Zeitschrift für Gerontologie und Geriatrie
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Dementia encompasses a variety of underlying conditions among which Alzheimer's disease represents the most common cause and in addition, vascular and Parkinson's disease dementia, dementia with Lewy bodies and frontotemporal lobar degeneration. All the current guidelines specify a two-step procedure for the diagnostics of dementia. ⋯ The presented article focuses on the second step: diagnosis of the etiology. This review gives an overview of the current diagnostic approaches including the new proposals of the biomarker in cerebrospinal fluid.
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For over 10 years, kyphoplasty has been established for the treatment of painful osteoporotic vertebral compression fractures. Its effectiveness has been substantiated in multiple clinical studies. Not only is prompt pain reduction achieved, but according to a new, large, long-term study, long-term survival is also increased. ⋯ Six major complications (1.06%) occurred. Kyphoplasty is a good procedure to treat painful osteoporotic fractures from the lumbar to thoracic spine. Major complications occur seldom after kyphoplasty; however, they must be considered and clarified.
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Giving fluids via the subcutaneous route is a safe and effective technique for the prophylaxis and for the treatment of dehydration. Side effects occur rarely when using this access route compared to the intravenous route, which has a much higher rate of side effects. ⋯ Agitated patients who frequently pull out their lines themselves are a group where the subcutaneous route is particularly useful. Subcutaneous infusions can avoid the necessity for admission of geriatric patients to a hospital.
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Pain management in nursing home residents (NHR) is insufficient. Hence, this guidance summarizes latest research results and guidelines of particular requirements on treatment of pain in the elderly. The purpose is to improve health care processes and outcomes on individual and institutional level. ⋯ Age-related changes in physiology may affect tolerance and effects of analgesics. Besides, drug interactions need to be considered. After all, education of NHR and involvement of their relatives in pain management foster successful management and treatment of pain.
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Increasing evidence in managing polypharmacy in the growing elderly population with a higher prevalence of multiple chronic disease is the basis for this paper. Poor adherence, drug-drug interactions, drug-disease interactions, and inappropriate medication challenge the prescriptions of health care providers in this group of patients. ⋯ Based on intervention trials, several tools in polypharmacy have emerged as practical guides for clinical practice or for the geriatric ward to solve this problem. The Medication Appropriateness Index (MAI) and national lists of potentially inappropriate medication used in clinical practice are presented, including Screening Tool to Alert Doctors to the Right Treatment (START), Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP), and Assess, Comprehensive Geriatric Assessment, Adherence, Development, Emergence, Minimization, Interdisciplinarity, Alertness (ACADEMIA).