scholarly journals Evaluation of cardiorespiratory functional reserve from arm exercise in the elderly

2010 ◽  
Vol 53 (8) ◽  
pp. 474-482 ◽  
Author(s):  
N. Tordi ◽  
L. Mourot ◽  
J. Maire ◽  
B. Parratte ◽  
J. Regnard
Keyword(s):  
The Elderly ◽  
Functional Reserve ◽  
Arm Exercise

A study of tolerance to treatment among the most frequent cancer in the elderly

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18609-18609
Author(s):  
N. G. Pilnik ◽  
R. Werbin ◽  
J. Dirienzo
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Gastrointestinal Disease ◽  
The Elderly ◽  
Cancer Type ◽  
Functional Reserve ◽  
Chi Square ◽  
Good General Condition ◽  
Chi Square Test

18609 Background: Besides, aging may influence pharmacological aspects due to functional reserve deterioration and comorbidities, affecting tolerance to treatment and increasing the likelihood of complications. Methods: 166 cancer pts (56 lung, 64 breast, and 46 colon), mean age 72 yrs, treated with Ch/Rt were studied. Lung cancer pts had PS 0:1 (2%); PS 1:17 (30%); and PS2:38 (68%). Breast cancer pts had PS 0:6 (9%); PS 1:25 (39%); PS 2:33 (52%). Colon cancer pts had PS 0:6 (13%); PS 1:17 (37%); PS 2:23 (50%). Comorbidities were hypertension, diabetes, arrhythmia, EPOC, coronary and gastrointestinal disease. All of the pts had adequate cardiac, hepatic, renal and bone marrow functions. Allergy, cardiovascular, gastrointestinal, hepatic, neurological, haematological and renal toxicities, and infection were evaluated following the WHO criteria. Toxicities were studied according to age and comorbidities, and correlated with the use of other medicines. QoL was studied through the improvement of symptoms and PS evolution. The Chi Square test was used for statistical analyses. Results: The prevalence of common toxicities in the lung cancer pts were anemia, 39 pts (70%), infection, 37 pts (66%), leukopenia 33 pts (59%), gastrointestinal 28 pts (50%). The most common toxicities in breast cancer, were leukopenia 43 pts (67%), gastrointestinal 37 pts (58%), infection 36 pts (56%), and anemia 32 pts (50%), while in colon cancer pts the toxicities found were gastrointestinal 38 pts (83%), anemia 33 pts (72%), leukopenia 32 pts (70%), and infection 25 pts (54%). There was no correlation between age and the most frequent toxicities. Grade 2 was the most common level of toxicity reached in all types of cancer studied. There was improvement in QoL when symptoms evolution and PS were evaluated independently of cancer type, 81% (134 pts) for symptoms (p < 0.0001), and 72% (120 pts) for PS (p < 0.0001) respectively. There was no association between age and toxicity grade, irrespective of toxicity type, age and comorbidities. Conclusions: Older pts in good general condition and with controlled morbidities may receive Ch/Rt if this treatment modality results in improvement of their QoL.-Low toxicities occurred in most of these pts, probably due to the fact that pts were adequately selected. No significant financial relationships to disclose.

scholarly journals Frailty as a growing challenge for anesthesiologists – results of a Dutch national survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Bouwhuis ◽  
C. E. van den Brom ◽  
S. A. Loer ◽  
C. S. E. Bulte
Keyword(s):  
Elderly Patients ◽  
Frail Elderly ◽  
Perioperative Care ◽  
Elderly Population ◽  
Multidisciplinary Approach ◽  
Anesthetic Management ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Functional Reserve ◽  
Patient File

Abstract Background Frailty is a multidimensional condition characterized by loss of functional reserve, which results in increased vulnerability to adverse outcomes following surgery. Anesthesiologists can reduce adverse outcomes when risk factors are recognized early and dedicated care pathways are operational. As the frail elderly population is growing, we investigated the perspective on the aging population, familiarity with the frailty syndrome and current organization of perioperative care for elderly patients among Dutch anesthesiologists. Methods A fifteen-item survey was distributed among anesthesiologists and residents during the annual meeting of the Dutch Society of Anesthesiology. The first section included questions on self-reported competence on identification of frailty, acquaintance with local protocols and attitude towards the increasing amounts of elderly patients presenting for surgery. The second part included questions on demographic features of the participant such as job position, experience and type of hospital. Answers are presented as percentages, using the total number of replies for the question per group as a denominator. Results A sample of 132 surveys was obtained. The increasing number of elderly patients was primarily perceived as challenging by 76% of respondents. Ninety-nine percent agreed that frailty should influence anesthetic management, while 85% of respondents claimed to feel competent to recognize frailty. Thirty-four percent of respondents reported the use of a dedicated pathway in the preoperative approach of frail elderly patients. However, only 30% of respondents reported to know where to find the frailty screening in the patient file and appointed that frailty is not consistently documented. Interestingly, only 43% of respondents reported adequate collaboration with geriatricians. This could include for example a standardized preoperative multidisciplinary approach or dedicated pathway for the elderly patient. Conclusions This survey demonstrated that the increasing number of frail elderly patients is perceived as important and relevant for anesthetic management. Opportunities lie in improving the organization and effectuation of perioperative care by more consistent involvement of anesthesiologists.

Chemotherapy-induced changes in the physiologic reserve of elderly patients diagnosed with cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19590-e19590
Author(s):  
MJ Molina-Garrido ◽  
Carmen Guillen-Ponce ◽  
MM Munoz-Sanchez ◽  
A. Olaverri Hernandez ◽  
Carolina Ortega Ruiperez ◽  
...  
Keyword(s):  
Grip Strength ◽  
Walking Speed ◽  
Peak Flow ◽  
The Elderly ◽  
Control Group ◽  
Chemotherapy Treatment ◽  
Functional Reserve ◽  
Organ Systems ◽  
Oncologic Patients ◽  
Group B

e19590 Background: Frailty is a biological syndrome of the elderly that is characterized by the loss of the reserve in multiple organ systems. The aims of this study were a) to identify the presence of frailty in the elderly with cancer, by measuring their functional reserve baseline and after chemotherapy treatment, and b) to assess which of the functional reserve parameters checked suffered a change ≥30%, suggestive of frailty. Methods: Prospective cohort study of oncologic patients ≥70 years of age, evaluated in a Spanish Unit of Cancer in the Elderly (from January 2010 to December 2011). Most of patients (88.9%) had a basal status between 0-1 (measured by the ECOG index). We collected information about the individual's physiologic reserve (skeletal muscle mass [SMM], walking speed, peak-flow, grip strength, creatinine clearance [CC] and Pfeiffer test). Parameters of functional reserve were determined at baseline and 4 months after chemotherapy was started. It was used a pre-post design, and a control group of patients not treated with chemoterapy (group B). To identify significant differences between the results of parameters of physiologic reserve it was used a t-student t test for independent groups. It was calculated the change percentage in each of these variables. Results: We analyzed data from 66 patients in group A (treatment with chemotherapy) and 68 in group B (no chemotherapy). Age average: 78.68 years. Gastrointestinal tumors (37.3%) and breast and gynecologic tumors (32.1%), others (30.6%); 28.8% were metastatic tumors. After chemotherapy, there were no significant differences in walking speed (p =0.323), handgrip strength (p =0.162), peak-flow (p =0.954), cognitive status (p =0.078) or CC (p =0.425). However, there was an increase in SMM (0.618 kg, 95% CI: 0.020 to 1.215, p =0.043). Changes after treatment were as follow: SMM and peak-flow increased by 2%, grip strength decreased by 15% and CC was reduced by 0.05%. Conclusions: The elderly physiologic reserve is not modified as a result of chemotherapy treatment, except for SMM. This change could be related to tumor response achievement. None of the physiologic reserve parameters was useful in this setting, as a "marker of frailty".

Frailty, Functional Reserve, and Sarcopenia in the Geriatric Dysphagic Patient

2008 ◽  
Vol 17 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Joseph Murray
Keyword(s):  
At Risk ◽  
Clinical Practice ◽  
The Elderly ◽  
Daily Clinical Practice ◽  
Functional Reserve ◽  
Dysphagic Patient ◽  
Vital Importance ◽  
Speech Language Pathologist ◽  
Poor Nutrition

In this review the interaction of senescence and dysphagia are discussed with attention to normal changes in bodily homeostasis that occur with aging and the acceleration of decline observed in frail individuals. The concepts of functional reserve, symmorphosis and sarcopenia are discussed in a way to aid the speech-language pathologist providing dysphagia services to the elderly. It is important for the practicing speech-language pathologist to realize the vital importance of compromised functional reserve and to be able to identify elders who are at risk of the spiral of poor nutrition and frailty as they present themselves in daily clinical practice.

Preoperative assessment and preparation of elderly patients undergoing major surgery

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Elderly Patients ◽  
Elective Surgery ◽  
Preoperative Assessment ◽  
The Elderly ◽  
Major Surgery ◽  
Patient Factors ◽  
Functional Reserve ◽  
Behavioural Adaptation ◽  
Disease States ◽  
Better Than

The benefits to the elderly of current surgical advances are as good as or better than to younger patients. Preassessment serves to individualize operative decisions to optimize the patient’s condition and improve the outcome. These processes require experienced surgical and anaesthetic input. General patient factors are detailed, including communication skills, behavioural adaptation, functional reserve, cognitive function, and frailty. Systematic comorbidities, such as cardiovascular, neurological, respiratory, renal and nutritional status are discussed. The risk/benefit of the proposed procedure, which is often assessed using risk-stratification systems, is reviewed. Time to full recovery and the duration of convalescence are identified as lacking appropriate data at present. Finally, the emerging data on active, multidisciplinary ‘prehabilitation’ before surgery to improve and optimize the general fitness, chronic disease states, and medication of elderly patients in the weeks before elective surgery are examined.

scholarly journals Renal functional reserve in healthy elderly subjects.

1993 ◽  
Vol 3 (7) ◽  
pp. 1371-1377
Author(s):  
D Fliser ◽  
M Zeier ◽  
R Nowack ◽  
E Ritz
Keyword(s):  
Renal Disease ◽  
The Elderly ◽  
Renal Hemodynamics ◽  
Elderly Subjects ◽  
Functional Reserve ◽  
Renal Functional Reserve ◽  
Healthy Elderly ◽  
Age Related ◽  
Before And After ◽  
Young Subjects

The increase in GFR after an amino acid (AA) load, the so-called renal functional reserve, is impaired in the aged rat. Whether the renal functional reserve predicts the progression of renal disease in humans is controversial, but it is possible that age-related alterations of renal hemodynamics are relevant for the evolution of renal disease in the elderly. We compared renal hemodynamics before and after an AA infusion in 15 healthy normotensive subjects of young age (seven women, eight men; median age, 26 yr; range, 23 to 32) and in 10 subjects of old age (six women, four men; median age, 70 yr; range, 61 to 82) on normal dietary protein intake. Baseline GFR and effective RPF were measured after 12 h of fasting by the inulin (Cin) and para-aminohippurate (Cpah) steady-state infusion techniques. The renal functional reserve was examined after an overnight AA infusion (7% solution; 83 mL/h). Median basal Cin and Cpah were significantly lower (P < 0.01) in the elderly (102 and 339 mL/min per 1.73 m2) than in the young subjects (122 and 647 mL/min per 1.73 m2), but virtually all GFR values of the elderly were still within the normal range. Median Cin upon infusion of AA was 118 mL/min per 1.73 m2 (range, 98 to 137) in the elderly and 146 (range, 120 to 171) in the young, respectively. Corresponding values of Cpah were 349 mL/min per 1.73 m2 in the elderly versus 689 mL/min per 1.73 m2 in the young. Cin increased significantly (P < 0.01) after the AA load in both young and elderly subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Visuoauditory Stimuli on the Acoustic Features of Swallowing in the Elderly

2020 ◽  
Vol 10 (10) ◽  
pp. 2324-2329
Author(s):  
Yacen Wu ◽  
Feng Lin ◽  
Huahua Li ◽  
Zhongli Jiang
Keyword(s):  
Visual Stimuli ◽  
The Elderly ◽  
Auditory Stimuli ◽  
Mirror Therapy ◽  
Acoustic Features ◽  
Functional Reserve ◽  
Swallowing Sounds ◽  
Audiovisual Stimulation ◽  
Speed Up

Objective: To investigate the effect of audiovisual stimulation on swallowing sounds in the elderly. Method: Mirror therapy (MT) videos were prepared and divided into AMs, LMs, AFs, and LFs. Sixty videos were randomly selected from AMs, LMs, AFs, and LFs. The selected videos were divided into two sections (10 min per section). The control videos were extracted from the film "Le Peuple Migrateur." Finally, the TD (ms), TE (dB), DHE (ms), DHE/TD (%), PI (dB), DPI (ms), FPI (Hz), and PF (Hz) were analyzed. Result: TD of AS was significantly shorter than that of AS. Lower TE and PI were observed in AS compared to those observed in visual and auditory stimuli (VAS). DHE/TD and DPI were longer in AS relative to VAS. In addition, a lower FPI was observed in AS than in VAS. Conclusion: VAS can significantly improve swallowing frequencies, speed up swallowing movements and increase swallowing functional reserve in the elderly. In addition, the decreased swallowing efficacy under auditory stimuli could be reversed by visual stimuli.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

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