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"Frail elderly"

M Iki, Y Fujita, J Tamaki, K Kouda, A Yura, Y Sato, J S Moon, A Harano, K Hazaki, E Kajita, M Hamada, K Arai, K Tomioka, N Okamoto, N Kurumatani
: Frail elderly individuals have elevated risks of both fracture and mortality. We found that incident fractures were associated with an increased risk of death even after adjusting for pre-fracture frailty status as represented by physical performance tests and laboratory tests for common geriatric diseases in community-dwelling elderly Japanese men. INTRODUCTION: While fractures reportedly increase the risk of mortality, frailty may complicate this association, generating a false-positive result...
October 18, 2016: Osteoporosis International
Alan J Wein
No abstract text is available yet for this article.
November 2016: Journal of Urology
Olivier Bruyère, Etienne Cavalier, Fanny Buckinx, Jean-Yves Reginster
PURPOSE OF REVIEW: This article reviews recently published evidence regarding the role of vitamin D in the physiopathology of physical frailty in elderly populations and its role in the management of this geriatric condition. RECENT FINDINGS: Some recent studies have found a low level of 25-hydroxyvitamin D, considered the best marker of vitamin D status, in frail individuals. All prospective studies consistently report that low vitamin D status is associated with an increased risk of becoming frail...
October 1, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Anne Same, Elinda Ai Lim Lee, Beverley McNamara, Lorna Rosenwax
Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening (n = 38) and post-gardening service delivery interviews (n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health...
November 2016: Home Health Care Management & Practice
Jennifer G Naples, Mary P Kotlarczyk, Subashan Perera, Susan L Greenspan, Joseph T Hanlon
OBJECTIVE: To determine the risk of recurrent falls associated with antidepressants other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) among frail older women. METHODS: This is a secondary analysis of the Zoledronic acid in frail Elders to STrengthen bone, or ZEST, trial data treated as a longitudinal cohort in 181 frail, osteoporotic women aged ≥65 years in long-term care. The primary exposure was individual non-TCA/non-SSRI antidepressants (i...
August 17, 2016: American Journal of Geriatric Psychiatry
T J E M Bakker
There is much negative publicity about the health care for the frail elderly especially in nursing homes. However, in scientific research programs the results are also quite disappointing. We see a low percentage (< 50 %) of treatment fidelity in the intervention programs at stake. Research on the education content with respect to the frail elderly showed that this is very poor for every profession. From the perspective of formal education the professionals who provide treatment and care the frail elderly are relatively unqualified and incompetent...
October 14, 2016: Tijdschrift Voor Gerontologie en Geriatrie
Tammy Vu Bach, Jonathan Pan, Anne Kirstein, Cindy Joanne Grief, Daphna Grossman
Palliative care clinicians are increasingly involved in the care of elderly patients suffering from chronic malignant and nonmalignant illnesses, of which neuropathic pain is a prevalent problem. As a person becomes more frail, pain medications such as opioid analgesics and adjuvant pain medications can result in unwanted effects such as sedation, confusion, and increased risk of falls. Treating pain in patients with advanced dementia or neurodegenerative diseases that can affect swallowing is particularly challenging because most adjuvant pain medications used to ameliorate neuropathic pain must be taken orally...
October 11, 2016: Journal of Palliative Medicine
Irene Torres-Sánchez, Marie Carmen Valenza, Irene Cabrera-Martos, Isabel López-Torres, Ángela Benítez-Feliponi, Alicia Conde-Valero
The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease (COPD) during hospitalization due to an acute exacerbation. This study was a randomized, single-blind clinical trial. Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD (AECOPD) were included in this study. All patients received standard medical and pharmacological care. Patients assigned to the intervention group also received an exercise intervention...
August 11, 2016: COPD
Alina Lelic, Chris P Verschoor, Vivian W C Lau, Robin Parsons, Carole Evelegh, Dawn M Bowdish, Jonathan L Bramson, Mark B Loeb
BACKGROUND:  Little is known about the immunogenicity of live-attenuated Oka/Merck varicella zoster vaccine (VZV) vaccine in frail nursing homes residents nor about immune phenotypes associated with a response. METHODS:  A cohort of 190 frail nursing home residents between the ages of 80 and 102 years and a cohort of 50 community dwelling seniors, ages 60 to 75 years, a comparison group, were vaccinated with the VZV vaccine. IFN-γ ELISpot assay was measured prior to and six-weeks following vaccination...
October 5, 2016: Journal of Infectious Diseases
Kaori Kitamura, Kazutoshi Nakamura, Kimiko Ueno, Tomoko Nishiwaki
BACKGROUND: Health-related quality of life (HRQOL) has been reported to be associated with cognitive function; however, whether or not this relationship involves causality is uncertain. This study aimed to determine whether HRQOL levels are associated with subsequent changes in cognitive function in elderly people requiring care. METHODS: Participants were 74 community-dwelling elderly people utilizing the long-term care service (69 % women) who underwent physical and psychological examinations at baseline and follow-up...
October 3, 2016: Environmental Health and Preventive Medicine
C Raina MacIntyre, Robert Menzies, Elizabeth Kpozehouen, Michael Chapman, Joanne Travaglia, Michael Woodward, Lisa Jackson Pulver, Christopher J Poulos, David Gronow, Timothy Adair
On the 20th June, 2014 the National Health and Medical Research Council's Centre for Research Excellence in Population Health "Immunisation in under Studied and Special Risk Populations", in collaboration with the Public Health Association of Australia, hosted a workshop "Equity in disease prevention: vaccines for the older adults". The workshop featured international and national speakers on ageing and vaccinology. The workshop was attended by health service providers, stakeholders in immunisation, ageing, primary care, researchers, government and non-government organisations, community representatives, and advocacy groups...
September 26, 2016: Vaccine
Angelique H Sadlon, Dimitrios A Tsakiris
BACKGROUND: Concerns regarding the use of direct oral anticoagulants (DOACs: apixaban, dabigatran, edoxaban, rivaroxaban) in the elderly persist owing to the lack of randomised controlled trials targeting this age group. OBJECTIVES: The aim of this study was to assess the efficacy and safety of DOACs in elderly patients (aged 75 years or more) with atrial fibrillation or venous thromboembolism (VTE), based on already published large randomised trials. METHODS: EMBASE, MEDLINE and the Cochrane Library were searched from inception to June 2015 for phase III trials...
2016: Swiss Medical Weekly
Annemarie de Vos, Jane-Murray Cramm, Jeroen D H van Wijngaarden, Ton J E M Bakker, Johan P Mackenbach, Anna P Nieboer
BACKGROUND: The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital-related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2-0.6]), lower depression (Geriatric Depression Scale 15; -0...
September 29, 2016: International Journal of Health Planning and Management
Simone Albisinni, Fouad Aoun, Thierry Roumeguère, Francesco Porpiglia, Andrea Tubaro, Cosimo De Nunzio
Life expectancy is constantly increasing and as a consequence older men, frequently with multiple comorbidities, are seeking treatment for benign prostatic hyperplasia. Given their frail health, these men need extreme attention in their management, as efficacious and safe treatment strategies in the general population may not be adequate for them. Across medications, α1-antagonists should be used with caution given the risk of orthostatic hypotension and consequent falls, cause of significant morbidity in the elderly...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sheila Johnston
Chronic kidney disease (CKD) stages 3-5 now affects 8.5% of adults in the United Kingdom; with 4% of patients expected to reach stage 5 CKD. Increasing numbers of older patients are contributing to the growth of demand of kidney services. With the exception of transplantation, dialysis has been the main form of renal replacement therapy (RRT) for advanced CKD. This elderly population is usually too frail and has many other co-existing medical complaints or co morbidities to undergo transplantation. Dialysis is an invasive treatment, and some frail elderly patients can experience many dialysis related symptoms...
2016: Healthcare (Basel, Switzerland)
Susan Schwinn, Robin McKay, Shirley Dinkel, Bobbe Mansfield, Brooke Faria Da Cunha, Savanna Cummins, Krystal Brunin
PURPOSE: The purpose of this quality improvement project was to evaluate hypertension (HTN) management in patients 80 years of age and older who reside in a large, long-term care (LTC) facility. DATA SOURCE: A retrospective chart audit was conducted on 75 charts of patients 80 years of age and older and who had a diagnosis of HTN. Using the 2011 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Expert Consensus Document on Management of Hypertension in the Elderly as a guide, blood pressure readings, significant comorbidities, and antihypertensive medication utilization were analyzed...
September 23, 2016: Journal of the American Association of Nurse Practitioners
Clive Rosendorff
Many guidelines for the management of hypertension have recommended that the goal of antihypertensive treatment in the elderly (usually specified as 80 years or above) should be less than 150/90 mmHg. SPRINT included subjects 50 years or above, and a substantial proportion of subjects 75 years and older. These are individuals at high risk for adverse cardiovascular events because of high prevalence of hypertension and atherosclerotic disease. The less stringent BP goals have been based on a percieved danger of lowering BP to levels that threaten vital organ pefusion (myocardium, brain, kidney)...
September 2016: Journal of Hypertension
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
Kwang-Il Kim
With the life-expectancy increased, the older population expected to grow all around the world. Especially, the increase of elderly population leads to increase of vulnerable or frail elderly people, who require special consideration in caring and managing chronic medical condition. Considering the substantial diversity in the prevalence of chronic medical conditions and functional impairment, elderly people are often highly heterogeneous and their physiological ability and vulnerability vary widely even in same chronological age...
September 2016: Journal of Hypertension
Katsuhiko Kohara
The effectiveness of antihypertensive treatment in elderly hypertensive patients has been established through numerous randomized clinical trials including the Hypertension in the Very Elderly Trial (HYVET). However, because of the diversity of biological aging among individuals, chronological age is not the sole determinant for the target blood pressure (BP) level at which antihypertensive medications are aimed. Several conditions, especially frailty, needed be evaluated in managing hypertension among elderly people...
September 2016: Journal of Hypertension
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