process by which the number of elderly people is increasing. Rapid development of information and communication technology (ICT) is changing basic needs of elderly people; therefore society should ensure opportunities for elderly to learn and use ICT in a way to manage their daily life activities and in this way enable them participation in the information and knowledge society. The purpose of the study was to find out whether elderly are acquainted with the advanced technology and to what extent they use it or they desire to use it. Within the single point study we interviewed 100 randomly selected elderly people from different geographical regions in Slovenia. Results showed the differences in the use of advanced technology by Slovenian regions; therefore in the future activities should be focused on organizing promotional and demonstrational activities including ICT courses to increase elderly's motivation for ICT interaction.