Aging clinical and experimental research
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Randomized Controlled Trial
Blood transfusion strategy and risk of postoperative delirium in nursing homes residents with hip fracture. A post hoc analysis based on the TRIFE randomized controlled trial.
To investigate whether a liberal blood transfusion strategy [Hb levels ≥11.3 g/dL (7 mmol/L)] reduces the risk of postoperative delirium (POD) on day 10, among nursing home residents with hip fracture, compared to a restrictive transfusion strategy [Hb levels ≥9.7 g/dL (6 mmol/L)]. Furthermore, to investigate whether POD influences mortality within 90 days after hip surgery. ⋯ In nursing home residents undergoing surgery for hip fracture, maintaining hemoglobin level above 11.3 g/dL reduces the rate of POD on day 10 compared to a RB. Development of POD is associated with increased mortality.
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Randomized Controlled Trial
Dexmedetomidine reduces postoperative delirium after joint replacement in elderly patients with mild cognitive impairment.
Postoperative delirium (POD) is a common and serious surgical complication among the elderly, especially in those with amnestic mild cognitive impairment (aMCI). Dexmedetomidine (DEX) is neuroprotective for delirium. In this study, we determined the effect of intravenously administered DEX during general anesthesia on POD in elderly aMCI patients undergoing elective hip joint or knee joint or shoulder joint replacement surgery. ⋯ These findings suggested that DEX treatment during surgery significantly reduced POD incidence in both normal and aMCI elderly patients, suggesting that it may be an effective option for the prevention of POD.
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Randomized Controlled Trial
Implications of palonosetron in elderly patients undergoing laparoscopic cholecystectomy with respect to its anti-shivering effect.
The elderly are vulnerable to hypothermia and have a higher risk of cardiovascular events induced by marked increases in oxygen consumption due to shivering. Five-hydroxytryptamine-3 (5-HT3) receptor antagonists have been previously reported to reduce post-anesthesia shivering. ⋯ Pre-operative administration of palonosetron 0.075 mg did not influence perioperative hypothermia or post-anesthesia shivering in elderly patients undergoing laparoscopic cholecystectomy. However, palonosetron might be beneficial for reducing early postoperative pain in elderly patients with opioid-based patient-controlled analgesia.
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Randomized Controlled Trial
Feasibility study of dual-task-managing training to improve gait performance of older adults.
Dual task (DT) training is becoming prominent in fall prevention. However, DT training should include task-managing strategies like task switching or task prioritization to be beneficial to improve gait performance under DT conditions. The aim of this pilot study was to evaluate the effect of a task managing training on gait stability. ⋯ The training successfully improved gait performance and therefore might be a promising approach to prevent falls. Additional fall prevention studies should focus on motor-cognitive performance and reinforce outcomes of task managing strategies.
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Randomized Controlled Trial
Feasibility of whole-body vibration training in nursing home residents with low physical function: a pilot study.
Whole-body vibration (WBV) training may offer an efficient option to improve physical performance of nursing home residents, but the feasibility of WBV training among frail elderly who require continuous institutional care is still open. ⋯ Frail nursing home residents form not only a potential but also challenging target group for physical rehabilitation with WBV. Side-alternating WBV training performed at low 12 Hz frequency was found generally feasible, whereas higher frequencies appeared formidable. Nevertheless, it is possible that physical performance of some frail elderly without contraindications to WBV can be improved with this type of rapidly executable physical training.