Journal of the American Geriatrics Society
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Comparative Study
Mortality associated with hip fractures in a single geriatric hospital and residential health facility: a ten-year review.
Mortality in 159 patients who sustained 163 hip fractures in a single geriatric hospital and residential health facility in a ten-year period was studied. This study confirms the major problem of mortality associated with hip fractures in the very elderly. Factors that seemed associated with mortality were preoperative and postoperative ambulatory status and the overall medical condition of the patients, as evidenced by the higher percentage of patients in the hospital who died after sustaining hip fractures. The age of these elderly patients did not seem to affect the type of fracture or the final outcome significantly.
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Constipation in institutionalized elderly is a common and difficult problem. Thirty-three institutionalized demented patients with severe constipation were given a high-bran bread instead of their accustomed laxatives. ⋯ The total laxative consumption (doses given per day) decreased by 93 per cent. Nutritional data and metabolic status were unchanged during the high-bran bread period except for a reduction of the postprandial blood glucose response after the glucose tolerance test.
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Nail changes similar to those reported by Terry and Lindsay were defined in an elderly inpatient population. Two hundred fifty-eight patients were studied, and an overall incidence of 19 per cent was found. There was no significant difference between men and women. ⋯ These nail changes are less frequent in the "less frail" elderly living in the community. Changes of the Terry type are common in children but disappear by early adult life. It is suggested that the nail changes are age-related phenomena and that they may reflect an underlying disturbance of collagen being manifested as changes in the nail bed, skin, and bone.
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The term pseudodementia should be avoided in clinical practice. Its importance lies in the fact that it has alerted clinicians to the existence of potentially reversible, or at least treatable, cases of intellectual dysfunction. ⋯ Second, the term is often mistakenly used diagnostically, whereas it is only descriptive. The term cognitive impairment is preferable to pseudodementia.