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evidence based problems with the elderly

Doris Y P Leung, Helen Y L Chan, Susan Z M Yau, Patrick K C Chiu, Fiona W K Tang, Joseph S K Kwan
AIM: To examine the effect of a video-supported nurse-led advance care planning to frail geriatric patients on end-of-life decision making outcomes in patients and their carers. DESIGN: This is a double-blinded randomized controlled trial with parallel arms. METHODS: The protocol was approved by the Institutional Review Board of the participating hospital on 1 August 2018. Frail elders and their carer if any are enrolled during hospitalization, and undergo randomization after discharged...
January 29, 2019: Journal of Advanced Nursing
Kade L Paterson, Lucy Gates
Foot and ankle osteoarthritis (OA) is a common and disabling problem that adversely affects physical function and significantly reduces quality of life. Although the knee was considered to be the lower-limb site most often affected by OA, recent population data showed foot OA is as prevalent as knee OA, and rates increase with advancing years. The most common foot OA sites include the first metatarsophalangeal joint and the midfoot, with the ankle affected less often. Despite the high prevalence and disabling nature of foot and ankle OA, the condition has been neglected by clinical researchers, and there are very few trials investigating non-surgical foot or ankle OA treatment options...
January 25, 2019: Drugs & Aging
Saya Terada, Miyae Yamakawa, Younhee Kang, Sayuri Kobayashi, Xiao-Yan Liao, Sirirat Panuthai, Huei-Chuan Sung, Mizue Suzuki, Kiyoko Makimoto
BACKGROUND: The aim of this cross-sectional study was to compare patterns of psychotropic prescription drug use among cognitively impaired residents in long-term care facilities in East Asia and to explore factors associated with these patterns. METHODS: This study included elderly participants with cognitive impairments residing in long-term care facilities with and without dementia care units in Japan, South Korea, China, Taiwan, and Thailand. The Mini-Mental State Examination, the Clinical Dementia Rating, and the Neuropsychiatric Inventory, Nursing Home version were used to assess cognitive status, examine dementia severity, and evaluate behavioural psychological symptoms of dementia, respectively...
January 21, 2019: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Sandra L Spoelstra, Alla Sikorskii, Laura N Gitlin, Monica Schueller, Margaret Kline, Sarah L Szanton
BACKGROUND/OBJECTIVES: Of older adults, 42% report problems with daily function, and physical function is the most important consideration for aging individuals. Thus, we implemented a model of care focused on improving physical function and examined health and use outcomes and satisfaction. DESIGN: A 3-year participatory, single-group pretrial/posttrial benchmarked to a usual care cohort that was evaluated prior to the study. SETTING: Four Medicaid home and community-based waiver sites in Michigan...
December 13, 2018: Journal of the American Geriatrics Society
Timra J Bowerman, Jan Zhang, Louise M Waite
Background: Aspiration pneumonia is a common problem in older people with high mortality and increasing prevalence. Objective: The aims of this paper were to systematically review the literature on the antibacterial treatment of aspiration pneumonia in elderly patients and identify the microbiology of aspiration pneumonia. Materials and methods: EMBASE, MEDLINE, and Cochrane databases were systematically searched for studies that examined the clinical efficacy of antibiotic treatment in elderly patients with aspiration pneumonia...
2018: Clinical Interventions in Aging
Erni J Nelwan
Dengue viral infection remains a major public health problem. As many as 400 million people are infected yearly. Even though the vaccine is available, the use of dengue vaccine is still limited due to some concerns. Among patient infected with dengue viral infection, early recognition of the virus and prompt supportive treatment are important to avoid complication and mortality.The clinical spectrum of dengue viral infection is diverse ranging from undifferentiated fever to dengue shock syndrome characterized by plasma leak and hemoconcentration...
July 2018: Acta Medica Indonesiana
Masahisa Arahata, Hidesaku Asakura
Compared with younger people, elderly people have higher risks for both thrombosis and bleeding. Furthermore, comorbidities frequently found in elderly patients complicate the management of antithrombotic therapy. Thus, when treating these patients, physicians often find it difficult to incorporate the principles of evidence-based medicine and must determine the best treatment option for each patient. Recently, in the fields of cerebrovascular and cardiovascular diseases, researchers have been rapidly accumulating new data regarding antithrombotic therapy, particularly in the areas of direct oral anticoagulants (DOACs) and dual antiplatelet therapy (DAPT)...
2018: Clinical Interventions in Aging
Wioletta Mędrzycka-Dąbrowska, Sebastian Dąbrowski, Aleksandra Gutysz-Wojnicka, Andrzej Basiński, Katarzyna Kwiecień-Jaguś
PURPOSE: The purpose of this study was to identify Polish nurses' experiences and perceptions about the barriers to postoperative pain management in older adults. DESIGN: The study was conducted using a dedicated questionnaire. METHODS: Eleven hospitals participated in this study. The project involved 1,602 nurses working on surgical hospital wards. A descriptive exploratory survey and a qualitative content analysis were used. FINDINGS: Access to journals on evidence-based practice related to pain assessment and management in elderly patients was assessed as less important by the respondents...
October 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Makini Chisolm-Straker
No abstract text is available yet for this article.
August 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tessa J Parsons, Efstathios Papachristou, Janice L Atkins, Olia Papacosta, Sarah Ash, Lucy T Lennon, Peter H Whincup, Sheena E Ramsay, S Goya Wannamethee
PURPOSE: To investigate associations between diet quality, dietary patterns and mobility limitation 15 years later in a population-based sample of older British men. METHODS: We used longitudinal data from 1234 men from the British Regional Heart Study, mean age 66 years at baseline. Mobility limitation was defined as difficulty going up- or downstairs or walking 400 yards as a result of a long-term health problem. Dietary intake was measured using a food frequency questionnaire data from which the Healthy Diet Indicator (HDI), the Elderly Dietary Index (EDI), and three a posteriori dietary patterns were derived...
July 23, 2018: European Journal of Nutrition
Italo Biaggioni
Orthostatic hypotension (OH) is an important and common medical problem, particularly in the frail elderly with multiple comorbidities and polypharmacy. OH is an independent risk factor for falls and overall mortality. Hypertension is among the most common comorbidities associated with OH, and its presence complicates the management of these patients because treatment of one can worsen the other. However, there is evidence that uncontrolled hypertension worsens OH so that both should be managed. The limited data available suggest that angiotensin receptor blockers and calcium channel blockers are preferable antihypertensives for these patients...
November 13, 2018: American Journal of Hypertension
Ewa Gawecka, Oddbjørn Viken
Background and purpose Postherpetic neuralgia (PHN) is a complication of acute herpes zoster (HZ). The evidence base for management of PHN has increased by recent publications. Therefore, we reviewed incidence of HZ, prevalence, risk factors, and mechanism of PHN pain, prevention and treatment of PHN with special interest in studies on adult vaccination and topical application of lidocaine and concentrated capsaicin patch. Methods We searched databases with an English language restriction: MEDLINE 1944-2011, EMBASE 1988-2011, PubMed, and the Cochrane Controlled Trial Register and Cochrane Library (2011)...
October 1, 2012: Scandinavian Journal of Pain
D Merlotti, M Materozzi, T Picchioni, S Bianciardi, M Alessandri, R Nuti, L Gennari
Osteoporosis is a growing health and health-economic problem due to the increased proportion of elderly people in the population. Basic and clinical advances in research over the past two decades have led to the development of different compounds with antiresorptive or anabolic activity on bone that improved substantially the management of patients with osteoporosis over calcitonin or estrogen replacement. New compounds are in preclinical and clinical development. Areas covered: In this review, the authors review the approaches for the preclinical and clinical development of antiresorptive and anabolic agents for osteoporosis, particularly focusing on the recent advances in technology and in the understanding of skeletal biology, together with their implications on novel osteoporosis drug discovery...
August 2018: Expert Opinion on Drug Discovery
Katherine A Hirchak, Emily Leickly, Jalene Herron, Jennifer Shaw, Jordan Skalisky, Lisa G Dirks, Jaedon P Avey, Sterling McPherson, Jenny Nepom, Dennis Donovan, Dedra Buchwald, Michael G McDonell
INTRODUCTION: Many American Indian and Alaska Native (AI/AN) people seek evidence-based, cost-effective, and culturally acceptable solutions for treating alcohol use disorders. Contingency management (CM) is a feasible, low-cost approach to treating alcohol use disorders that uses "reinforcers" to promote and support alcohol abstinence. CM has not been evaluated among AI/AN communities. This study explored the cultural acceptability of CM and adapted it for use in diverse AI/AN communities...
July 2018: Journal of Substance Abuse Treatment
Yankun Sun, Le Shi, Yanping Bao, Yan Sun, Jie Shi, Lin Lu
BACKGROUND: There are several studies that have focused on the relationship between sleep duration and depression, however, only a few prospective studies have centered on the bidirectional relationship between them. This four-year longitudinal study aimed to identify the association between sleep duration and depression in community-dwelling mid-age and elderly individuals. METHODS: 10,704 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included for baseline and four-year follow up...
March 31, 2018: Sleep Medicine
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
August 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Moïse Roche, Naaheed Mukadam, Simon Adelman, Gill Livingston
OBJECTIVE: We evaluated the feasibility and acceptability of a tailored evidence-based intervention, consisting of a leaflet and a letter, to encourage timely help-seeking for dementia in Black elders. METHODS: Participating GP surgeries were randomised to send either the intervention or a control leaflet about ageing well to Black patients aged ≥50 years old without known dementia. We interviewed patients 2 weeks later about the intervention's acceptability using closed and open-ended questions, and they completed a Theory-of-Planned-behaviour questionnaire about what they would do if they developed memory problems, which they also completed 4 months later...
August 2018: International Journal of Geriatric Psychiatry
Harris Hyun-Soo Kim, JongSerl Chun
Research indicates that mobile phone dependency (MPD) is associated with various behavioral and internalizing problems. While a significant amount of findings points to its negative outcomes, there is a dearth of evidence concerning the determinants of MPD. This study focuses on this critical, yet understudied, subject by analyzing the associations between abusive parenting style, neighborhood characteristics, and MPD among youths in South Korea, a country with one of the highest mobile broadband penetration rates in the world...
2018: PloS One
Merita Berisha, Florie Miftari-Basholli, Naser Ramadani, Sanije Gashi, Rina Hoxha, Dardan Kocinaj
Introduction: Malignant diseases are serious socio-medical problem, being that they cause grave problems in terms of health, social and economic perspective to an individual, in particular, and society in general. A proper reporting and monitoring system enables adequate calculation of indicators and evidence based decision making. Aim: The study aims to examine the appearance of malignancies diagnosed and reported in Kosovo for a three years period: 2012, 2013, and 2014 by its modalities such as by the years of appearance, gender, age, and most frequent types of malignancies...
2018: Acta Informatica Medica: AIM
Joyce Hawk, Mary Shannon
The incidence and prevalence of skin tears in long-term care (LTC) facilities has not been well established. To ascertain the point prevalence of reported skin tears, a retrospective review of incident reports was performed in 6 LTC facilities in western Pennsylvania from November 1, 2016 through December 31, 2016. Report data, including resident age; gender; mobility limitations; skin tear location, number, and cause (if known); occurrence time (7 am to 3 pm, 3 pm to 11 pm, or 11 pm to 7 am nursing shift); and history of previous skin tears, were abstracted...
April 2018: Ostomy/wound Management
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