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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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Outcomes in elderly patients with acute coronary syndromes randomized to enoxaparin vs. unfractionated heparin: results from the SYNERGY trial Elderly patients are at high risk from non-ST-segment elevation acute coronary syndromes (NSTE ACS) as well as from treatment-related complications. Age-associated changes in physiology may alter the risk and benefit expected from therapy. The SYNERGY database was used to study the influence of age on treatment outcomes with enoxaparin vs. unfractionated (...) by treatment and age. Overall, 9977 randomized patients had age information, of whom 25.5% (2540) were >or=75 years of age. Elderly patients (>or=75 years) had more cardiovascular risk factors, prior cardiac disease, and higher acuity at presentation. After adjustment, advanced age (per 10 years) was associated with 30-day death or MI [risk odds ratios (ROR): 1.14, P = 0.002], 30-day death (ROR: 1.54, P < 0.0001), and 1-year death (ROR: 1.47, P < 0.0001), as well with TIMI major bleeding (ROR: 1.21, P
Coronary artery calcium to predict all-cause mortality in elderly men and women We sought to study the prognostic utility of coronary artery calcium (CAC) in the elderly.The prognostic significance of CAC in the elderly is not well known.All-cause mortality was assessed in 35,388 patients (3,570 were >or=70 years old at screening, and 50% were women) after a mean follow-up of 5.8 +/- 3 years.In older patients, risk factors and CAC were more prevalent. Overall survival was 97.9% at the end (...) the 20,562 patients with no CAC, annual mortality rates ranged from 0.3% to 2.2% for patients age 40 to 49 years or >or=70 years (p < 0.0001). The use of CAC allowed us to reclassify more than 40% of the patients >or=70 years old more often by excluding risk (i.e., CAC <400) in those with >3 risk factors.Despite their limited life expectancy, the use of CAC discriminates mortality risk in the elderly. Furthermore, the use of CAC allows physicians to reclassify risk in the elderly.
Association between unmet needs for medication support and all-cause hospitalization in community-dwelling disabled elderly people To clarify the association between unmet medication management need and 3-year mortality and hospitalization for community-dwelling older people with various levels of disabilities.Prospective cohort study (the Nagoya Longitudinal Study for Frail Elderly).Community-based.One thousand seven hundred seventy-two community-dwelling elderly subjects (611 men, 1,161 women (...) regression models adjusting for potential confounders showed that the lack of assistance in those who needed medication assistance was associated with hospitalization but not mortality during the study period.In community-dwelling disabled elderly people, lack of medication assistance in those needing medication support was associated with higher risk of hospitalization.
Health literacy, cognitive abilities, and mortality among elderly persons Low health literacy and low cognitive abilities both predict mortality, but no study has jointly examined these relationships.We conducted a prospective cohort study of 3,260 community-dwelling adults age 65 and older. Participants were interviewed in 1997 and administered the Short Test of Functional Health Literacy in Adults and the Mini Mental Status Examination. Mortality was determined using the National Death Index
Telomere length and mortality: a study of leukocytes in elderly Danish twins. Leukocyte telomere length, representing the mean length of all telomeres in leukocytes, is ostensibly a bioindicator of human aging. The authors hypothesized that shorter telomeres might forecast imminent mortality in elderly people better than leukocyte telomere length. They performed mortality analysis in 548 same-sex Danish twins (274 pairs) aged 73-94 years, of whom 204 pairs experienced the death of one or both
U-slab, hanging cast or collar and cuff in uncomplicated shaft of humerus fractures in the elderly BestBets: U-slab, hanging cast or collar and cuff in uncomplicated shaft of humerus fractures in the elderly U-slab, hanging cast or collar and cuff in uncomplicated shaft of humerus fractures in the elderly Report By: Ashes Mukerjee - Research Fellow Search checked by Magnus Harrison - Consultant Institution: Manchester Royal Infirmary Current web editor: Magnus Harrison - SpR in Emergency (...) Medicine Date Submitted: 1st March 2000 Date Completed: 26th March 2008 Last Modified: 25th January 2008 Status: Green (complete) Three Part Question In [elderly patients with uncomplicated shaft of humerus fractures] is [a u-slab, a hanging cast or a collar and cuff] better at [reducing pain and promoting healing]? Clinical Scenario A 60 year old woman presents with a closed, undisplaced, uncomplicated fracture of the shaft of the humerus. You seek advice on the best method to support / splint the arm
Effects of 2-week treatment with temazepam and diphenhydramine in elderly insomniacs: a randomized, placebo-controlled trial A randomized, controlled, crossover clinical study compared 14-night treatment with 15 mg temazepam, 50 mg diphenhydramine, and placebo in elderly individuals with insomnia (mean age, 73.9 years; range, 70-89 years). Primary outcome measures were subjective assessments of sleep recorded on sleep diaries. Secondary measures were the morning-after psychomotor impairment (...) in the elderly must consider these relative benefits and risks.
Self-rated health and a healthy lifestyle are the most important predictors of survival in elderly women to test the hypothesis that morbidity and health related behavioural factors are stronger than social factors as predictors of death among older women.we used data from 12,422 participants in the Australian Longitudinal Study on Women's Health who were aged 70-75 in 1996. Proportional hazards models of survival up to 31 October 2005 were fitted separately for the whole cohort and those women
Distal radius fracture management in elderly patients: a literature review Distal radius fracture management in elderly patients remains without consensus regarding the appropriate treatment or anticipated outcome. Forty-one studies that included at least 10 patients with a minimum mean age of 65 years and that were indexed in Medline or Embase were reviewed. Treatment methods included pins and plaster, external fixation, K-wires, bone cement, and open reduction and internal fixation (...) with plates. The methodological quality of each study was evaluated through use of a grading scale. Despite study heterogeneity, higher rates of infection were noted with external fixation and K-wire stabilization. Stratifying patients into low-demand and high-demand groups may improve the management of distal radius fractures in elderly patients. In sedentary patients with low demands, functional outcomes are good despite the presence of deformity. Patients with higher demands may benefit from fracture
Antipsychotic Drug Use and Risk of Pneumonia in Elderly People To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people.A nested case-control analysis.Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records.A cohort of 22,944 elderly people with at least one antipsychotic prescription; 543 cases of hospital admission for pneumonia were identified. Cases were compared with four (...) of antipsychotics was associated with an almost 60% increase in the risk of pneumonia (adjusted OR=1.6, 95% CI=1.3-2.1). The risk was highest during the first week after initiation of an antipsychotic (adjusted OR=4.5, 95% CI=2.8-7.3). Similar associations were found after exclusion of elderly people with a diagnosis of delirium. Current users of atypical agents showed a higher risk of pneumonia (adjusted OR=3.1, 95% CI=1.9-5.1) than users of conventional agents (adjusted OR=1.5, 95% CI=1.2-1.9
Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. In old age, reduction in physical function leads to loss of independence, the need for hospital and long-term nursing-home care, and premature death. We did a systematic review to assess the effectiveness of community-based complex interventions in preservation of physical function and independence in elderly people.We searched systematically (...) for randomised controlled trials assessing community-based multifactorial interventions in elderly people (mean age at least 65 years) living at home with at least 6 months of follow-up. Outcomes studied were living at home, death, nursing-home and hospital admissions, falls, and physical function. We did a meta-analysis of the extracted data.We identified 89 trials including 97 984 people. Interventions reduced the risk of not living at home (relative risk [RR] 0.95, 95% CI 0.93-0.97). Interventions reduced
Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60) Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is used to treat patients with non-Hodgkin lymphoma. Interval decrease from 3 weeks of treatment (CHOP-21) to 2 weeks (CHOP-14), and addition of rituximab to CHOP-21 (R-CHOP-21) has been shown to improve outcome in elderly patients with diffuse large B-cell (...) lymphoma (DLBCL). This randomised trial assessed whether six or eight cycles of R-CHOP-14 can improve outcome of these patients compared with six or eight cycles of CHOP-14.1222 elderly patients (aged 61-80 years) were randomly assigned to six or eight cycles of CHOP-14 with or without rituximab. Radiotherapy was planned to sites of initial bulky disease with or without extranodal involvement. The primary endpoint was event-free survival; secondary endpoints were response, progression during treatment
Vitamin d supplementation to prevent falls in the elderly: evidence and practical considerations. Pharmacists in both ambulatory and institutional settings are often in a position to help optimize the drug regimens of patients who are experiencing falls. Supplementation with vitamin D is an important emerging therapy for the prevention of falls. Numerous investigators have recently studied or reviewed the association between vitamin D supplementation and decreased risk of falls in elderly (...) patients, yet little of this information is available in the pharmacy literature. A MEDLINE search was conducted to collect relevant articles about the role of vitamin D in preventing falls among elderly patients; recently published meta-analyses and randomized controlled trials were identified and reviewed. The studies indicated a statistically significant positive relationship between vitamin D supplementation with either cholecalciferol 700 IU/day or greater or ergocalciferol 800 IU/day or greater
Lung cancer in elderly patients: an analysis of the surveillance, epidemiology, and end results database. To study the burden and outcome of lung cancer in the elderly, particularly for patients aged 80 years and older.The national Surveillance, Epidemiology, and End Results database was analyzed for lung cancer outcomes during the period 1988 to 2003. A comparison was carried out between patients with lung cancer 80 years and older, 70 to 79 years, and younger than 70 years for demographics (...) ; stage distribution; 5-year relative survival; and survival based on histology, sex, race, stage, and treatment. The temporal trends in survival during the years 1988 to 1997 and 1998 to 2003 were also analyzed.Of 316,682 patients eligible for the analysis, 45,912 (14%) were 80 years or older (ie, very elderly); 103,963 (33%) were 70 to 79 years; and 166,807 (53%) were younger than 70 years. The distribution by stage and histology was comparable for all the three groups. Overall survival rate at 5
Prediction of mortality in community-living frail elderly people with long-term care needs. To develop and validate a prognostic index for mortality in community-living, frail elderly people.Cohort study of Program of All-Inclusive Care for the Elderly (PACE) participants enrolled between 1988 and 1996.Eleven PACE sites, a community-based long-term care program that cares for frail, chronically ill elderly people who meet criteria for nursing home placement.Three thousand eight hundred ninety (...) and validation cohorts, respectively.A multidimensional prognostic index was developed and validated using age, sex, functional status, and comorbidities that effectively stratifies frail, community-living elderly people into groups at varying risk of mortality.
The Growing Burden of Diabetes Mellitus in the US Elderly Population The prevalence of diabetes mellitus is growing worldwide. Consequently, there has been increased emphasis on primary and secondary prevention of diabetes. To our knowledge, whether there have been actual improvements in outcomes in the last decade or so has not been documented in a nationally representative sample.We undertook this study to examine trends in rates of occurrence of diabetes and its complications in persons
Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people: a randomized controlled trial (ISRCTN 64716113) Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people: a randomized controlled trial (ISRCTN 64716113) Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people: a randomized controlled trial (ISRCTN 64716113) Hendriks M R, Evers S M, Bleijlevens M H (...) -dwelling elderly. The study demonstrated that the multidisciplinary intervention programme was not cost-effective compared with usual care in the Dutch setting, as the two strategies were similarly costly and effective. The study methodology was of satisfactory quality and was presented clearly, so the authors’ conclusions appear valid. Type of economic evaluation Cost-effectiveness analysis, cost-utility analysis Study objective The objective was to examine the cost-effectiveness
Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.