Gerontology
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Observational Study
Predictive validity of the identification of seniors at risk screening tool in a German emergency department setting.
The identification of patients at high risk for adverse outcomes [death, unplanned readmission to emergency department (ED)/hospital, functional decline] plays an important role in emergency medicine. The Identification of Seniors at Risk (ISAR) instrument is one of the most commonly used and best-validated screening tools. As to the authors' knowledge so far there are no data on any screening tool for the identification of older patients at risk for a negative outcome in Germany. ⋯ The German version of the ISAR screening tool acceptably identified elderly patients in the ED with an increased risk of a negative outcome. Using the cutoff ≥3 points instead of ≥2 points yielded better overall results.
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As the world's population ages, elderly people are becoming an increasingly important group that merits special attention with regard to health and social issues. Lifestyles affect health and survival at all ages, but the consequences of poor lifestyle behaviors may be different for elderly people than for younger adults. They can also be heavily dependent on exposure earlier in life. ⋯ It focuses on behaviors modifiable by individual actions and public health interventions, such as smoking, obesity and sedentary behavior, which predispose numerous people to diseases that rank among the leading causes of death, including heart disease, cancer, stroke, diabetes and dementia. These factors not only shorten life but, when they occur together, also have a major impact on survival beyond that associated with each single lifestyle factor. We propose an integrated life course model to guide research on longevity to answer questions that remain open and to find new strategies to ensure a longer and healthier life for future generations.
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Frailty and body mass index (BMI) are known to be predictive of late life mortality, but little is known about the combined effects of frailty and BMI on mortality. ⋯ Among older people who were of normal weight or underweight, greater frailty was associated with poorer survival. Whereas being overweight tended to be neutral of the influence of frailty on mortality, the obese frail exhibited a significantly elevated rate of death.
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For people with dementia dying from pneumonia, hospitalization at the end of life may be of little benefit and result in unfavourable outcomes such as hospital death. ⋯ Almost half of all those with dementia dying from pneumonia and a quarter of those living in long-term care settings died in a hospital. These results suggest shortcomings in the Belgian healthcare system in preventing potentially avoidable terminal hospitalizations in a vulnerable population.
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It was found that age and female gender are predisposing factors for hyponatremia in patients taking thiazides. ⋯ Sodium levels were lower with increasing age, independent of diuretic intake, while potassium levels were higher. We found dramatically increasing prevalences of hyponatremia and hyperkalemia with increasing age, while no such effect could be found for hypernatremia and hypokalemia.