Aging clinical and experimental research
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Hip and knee replacements have become increasingly common in the older population but the prevalence of these procedures and the potential impact on functioning towards the end of life have not been previously described. The aim of this study was to estimate the rates and distribution of hip and knee joint replacements and hip implants (surgical pins, screws, rods, plates, etc.) in people aged 65 and over who died in the US in 1993, and to measure mobility outcomes during their last year of life. ⋯ Implanted hip and knee devices were common in older people who died in the US in 1993. Large sociodemographic differences in those who received vs those who did not were present at the end of life. While difficulty in walking is the main indication for joint replacements, a majority of those receiving replacements experienced less than 6 months of mobility difficulties in their own homes during the last year of their lives.
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Pressure ulcers are associated with impaired nutritional status in acutely ill elderly patients. The objective of this study was to establish whether a difference exists between biochemical nutritional parameters in acutely ill elderly with stage III to IV pressure ulcers and a group of acutely ill elderly with no pressure ulcers. ⋯ In this study, serum levels of biochemical nutritional parameters in acutely ill elderly patients with stage III to IV pressure ulcers are lower than those of acutely ill elderly subjects with no pressure ulcers, indicating a worse nutritional status of the PU patients. These findings, while not documenting a causal relationship, suggest the need for routine nutritional assessment and support in older patients, especially those with pressure ulcers.
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Many studies have identified specific demographic, social, health or life-style pre-operative indicators of long-term outcome among older hip fracture patients who underwent surgical treatment. The purpose of this study was to determine the predictive value of peri- and intra-operative factors, and more specifically of the pre-operative American Society of Anesthesiologists (ASA) score on functional outcome in these patients. ⋯ Although the ASA classification is a good predictor of long-term mortality, the findings of the present investigation do not conclusively associate ASA score with post-operative restoration of mobility and functional independence.