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Latest & greatest articles for elderly
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on elderly or other clinical topics then use Trip today.
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Pharmacotherapy for hypertension in adults aged 18 to 59 years. Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects (...) of therapy are in people 18 to 59 years of age.To quantify antihypertensive drug effects on all-cause mortality in adults aged 18 to 59 years with mild to moderate primary hypertension. To quantify effects on cardiovascular mortality plus morbidity (including cerebrovascular and coronary heart disease mortality plus morbidity), withdrawal due adverse events and estimate magnitude of systolic blood pressure (SBP) and diastolic blood pressure (DBP) lowering at one year.The Cochrane Hypertension Information
Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS). Little is known about how the proportions of dependency states have changed between generational cohorts of olderpeople. We aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care.In this population-based study, we compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of olderpeople (...) with substantial care needs, and most will live in the community. These findings have considerable implications for families of olderpeople who provide the majority of unpaid care, but the findings also provide valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations.Medical Research Council (G9901400) and (G06010220), with support from the National Institute for Health Research Comprehensive Local research networks
. The results show the heterogeneous effect of the reduction of asbestos exposure on different age groups; decreasing mortality in young people reflects reduced exposure opportunity, and increasing mortality in the elderly shows the long-term effect of early exposures. (...) Classification of Diseases, which includes a specific code for mesothelioma. Olderage groups showed an increase (in the United States, a weaker decrease) during the study period, whereas in young age groups, there was a decrease (in Poland, a weaker increase, starting, however, from low rates). Results were consistent between men and women and between pleural and peritoneal mesothelioma, although a smaller number of events in women and for peritoneal mesothelioma resulted in less precise results
review of current and emerging perioperative strategies for the treatment of elderly patients with gastrointestinal malignancies and frequent comorbidities.Especially in combination with advanced age, the effects of malignancies can be devastating, bringing new health challenges, exacerbating preexisting conditions, and exerting severe psychological strain. An interdisciplinary assessment and process planning provide an ideal setting to identify and prevent potential complications, especially (...) Perioperative Management of Elderly Patients with Gastrointestinal Malignancies: The Contribution of Anesthesia Elderly patients suffering from gastrointestinal malignancies are particularly prone to perioperative complications. Elderly patients often present with reduced physiological reserves, and comorbidities can limit treatment options and promote complications. Surgeons and anesthesiologists must be aware of strategies required to deal with this vulnerable subgroup.We provide a brief
Risk Factors for Adverse Outcome for Elderly Patients undergoing Curative Oncological Resection for Gastrointestinal Malignancies The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges.A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools (...) and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies.Surgical procedures in this patient cohort, particularly complex resections, may result in increased morbidity and mortality. The decision to treat an elderly patient with curative intent requires sound clinical judgment based on knowledge, consideration of objective parameters, and experience. These patients could potentially be optimized for surgery with the improvement
Blood pressure targets for hypertension in older adults. Eight out of 10 major antihypertensive trials in older adults attempted to achieve a target systolic blood pressure (BP) less than 160 mmHg. Collectively these trials demonstrated benefit for treatment, as compared to no treatment, for an older adult with BP greater than 160 mmHg. However an even lower BP target of less than 140 mmHg is commonly applied to all age groups. At the present time it is not known whether a lower or higher BP (...) target is associated with better cardiovascular outcomes in older adults.To assess the effects of a higher (less than 150 to 160/95 to 105 mmHg) BP target compared to the lower BP target of less than 140/90 mmHg in hypertensive adults 65 years of age or older.The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to February 2017: the Cochrane Hypertension Specialised Register, MEDLINE, Embase, ClinicalTrials.gov and the World Health
Colorectal Cancer Mortality Rates in Adults Aged 20 to 54 Years in the United States, 1970-2014 28787497 2017 09 20 2018 11 13 1538-3598 318 6 2017 08 08 JAMA JAMA Colorectal Cancer Mortality Rates in Adults Aged 20 to 54 Years in the United States, 1970-2014. 572-574 10.1001/jama.2017.7630 Siegel Rebecca L RL Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia. Miller Kimberly D KD Surveillance and Health Services Research Program, American Cancer (...) Society, Atlanta, Georgia. Jemal Ahmedin A Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia. eng Letter United States JAMA 7501160 0098-7484 AIM IM Adult African Americans Age Distribution Colorectal Neoplasms ethnology mortality European Continental Ancestry Group Female Humans Male Middle Aged Mortality trends United States epidemiology Young Adult 2017 8 9 6 0 2017 8 9 6 0 2017 9 21 6 0 ppublish 28787497 2647859 10.1001/jama.2017.7630 PMC5817468 Cancer
Attitudes of Surgeons toward Elderly Cancer Patients: A Survey from the SIOG Surgical Task Force Cancer care in elderly patients is complex. A recent survey showed that among mostly academic surgeons, practice patterns varied in the care of elderly patients. The authors suggested three areas of intervention in improving care of this population: frailty assessment, nutritional assessment, and assessment of quality of life.
Age and Outcome in Gastrointestinal Cancers: A Population-Based Evaluation of Oesophageal, Gastric and Colorectal Cancer With demographic changes and partial representativeness of randomized studies the question arises which results are achieved in the treatment of the elderly. The objective was to analyse population-based data on gastrointestinal cancers in terms of age.Analyses included data of the Munich Cancer Registry, i.e. 4,014, 10,127 and 42,809 invasive oesophageal, gastric (...) and colorectal cancer patients, respectively, which were diagnosed between 1998 and 2014. Tumour characteristics and outcome were analysed by age groups and therapy. Overall survival was analysed using the Kaplan-Meier method, and relative survival was computed as estimation for cancer-specific survival. Additionally, conditional survival of patients surviving at least 6 or 12 months was analysed by age.21, 44 and 38% of oesophageal, gastric and colorectal cancer patients, respectively, were aged >75 years
A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study. Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality.Design Growth curve construction and longitudinal cohort (...) study.Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe.Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children
Integration of Geriatric Assessment in the Care of Patients with Gastrointestinal Malignancies The majority of patients with gastrointestinal (GI) malignancies are older. Recently, it has become evident that elements from a geriatric assessment (GA) are powerful predictors of outcomes such as postoperative morbidity and mortality, length of stay, type of treatment received, and survival across several GI tumor types in older adults. A GA is a systematic evaluation of functional status (...) findings.Increasing data shows that elements from a GA and frailty are consistently associated with negative short- and long-term treatment outcomes in older patients with GI malignancies. Future studies should investigate the impact of geriatric interventions on outcomes.
of olderpeople. AgeAgeing . 2016;45(5):703-707. [ ] 16. Rosen T, Hargarten S, Flomenbaum N, Platts-Mills T. Identifying Elder Abuse in the Emergency Department: Toward a Multidisciplinary Team-Based Approach. Ann Emerg Med . 2016;68(3):378-382. [ ] 17. Anglin D, Homeier D. Elder abuse and neglect. In: Marx J, Hockberger R, eds. Rosen’s Emergency Medicine . Elsevier/Saunders; 2014:885-892. 18. Acute functional decline. Geri-EM. . Published 2013. Accessed July 21, 2017. 19. The geriatrics (...) ecosystem, a hub connecting seniors to resources, investigations, specialists, and acute care. In this post, I’d like to share the Top Five things I’ve found interesting about geriatric emergency medicine, as well as some practical advice for learners. 1. Older adults come to the ED often, and are more unwell when they do. In Ontario, persons over the age of 75 have the highest ED visit rate (73.1 per 100 of the population, compared to an average of 39.7). 1 In 2015, adults aged 65 or better accounted
Do factor V Leiden and prothrombin G20210A mutations predict recurrent venous thromboembolism in older patients? The value of genetic thrombophilia testing in elderly patients with an unprovoked venous thromboembolism is unclear. We assessed whether the Factor V Leiden and the prothrombin G20210A mutation are associated with recurrent venous thromboembolism in elderly patients in a prospective multicenter cohort study.We genotyped the Factor V Leiden and the prothrombin G20210A mutation in 354 (...) consecutive in- and outpatients aged ≥65 years with a first unprovoked venous thromboembolism from 9 Swiss hospitals. Patients and managing physicians were blinded to testing results. The outcome was recurrent symptomatic venous thromboembolism during follow-up. We examined the association between the Factor V Leiden and the prothrombin G20210A mutation and venous thromboembolism recurrence using competing risk regression, adjusting for age, sex, and periods of anticoagulation as a time-varying
was to assess the added benefit of vandetanib compared with best supportive care (BSC) as appropriate comparator therapy (ACT) in adolescents and children aged 5 years and older with aggressive and symptomatic medullary thyroid carcinoma (MTC) with unresectable, locally advanced or metastatic disease. Table 2 shows the therapeutic indication to be assessed and the ACT specified by the G-BA for it. Table 2: Research question of the benefit assessment of vandetanib Research question Therapeutic indication (...) Appropriate comparator therapy a 1 Adolescents and children aged 5 years and older with aggressive and symptomatic MTC with unresectable, locally advanced or metastatic disease Best supportive care b a: Presentation of the ACT specified by the G-BA. b: Best supportive care refers to the therapy that provides the patient with the best possible, individually optimized, supportive treatment to alleviate symptoms and improve the quality of life. ACT: appropriate comparator therapy; G-BA: Federal Joint
The prevalence of zinc deficiency in 6-month to 12-year old children in Bandar Abbas in 2013 Zinc deficiency is an important problem in children, especially in developing countries. Zinc supplements have beneficial effects on multiple factors, including treatment of growth retardation and hypogonadism, and they can be used as therapeutic and prophylactic agents against infection in children.To determine the prevalence of zinc deficiency in 6-month to 12-year-old children in Bandar Abbas.This (...) with a mean age of 42.82±30.68 months participated in this study. Among the participants, 263 (45.1%) were females, and 320 (54.9%) were males. The prevalence of zinc deficiency was 17.5% in this study. Zinc deficiencies were reported in 67 males (20.94%) males and in 35 females (13.30%). Zinc deficiencies were more common in boys, and this difference was statistically significant (p=0.01).The results of this study indicated that the prevalence of zinc deficiencies is high in Bandar Abbas
Longitudinal Research on Aging Drivers (LongROAD): study design and methods As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults.The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data (...) for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging.A total of 2990 active drivers aged 65-79 years at baseline have been recruited through primary care clinics or health care systems in five study sites located in California, Colorado, Maryland, Michigan, and New York. Consented participants were assessed at baseline with standardized research protocols and instruments, including vehicle inspection, functional performance
GRADE.We included 19 studies conducted in USA, Europe, China, and Australia. We judged the trials that contributed data to the review to be at low or unclear risk of bias.Nine studies compared multivitamins with placebo (7 studies) or no treatment (2 studies) in people with early and moderate AMD. The duration of supplementation and follow-up ranged from nine months to six years; one trial followed up beyond two years. Most evidence came from the Age-Related Eye Disease Study (AREDS) in the USA. People (...) is needed. Supplements containing lutein and zeaxanthin are heavily marketed for people with age-related macular degeneration but our review shows they may have little or no effect on the progression of AMD.
Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD).To determine whether or not taking antioxidant vitamin or mineral supplements, or both, prevent the development of AMD.We searched the Cochrane (...) data into RevMan 5; the other author checked the data entry. We pooled data using a fixed-effect model. We graded the certainty of the evidence using GRADE.We included a total of five RCTs in this review with data available for 76,756 people. The trials were conducted in Australia, Finland, and the USA, and investigated vitamin C, vitamin E, beta-carotene, and multivitamin supplements. All trials were judged to be at low risk of bias.Four studies reported the comparison of vitamin E with placebo
Treadmill interventions in children under six years of age at risk of neuromotor delay. Delayed motor development may occur in children with Down syndrome, cerebral palsy, general developmental delay or children born preterm. It limits the child's exploration of the environment and can hinder cognitive and social-emotional development. Literature suggests that task-specific training, such as locomotor treadmill training, facilitates motor development.To assess the effectiveness of treadmill (...) interventions on locomotor development in children with delayed ambulation or in pre-ambulatory children (or both), who are under six years of age and who are at risk for neuromotor delay.In May 2017, we searched CENTRAL, MEDLINE, Embase, six other databases and a number of trials registers. We also searched the reference lists of relevant studies and systematic reviews.We included randomised controlled trials (RCTs) and quasi-RCTs that evaluated the effect of treadmill intervention in the target