Gerontology
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Risk factors for functional decline in nonagenarians: a one-year follow-up. The NonaSantfeliu study.
Disability and a decline in functional capacity are common in old age. ⋯ According to the definition used to describe functional basic ADL decline, poor performance in instrumental ADL at baseline and a history of a stroke appear to be independent risk factors. Prevention strategies could be intensified in this subgroup of nonagenarians.
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It has been suggested that regular moderate physical activity (PA) promotes resistance to upper respiratory tract infections (URTI). In an older population, this relationship should be examined in a wider concept of multiple factors potentially able to influence infection rate and reported symptomatology. Especially, the impact of depression should be taken into consideration. ⋯ These results indicate that in elderly subjects the symptomatology of URTI is interrelated with their habitual PA and depressive symptomatology. Less active and more depressed subjects develop more URTI symptoms during 1-year follow-up. This URTI symptomatology, together with the baseline PA and the depressive status, contributes to the follow-up PA and depression scores.
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Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalized patients; however in many patients the etiology remains unclear even after routine investigations. ⋯ Potentially, urinary retention by itself may cause hyponatremia. The possible mechanism for this is SIADH, triggered by bladder distention or pain due to bladder distention. Urinary catheterization may be the key to treatment in these cases of hyponatremia.
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Bereavement is often associated with increased levels of depression, anxiety, and stress. The question of whether grief is associated with cognitive deficits in older adults remains largely unanswered. Although Xavier and coworkers (see text) found preliminary evidence that grief, in the absence of depression, impacted on memory in a sample of the oldest-old in Brazil, the impact of bereavement on cognitive functioning, independent of the effects of mood, has not been adequately examined. ⋯ The evidence suggests that grief associated with death of a spouse has limited associations with cognition beyond those that would be expected to occur as a result of depression, anxiety, and stress.
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Diagnosis of acute abdominal pain in older persons is a challenge, with the age-related increase in concurrent diseases. In most western countries the number of elderly people is constantly rising, which means that an increasing proportion of patients admitted for abdominal pain at the emergency department are elderly. ⋯ Both the preliminary diagnosis at the emergency department and the discharge diagnosis were less reliable in elderly than in younger patients. Elderly patients more often had specific organic disease and arrived at the emergency department after a longer history of abdominal pain compared to younger patients.