Age and ageing
-
dysphagia is common in acute stroke. Accurate detection of the presence or absence of aspiration by bedside swallowing assessment is difficult without objective methods, tending to over-diagnose aspiration. As a result, some patients suffer restricted oral intake unnecessarily. ⋯ screening by saturation assessments detects 86% of aspirators/penetrators and should be followed immediately by bedside swallowing assessment, as the combination of the two assessments gives the best positive predictive value. For patients with acute stroke, we advocate a 10 ml water-swallow screening test with simultaneous pulse oximetry by suitably trained medical and nursing staff. Use of this screening test would improve dysphagia detection whilst minimizing unnecessary restriction of oral intake in stroke patients.
-
to review the literature on the prevalence and effect on outcome of psychiatric illness in older people with hip fracture. ⋯ depression, delirium and dementia are common in older people with hip fracture. Further research is required to examine the effect on outcome of psychiatric illness, and the effect of psychiatric interventions in this setting.
-
Randomized Controlled Trial Clinical Trial
Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind, placebo-controlled trial.
undernourishment is common in elderly hip fracture patients and has been linked to poorer recovery and increased post-operative complications. ⋯ based on our results, we cannot recommend routine nutritional supplementation of all elderly hip fracture patients. While nutritional supplementation may be useful in decreasing complications, this reduction does not result in improvement in functional recovery and nor does it decrease fracture-related mortality. Selected patients may, however, benefit from nutritional supplementation.
-
to examine the influence of low-intensity, habitual physical activity on blood lipids and lipoproteins and other cardiovascular risk factors in older adults living at home. ⋯ low-intensity, habitual physical activity is a sufficient stimulus to enhance blood lipids/lipoproteins and glucose in older adults, independent of abdominal and overall adiposity.