Age and ageing
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The rate of surgical procedures in the older population is rising. Despite surgical, anaesthetic and medical advances, older surgical patients continue to suffer from adverse postoperative outcomes. ⋯ Despite this identification of frailty as a significant predictor of adverse postoperative outcome, there is not yet a consensus on the definition of frailty or how best to assess and diagnose it. This review describes our current definitions of frailty and discusses the available methods of assessing frailty, the impact on the older surgical population and the emerging potential for modification of this important syndrome.
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multidisciplinary rehabilitation is of proven benefit in the management of older inpatients. However, the identification of patients who will do well with rehabilitation currently lacks a strong evidence base. ⋯ frailty is associated with adverse rehabilitation outcomes. The FI may have clinical utility, augmenting clinical judgement in the management of older inpatients.
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there were a few studies on the case mortality of pneumonia in older people, of which results were conflicting. ⋯ in keeping with previous studies, CURB score and comorbidities were the most significant independent predictors of mortality of CAP in older patients. Our study concluded that nutritional status was also an important factor affecting their survival. This study failed to demonstrate functional status as a predictor of mortality due to limitation of Katz's index.
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Review Meta Analysis
Is power training or conventional resistance training better for function in elderly persons? A meta-analysis.
to determine the effects of power training with high movement velocity compared with conventional resistance training with low movement velocity for older community-dwelling people. ⋯ the Cochrane Central Register of Controlled TRIALS, PubMed (Medline), EMBASE, CINAHL, PEDro and Scholar-Google.
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delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset. ⋯ plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium.