Trauma and Mentalization Ability in Older Patients

GeroPsych ◽  
2021 ◽  
Author(s):  
Meinolf Peters
Keyword(s):  
Old Age ◽  
Older Patients ◽  
Stressful Events ◽  
Older Age ◽  
Recent Past ◽  
War Experiences ◽  
Therapeutic Context ◽  
Early Trauma ◽  
Posttraumatic Symptomatology

Abstract. The topic of trauma and aging has been studied more frequently in the recent past from the perspective of the consequences of early trauma experiences, especially in the context of war experiences. However, trauma can also occur later in life and have lasting consequences into older age. The study presented here assumed that these consequences can also manifest themselves in an impairment of mentalization ability. It examined a sample of patients between 40 and 80 years of age from a psychosomatic clinic ( N = 150) was examined with the Essen Trauma Inventory (ETI) and two mentalization instruments. Results show that, as age increased, stressful events in adulthood correspond with impairment in mentalization ability in old age. Regarding posttraumatic symptomatology, the influence of intrusions increased as age increased. Finally, the results are discussed in a theoretical and therapeutic context.

Three Hysterical Movement Disorders

1988 ◽  
Vol 62 (3) ◽  
pp. 979-985 ◽  
Author(s):  
Arthur S. Walters ◽  
Doris Wright ◽  
James Boudwin ◽  
Karl Jones
Keyword(s):  
Movement Disorders ◽  
Hemifacial Spasm ◽  
Older Patients ◽  
Life Experiences ◽  
Spontaneous Resolution ◽  
Older Age ◽  
Supportive Psychotherapy ◽  
Involuntary Movements ◽  
Neurological Condition ◽  
The Third

Three hysterical movement disorders are reported: a case of hysterical bilateral blepharospasm which later presented as hysterical hemifacial spasm, a case of hysterical myoclonus, and a case of hysterical parkinsonism. Two patients presented with a relative indifference to preceding life experiences that would normally have evoked considerable emotion. Two of the cases first presented at an older age and one of these older patients was a man. Two of the patients agreed to hypnotherapy and supportive psychotherapy. In both cases the “involuntary” movements disappeared during hypnosis. In the third case, there was a complete spontaneous resolution of symptoms in a neurological condition where resolution would not be expected to occur.

scholarly journals Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia: A Retrospective Study of 173 Patients in Wuhan, China

2020 ◽  
Author(s):  
Yang Zhang ◽  
Jun Xue ◽  
Mi Yan ◽  
Jing Chen ◽  
Hai Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Predictive Model ◽  
Disease Severity ◽  
Roc Curve ◽  
Predictive Value ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Lactic Dehydrogenase ◽  
Older Age ◽  
Hospital Outcome

Abstract Background: COVID-19 is a globally emerging infectious disease. As the global epidemic continues to spread, the risk of COVID-19 transmission and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia from Wuhan. Methods: Patients with COVID-19 pneumonia admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female. The mean age of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension (24.9%). The most common symptoms on admission were fever (67.6%) and cough (60.1%), digestive symptoms (22.0%) was also very common. Older age (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea and lymphopenia need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

scholarly journals Somatic mutations in breast and serous ovarian cancer young patients: a systematic review and meta-analysis

2015 ◽  
Vol 61 (5) ◽  
pp. 474-483 ◽  
Author(s):  
Giselly Encinas ◽  
Simone Maistro ◽  
Fátima Solange Pasini ◽  
Maria Lucia Hirata Katayama ◽  
Maria Mitzi Brentani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Ovarian Cancer ◽  
Somatic Mutation ◽  
Early Onset ◽  
Older Patients ◽  
Somatic Mutations ◽  
Age Groups ◽  
Older Age ◽  
Serous Ovarian Cancer

Summary Objective: our aim was to evaluate whether somatic mutations in five genes were associated with an early age at presentation of breast cancer (BC) or serous ovarian cancer (SOC). Methods: COSMIC database was searched for the five most frequent somatic mutations in BC and SOC. A systematic review of PubMed was performed. Young age for BC and SOC patients was set at ≤35 and ≤40 years, respectively. Age groups were also classified in <30years and every 10 years thereafter. Results: twenty six (1,980 patients, 111 younger) and 16 studies (598, 41 younger), were analyzed for BC and SOC, respectively. In BC, PIK3CA wild type tumor was associated with early onset, not confirmed in binary regression with estrogen receptor (ER) status. In HER2-negative tumors, there was increased frequency of PIK3CA somatic mutation in older age groups; in ER-positive tumors, there was a trend towards an increased frequency of PIK3CA somatic mutation in older age groups. TP53 somatic mutation was described in 20% of tumors from both younger and older patients; PTEN, CDH1 and GATA3 somatic mutation was investigated only in 16 patients and PTEN mutation was detected in one of them. In SOC, TP53 somatic mutation was rather common, detected in more than 50% of tumors, however, more frequently in older patients. Conclusion: frequency of somatic mutations in specific genes was not associated with early-onset breast cancer. Although very common in patients with serous ovarian cancer diagnosed at all ages, TP53 mutation was more frequently detected in older women.

Old Age and the Embrace of the Uncanny

2020 ◽  
pp. 279-320
Author(s):  
Melanie V. Dawson
Keyword(s):  
Old Age ◽  
Older Age ◽  
The Uncanny

Contextualizing Wharton’s old-aged fiction within depictions of a destabilized old age, or a senescence of decline and imperilled personhood, this chapter compares Wharton’s writing to that of Vorse and Hall. In contrast with visions of a defamiliarized, uncanny aged self, Wharton’s work posits an older age filled with motivating desires and ambitions. This is also fiction that deploys gothic tropes to reveal how completely interaction with the aged tends to destabilize others, especially younger viewers, who see only age’s vagaries and unsteadiness, and who find it fearful.

Serum cholesterol and cognitive functions: the Lothian Birth Cohort 1936

2014 ◽  
Vol 27 (3) ◽  
pp. 439-453 ◽  
Author(s):  
Janie Corley ◽  
John M. Starr ◽  
Ian J. Deary
Keyword(s):  
Cognitive Function ◽  
Cognitive Ability ◽  
Birth Cohort ◽  
Old Age ◽  
Serum Cholesterol ◽  
Processing Speed ◽  
Verbal Ability ◽  
Older Age ◽  
Lothian Birth Cohort ◽  
Statin Use

ABSTRACTBackground:We examined the associations between serum cholesterol measures, statin use, and cognitive function measured in childhood and in old age. The possibility that lifelong (trait) cognitive ability accounts for any cross-sectional associations between cholesterol and cognitive performance in older age, seen in observational studies, has not been tested to date.Methods:Participants were 1,043 men and women from the Lothian Birth Cohort 1936 Study, most of whom had participated in a nationwide IQ-type test in childhood (Scottish Mental Survey of 1947), and were followed up at about age 70 years. Serum cholesterol measures included total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and cholesterol:HDL cholesterol ratio. Cognitive outcome measures were age 70 IQ (using the same test as at age 11 years), general cognitive ability (g), processing speed, memory, and verbal ability.Results:Higher TC, higher HDL-C, and lower triglycerides were associated with higher age 70 cognitive scores in most cognitive domains. These relationships were no longer significant after covarying for childhood IQ, with the exception a markedly attenuated association between TC and processing speed, and triglycerides and age 70 IQ. In the fully adjusted model, all conventionally significant (p < 0.05) effects were removed. Childhood IQ predicted statin use in old age. Statin users had lower g, processing speed, and verbal ability scores at age 70 years after covarying for childhood IQ, but significance was lost after adjusting for TC levels.Conclusions:These results suggest that serum cholesterol and cognitive function are associated in older age via the lifelong stable trait of intelligence. Potential mechanisms, including lifestyle factors, are discussed.

Cancer in older patients

2003 ◽  
Vol 13 (3) ◽  
pp. 203-213 ◽  
Author(s):  
N Beechey-Newman ◽  
D Kulkarni
Keyword(s):  
Life Expectancy ◽  
Old Age ◽  
Older Patients ◽  
Causes Of Death ◽  
Late Life ◽  
General Context ◽  
Age Group ◽  
Men And Women ◽  
Very High

As the number of people living to reach old age increases, so the proportion of cancers presenting in this age group increases to an even greater degree. Although 70% of all cancers in men and women occur over the age of 65 and in the over-75s, who are perhaps more appropriately classified as ‘elderly’, the figures are still very high (46% of all cancers occur in women over 75 and 35% in men over 75). As a consequence, cancer is rapidly becoming a problem of late life, and the management of patients in old age is an important part of general oncology. The magnitude of the overlap between old age and cancer is increasing because of improved life expectancy, more sensitive methods of diagnosing cancer and the biological fact that most cancers occur more commonly with increasing age. It is interesting, however, to put these figures into a more general context by examining the different causes of death in older patients by decade.

Malignant melanoma in the elderly.

1987 ◽  
Vol 5 (1) ◽  
pp. 100-106 ◽  
Author(s):  
H J Cohen ◽  
E Cox ◽  
K Manton ◽  
M Woodbury
Keyword(s):  
Malignant Melanoma ◽  
Prognostic Factor ◽  
Older Patients ◽  
Cox Model ◽  
Primary Site ◽  
Older Age ◽  
Age Group ◽  
Superficial Spreading ◽  
Poor Prognostic Factor ◽  
Male Predominance

Advancing age is associated with poorer prognosis in malignant melanoma. We studied 3,872 cases of malignant melanoma to evaluate whether the effect of age could be analyzed relative to sex, tumor depth, primary site, and other clinical and pathologic variables. The sex distribution by age shows a slight female predominance in the early and late decades but male predominance in the middle years. The percentage of patients with metastatic disease at initial diagnosis did not vary with age, despite greater diameter and depth of lesions in the older patients. In fact, in the older age groups, initial nodal metastasis occurred slightly less frequently. Trunk primaries decreased in frequency with increasing age, while extremity lesions remained relatively constant, and face, nose, and ear lesions increased. This was in part related to the histopathologic type, as lentigo maligna lesions increased in frequency with age, superficial spreading lesions were somewhat less frequent in the older age group and nodular types were fairly constant. On the basis of both Clark's level and Breslow thickness, there was an increasing proportion of deeper penetrating lesions in the older age group. The mean diameter of these lesions on the skin surface was also greater for the older patients. This would suggest that lesions in the older individual remain confined to the local site longer, penetrate and spread, but do not necessarily metastasize more rapidly. Cox model regression analysis of survival time within stage showed that age was highly significant as a poor prognostic factor. Though the adverse relation of advancing age with survival was partially explained by predominance of other unfavorable factors, such as primary site, depth of lesion, or histologic type, age remained an independent poor prognostic factor (chi 2 = 5.3; P = .02) for death due to melanoma.

scholarly journals Trastuzumab-Related Cardiotoxicity Among Older Patients With Breast Cancer

2013 ◽  
Vol 31 (33) ◽  
pp. 4222-4228 ◽  
Author(s):  
Mariana Chavez-MacGregor ◽  
Ning Zhang ◽  
Thomas A. Buchholz ◽  
Yufeng Zhang ◽  
Jiangong Niu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Older Patients ◽  
Cox Proportional Hazards ◽  
Older Age ◽  
Coding System ◽  
Breast Cancer Patients ◽  
Common Procedure ◽  
Factors Associated

Purpose The use of trastuzumab in the adjuvant setting improves outcomes but is associated with cardiotoxicity manifested as congestive heart failure (CHF). The rates and risk factors associated with trastuzumab-related CHF among older patients are unknown. Patients and Methods Breast cancer patients at least 66 years old with full Medicare coverage, diagnosed with stage I-III breast cancer between 2005 and 2009, and treated with chemotherapy were identified in the SEER-Medicare and in the Texas Cancer Registry–Medicare databases. The rates and risk factors associated with CHF were evaluated. Chemotherapy, trastuzumab use, comorbidities, and CHF were identified using International Classification of Diseases, version 9, and Healthcare Common Procedure Coding System codes. Analyses included descriptive statistics and Cox proportional hazards models. Results In total, 9,535 patients were included, of whom 2,203 (23.1%) received trastuzumab. Median age of the entire cohort was 71 years old. Among trastuzumab users, the rate of CHF was 29.4% compared with 18.9% in nontrastuzumab users (P < .001). Trastuzumab users were more likely to develop CHF than nontrastuzumab users (hazard ratio [HR], 1.95; 95% CI, 1.75 to 2.17). Among trastuzumab-treated patients, older age (age > 80 years; HR, 1.53; 95% CI, 1.16 to 2.10), coronary artery disease (HR, 1.82; 95% CI, 1.34 to 2.48), hypertension (HR, 1.24; 95% CI, 1.02 to 1.50), and weekly trastuzumab administration (HR, 1.33; 95% CI, 1.05 to 1.68) increased the risk of CHF. Conclusion In this large cohort of older breast cancer patients, the rates of trastuzumb-related CHF are higher than those reported in clinical trials. Among patients treated with trastuzumab, those with cardiac comorbidities and older age may be at higher risk. Further studies need to confirm the role that the frequency of administration plays in the development of trastuzumab-related CHF.

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