The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Sep 1996
Suppression of first pain and slow temporal summation of second pain in relation to age.
Thermal stimuli delivered to skin of the arms or legs can produce a sensation of two distinct pains. These pains have been associated with activity in A-delta (first pain) and C-fiber (second pain) nociceptive fibers, respectively. Under appropriate conditions first pain decreases in intensity (adaptation) while second pain increases in intensity (slow temporal summation). Change in first and second pain to repeated stimulation of skin has not been assessed in relation to age. ⋯ Age did not influence pain intensity to unadapted and unsensitized skin. Slow temporal summation of second pain was not observed at the leg in the older group, suggesting that mechanisms subserving C-fiber mediated sensitization of second order nociceptive neurons may fail with age. Longer response times to first, but not second pain in older subjects may represent an age effect on myelinated (A-delta; first pain) and not unmyelinated (C-fiber; second pain) nociceptive afferents and may represent a type of small fiber peripheral neuropathy.
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J. Gerontol. A Biol. Sci. Med. Sci. · Sep 1996
Risk factors for nursing home use after hospitalization for medical illness.
Hospitalization, a sentinel event for many older persons, may mark a transition from independent living to either community-based or institutionalized long-term care. We determined the independent risk factors, including loss of function, of nursing home (NH) admission at hospital discharge and NH use at 3 months after hospital discharge among a diverse group of hospitalized older persons. ⋯ Simple but different clinical variables predict NH use at hospital discharge and at 3 months. Furthermore, functional loss during and after hospitalization is an important independent risk factor of nursing home use and is a clinical outcome that may be modified to decrease the likelihood of NH admission.