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Latest & greatest articles for elderly
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Long-term persistence in use of statin therapy in elderly patients. Knowledge of long-term persistence with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) therapy is limited because previous studies have observed patients for short periods of time, in closely monitored clinical trials, or in other unrepresentative settings.To describe the patterns and predictors of long-term persistence with statin therapy in an elderly US population.Retrospective cohort study including 34
Adherence with statin therapy in elderly patients with and without acute coronary syndromes. Landmark clinical trials have demonstrated the survival benefits of statins, with benefits usually starting after 1 to 2 years of treatment. Research prior to these trials of older lipid-lowering agents demonstrated low levels of 1-year adherence.To compare 2-year adherence following statin initiation in 3 cohorts of patients: those with recent acute coronary syndrome (ACS), those with chronic coronary (...) cohorts.Adherence to statins, defined as a statin being dispensed at least every 120 days after the index prescription for 2 years.Two-year adherence rates in the cohorts were only 40.1% for ACS, 36.1% for chronic CAD, and 25.4% for primary prevention. Relative to the ACS cohort, nonadherence was more likely among patients receiving statins in the chronic CAD (relative risk [RR], 1.14; 95% CI, 1.11-1.16) and primary prevention cohorts (RR, 1.92; 95% CI, 1.87-1.96).Elderly patients with and without recent ACS
Process of care and outcomes for elderly patients hospitalized with peptic ulcer disease: results from a quality improvement project. Since publication in 1994 of guidelines for management of peptic ulcer disease (PUD), trends in physician practice and outcomes related to guideline application have not been evaluated.To describe changes in process of care that occurred in a quality improvement program for patients hospitalized with PUD and to evaluate associations between in-hospital treatment (...) odds ratio [OR], 1.24; 95% confidence interval [CI], 0.65-2.36) or with a reduction in mortality (adjusted OR, 1.08; 95% CI, 0.68-1.71). Counseling about NSAID use was associated with a decrease in risk of 1-year rehospitalization for PUD (adjusted OR, 0.47; 95% CI, 0.22-0.99) and risk of all-cause mortality (adjusted OR, 0.44; 95% CI, 0.26-0.75).This quality improvement program for elderly patients with PUD resulted in increased screening for H pylori and increased treatment of H pylori infection
Depression in the elderly. In elderly people, depression mainly affects those with chronic medical illnesses and cognitive impairment, causes suffering, family disruption, and disability, worsens the outcomes of many medical illnesses, and increases mortality. Ageing-related and disease-related processes, including arteriosclerosis and inflammatory, endocrine, and immune changes compromise the integrity of frontostriatal pathways, the amygdala, and the hippocampus, and increase vulnerability (...) to depression. Heredity factors might also play a part. Psychosocial adversity-economic impoverishment, disability, isolation, relocation, caregiving, and bereavement-contributes to physiological changes, further increasing susceptibility to depression or triggering depression in already vulnerable elderly individuals. Treatment with antidepressants is well tolerated by elderly people and is, overall, as effective as in young adults. Evidence-based guidelines for prevention of new episodes of depression
In elderly patients with ankle fractures who are unable to safely mobilise non-weight bearing using appropriate walking aids; does allowing partial weight bearing of the affected leg reduce the length of time spent in hospital, reduce complications of bed Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: December 2017 Date CAT completed December 2017 Date for review December 2022 CAT leads Jennifer Hamblin Jennifer.Hamblin@nhs.net Katie Wills (...) Katie.Wills@nhs.net Clinical bottom line The search revealed no evidence to answer this question. Further research is required. Why is this important? Ankle fractures are the fifth most common fracture and have an incidence of 122/100,000 per year. A quarter of ankle fractures occur in patients over 60 years of age. For elderly patients with traumatic ankle fractures, current practice in many orthopaedic wards in the UK is to mobilise non-weight bearing (i.e hopping on the unaffected leg with the use
[Trans-Cultural Prevention of Alcohol-Related Disorders in Elderly Immigrants]. In migrants alcohol-related problems increase with increasing age. This group, in particular, is hardly reached by alcohol-specific care offers. Thus our project aimed at the identification of target group-specific barriers to health-care use by means of a cross-sectional study (n=435). Based on these results a trans-cultural concept for alcohol prevention among elderly migrants was developed and evaluated
Pharmacistâ€™s Comprehensive Geriatric Assessment: Introduction and Evaluation at Elderly Patient Admission The role of the clinical pharmacist within the healthcare system remains unclear.Our objective was to describe a pharmacist's comprehensive geriatric assessment (pCGA) at admission of elderly patients and to assess its relevance in terms of medication compliance and pharmacist interventions (PIs).We conducted a prospective interventional study over 29 months in a 34-bed medical
Use of pneumococcal vaccines in the elderly an economic evaluation Use of pneumococcal vaccines in the elderly an economic evaluation Use of pneumococcal vaccines in the elderly an economic evaluation Blommaert A, Hanquet G, Willem L, Theeten H, Thiry N, Bilcke J, Verhaegen J, Beutels P Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation (...) Blommaert A, Hanquet G, Willem L, Theeten H, Thiry N, Bilcke J, Verhaegen J, Beutels P. Use of pneumococcal vaccines in the elderly an economic evaluation. Brussels: Belgian Health Care Knowledge Centre (KCE). KCE Reports. 2016 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Aged; Cost-Benefit Analysis; Humans; Pneumococcal Vaccines Language Published English Country of organisation Belgium English summary An English language summary is available. Address for correspondence
Self-medication and its Effective Modifiable Factors among Elderly Referred Health Care Centers in Shahr-e-Kord in 2015 Drug overuse is a serious problem for health care, and one of the biggest problems for the socio-economic well-being of different communities. The elderly tend to use more drugs due to changes in their cognitive and physiological factors. One of the best ways to evaluate the health level of elderly people is to evaluate their self-medication. This study was conducted (...) to investigate self-medication among the elderly in Shahr-e-Kord.This cross-sectional study was conducted on 350 people older than 65 in Shahr-e-Kord in 2015. Sampling was done in two stages. In the first stage, the city of Shahr-e-Kord was divided into four areas using geographical maps. Eighty-eight people were selected from each area. The research instrument was a questionnaire called the Health Belief Model (HBM). The data were analyzed using SPSS version 20, the chi-squared test, the independent-samples
Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the early diagnosis of dementia across a variety of healthcare settings. The Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) is a structured interview based on informant responses that is used to assess for possible dementia. IQCODE has been used for retrospective or contemporaneous assessment of cognitive decline. There is considerable interest in tests that may identify those at future risk
Efficacy and toxicity of adjuvant chemotherapy in elderly patients with colorectal cancer: the ACCORE study Elderly patients with primary colorectal cancer (CRC) are less frequently treated with adjuvant chemotherapy than younger patients due to concerns regarding toxicity and efficiency. We investigated how age, performance status (PS) and comorbidity influence treatment outcomes.A retrospective single-centre study of 529 patients with stages II-III CRC treated with adjuvant chemotherapy (5 (...) -fluorouracil/capecitabine+/÷oxaliplatin) from 2001 to 2011 at Herlev Hospital, Denmark. Baseline characteristics, chemotherapy and outcome were analysed with respect to age after adjusting for PS and comorbidity.Elderly patients (>70 years) had significantly more comorbidity (p<0.001) and poorer PS (p=0.001) than younger patients. Elderly were more frequently treated with single-agent therapy (p=0.001) and at lower initial dose (p<0.001). There was no age-dependent difference in 3-year disease-free
Rightâ€sided Bochdalek hernia in an elderly patient: a case review of adult Bochdalek hernias from 1982 to 2015 in Japan An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made.Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic (...) cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing. The patient had good recovery and was discharged 78 days later.Bochdalek hernias in elderly patients are rare, but may be complicated by strangulation of the herniated organ. This should be taken into account by acute care physicians. To prevent this fatal complication, regardless of symptoms, surgical treatment may be essential as soon as a diagnosis