Age-related Utilization of Advanced Life Support Services

1991 ◽  
Vol 6 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Steven A. Meador
Keyword(s):  
Life Support ◽  
Age Groups ◽  
Rank Correlation ◽  
Advanced Life Support ◽  
The Elderly ◽  
Population Projections ◽  
Patient Treatment ◽  
Related Case ◽  
Spearman’S Rank Correlation ◽  
Age Related

AbstractPurpose:To investigate the relationship between age and Advanced Life Support (ALS) utilization.Population:All patients from 1 January 1987 to 31 December 1988 transported by ALS ambulances within Lebanon County, a rural/urban county of 112,000.Methods:All runs resulting in patient treatment by ALS personnel were tallied at five-year age intervals and sub-grouped by trauma- and non-trauma-related calls. Utilization rates for each age group were obtained by dividing the calls by the population of each group. Correlation with age was tested by Spearman's rank correlation. Treatment rates for age groups were calculated for the six most frequent medical etiologies. To illustrate the effect of age distributions, age rates were applied to projected state and national population distributions.Results:There was a significant correlation with age for all transports (p < .01; r=.93) and for those not related to trauma (p<.01; r=.98). Correlation was not detected for trauma-related responses (p>.10; r=.19). Non-trauma-related case incidence varied among age groups, ranging from 1.1/1,000 for age five through nine years to 89/1,000 for age 80–84 years. Congestive heart failure, cardiac ischemia, syncope, myocardial infarction, and cardiac arrest evidenced increased incidence with age. Seizure did not. Older populations had a higher projected utilization of ALS services than did the younger age groups.Conclusion:Non-trauma ALS utilization is highly dependent on the age of the patient. Due to projected aging of the population and increased utilization of ALS by the elderly, projected utilization will increase at a rate faster than will the population. Age:rate data can be combined with population projections to estimate future need.

Optimizing Antiepileptic Drug Therapy in the Elderly

2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Antiepileptic Drug ◽  
Age Groups ◽  
The Elderly ◽  
Complex Partial Seizures ◽  
Medline Search ◽  
Age Related ◽  
Epilepsy In The Elderly ◽  
Clonic Seizures

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

scholarly journals Age-related mortality in 61,993 confirmed COVID-19 cases over three epidemic waves in Aragon, Spain. Implications for vaccination programmes

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261061
Author(s):  
Diego Casas-Deza ◽  
Vanesa Bernal-Monterde ◽  
Angel Nicolás Aranda-Alonso ◽  
Enrique Montil-Miguel ◽  
Ana Belen Julián-Gomara ◽  
...  
Keyword(s):  
Age Groups ◽  
Case Fatality ◽  
The Elderly ◽  
Progressive Increase ◽  
University Hospital ◽  
Rapid Progression ◽  
Targeted Prevention ◽  
Older Individuals ◽  
Prevention Measures ◽  
Age Related

Background Risk for severe COVID-19 increases with age. Different vaccination strategies are currently being considered, including those aimed at slowing down transmission and those aimed at providing direct protection to those most at risk. Methods The objectives of the current study were i) to assess age-related incidence and survival between PCR-diagnosed COVID-19 cases (n = 61,993) in the Autonomous Community of Aragon from March to November 2020, and ii) to characterize age differences regarding the course of the disease in hospitalized patients in a tertiary university hospital. Results We found a similar incidence of COVID-19 in individuals between 10 and 79 years. Incidence increased in those over 80 years possibly because of the elevated transmission within the nursing homes. We observed a profound disparity among age groups; case fatality rates (CFRs) were near 0 in cases younger than 39 years throughout different waves. In contrast, there was an age-dependent and progressive increase in the CFRs, especially during the first pandemic wave. SARS-CoV-2 infection caused a more severe and rapid progression in older patients. The elderly required faster hospitalization, presented more serious symptoms on admission, and had a worse clinical course. Hospitalized older individuals, even without comorbidities, had an increased mortality risk directly associated with their age. Lastly, the existence of comorbidities dramatically increased the CFRs in the elderly, especially in males. Conclusion The elevated incidence of COVID-19 and the vulnerability of the elderly call for their prioritization in vaccination and targeted prevention measures specifically focused on this aged population.

scholarly journals Age-Related Changes in the 25-Hydroxyvitamin D Versus Parathyroid Hormone Relationship Suggest a Different Reason Why Older Adults Require More Vitamin D

2003 ◽  
Vol 88 (1) ◽  
pp. 185-191 ◽  
Author(s):  
Reinhold Vieth ◽  
Yasmin Ladak ◽  
Paul G. Walfish
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Age Groups ◽  
The Elderly ◽  
Age Group ◽  
Hydroxyvitamin D ◽  
Age Related ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Vitamin D requirements are thought to vary with age, but there is little comparative evidence for this. One goal in establishing a vitamin D requirement is to avoid secondary hyperparathyroidism. We studied 1741 euthyroid, thyroid clinic outpatients without evidence of calcium abnormalities, ranging in age from 19 to 97 yr, whose serum and urine had been analyzed for calcium, vitamin D, and parathyroid status. We found no effect of age on the 25-hydroxyvitamin D [25(OH)D] concentration associated with specific vitamin D intakes, and there was no relationship between 25(OH)D and 1,25hydroxyvitamin D [1,25(OH)2D]. In every age group, serum 1,25(OH)2D declined with increasing creatinine (P &lt; 0.001). What changed with age included creatinine, which correlated with 25(OH)D (r = 0.146, P &lt; 0.001) only in the youngest age group (19–50 yr) but not in the older age groups (P &gt; 0.1). Creatinine did not correlate with PTH in the youngest age group, but the relationship became significant as age increased (e.g. for the elderly, r = 0.365, P &lt; 0.001). Linear regression of log PTH vs. log 25(OH)D agreed with the natural shape of the relationship observed with scatterplot smoothing, and this showed no plateau in PTH as 25(OH)D increased. We compared PTH concentrations among age groups, based on 20 nmol/liter increments in 25(OH)D. Mean PTH in adults older than 70 yr was consistently higher than in adults younger than 50 yr (P &lt; 0.05 by ANOVA and Dunnett’s t test). PTH levels of the elderly who had 25(OH)D concentrations greater than 100 nmol/liter matched PTH of younger adults having 25(OH)D concentrations near 70 nmol/liter. This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function.

Consumer preferences for banking technologies by age groups

2016 ◽  
Vol 34 (4) ◽  
pp. 587-602 ◽  
Author(s):  
Michael Harris ◽  
K. Chris Cox ◽  
Carolyn Findley Musgrove ◽  
Kathryn W Ernstberger
Keyword(s):  
New Technologies ◽  
Consumer Preferences ◽  
Age Groups ◽  
The Elderly ◽  
Analysis Of Covariance ◽  
Content Type ◽  
Cohort Differences ◽  
Use Of Technology ◽  
Age Related ◽  
Concepts Of Technology

Purpose – The prevailing mindset is that younger people value and more readily adopt technology. The purpose of this paper is to determine if this is true with respect to banking practices. Design/methodology/approach – A survey was conducted to evaluate the importance of mobile, online, and physical-based banking across multiple age groups. Factor analysis and analysis of covariance were used to evaluate the responses. Findings – The results show that older consumers see more value in traditional, physical-based banking, all ages are equally interested in currently emerging technologies (online), and younger users are more interested in the newest technologies. Research limitations/implications – The stereotype of technology-adverse elderly may be too limiting. Age influences are not absolute barriers enacted by time, but are potentially learned behaviors. Practical implications – Practitioners interested in introducing new technologies to the elderly might consider making their innovations more compatible with existing technologies already in use. Originality/value – This study builds on the concepts of technology adoption and previous work on aging as it relates to adoption. However, it is shown that cognitive declines are not the only factor that can explain age-related differences in technology usage. Cohort differences in experience and resources may also be important. This is of value not only to the banks, but to all businesses that rely on consumer use of technology to maintain the business relationship.

scholarly journals Age and Lateral Sleep Position: A Pilot Study

2009 ◽  
Author(s):  
Susan Gordon ◽  
Petra Buettner
Keyword(s):  
Pilot Study ◽  
Research University ◽  
Age Groups ◽  
Elderly Person ◽  
South Australia ◽  
The Elderly ◽  
Total Sample ◽  
Lateral Position ◽  
Sleep Position ◽  
Age Related

Purpose: Previous research, undertaken using a Super 8 camera and non-continuous data, has reported that with increasing age, people are more likely to sleep in the right lateral position. It has been postulated that this is due to age related alterations in cardiovascular function. This pilot study was undertaken to determine if collection and analysis of continuous sleep data was a feasible method for further investigation of this topic and to determine the sample size required for an adequately powered study. Increased understanding of age related changes in sleep position may provide valuable information to improve sleep quality and nursing care of the elderly person. Method: Research at the Centre for Sleep Research, University of South Australia, investigated the association between age and sleep position. Infra-red illumination and video cameras recorded the sleep patterns of 12 subjects for two nights. Videos were examined and the amount of time spent in each sleep position was calculated in seconds. Results: In a one-way analysis of variance, sample sizes of 19, 19, and, 19 are necessary from the three age groups whose means are to be compared. The expected means are 20, 25 and 45 for the three age groups respectively. The total sample of 57 subjects achieves 82% power to detect differences among the means versus the alternative of equal means using an F test with a 0.05 significance level.Conclusions: The results of this pilot study support further investigation of the relationship between age and lateral sleep position preference, and particularly the physiological parameters which may underpin the adoption of different sleep positions with increasing age. The described method is appropriate and modifications are suggested to further improve future studies.

scholarly journals Age-related changes in plasma lycopene concentrations, but not in vitamin E, are associated with fat mass

2000 ◽  
Vol 84 (5) ◽  
pp. 711-716 ◽  
Author(s):  
Pascal Grolier ◽  
Yves Boirie ◽  
Evelyne Levadoux ◽  
Marion Brandolini ◽  
Patrick Borel ◽  
...  
Keyword(s):  
Vitamin E ◽  
Fat Mass ◽  
Plasma Cholesterol ◽  
Age Groups ◽  
The Elderly ◽  
Fat Free Mass ◽  
Plasma Vitamin ◽  
Tocopherol Concentration ◽  
Age Related ◽  
Effect Of Age

The aim of the present study was to assess the influence of age on plasma concentration of α-tocopherol, retinol and carotenoids with a special attention paid to natural differences in body composition. Forty healthy subjects were recruited: twenty were less than 35 years old and twenty above 60 years old. Males and females were equally represented in each age group. Subjects were kept in energy balance and received controlled diets for 36 h. Fat mass and fat-free mass were determined with the180-enriched water dilution technique. Plasma vitamins A and E, and carotenoid levels were determined after 12 h fasting and were shown to be similar in women and men. Plasma α-tocopherol concentration increased with age (+44 % elderlyv.young), and correlated with % fat mass and plasma cholesterol. After adjustment for plasma cholesterol, the effect of age and % fat mass disappeared. In contrast, plasma lycopene level was 2-fold lower in the elderly than in the young group, and was inversely correlated with fat mass. When lycopene values were adjusted for fat mass, the effect of age disappeared. These results suggest that plasma levels of vitamin E and lycopene differed in the two age groups and that differences in plasma cholesterol and fat mass might participate in such an effect. Short-term vitamin intake did not appear to influence plasma vitamin concentrations.

scholarly journals Age Differences in the Quality of Chronic Pain: A Preliminary Study

1997 ◽  
Vol 2 (3) ◽  
pp. 157-162 ◽  
Author(s):  
Lucia Gagliese ◽  
Ronald Melzack
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Age Differences ◽  
Pain Assessment ◽  
Age Groups ◽  
The Elderly ◽  
Chronic Arthritis ◽  
Assessment Tools ◽  
Mcgill Pain Questionnaire ◽  
Age Related

BACKGROUND: Recent studies of the relationship between age and the intensity of chronic pain report increases, decreases or no change in pain intensity as a function of age. These inconsistencies may be due in part to the pain assessment tools employed and their appropriateness with different age groups.OBJECTIVES: To assess age differences in chronic pain by using several measures of pain intensity and a multidimensional measure of pain qualities in the same sample; to assess the consistency of pain intensity estimates obtained from different scales within age groups; to determine whether the failure rates for appropriately completing the scale (such as choosing more than one descriptor or making more than one mark on the Visual Analog Scale [VAS]) differ among age groups.SUBJECTS: Seventy-nine adults aged 27 to 79 years with chronic arthritis pain.MEASUREMENTS: The unidimensional pain intensity scales used were the VAS, the Verbal Descriptor Scale and the Behavioural Rating Scale. The multidimensional pain scale used was the short form McGill Pain Questionnaire (SF-MPQ). The Beck Depression Inventory was also administered.RESULTS: Age-related decreases were found in the sensory and affective dimensions of chronic pain as measured with the SF-MPQ. No age differences in pain intensity were measured with any of the unidimensional scales. These results were maintained after controlling for the effects of concurrent depressive symptomatology. Pain intensity estimates differed within groups, with verbal descriptors yielding the most consistent estimates in the elderly group. The elderly were significantly more likely to fail on the VAS than younger subjects. There were no age differences on any other measure.CONCLUSIONS: There may be age-related changes in the quality but not in the intensity of chronic arthritis pain. Implications for clinical pain assessment in the elderly are discussed.

AGE-RELATED AND POST-EXTRACTION ATROPHY OF THE JAWS AND MODERN POSSIBILITIES FOR RESTORING THE MASTICATORY APPARATUS IN THE ELDERLY PEOPLE

2021 ◽  
pp. 134-143
Author(s):  
М.И. Музыкин ◽  
Е.В. Коковихина ◽  
Е.А. Герасимова ◽  
В.Ф. Мищук ◽  
А.К. Иорданишвили ◽  
...  
Keyword(s):  
Age Groups ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Older Age ◽  
Leningrad Region ◽  
Stage Of Development ◽  
Age Related ◽  
Number Of Patients ◽  
Dental Rehabilitation ◽  
Masticatory Apparatus

Представлены данные клинического обследования 3 329 человек (1 760 мужчин и 1 569 женщин), проживающих в различных регионах РФ (Санкт-Петербург и Ленинградская обл., Москва и Московская обл., Краснодарский край). Цель работы заключалась в изучении частоты утраты зубов и клинических проявлений атрофии альвеолярных отростков (частей) челюстей у пациентов старших возрастных групп для оценки возможности стоматологической реабилитации с использованием ортопедических конструкций на дентальных имплантатах. Изучение распространенности и степени атрофии показало, что в старшей возрастной группе у пациентов в большей мере преобладала 4-я и 5-я степень атрофии, частота встречаемости составила около 20-30 %. Встречаемость 6-й степени атрофии также была выше, чем в других возрастных группах, - она была обнаружена у 17,22 % мужчин и 17,81 % женщин на верхней челюсти и у 22,18 и 15,79 % - на нижней челюсти соответственно. Несмотря на то, что количество пожилых пациентов с полной или частичной утратой зубов не имеет тенденции к снижению, на современном этапе развития стоматологии и дентальной имплантологии восстановление целостности жевательного аппарата с применением искусственных опор возможно фактически во всех клинических случаях. Наличие коморбидной или мультиморбидной патологии не является абсолютным противопоказанием, а является лишь временны΄м фактором, откладывающим стоматологическую реабилитацию до стабилизации общесоматического статуса пациента. The data of clinical examination of 3 329 people (1 760 men and 1 569 women) living in various regions of the Russian Federation (St. Petersburg and Leningrad region, Moscow and Moscow region, Krasnodar Territory) are presented. The aim of the investigation was to study the frequency of tooth loss and clinical manifestations of atrophy of the alveolar processes (parts) of the jaws in patients of older age groups to assess the possibility of dental rehabilitation using orthopedic structures on dental implants. The study of the prevalence and degree of atrophy showed that in the older age group, patients of senile age were more dominated by 4 and 5 degrees of atrophy, the frequency of their occurrence was about 20-30 %. The incidence of grade 6 atrophy was also higher than in other age groups, it was found in 17,22 % of men and 17,81 % of women in the upper jaw and 22,18 % and 15,79 % in the lower jaw, respectively. Despite the fact that the number of patients in older age groups with complete or partial loss of teeth does not tend to decrease, at the present stage of development of dentistry and dental implantology, the possibility of restoring the integrity of the masticatory apparatus with the use of artificial supports is possible in virtually all clinical cases. The presence of comorbid or multimorbid pathology is not an absolute contraindication, but is only a temporary factor that postpones dental rehabilitation until the general somatic status of the patient is stabilized.

Recommended Guidelines for Uniform Reporting of Pediatric Advanced Life Support: The Pediatric Utstein Style

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 765-779 ◽  
Author(s):  
Arno Zaritsky ◽  
Vinay Nadkarni ◽  
Mary Fran Hazinski ◽  
George Foltin ◽  
Linda Quan ◽  
...  
Keyword(s):  
Life Support ◽  
Task Force ◽  
Age Groups ◽  
Advanced Life Support ◽  
Data Set ◽  
Consensus Document ◽  
Eastern Virginia Medical School ◽  
Pediatric Resuscitation ◽  
Recommended Guidelines

This consensus document is an attempt to provide an organized method of reporting pediatric ALS data in out-of-hospital, emergency department, and in-hospital settings. For this methodology to gain wide acceptance, the task force encourages development of a common data set for both adult and pediatric ALS interventions. In addition, every effort should be made to ensure that consistent definitions are used in all age groups. As health care changes, we will all be challenged to document the effectiveness of what we currently do and show how new interventions or methods of treatment improve outcome and/or reduce cost. Only through collaborative research will we obtain the necessary data. For these reasons, and to improve the quality of care and patient outcomes, it is the hope of the task force that clinical researchers will follow the recommendations in this document. It is recognized that further refinements of this statement will be needed; these recommendations will improve only when researchers, clinicians, and EMS personnel use them, work with them, and modify them. Suggestions, emendations, and other comments aimed at improving the reporting of pediatric resuscitation should be sent to Arno Zaritsky, MD, Eastern virginia Medical School, Children's Hospital of The King's Daughter, Division of Critical Care Medicine, 601 Children's Lane, Norfolk, VA 23507.

Age-Related Changes in Pharyngeal and Supraglottic Sensation

1994 ◽  
Vol 103 (10) ◽  
pp. 749-752 ◽  
Author(s):  
John H. Martin ◽  
Beverly Diamond ◽  
Jonathan E. Aviv ◽  
Michael E. Jones ◽  
Monte S. Keen ◽  
...  
Keyword(s):  
Age Groups ◽  
Superior Laryngeal Nerve ◽  
The Elderly ◽  
Anterior Wall ◽  
Sensory Discrimination ◽  
New Device ◽  
Age Related ◽  
Significant Difference ◽  
Pulse Stimulation ◽  
Stimulation Of

As one ages, sensory discrimination in the oral cavity progressively diminishes, and dysphagia and aspiration are more likely to occur. Whether similar age-related laryngeal and pharyngeal sensory abnormalities exist and contribute to dysphagia and aspiration is unknown. The purpose of this study was to determine if sensory discrimination in the area innervated by the superior laryngeal nerve diminishes with increasing age. By applying a previously described new device and technique that utilizes brief air pulse stimulation of the anterior wall of the pyriform sinus, sensory discrimination can be reliably determined. We carried out 672 trials in 56 healthy adults divided into three age groups: 20 to 40, 41 to 60, and 61 to 90 years of age. Overall, the average sensory discrimination was 2.30 ± 0.50 mm Hg. In subjects 20 to 40 years of age, sensory discrimination was 2.07 ± 0.20 mm Hg, while in subjects 61 to 90 years of age, sensory discrimination was 2.68 ± 0.63 mm Hg (p < .05). There also was a statistically significant difference between the 41- to 60-year and 61- to 90-year age groups (p < .05). Progressive diminution in pharyngeal and supraglottic sensitivity with increasing age might be a contributing factor in the development of dysphagia and aspiration in the elderly.

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