Clinical interventions in aging
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Randomized Controlled Trial
A new delirium phenotype with rapid high amplitude onset and nearly as rapid reversal: Central Coast Australia Delirium Intervention Study.
Traditional models for delirium based on the Diagnostic and Statistical Manual for Mental Disorders and its 1990 offspring, the Confusion Assessment Method (CAM), were not designed to distinguish behavioral and psychological symptoms of dementia from rapid cognitive decline. We examined a new diagnostic criterion for delirium plus exclusion of behavioral and psychological symptoms of dementia and recent inattention with a 25% decline in digit span forward (DSF). ⋯ This delirium phenotype selects for a rapid high amplitude critical decline in attention, executive function, IADL, and apathy that recovers almost as rapidly.
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Review
Epidemiology and management of osteoporosis in the People's Republic of China: current perspectives.
With the progressive aging of the population, osteoporosis has gradually grown into a global health problem for men and women aged 50 years and older because of its consequences in terms of disabilities and fragility fractures. This is especially true in the People's Republic of China, which has the largest population and an increasing proportion of elderly people, as osteoporosis has become a serious challenge to the Chinese government, society, and family. ⋯ Therefore, understanding the epidemiology of osteoporosis is essential and is significant for developing strategies to help reduce this problem. In this review, we will summarize the epidemiology of osteoporosis in the People's Republic of China, including the epidemiology of osteoporotic fractures, focusing on preventive methods and the management of osteoporosis, which consist of basic measures and pharmacological treatments.
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Multicenter Study
Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients?
Controversy exists regarding the use of cement in hemiarthroplasty when treating a displaced femoral neck fracture in elderly patients. The primary hypothesis of this study was that the use of cement would afford better visual analog pain and activity scores in elderly patients. ⋯ The use of cement during hip hemiarthroplasty in patients over 65 years of age had no negative impact on mortality or morbidity. Hemodynamic changes during cement application are important, but it is noteworthy that patients fitted with cemented endoprostheses had increased levels of activity and lower pain levels.
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Review Case Reports
Preoperative assessment of the older surgical patient: honing in on geriatric syndromes.
Nearly 50% of Americans will have an operation after the age of 65 years. Traditional preoperative anesthesia consultations capture only some of the information needed to identify older patients (defined as ≥65 years of age) undergoing elective surgery who are at increased risk for postoperative complications, prolonged hospital stays, and delayed or hampered functional recovery. As a catalyst to this review, we compared traditional risk scores (eg, cardiac-focused) to geriatric-specific risk measures from two older female patients seen in our preoperative clinic who were scheduled for elective, robotic-assisted hysterectomies. ⋯ Adequate screening of physiologic and cognitive reserves in older patients scheduled for surgery could identify at-risk, vulnerable elders and enable proactive perioperative management strategies (eg, strength, balance, and mobility prehabilitation) to reduce adverse postoperative outcomes and readmissions. Here, we describe our initial two cases and review the stress response to surgery and the impact of advanced age on this response as well as preoperative geriatric assessments, including frailty, nutrition, physical function, cognition, and mood state tests that may better predict postoperative outcomes in older adults. A brief overview of the literature on anesthetic techniques that may influence geriatric-related syndromes is also presented.
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To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. ⋯ The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents.