Latest & greatest articles for elderly

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Top results for elderly

1. Promotion of Behavioral Change and the Impact on Quality of Life in Elderly Patients with Advanced Cancer: A Physical Activity Intervention of the Multimodal Nutrition and Exercise Treatment for Advanced Cancer Program. (Full text)

Promotion of Behavioral Change and the Impact on Quality of Life in Elderly Patients with Advanced Cancer: A Physical Activity Intervention of the Multimodal Nutrition and Exercise Treatment for Advanced Cancer Program. Physical activity (PA) may improve the quality of life (QOL) of cancer survivors. However, the impact on patients with advanced cancer with high cachectic potential is unknown. We analyzed the feasibility of PA intervention using the multimodal program Nutrition and Exercise (...) Treatment for Advanced Cancer (NEXTAC) and the impact on QOL in elderly patients with advanced cancer.We recruited 30 patients aged ≥70 years who were scheduled to receive the first-line chemotherapy for newly diagnosed advanced pancreatic or non-small-cell lung cancer. The QOL was assessed using the European Organization for Research and Treatment of Cancer QOL Questionnaire version 3.0, while the PA was measured using a pedometer/accelerometer. Instructors counseled patients to increase daily activity

2019 Asia-Pacific journal of oncology nursing Controlled trial quality: uncertain PubMed abstract

2. Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly. (Full text)

Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly. The association of old age and chronic conditions, such as hypertension and obesity, can lead to larger decreases in the physical capacities of elderly, compared with their healthy counterparts. Physical exercise has been demonstrated to be efficient in postponing this phenomenon, mainly strength training. However, little is known about the effect of aerobic training on this condition. The aim of this work (...) with CG (p = .03) and increases in flexibility compared with basal moment (+21.6%; p = .01) after 12 weeks, whereas CG did not show any significant alterations. Moderate aerobic training is capable of inducing increases in maximal aerobic power and flexibility in hypertensive obese elderly. However, other essential physical capacities associated with independence in elderly people (i.e., muscle power and strength) were not responsive to this kind of protocol.

2019 Gerontology & geriatric medicine Controlled trial quality: uncertain PubMed abstract

3. [Efficacy of a reconciliation intervention by a specialized pharmacist to resolve medication-related problems of elderly patients admitted to an emergency department short-stay unit: a randomized clinical trial]. (Abstract)

[Efficacy of a reconciliation intervention by a specialized pharmacist to resolve medication-related problems of elderly patients admitted to an emergency department short-stay unit: a randomized clinical trial]. To determine the effect on medication-related problems (MRPs) of a process of medication reconciliation carried out by a specialized pharmacist for patients aged 65 years or older admitted to an emergency department short-stay unit (SSU).Randomized clinical trial of 17 months (February (...) reconciliation by a specialized pharmacist in the emergency department reduces MRPs for at-risk elderly patients in a SSU.

2019 Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias Controlled trial quality: uncertain

4. The role of CPAP treatment in elderly patients with moderate obstructive sleep apnoea: a multicentre randomised controlled trial (Abstract)

The role of CPAP treatment in elderly patients with moderate obstructive sleep apnoea: a multicentre randomised controlled trial The efficacy of continuous positive airway pressure (CPAP) treatment in elderly patients with nonsevere obstructive sleep apnoea (OSA) is controversial. The objective of this study was to assess the effect of CPAP treatment in elderly patients with moderate OSA in terms of clinical, quality-of-life and neurocognitive measures.This was an open-label, randomised (...) , multicentre clinical trial in 145 elderly patients (≥70 years old) with confirmed moderate OSA (apnoea-hypopnoea index 15-29.9 events·h-1) randomised to receive CPAP (n=73) or no CPAP (n=72) for 3 months. The primary end-point was the Epworth Sleepiness Scale (ESS) score, and the secondary end-points included quality of life (Quebec Sleep Questionnaire (QSQ) domain scores), sleep-related symptoms, presence of anxiety/depression, office-based blood pressure measurements and some neurocognitive tests

2019 EvidenceUpdates

5. Smaller Quantity Benzodiazepine Prescribing for the Elderly or Patients with Mental Illness: Clinical Effectiveness and Guidelines

Smaller Quantity Benzodiazepine Prescribing for the Elderly or Patients with Mental Illness: Clinical Effectiveness and Guidelines Smaller Quantity Benzodiazepine Prescribing for the Elderly or Patients with Mental Illness: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Smaller Quantity Benzodiazepine Prescribing for the Elderly or Patients with Mental Illness: Clinical Effectiveness and Guidelines Smaller Quantity Benzodiazepine Prescribing for the Elderly (...) or Patients with Mental Illness: Clinical Effectiveness and Guidelines Last updated: June 21, 2019 Project Number: RA1040-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the clinical effectiveness of prescribing benzodiazepines in smaller quantities for elderly patients or patients with mental illness? What are the evidence-based guidelines associated with benzodiazepine prescribing for elderly patients or patients with mental illness? Key Message One

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

6. Planning to reduce 30-day adverse events after discharge of frail elderly patients with acute heart failure: design and rationale for the DEED FRAIL-AHF trial. (Abstract)

Planning to reduce 30-day adverse events after discharge of frail elderly patients with acute heart failure: design and rationale for the DEED FRAIL-AHF trial. To demonstrate the efficacy of a system for comprehensive care transfer (Multilevel Guided Discharge Plan [MGDP]) for frail older patients diagnosed with acute heart failure (AHF) and to validate the results of MGDP implementation under real clinical conditions. The MGDP seeks to reduce the number of adverse outcomes within 30 days

2019 Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias Controlled trial quality: uncertain

7. Nonoperative Treatment Compared with Volar Locking Plate Fixation for Dorsally Displaced Distal Radial Fractures in the Elderly: A Randomized Controlled Trial (Full text)

Nonoperative Treatment Compared with Volar Locking Plate Fixation for Dorsally Displaced Distal Radial Fractures in the Elderly: A Randomized Controlled Trial The usage of volar locking plate fixation for distal radial fractures has increased in older patient populations, despite the fact that surgical treatment in the elderly population has not clearly been proven to be superior to nonoperative treatment. The purpose of the present study was to compare nonoperative treatment with volar locking (...) plate fixation with regard to clinical outcome for elderly patients with dorsally displaced distal radial fractures.In this study, 140 patients were randomly allocated to nonoperative treatment with a plaster splint (n = 72) or volar locking plate fixation (n = 68). The outcome variables were the Patient-Rated Wrist Evaluation (PRWE) score, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire score, EuroQol-5 Dimensions (EQ-5D) score, range of motion, grip strength, radiographic outcomes

2019 EvidenceUpdates PubMed abstract

8. Repair of Rotator Cuff Tears in the Elderly: Does It Make Sense? A Systematic Review (Abstract)

Repair of Rotator Cuff Tears in the Elderly: Does It Make Sense? A Systematic Review The indications and outcomes for rotator cuff repair (RCR) among patients ≥70 years old are not widely reported. Many active patients in this age range desire a joint-preserving option, and several small series reported successful clinical outcomes after RCR among patients aged ≥70 years.The purpose of this study was to systematically review the literature on the outcomes of RCR among patients ≥70 years

2019 EvidenceUpdates

9. Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014 (Abstract)

Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014 To examine all-cause and cause-specific mortality in adult-onset and elderly-onset IBD and to describe time trends in mortality over the past 50 years.Swedish nationwide register-based cohort study 1964-2014, comparing mortality in 82 718 incident IBD cases (inpatient and non-primary outpatient care) with 10 times as many matched general population reference individuals (n=801 180) using (...) multivariable Cox regression to estimate HRs. Among patients with IBD, the number of participants with elderly-onset (≥60 years) IBD was 17 873.During 984 330 person-years of follow-up, 15 698/82 718 (19%) of all patients with IBD died (15.9/1000 person-years) compared with 121 095/801 180 (15.1%) of reference individuals, corresponding to an HR of 1.5 for IBD (95% CI=1.5 to 1.5 (HR=1.5; 95% CI=1.5 to 1.5 in elderly-onset IBD)) or one extra death each year per 263 patients. Mortality was increased

2019 EvidenceUpdates

10. Five-Year Outcome After Off-Pump or On-Pump Coronary Artery Bypass Grafting in Elderly Patients (Full text)

Five-Year Outcome After Off-Pump or On-Pump Coronary Artery Bypass Grafting in Elderly Patients The 30-day and 1-year follow-up analysis of the GOPCABE trial (German Off-Pump Coronary Artery Bypass Grafting in Elderly Patients) revealed no significant difference in the composite end point consisting of death, stroke, myocardial infarction, new renal replacement therapy, or repeat revascularization. The 5-year follow-up data of this trial are reported here.From June 2008 to September 2011 (...) rates were 72% (95% CI, 67-76) with incomplete versus 76% (95% CI, 74-80) with complete revascularization (log-rank test: P=0.02) after off-pump CABG and 72% (95% CI, 67-76) versus 77% (95% CI, 74-80) after on-pump CABG (log-rank test: P=0.03), respectively. Cox regression analysis revealed a hazard ratio incomplete/complete revascularization of 1.19 (95% CI, 1.01-1.39; P=0.04).In elderly patients ≥75 years of age, the 5-year survival rates and the combined outcome of death, myocardial infarction

2019 EvidenceUpdates PubMed abstract

11. The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study (Full text)

The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study Knee osteoarthritis (KOA) is common in elderly people, causes pain, loss of physical functioning, and disability. This was a two-arm, superiority, quasi-experimental trial. The aim of this study was to evaluate the effectiveness of a home-based exercise intervention (HBEI) to reduce KOA symptoms and improve the physical functioning of elderly patients.A total of 171 elderly (...) be effective for relieving KOA symptoms, increasing the physical functioning, and improving quality of life in community-dwelling KOA elderly patients. A large randomized controlled trial with long-term follow-up is needed to confirm these findings.Chinese Clinical Trails Registry number ChiCTR1800017026 (retrospectively registered). Registered 9 July 2018.

2019 EvidenceUpdates PubMed abstract

12. Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis (Abstract)

Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis Recent literature has shown that acute reverse total shoulder arthroplasty (RTSA) yields good outcomes in the treatment of displaced proximal humeral fractures, and there have also been recent studies showing that delayed RTSA can be successfully used for sequelae of proximal humeral fractures such as nonunion and malunion (...) ) were found between the 2 groups. Patients undergoing delayed RTSA achieved 6° more external rotation than those undergoing acute RTSA; this difference was significant (P = .01).Given the risks associated with surgery in the elderly population, consideration may be given to an initial trial of nonoperative treatment in these patients, saving RTSA for those in whom nonoperative treatment fails without compromising the ultimate outcome.Copyright © 2018 Journal of Shoulder and Elbow Surgery Board

2019 EvidenceUpdates

13. 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. (Full text)

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

2019 BMJ PubMed abstract

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

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

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

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

16. Locking nail versus locking plate for proximal humeral fracture fixation in an elderly population: a prospective randomised controlled trial (Full text)

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

2019 EvidenceUpdates PubMed abstract

17. 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 (Abstract)

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

18. 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? (Abstract)

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

19. Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial (Abstract)

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

20. 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