The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care

2014 ◽  
Vol 24 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Francisco J Tarazona-Santabalbina ◽  
Juan R Doménech-Pascual ◽  
Ángel Belenguer-Varea A ◽  
Eduardo Rovira Daudi
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Older Patients ◽  
Future Research ◽  
Research Perspectives ◽  
Increased Risk ◽  
Risk Of Falls

SummaryHip fracture is very common among older patients, who are characterized by increased co-morbidities, including cognitive impairment. These patients have an increased risk of falls and fractures, poorer functional recovery and lower survival both in hospital and 12 months after discharge. We review the survival and functional outcomes of older patients with cognitive impairment and hip fracture managed in orthogeriatric units, and highlight the gaps in our knowledge of the efficacy and efficiency of specific orthogeriatric programmes for such patients and the future research perspectives in this field.

A 2-min cognitive screener for predicting 1-year functional recovery and survival in older adults after hip fracture repair

2021 ◽  
Author(s):  
Sileno de Queiroz Fortes-Filho ◽  
Márlon Juliano Romero Aliberti ◽  
Juliana de Araújo Melo ◽  
Daniel Apolinario ◽  
Maria do Carmo Sitta ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Cognitive Assessment ◽  
Older Patients ◽  
Fracture Repair ◽  
Screening Tools ◽  
Hip Surgery ◽  
Word Recall ◽  
Risk Of Death

Abstract Background Implementing cognitive assessment in older people admitted to hospital with hip fracture – lying in bed, experiencing pain – is challenging. We investigated the value of a quick and easy-to-administer 10-point cognitive screener (10-CS) in predicting 1-year functional recovery and survival after hip surgery. Methods Prospective cohort study comprising 304 older patients (mean age=80.3±9.1 years; women=72%) with hip fracture consecutively admitted to a specialized academic medical center that supports secondary hospitals in Sao Paulo Metropolitan Area, Brazil. The 10-CS, a 2-minute bedside tool including temporal orientation, verbal fluency, and three-word recall, classified patients as having normal cognition, possible cognitive impairment, or probable cognitive impairment on admission. Outcomes were time-to-recovery activities of daily living (ADLs; Katz index) and mobility (New Mobility Score), and survival during 1-year after hip surgery. Hazard models, considering death as a competing risk, were used to associate the 10-CS categories with outcomes after adjusting for sociodemographic and clinical measures. Results On admission, 144 (47%) patients had probable cognitive impairment. Compared to those cognitively normal, patients with probable cognitive impairment presented less postsurgical recovery of ADLs (77% vs. 40%; adjusted sub-hazard ratio [HR]=0.44; 95%CI=0.32-0.62) and mobility (50% vs. 30%; adjusted sub-HR=0.52; 95%CI=0.34-0.79), and higher risk of death (15% vs. 40%; adjusted HR=2.08; 95%CI=1.03-4.20) over 1-year follow-up. Conclusions The 10-CS is a strong predictor of functional recovery and survival after hip fracture repair. Cognitive assessment using quick and easy-to-administer screening tools like 10-CS can help clinicians make better decisions and offer tailored care for older patients admitted with hip fracture.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

Ethnic Differences in the Smoking-Related Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Daniele Piovani ◽  
Claudia Pansieri ◽  
Soumya R R Kotha ◽  
Amanda C Piazza ◽  
Celia-Louise Comberg ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Latin American ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Study Data ◽  
Future Research ◽  
Related Risk ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background and aims The association between smoking and inflammatory bowel disease (IBD) relies on old meta-analyses including exclusively non-Jewish White populations. Uncertainty persists regarding the role of smoking in other ethnicities. Methods We systematically searched Medline/PubMed, Embase and Scopus for studies examining tobacco smoking and the risk of developing IBD, i.e., Crohn’s disease (CD) or ulcerative colitis (UC). Two authors independently extracted study data and assessed each study’s risk-of-bias. We examined heterogeneity and small-study effect, and calculated summary estimates using random-effects models. Stratified analyses and meta-regression were employed to study the association between study-level characteristics and effect estimates. The strength of epidemiological evidence was assessed through prespecified criteria. Results We synthesized 57 studies examining the smoking-related risk of developing CD and UC. Non-Jewish White smokers were at increased risk of CD (29 studies; RR: 1.95, 95% CI: 1.69‒2.24; moderate evidence). No association was observed in Asian, Jewish and Latin-American populations (11 studies; RR: 0.97; 95% CI: 0.83–1.13), with no evidence of heterogeneity across these ethnicities. Smokers were at reduced risk of UC (51 studies; RR: 0.55, 95% CI: 0.48–0.64; weak evidence) irrespectively of ethnicity; however, cohort studies, large studies and those recently published showed attenuated associations. Conclusions This meta-analysis did not identify any increased risk of CD in smokers in ethnicities other than non-Jewish Whites, and confirmed the protective effect of smoking on UC occurrence. Future research should characterize the genetic background of CD patients across different ethnicities to improve our understanding on the role of smoking in CD pathogenesis.

The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation

2017 ◽  
Vol 28 (5) ◽  
pp. 1569-1576 ◽  
Author(s):  
F. Landi ◽  
R. Calvani ◽  
E. Ortolani ◽  
S. Salini ◽  
A. M. Martone ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Functional Outcomes ◽  
Older Patients ◽  
Hospital Rehabilitation

Fundamentals of Electrostatic Spraying

2015 ◽  
pp. 461-490 ◽  
Author(s):  
Manoj Kumar Patel ◽  
Chirravoori Ghanshyam
Keyword(s):  
Cost Effective ◽  
Future Research ◽  
Electrostatic Spraying ◽  
Research Perspectives ◽  
The People ◽  
Agricultural Applications ◽  
Engineering Practices ◽  
Agriculture And Food ◽  
Uniform Deposition

The desired attributes of electrostatic spraying are uniform deposition onto both directly exposed or obscured crop surfaces which minimize the off-target losses of active ingredients to soil, water, atmosphere and provide more effective and economical pest control. This chapter presents an overview of electrostatic spraying technologies in the field of agriculture emphasizing the key role of advanced electrostatic instrumentation and chronicles the scientific innovations in the parlance of providing cost effective and reliable commercial systems along with an insight on the needs of future research perspectives and directives. It is aimed primarily at a familiarization with spraying concepts and engineering practices. This text is to bridge the knowledge and experience gap among researchers and technology developers and the people involved in electrostatic processes applied to agriculture and food processing. It will also introduce the engineering aspects of design and development of an electrostatic spraying nozzle for agricultural applications.

scholarly journals Role of nitric oxide in plant responses to heavy metal stress: exogenous application versus endogenous production

2019 ◽  
Vol 70 (17) ◽  
pp. 4477-4488 ◽  
Author(s):  
Laura C Terrón-Camero ◽  
M Ángeles Peláez-Vico ◽  
Coral Del-Val ◽  
Luisa M Sandalio ◽  
María C Romero-Puertas
Keyword(s):  
Nitric Oxide ◽  
Heavy Metals ◽  
Heavy Metal ◽  
Human Health Risk ◽  
Heavy Metal Stress ◽  
Metal Stress ◽  
Future Research ◽  
Plant Responses ◽  
Research Perspectives

Abstract Anthropogenic activities, such as industrial processes, mining, and agriculture, lead to an increase in heavy metal concentrations in soil, water, and air. Given their stability in the environment, heavy metals are difficult to eliminate and can constitute a human health risk by entering the food chain through uptake by crop plants. An excess of heavy metals is toxic for plants, which have various mechanisms to prevent their accumulation. However, once metals enter the plant, oxidative damage sometimes occurs, which can lead to plant death. Initial production of nitric oxide (NO), which may play a role in plant perception, signalling, and stress acclimation, has been shown to protect against heavy metals. Very little is known about NO-dependent mechanisms downstream from signalling pathways in plant responses to heavy metal stress. In this review, using bioinformatic techniques, we analyse studies of the involvement of NO in plant responses to heavy metal stress, its possible role as a cytoprotective molecule, and its relationship with reactive oxygen species. Some conclusions are drawn and future research perspectives are outlined to further elucidate the signalling mechanisms underlying the role of NO in plant responses to heavy metal stress.

Mild Cognitive Impairment: An Overview

CNS Spectrums ◽  
2008 ◽  
Vol 13 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Ronald C. Petersen ◽  
Selamawit Negash
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Normal Aging ◽  
Future Research ◽  
Community Based ◽  
Cognitive Changes ◽  
Nutritional Interventions ◽  
Transitional State ◽  
Research Perspectives ◽  
Early Dementia

ABSTRACTMild cognitive impairment (MCI) refers to the transitional state between the cognitive changes of normal aging and very early dementia. MCI has generated a great deal of research from both clinical and research perspectives. Several population- and community-based studies have documented an accelerated rate of progression to dementia and Alzheimer's disease in individuals diagnosed with MCI. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. Progression factors, including genetic, neuroimaging, biomarker, and clinical characteristics, are discussed. Neuropathological studies indicating an intermediate state between normal aging and early dementia in subjects with MCI are presented. The recently completed clinical trials as well as neuropsychological and nutritional interventions are discussed. Finally, the clinical utility of MCI, and directions for future research are proposed.

Subjective Memory Complaints and Mild Cognitive Impairment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M. Simoes ◽  
L.C. Castro ◽  
O. Ribeiro ◽  
T. Salgado ◽  
C. Paz
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
The Elderly ◽  
Future Research ◽  
Older Individuals ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Cross Sectional ◽  
Memory Complaints ◽  
Increased Risk

Background:Subjective Memory Complaints (SMC) are common in clinical practice. the clinical significance of these subjective complaints among older individuals is not well understood.Aim:To study and discuss the association between SMC and MCI, underlining the importance of an adequate clinical assessment of SMC in the elderly.Methods:Review of the literature.Results:There is no consistent definition of SMC in the literature. Some prospective studies showed an association with objective memory impairments, conceptualizing SMC as a Pre-Mild Cognitive Impairment. SMC are also currently considered to be a core feature of Mild Cognitive Impairment (MCI). Cross-sectional studies and longitudinal studies showed conflicting results concerning the association between SMC and MCI.Discussion:The understanding of the predictive value of SMC in cognitive decline is still poorly understood. It is important to define criteria aimed to increase specificity of memory complaints, allowing an earlier identification of populations with higher risk of MCI. Future research on this complex association is important to identify SMC individuals at increased risk of conversion to MCI and dementia.

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