Multiple Sclerosis in the Elderly: Considerations in the Geriatric Population for Diagnosis and Management

2015 ◽  
Vol 4 (2) ◽  
pp. 131-141
Author(s):  
Claire S. Riley ◽  
Wendy Vargas
Keyword(s):  
Multiple Sclerosis ◽  
The Elderly ◽  
Geriatric Population ◽  
Diagnosis And Management

scholarly journals Disease-modifying therapy prescription patterns in people with multiple sclerosis by age

2021 ◽  
Vol 14 ◽  
pp. 175628642110064
Author(s):  
Yinan Zhang ◽  
Amber Salter ◽  
Shan Jin ◽  
William J. Culpepper ◽  
Gary R. Cutter ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Age Groups ◽  
The Elderly ◽  
Department Of Veterans Affairs ◽  
Real World Data ◽  
Research Committee ◽  
The North ◽  
Disease Modifying ◽  
Magnetic Resonance Imaging Mri

Background: Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for their ability to reduce disease activity, namely clinical relapses and signal changes on magnetic resonance imaging (MRI). Disease activity appears age dependent. Thus, the greatest benefit would be expected in younger people with MS (PwMS) whereas benefits in the elderly are uncertain. Methods: Real-world data were obtained from PwMS from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry and the US Department of Veterans Affairs Multiple Sclerosis Surveillance Registry (MSSR). Results: 6948 PwMS were surveyed from NARCOMS, and the MSSR had 1719 participants. In younger adult PwMS 40-years old or less, 183 (61.4%) in NARCOMS and 179 (70.5%) in the MSSR were prescribed DMTs. Among PwMS over age 60, 1575 (40.1%) in NARCOMS and 239 (36.3%) in the MSSR were prescribed DMTs. More PwMS in the age group of 31–40 ( p = 0.035) and 41–50 ( p = 0.001) in the MSSR were using DMTs compared with PwMS of the same age groups in NARCOMS. Conclusion: These findings suggest that DMTs are under-utilized in the younger population and continue to be commonly prescribed in the elderly. Broader access may explain the higher prescription rate of DMTs in US veterans.

scholarly journals Adult onset Still’s disease in the elderly: a case-based literature review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arash Mollaeian ◽  
Jingjing Chen ◽  
Nina N. Chan ◽  
Gregory A. Nizialek ◽  
Christopher J. Haas
Keyword(s):  
Delayed Diagnosis ◽  
The Elderly ◽  
Adult Onset Still’S Disease ◽  
Inflammatory Disorder ◽  
Adult Onset ◽  
Still’S Disease ◽  
Diagnosis And Management ◽  
Still's Disease ◽  
Area Of Interest ◽  
Adult Onset Still's Disease

Abstract Background Adult onset Still’s disease (AOSD) is a rare inflammatory disorder that classically presents with high spiking fevers, evanescent rash, and arthritis. The diagnosis is one of exclusion and can be further complicated by atypical presentations, particularly in elderly patients in whom AOSD is very rare. Case presentation A case of AOSD in a 73-year-old woman with a non-classic presentation, leading to delayed diagnosis and management, is presented along with a review of the English literature for AOSD cases in elderly people over 70 years of age. Thirty nine case reports and series were identified and the current case was added, totaling 42 individual cases. Significant findings included a four-times higher prevalence in females, a higher prevalence of macrophage activation syndrome despite lower mortality, the presence of pruritic rash in almost one fifth of the cases, and high prevalence of delayed diagnosis. Conclusions AOSD in the elderly may vary from the classic criteria described in the medical literature and may lead to delayed diagnosis and management. Further evaluation and better characterization of AOSD in the elderly remains an area of interest.

Effectiveness of the Complete Health Improvement Program in a Geriatric Population

2021 ◽  
pp. 155982762110493
Author(s):  
Emily Scriven ◽  
Bhakti Chavan ◽  
David Drozek
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Lipoprotein Cholesterol ◽  
Health Improvement ◽  
Cvd Risk ◽  
Improvement Program ◽  
Geriatric Population ◽  
Complete Health

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65 years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level ( P < .001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables ( P > .05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population.

The Elderly Person With Multiple Sclerosis

2015 ◽  
Vol 47 (6) ◽  
pp. 333-339 ◽  
Author(s):  
Marijean Buhse
Keyword(s):  
Multiple Sclerosis ◽  
Elderly Person ◽  
The Elderly

scholarly journals Geriatric oral health concerns, a dental public health narrative

2019 ◽  
Vol 6 (2) ◽  
pp. 883
Author(s):  
Ramprasad Vasthare ◽  
Anil V. Ankola ◽  
Arron Lim Yan Ran ◽  
Prateek Mansingh
Keyword(s):  
Public Health ◽  
Oral Health ◽  
Healthy Aging ◽  
Dental Health ◽  
The Elderly ◽  
Dental Public Health ◽  
Cognitive Changes ◽  
Geriatric Population ◽  
Health Concerns ◽  
Treatment Services

Across the world, the segment of the elderly in populations is seen to be increasing at a rapid rate. There also exists a trend in which more teeth are retained as age increases due to effective dental public health measures like fluoridation. This inevitably places an increased need for dental healthcare among the geriatric populations. Since oral health greatly affects the systemic health of aged individuals, it is imperative for dentists and physicians to work together as a team to impart treatment to the best of one’s abilities for geriatric patients. It is therefore, necessary to first assess the oral health concerns surrounding the geriatric population from the perspective of public health dentistry. Relationship of the elderly with periodontal disease, dental caries, salivary hyposalivation and xerostomia, cognitive changes, and simultaneous usage of diverse medications was discussed. This paper reviewed the literature and then examined and discussed the various problems mentioned in depth and suggested recommendations for a plan of action. Knowledge about the specific oral health concerns and issues will help to better position us in developing strategies for providing better oral healthcare to the geriatric population in addition to the existing systemic healthcare. In the future, the elderly will make up a huge portion of the demographic visiting dentist regularly for a myriad of oral health problems. Dental health professionals therefore, must have adequate training and competency to deal with the predicament of this geriatric population. Preventive and treatment services can ensure healthy aging which will improve the quality of life.

scholarly journals OLD AGE HOMES: ARE THEY ACCEPTABLE TO PAKISTANI GERIATRIC POPULATION? RESULTS OF A SURVEY OF ELDERLY OUTPATIENTS VISITING TEACHING HOSPITALS IN KARACHI, PAKISTAN

2018 ◽  
Vol 8 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Waris Qidwai ◽  
Imdad Ali Khushk ◽  
Fizzah Farooq ◽  
Muhammad Yusuf Hafiz ◽  
Kashmira Nanji
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Chi Square ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Term Care ◽  
Old Age Homes

Background: Worldwide, some one million people pass the sixty year old threshold every month (Ageing, WHO). Between 2010 and 2050, the number of older people in less developed countries is projected to increase. Methods: Cross-sectional study conducted in Outpatient clinics (OPD) of two hospitals in Karachi from April to May 2013. Elderly (> 60 years of age) visiting the clinics were consecutively recruited. 477 elderly were approached and a pretested, structured questionnaire was used to obtain information. Data was analyzed using SPSS version 19 and Pearson chi-square test was used to identify the factors related to choosing of "Old Age Homes". Results: A total of 400 participants were selected. Fifty-five percent of the elderly were in between 60 to 65 years of age and majority was males 54.8 percent. Elderly were aware of the presence of "Old Age Homes" in Pakistan, however only 7 percent choose to live in there. The main reason was found to be that the elderly did not want to go away from their families and loved ones. Conclusion: In conclusion, majority of the participants felt insecure to live in a home with strangers. However, "Old Age Homes" were preferred choice for those with chronic diseases or those living alone. Media should initiate public education programs to reduce social stigmas in seeking alternate long-term care services outside of the family.

Multiple Sclerosis: Pathology, Diagnosis and Management

JAMA ◽  
1984 ◽  
Vol 251 (2) ◽  
pp. 265
Author(s):  
Charles M. Poser
Keyword(s):  
Multiple Sclerosis ◽  
Diagnosis And Management

Asthma pathogenesis, diagnosis, and management in the elderly

2017 ◽  
Vol 38 (3) ◽  
pp. 184-191 ◽  
Author(s):  
M. Asghar Pasha ◽  
Britta Sundquist ◽  
Robert Townley
Keyword(s):  
The Elderly ◽  
Diagnosis And Management

Case Series of Skull Base Meningioma Resection in the Octogenarian Population

2021 ◽  
Author(s):  
Dorian M. Kusyk ◽  
Gordon Mao ◽  
Rocco Dabecco ◽  
Alexander K. Yu
Keyword(s):  
Skull Base ◽  
Case Series ◽  
The Elderly ◽  
Outcome Data ◽  
Skull Base Tumor ◽  
Geriatric Population ◽  
Perioperative Morbidity ◽  
Wide Range ◽  
Potential Risk Factors ◽  
Skull Base Meningiomas

Abstract Introduction The geriatric population is the fastest growing segment of the American population, and octogenarians are increasingly seen by neurosurgeons for relatively common lesions such as meningiomas. Unfortunately, providers do not have clear data to guide decision-making regarding these lesions, particularly if they involve the skull base. Current research in outcomes among the elderly looks at a wide range of ages, often anyone older than 65. Previous studies in octogenarians report a wide-range of mortality rates and do not focus on skull base lesions. This paper strives to clarify the experiences and outcomes of octogenarians. Patients and Methods This retrospective series reviews skull base tumor surgeries performed at a single academic institution over the past 15 years in octogenarian patients. Primary endpoint was 30-day mortality; however, potential risk factors, perioperative morbidity, postdischarge disposition, and longer term follow-up were also captured. Multivariate logistic regression was performed to identify relevant perioperative and medical characteristics that increases the risk of adverse events. Results Fourteen patients underwent craniotomies for skull base procedures with an average age of 84.5, with a 14% 30-day mortality rate. One patient required a tracheostomy on discharge and approximately half were able to either go home or rehabilitation after their procedure. On statistical analysis, there were no noted characteristics that predisposed any of the patients to a poorer outcome. Conclusion Octogenarian patients were able to tolerate surgery for skull base meningiomas resection. This outcome data may be used to inform surgical decision and guide conversation with patients and their families.

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