Latest & greatest articles for elderly

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Top results for elderly

1. Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. (PubMed)

Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study. To evaluate the association between antibiotic treatment for urinary tract infection (UTI) and severe adverse outcomes in elderly patients in primary care.Retrospective population based cohort study.Clinical Practice Research Datalink (2007-15) primary care records linked to hospital episode statistics (...) at risk for both bloodstream infection and 60 day all cause mortality.In elderly patients with a diagnosis of UTI in primary care, no antibiotics and deferred antibiotics were associated with a significant increase in bloodstream infection and all cause mortality compared with immediate antibiotics. In the context of an increase of Escherichia coli bloodstream infections in England, early initiation of recommended first line antibiotics for UTI in the older population is advocated.Published by the BMJ

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2019 BMJ

2. Does Systemic Administration of Parathyroid Hormone After Noninstrumented Spinal Fusion Surgery Improve Fusion Rates and Fusion Mass in Elderly Patients Compared to Placebo in Patients With Degenerative Lumbar Spondylolisthesis?

Does Systemic Administration of Parathyroid Hormone After Noninstrumented Spinal Fusion Surgery Improve Fusion Rates and Fusion Mass in Elderly Patients Compared to Placebo in Patients With Degenerative Lumbar Spondylolisthesis? Prospective, randomized, double-blinded, placebo-controlled clinical trial.To evaluate whether 90-day subcutaneous injections with 20 μg teriparatide increases the volume and quality of the fusion mass compared to placebo based on 12-month postop fine cut computed (...) groups.Ninety-day subcutaneous administration of 20 μg teriparatide did not increase fusion volume or improve the quality of the fusion mass in elderly patients compared to placebo after noninstrumented spinal fusion surgery for degenerative spondylolisthesis.1.

2019 EvidenceUpdates

3. The depressing evidence for antidepressants in the elderly

The depressing evidence for antidepressants in the elderly Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 5,000 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research. www.acfp.ca February 4 (...) , 2019 The depressing evidence for antidepressants in the elderly Clinical Question: How effective are antidepressants for treating depression in the elderly? Bottom Line: The efficacy of antidepressants in the elderly is inconsistent and may decrease as patients age. From 80% to 40% of elderly patients will recover with antidepressants, with some studies showing no difference from placebo response rates. Harms of antidepressants are common, with ~20% stopping due to adverse effects. Evidence: • 5

2019 Tools for Practice

4. Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients-does it improve outcomes? A systematic review and meta-analysis

Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients-does it improve outcomes? A systematic review and meta-analysis Reverse shoulder arthroplasty (RSA) is being increasingly used for complex, displaced fractures of the proximal humerus in older patients. Anatomic tuberosity healing in RSA has been recognized to restore better shoulder function. We compared the reported clinical and functional outcomes of RSA in proximal humeral (...) . 56.6, P < .05) than with those with nonhealed tuberosity.The RSA group with healed greater tuberosity showed better range of motion, especially forward flexion and external rotation and Constant scores, compared with the nonhealed greater tuberosity group. Tuberosity healing may influence overall shoulder function after RSA for proximal humeral fractures in the elderly, and this needs verification with future prospective studies.Copyright © 2018 Journal of Shoulder and Elbow Surgery Board

2019 EvidenceUpdates

5. Controlling Nutritional Status (CONUT) Score Predicts Outcomes of Curative Resection for Gastric Cancer in the Elderly

Controlling Nutritional Status (CONUT) Score Predicts Outcomes of Curative Resection for Gastric Cancer in the Elderly Preoperative nutritional status is considered to affect the short-term and long-term outcomes of cancer patients. The clinical value of the controlling nutritional status (CONUT) score in elderly patients undergoing gastrectomy for gastric cancer remains unknown.This study reviewed 211 elderly patients aged 75 years or over who underwent curative resection for gastric cancer (...) was a strong predictors of overall survival (hazard ratio [HR], 2.12; 95% CI, 1.18-3.69; P = 0.012) and cancer-specific survival (HR, 3.75; 95% CI, 1.30-10.43; P = 0.015) independent of disease stage.The preoperative CONUT score is a simple and promising predictor of postoperative procedure-unrelated infectious morbidity and prognosis in elderly gastric cancer patients.

2019 EvidenceUpdates

6. A systematic review on the quality of life and functional status after abdominal aortic aneurysm repair in elderly patients with an average age older than 75 years

A systematic review on the quality of life and functional status after abdominal aortic aneurysm repair in elderly patients with an average age older than 75 years Endovascular aneurysm repair (EVAR) and open repair (OR) of abdominal aortic aneurysms (AAAs) are increasingly performed in elderly patients (>75 years of age) with satisfactory results. Quality of life (QOL) is increasingly considered a primary goal of intervention after AAA repair. However, there is currently no consensus on QOL (...) after these procedures in elderly patients.A systematic review was performed using strict eligibility criteria. Clinical studies reporting QOL in elderly patients (average age >75 years) after EVAR and OR were included. Quality appraisal and data tabulation were performed using predetermined forms. Data were synthesized by narrative review. Study quality was assessed.Thirteen studies with 1272 patients were included. After elective EVAR, disease-specific and generic QOL scores demonstrated

2019 EvidenceUpdates

7. Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial

Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial Elderly patients with a displaced femoral neck fracture treated with hip arthroplasty may have better function than those treated with internal fixation. We hypothesized that hemiarthroplasty would be superior to screw fixation with regard to hip function, mobility, pain, quality of life, and the risk of a reoperation in elderly patients (...) function as measured by the HHS (the primary outcome). However, hemiarthroplasty led to improved mobility and fewer major reoperations. The findings suggest that certain elderly patients with a nondisplaced femoral neck fracture may benefit from being treated with a latest-generation hemiarthroplasty rather than screw fixation.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

2019 EvidenceUpdates

8. Locking nail versus locking plate for proximal humeral fracture fixation in an elderly population: a prospective randomised controlled trial

Locking nail versus locking plate for proximal humeral fracture fixation in an elderly population: a prospective randomised controlled trial Proximal humeral fractures (PHFs) are the third most common fracture in older patients. The purpose of the study was to prospectively evaluate the outcomes of PHF fixation with a locking blade nail (LBN) or locking plate (PHILOS) osteosynthesis in a homogeneous elderly patient population.Inclusion criteria were an age > 60 years and the capacity to give (...) complications (in 11 patients) in the PHILOS group (p = 0.941). No significant inter-group difference was observed for any other outcome measures, nor was fracture morphology seen to be associated with clinical outcome or complication rate.At short-term follow-up, LBN osteosynthesis yielded similar outcomes and complication rates to PHILOS plate fracture fixation in an elderly patient population, though with a significantly lower rate of secondary loss of reduction and screw cut-out.No. DRKS00015245

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2019 EvidenceUpdates

9. Assessment of falls in the elderly

Assessment of falls in the elderly Assessment of falls in the elderly - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of falls in the elderly Last reviewed: February 2019 Last updated: January 2019 Summary Falls are often multifactorial in origin. Deandrea S. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010 Sep;21(5):658-68. http (...) ://www.ncbi.nlm.nih.gov/pubmed/20585256?tool=bestpractice.com The presence of the following factors is associated with greater probability of future falls, Rubenstein LZ, Josephson KR. Falls and their prevention in elderly people: what does the evidence show? Med Clin North Am. 2006 Sep;90(5):807-24. http://www.ncbi.nlm.nih.gov/pubmed/16962843?tool=bestpractice.com McInnes L, Gibbons E, Chandler-Oatts J. Clinical practice guideline for the assessment and prevention of falls in older people. Worldviews Evid Based Nurs

2019 BMJ Best Practice

10. Bioprosthetic aortic valve replacement in elderly patients: Meta-analysis and microsimulation

Bioprosthetic aortic valve replacement in elderly patients: Meta-analysis and microsimulation To support decision-making in aortic valve replacement (AVR) in elderly patients, we provide a comprehensive overview of outcome after AVR with bioprostheses.A systematic review was conducted of studies reporting clinical outcome after AVR with bioprostheses in elderly patients (mean age ≥70 years; minimum age ≥65 years) published between January 1, 2000, to January 9, 2016. Reported event rates (...) rate was 0.75%/year (95% CI, 0.50-1.11). Structural valve deterioration (SVD) was based on pooled time to SVD data (Gompertz; shape: 0.124, rate: 0.003). For a 75-year-old patient, this translated to an estimated life expectancy of 9.8 years (general population: 10.2 years) and lifetime risks of bleeding of 7%, thromboembolism of 17%, and reintervention of 9%.The low risks of SVD and reintervention support the use of bioprostheses in elderly patients in need of AVR. The estimated life expectancy

2019 EvidenceUpdates

11. Effect on falls among elderly persons after training elderly care staff

Effect on falls among elderly persons after training elderly care staff Effect on falls among elderly persons after training elderly care staff We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Effect on falls among elderly persons after training elderly care staff Share: Reading time approx. 4 minutes In general, every person aged 65 years or older (...) , experience at least one fall per year. Falls are common reasons for injuries, and even death. Fall prevention among elderly persons is important due to reasons such as reduced functioning, individual suffering and societal costs. Staff training is one, frequently used, intervention. Question Does staff training in fall prevention, medication or nutrition effect falls among elderly persons? Tables with identified studies Table 1. Systematic reviews Included studies Population Outcome Balzer et al 2012 [1

2019 Swedish Council on Technology Assessement

12. Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial

Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial Functional decline is prevalent among acutely hospitalized older patients. Exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients.To assess the effects of an innovative multicomponent exercise intervention on the functional status of this patient population.A single-center (...) , single-blind randomized clinical trial was conducted from February 1, 2015, to August 30, 2017, in an acute care unit in a tertiary public hospital in Navarra, Spain. A total of 370 very elderly patients undergoing acute-care hospitalization were randomly assigned to an exercise or control (usual-care) intervention. Intention-to-treat analysis was conducted.The control group received usual-care hospital care, which included physical rehabilitation when needed. The in-hospital intervention included

2018 EvidenceUpdates

13. Effect of Physical Disability on Mortality in Elderly Patients of >/=80 Years of Age Undergoing Percutaneous Coronary Intervention

Effect of Physical Disability on Mortality in Elderly Patients of >/=80 Years of Age Undergoing Percutaneous Coronary Intervention Functional decrease has been linked with adverse events in different clinical contexts. The predictive role of activity of daily living status as assessed by the Barthel index (BI) in elderly patients who underwent percutaneous coronary intervention (PCI) has not been investigated, yet. In this study, a total of 616 patients (≥80 years) who underwent PCI between (...) of daily living should be incorporated into the risk stratification of elderly patients with coronary artery disease.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 EvidenceUpdates

14. Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial

Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial Acute myeloid leukemia (AML) in elderly patients has a poor prognosis. In an attempt to improve outcome for these patients, the prospective open-label phase III LAM-SA 2007 (Adding Lomustine to Chemotherapy in Older Patients With Acute Myelogenous Leukemia (AML), and Allogeneic Transplantation for Patients From 60 to 65 Years (...) , were significantly higher in the ICL arm ( P = .04), and fewer patients required a second treatment after ICL.Adding lomustine to standard chemotherapy significantly improved the outcome of elderly patients with AML.

2018 EvidenceUpdates

15. Cost-effectiveness of the HiBalance training program for elderly with Parkinson`s disease: analysis of data from a randomized controlled trial

Cost-effectiveness of the HiBalance training program for elderly with Parkinson`s disease: analysis of data from a randomized controlled trial To determine the cost-effectiveness of the HiBalance training program for managing Parkinson's disease (PD)-related balance and gait disorders.Cost comparison design following the randomized controlled trial comparing a novel balance training intervention with care as usual.A total of 100 participants with mild-moderate PD were randomized to either

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2018 EvidenceUpdates

16. Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. (PubMed)

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. In the primary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, now published in the Journal, we report that the daily use of aspirin did not provide a benefit with regard to the primary end point of disability-free survival among older adults. A numerically higher rate of the secondary end point of death from any cause was observed with aspirin than with placebo.From 2010 through 2014, we enrolled

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2018 NEJM

17. Effect of Aspirin on Disability-free Survival in the Healthy Elderly. (PubMed)

Effect of Aspirin on Disability-free Survival in the Healthy Elderly. Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors is unclear.From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did (...) 1000 person-years in the placebo group), dementia, or persistent physical disability. The rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%; hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001).Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo. (Funded by the National Institute on Aging and others; ASPREE ClinicalTrials.gov number

2018 NEJM

18. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. (PubMed)

Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk.From 2010 through 2014, we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics

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2018 NEJM

19. The validation of the PRISMA-7 questionnaire in community-dwelling elderly people living in Antalya, Turkey (PubMed)

The validation of the PRISMA-7 questionnaire in community-dwelling elderly people living in Antalya, Turkey The screening of frailty in older adults is an important issue in the preventive approach in medicine. Frailty is one of the leading causes of morbidity and premature mortality in older adults.The aim of this study was to validate the PRISMA-7 questionnaire in community-dwelling elderly people living in Antalya, Turkey.This study was cross-sectional and observational in nature (...) was translated back by two translators to English. The translation was then compiled to one text and compared with the original text. After agreement on the translation, both translations were piloted in 10 elderly people. The final form has been applied in this study. Data of the ten piloted patients have not been included into the dataset. Data were analyzed by IBM-SPSS version 22, using descriptive statistics, Pearson product-moment correlation, and receiver operator characteristic (ROC) analysis

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2018 Electronic physician

20. Cisplatin-Based First-Line Treatment of Elderly Patients With Advanced Non-Small-Cell Lung Cancer: Joint Analysis of MILES-3 and MILES-4 Phase III Trials

Cisplatin-Based First-Line Treatment of Elderly Patients With Advanced Non-Small-Cell Lung Cancer: Joint Analysis of MILES-3 and MILES-4 Phase III Trials Purpose To test the efficacy of adding cisplatin to first-line treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC) within a combined analysis of two parallel phase III trials, MILES-3 and MILES-4. Patients and Methods Patients with advanced NSCLC who were older than age 70 years with Eastern Cooperative Oncology (...) score of quality of life was not improved, whereas progression-free survival (HR, 0.76; 95% CI, 0.63 to 0.92; P = .005) and objective response rate (15.5% v 8.5%; P = .02) were significantly better. Significantly more severe hematologic toxicity, fatigue, and anorexia were found with cisplatin. Conclusion The addition of cisplatin to single-agent chemotherapy does not significantly prolong overall survival, and it does not improve global health status score of quality of life in elderly patients

2018 EvidenceUpdates