Zeitschrift für Gerontologie und Geriatrie
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There is a strong relation between mobility, walking safety and living independently in old age. People with walking problems suffer from fear of falling and tend to restrict their mobility and performance level in the community environment--even before falls occur. This study was planned to test the validity and prognostic value of a fall risk screening instrument ("Sturz-Risiko-Check") that has already shown its feasibility, acceptance and reliability, targeting independently living senior citizens. ⋯ The fall-risk screening instrument ("Sturz-Risiko-Check" questionnaire) was useful and valid to predict risk of falling and functional decline in independently living senior citizens transitioning to frailty. This screening will be part of a prevention approach in the City of Hamburg to offer primary and secondary prevention interventions adapted to special target groups of community- dwelling elder people (robust in contrast to frail elderly). The implementation should be accompanied by training sessions for physicians in the primary care sector and health improvement programmes for elder citizens.
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Randomized Controlled Trial Comparative Study
[Geriatric health promotion and prevention for independently living senior citizens: programmes and target groups].
Nearly all diseases in old age that are epidemiologically important can be reduced or prevented successfully through consequent changes in individual lifestyle, a systematic provision of measures in primary prevention (i.e. vaccination programmes) and the creation of health promoting settings. However, at the moment the amount of potential for preventative interventions is neither systematically nor sufficiently utilised in Germany. ⋯ The strongest reason to refuse participation in health promoting programmes was the personal attitude related to one's own personal health. Taking account of needs and wants of the seniors who refused to participate more people expressed the reason "no interest" in the preventive home visit than in the small group session at the geriatric centre. To strengthen the integration of the GP as a trustworthy person would seem to be more successful to motivate senior citizens to participate in health promoting and preventative programmes in the future. This could succeed in a cooperation with geriatric centres to establish community centres for generally healthy senior citizens.
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In autumn 2005, the Geriatric and Gerontological Scientific Societies together with the Organisation of Geriatric Departments developed a quality seal in a discussion process over about 18 months. The needs to be addressed were corporate development, allocation through an independent and external institution for quality management, consideration of the heterogeneous German structure of geriatric medicine, independence of specific conditions and the consideration of 20 years of geriatric medicine practise in Germany. ⋯ It describes the needs in the area of structure, process and outcome quality. Since introduction, 12 geriatric departments (as of March 2007) have been successfully certified.
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In the past the concept of delirium was associated with different diseases. Even today numerous synonyms of delirium exist. The author gives an overview of the definition of delirium in the past and today. ⋯ Pathological mechanisms, risk factors and triggers as well as different forms of delirium for patients suffering from dementia are discussed. Diagnostics and differential diagnostics are discussed and possible medicamentous and non-medicamentous therapy procedures as well as the prevention of delirium are shown. The author points out the necessity of education and training of medical staff to prevent or to diagnose early delirium for patients suffering from dementia and to start therapy as early as possible.
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Malnutrition in institutionalized elderly is of individual and public concern since it negatively affects health outcome and quality of life and is often preventable. Over the past years several studies have examined the prevalence of malnutrition in institutionalized elderly and reported greatly diverse results. The purpose of the present literature review is to give an overview of the current knowledge about the nutritional situation of institutionalized elderly having specific regard to the prevalence of protein-energy malnutrition and nutrition-related problems. ⋯ It can be concluded that malnutrition is generally widespread in institutionalized elderly. Prevalence rates vary according to the parameters and cut-off values used for nutritional assessment and according to the population under study. Future studies should carefully characterize their participants and use standardized nutritional assessment tools in order to achieve better comparability of study results as up to now.