Age and ageing
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the diagnosis of cerebral small vessel disease, a leading cause of vascular dementia (VaD), relies solely on neuroimaging studies. Circulating microRNAs (miRNAs) have been proposed as diagnostic biomarkers in various disorders. Our aim was to identify differentially expressed, circulating miRNAs in small vessel VaD which could serve as diagnostic biomarkers for this disease. ⋯ plasma miR-409-3p, miR-502-3p, miR-486-5p and miR-451a could be used to differentiate small vessel VaD patients from healthy controls. Large-scale studies of their biomarker potential are warranted.
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In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. ⋯ Furthermore, the use of frailty screening tools may facilitate more informed early decision-making in relation to treatment interventions in older trauma victims. We call for geriatric medicine and emergency medicine departments to collaborate-equipping urgent care staff with the basic competencies necessary to initiate CGA should be a priority, and geriatricians have a key role to play in delivery of such educational interventions.
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Review Meta Analysis
Is sarcopenia associated with depression? A systematic review and meta-analysis of observational studies.
to explore whether sarcopenia is associated with depression. ⋯ sarcopenia was independently associated with depression. The causal relationship between the two clinical conditions requires future validation with cohort studies.
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frailty is proposed as a summative measure of health status and marker of individual vulnerability. We aimed to investigate the discriminative capacity of a frailty index (FI) derived from interRAI Comprehensive Geriatric Assessment for Acute Care (AC) in relation to multiple adverse inpatient outcomes. ⋯ the interRAI-AC can be used to derive a single score that predicts multiple adverse outcomes in older inpatients. A score of ≤0.40 can well discriminate patients who are unlikely to die or experience a geriatric syndrome. Whether the FI-AC can result in management decisions that improve outcomes requires further study.
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Comparative Study Observational Study
The relationship between cognitive impairment, mortality and discharge characteristics in a large cohort of older adults with unscheduled admissions to an acute hospital: a retrospective observational study.
older people with dementia admitted to hospital for acute illness have higher mortality and longer hospital stays compared to those without dementia. Cognitive impairment (CI) is common in older people, and they may also be at increased risk of poor outcomes. ⋯ the admission characteristics, mortality and length of stay of patients with CI resemble those of patients with diagnosed dementia. Whilst attention has been focussed on the need for additional support for people with dementia, patients with CI, which may include those with undiagnosed dementia or delirium, appear to have equally bad outcomes from hospitalisation.