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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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Targeting NAD+ in Metabolic Disease: New Insights Into an Old Molecule Nicotinamide adenine dinucleotide (NAD+) is an established cofactor for enzymes serving cellular metabolic reactions. More recent research identified NAD+ as a signaling molecule and substrate for sirtuins and poly-adenosine 5'-diphosphate polymerases; enzymes that regulate protein deacetylation and DNA repair, and translate changes in energy status into metabolic adaptations. Deranged NAD+ homeostasis and concurrent (...) alterations in mitochondrial function are intrinsic in metabolic disorders, such as type 2 diabetes, nonalcoholic fatty liver, and age-related diseases. Contemporary NAD+ precursors show promise as nutraceuticals to restore target tissue NAD+ and have demonstrated the ability to improve mitochondrial function and sirtuin-dependent signaling. This review discusses the accumulating evidence for targeting NAD+ metabolism in metabolic disease, maps the different strategies for NAD+ boosting, and addresses
Experiences of the home-dwelling elderly in the use of telecare in home care services: a qualitative systematic review protocol. The objective of this systematic review is to identify and synthesize the best evidence on the home-dwelling elderly's experiences with the use of telecare in home care services. Furthermore, the study will identify experiences with telecare devices and examine what beliefs the home-dwelling elderly hold regarding the impact of telecare on the ability to age (...) in place.Review question 1: How do the home-dwelling elderly experience the use of telecare in the context of home care services?Review question 2: How do the home-dwelling elderly experience telecare devices?Review question 3: What beliefs do the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place?
The meaning of confidence for olderpeople living with frailty: a qualitative systematic review. In many countries, the oldest old (those aged 85 years and older) are now the fastest growing proportion of the total population. This oldest population will increasingly be living with the clinical condition of frailty. Frailty syndromes negatively impact on the person as they do the healthcare systems supporting them. Within healthcare literature "loss of confidence" is occasionally connected (...) to olderpeople living with frailty, but ambiguously described. Understanding the concept of confidence within the context of frailty could inform interventions to meet this growing challenge.The objective of this systematic review was to explore the meaning of confidence from the perspective of olderpeople living with frailty through synthesis of qualitative evidence to inform healthcare practice, research and policy.Studies that included frail adults, aged over 60 years, experiencing acute hospital
Aldosterone-Producing Cell Clusters Frequently Harbor Somatic Mutations and Accumulate With Age in Normal Adrenals Aldosterone synthase (CYP11B2) immunohistochemistry and next-generation sequencing (NGS) have revealed the frequent presence of aldosterone-producing cell clusters (APCCs) harboring somatic mutations in aldosterone-regulating genes in adrenals from Americans without defined hypertension status.Determine the frequency and somatic mutation status of APCCs in a Japanese (...) (average of 0.6 APCCs per gland). APCC score was positively correlated with age (r = 0.50, P < 0.0001). NGS demonstrated high confidence somatic mutations in 21 of 61 APCCs (34%). Notably, 16 of 21 APCCs (76%) harbored somatic mutations in CACNA1D, the most frequently mutated gene in our previous studies of APCCs in Americans and CYP11B2-positive micronodules in cross-sectional imaging (computed tomography) negative primary aldosteronism (PA), whereas no APCCs harbored mutations in KCNJ5, the most
of this method of decision analysis, we applied it to the treatment of hypercholesterolaemia in a geriatric population of 50 individuals. We highlighted the results of four of these individuals.This method of analysis provided individualized quantifications of the effect of age and comorbidity on the probability of treatment benefit. The average probability of deriving a benefit, of at least 50% of the magnitude of benefit available to an individual without comorbidity, was only 0.8%.The effects of age (...) A method of decision analysis quantifying the effects of age and comorbidities on the probability of deriving significant benefit from medical treatments The external validity, or generalizability, of trials and guidelines has been considered poor in the context of multiple morbidity. How multiple morbidity might affect the magnitude of benefit of a given treatment, and thereby external validity, has had little study.To provide a method of decision analysis to quantify the effects of age
physician practices in Ontario, Canada (January-December 2012).Patients aged 66 years or older with nonbacterial AURIs. Patients with cancer or immunosuppressive conditions and residents of long-term care homes were excluded.Antibiotic prescriptions for physician-diagnosed AURIs. A multivariable logistic regression model with generalized estimating equations was used to examine whether prescribing rates varied by physician characteristics, accounting for clustering of patients among physicians (...) Antibiotic Prescribing for Nonbacterial Acute Upper Respiratory Infections in Elderly Persons. Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice.To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics.Retrospective analysis of linked administrative health care data.Primary care
Hepatitis C Virus Infection Among Reproductive-Aged Women and Children in the United States, 2006 to 2014. In the United States, hepatitis C virus (HCV) infection has increased among young persons who inject drugs, but the extent of this epidemic among reproductive-aged women and their children is unknown.To estimate numbers and describe characteristics of reproductive-aged women with HCV infection and of their offspring.Analysis of the National Notifiable Diseases Surveillance System (NNDSS (...) ) from 2006 to 2014 and the Quest Diagnostics Health Trends national database from 2011 to 2014.United States.171 801 women (aged 15 to 44 years) and 1859 children (aged 2 to 13 years) with HCV infection reported to the NNDSS; 2.1 million reproductive-aged women and 56 684 children who had HCV testing by Quest Diagnostics.NNDSS HCV case reports and Quest laboratory data regarding unique reproductive-aged women and children who were tested for HCV infection.The number of reproductive-aged women
Age of initial cohort of dengue patients could explain the origin of disease outbreak in a setting: a case control study in Rajasthan, India Dengue fever (DF) and dengue hemorrhagic fever (DHF) is a public health problem with 390 million cases reported in world annually. In Rajasthan, DF with DHF is being reported for about two decades. For undertaking interventions into disease transmission, locating origin of transmission is very important. Present paper reports retrospective analysis
Select physical performance measures and driving outcomes in older adults Improving physical functioning may be a future intervention to keep older adults driving safely longer as it can help maintain both physical and cognitive health longer. This systematic review assesses the evidence on the association between three physical functioning measures: the Short Physical Performance Battery, the Timed Up-and-Go test, and the Rapid Pace Walk with driving outcomes in older adults.Older adult (...) studies published between 1994 and 2015 that included the Short Physical Performance Battery, the Timed Up-and-Go test, or the Rapid Pace Walk as a measure of physical functioning and included a driving-related outcome were identified through a comprehensive search and reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Thirteen studies involving 5,313 older adults met the inclusion criteria. Lower Short Physical Performance Battery scores were associated
The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana Suicide is recognised as the third leading cause of death among adolescents globally. There is however limited data on the prevalence and factors associated with suicide particularly in Ghana. To explore the prevalence and risk and protective factors associated with suicide in Ghana, a nationwide Global School-based Student Health Survey data collected among senior (...) and worries remained a significant protective factor for all the indices of suicidal behaviour after adjusting for other variables. Parental respect for privacy was protective of suicidal attempt but was not significant after adjusting for other variables. Early identification and intervention for at-risk adolescents in senior high schools, for example those experiencing different forms of physical abuse, drug and substance use and hunger can potentially reduce the prevalence of suicide among
Conserved and species-specific molecular denominators in mammalian skeletal muscle agingAging is a complex phenomenon involving functional decline in multiple physiological systems. We undertook a comparative analysis of skeletal muscle from four different species, i.e. mice, rats, rhesus monkeys, and humans, at three different representative stages during their lifespan (young, middle, and old) to identify pathways that modulate function and healthspan. Gene expression profiling (...) and computational analysis revealed that pathway complexity increases from mice to humans, and as mammals age, there is predominantly an upregulation of pathways in all species. Two downregulated pathways, the electron transport chain and oxidative phosphorylation, were common among all four species in response to aging. Quantitative PCR, biochemical analysis, mitochondrial DNA measurements, and electron microscopy revealed a conserved age-dependent decrease in mitochondrial content, and a reduction
. There were no restrictions on the number of times subjects could use the app. A 15-question survey was developed to assess feasibility and utility of the HealtheBrain app and completed online following the brief exposure period.Of 135 people who were identified, 95 were contacted between September 2014 to August 2015, 27 downloaded the HealtheBrain app on their iPhone or iPad from the App Store and 19 completed the questionnaire. Subjects (n=19) were an average age of 68.3±5.4; 74% female and had 15.5 (...) HealtheBrain: an innovative smartphone application to improve cognitive function in older adults Exercise-based interventions have shown promise in slowing cognitive decline, however there is limited evidence for scalability. Our previous research has linked a novel visuospatial memory exercise intervention, incorporating patterned walking or square-stepping exercise (SSE) with significant improvements in executive function and memory among older adults with normal cognition as well as those
Endothelial keratoplasty for posterior polymorphous corneal dystrophy in a 4-month-old infant To report a case of endothelial keratoplasties (EKs) performed in a 4 month old with a posterior polymorphous corneal dystrophy.A 4 month old infant underwent Descemet membrane endothelial keratoplasty (DMEK) for posterior polymorphous corneal dystrophy. The graft was found to be dislocated on day 5 post-operatively and an attempt to unfold the DMEK scroll and re-bubble was not successful. The patient (...) was then treated successfully with bilateral Descemet stripping automated endothelial keratoplasty (DSAEK). At 3 years of follow-up, her visual acuity was 20/70 in the right and 20/60 in the left eye with good endothelial cell counts.and Importance: This study reports the youngest case of EKs performed at the age of 4 months in an infant. This is also the first reported case of attempted DMEK highlighting its challenges in infants. DSAEK remains a good treatment option for endothelial dysfunction secondary
Implementation of a feasible monthly vitamin D intervention in homebound older adults using a Meals-on-Wheels programme. 27056839 2017 05 03 2018 12 02 1468-9618 19 3 2016 07 Evidence-based nursing Evid Based Nurs Implementation of a feasible monthly vitamin D intervention in homebound older adults using a Meals-on-Wheels programme. 96 10.1136/eb-2016-102331 Lagari Violet S VS University of Miami School of Medicine, Miami, Florida, USA; Miami Veterans Affairs Healthcare System, Miami, Florida (...) , USA. Levis Silvina S University of Miami School of Medicine, Miami, Florida, USA; Miami Veterans Affairs Healthcare System, Miami, Florida, USA. eng Journal Article Comment 2016 04 07 England Evid Based Nurs 9815947 1367-6539 0 Cholestanes 0 Vitamins 1406-16-2 Vitamin D IM N J Am Geriatr Soc. 2015 Sep;63(9):1861-7 26277680 Cholestanes Food Services Homebound Persons Humans Vitamin D Vitamins GERIATRIC MEDICINE 2016 4 9 6 0 2016 4 9 6 0 2017 5 4 6 0 ppublish 27056839 eb-2016-102331 10.1136/eb-2016
Effect of Metabolic Syndrome on the Mobility Benefit of a Structured Physical Activity Intervention-The Lifestyle Interventions and Independence for Elders Randomized Clinical Trial To test whether structured physical activity (PA) is associated with a greater reduction in major mobility disability (MMD) in older persons with metabolic syndrome (MetS) than in those without.Data from the Lifestyle Interventions and Independence for Elders (LIFE) Study, a multicenter randomized trial of 1,635 (...) persons with assessments every 6 months (average 2.7 years).Eight U.S. centers.Sedentary men and women aged 70 to 89 with functional limitations (N = 1,535); 100 participants were excluded because of missing MetS data.Participants were randomized to a moderate-intensity PA program (n = 766) or a health education program (n = 769).MetS was defined according to the 2009 multiagency harmonized criteria. Outcomes included incident MMD (loss of ability to walk 400 m) and persistent MMD (two consecutive MMD
The effectiveness of optimised clinical medication reviews for geriatric patients: Opti-Med a cluster randomised controlled trial Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use.The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual (...) care in older patients with geriatric problems in the general practice.We performed a cluster randomised controlled trial in 22 Dutch general practices. Patients of ≥65 years were eligible if they newly presented with pre-specified geriatric symptoms in general practice and the chronic use of ≥1 prescribed drug. The intervention consisted of CMRs which were prepared by an independent expert team and discussed with the patient by the general practitioner. Primary outcomes: QoL and the presence
nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with olderage and higher prevalence of acute coronary syndrome and chronic kidney disease. During (...) Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric
Watchful Waiting Versus Surgery of Mildly Symptomatic or Asymptomatic Inguinal Hernia in Men Aged 50 Years and Older: A Randomized Controlled Trial To compare if watchful waiting is noninferior to elective repair in men aged 50 years and older with mildly symptomatic or asymptomatic inguinal hernia.The role of watchful waiting in older male patients with mildly symptomatic or asymptomatic inguinal hernia is still not well-established.In this noninferiority trial, we randomly assigned men aged (...) as a reasonable alternative compared with surgery in men aged 50 years and older.