Drug therapy in the elderly: The problem from the point of view of a clinical pharmacologist

1987 ◽  
Vol 42 (6) ◽  
pp. 677-680 ◽  
Author(s):  
Marcus M Reidenberg
Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2254
Author(s):  
Francisco Javier González-Cañete ◽  
Eduardo Casilari

Over the last few years, the use of smartwatches in automatic Fall Detection Systems (FDSs) has aroused great interest in the research of new wearable telemonitoring systems for the elderly. In contrast with other approaches to the problem of fall detection, smartwatch-based FDSs can benefit from the widespread acceptance, ergonomics, low cost, networking interfaces, and sensors that these devices provide. However, the scientific literature has shown that, due to the freedom of movement of the arms, the wrist is usually not the most appropriate position to unambiguously characterize the dynamics of the human body during falls, as many conventional activities of daily living that involve a vigorous motion of the hands may be easily misinterpreted as falls. As also stated by the literature, sensor-fusion and multi-point measurements are required to define a robust and reliable method for a wearable FDS. Thus, to avoid false alarms, it may be necessary to combine the analysis of the signals captured by the smartwatch with those collected by some other low-power sensor placed at a point closer to the body’s center of gravity (e.g., on the waist). Under this architecture of Body Area Network (BAN), these external sensing nodes must be wirelessly connected to the smartwatch to transmit their measurements. Nonetheless, the deployment of this networking solution, in which the smartwatch is in charge of processing the sensed data and generating the alarm in case of detecting a fall, may severely impact on the performance of the wearable. Unlike many other works (which often neglect the operational aspects of real fall detectors), this paper analyzes the actual feasibility of putting into effect a BAN intended for fall detection on present commercial smartwatches. In particular, the study is focused on evaluating the reduction of the battery life may cause in the watch that works as the core of the BAN. To this end, we thoroughly assess the energy drain in a prototype of an FDS consisting of a smartwatch and several external Bluetooth-enabled sensing units. In order to identify those scenarios in which the use of the smartwatch could be viable from a practical point of view, the testbed is studied with diverse commercial devices and under different configurations of those elements that may significantly hamper the battery lifetime.


2021 ◽  
Vol 13 (5) ◽  
pp. 2563
Author(s):  
Małgorzata Ćwiek ◽  
Katarzyna Maj-Waśniowska ◽  
Katarzyna Stabryła-Chudzio

This article undertakes the research problem of the assessment of the significance of poverty as a social challenge for local self-government units, and the differences in the assessment of the incidence of this phenomenon depending on the type of municipality. The authors also analyse the relationships between the ageing of the population and the assessment of the extent of poverty by municipalities. It must be pointed out that the undertaken problem has not been a subject of in-depth analysis thus far. Hence, this article fills the identified research gap in this field. The empirical part is based on the results of our own research, conducted using the Computer-Assisted Web Interview (CAWI) method on a sample of 144 municipalities of the Małopolskie Voivodship (Poland). In order to verify whether there is a relationship between the researched qualitative variables, the chi-square test of independence was used. In order to determine the relationships occurring between the categories of variables characterising the scale of the incidence of poverty and the remaining variables, a correspondence analysis was conducted. The research enabled us to find the issue of poverty to be one of the most important social problems from the point of view of municipalities. It is also worth noting that the degree of ageing in the population has an impact on the assessment of poverty among the elderly.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V A Sironi ◽  
M A Riva

Abstract The recent epidemic caused by the Covid-19 virus, which originated in China and then spread rapidly, can rightly be defined as the real 'first' epidemic in the social era. In an increasingly globalized world other recent epidemics (but more circumscribed, even if severely more lethal, such as Ebola and Sars) have been experienced with less media and emotional involvement, while the recent epidemic due to the new coronavirus has generated deserving reactions of analysis from an anthropological and social point of view, rather than on a health aspect. In Italy the epidemic event provoked sometimes excessive and irrational psychological reactions (from an unjustified panic to an irresponsible underestimation) and a cognitive distortion on anthropological level (wrong perspective perception of the pathological event). It has also generated disproportionate social repercussions at national level (refusal of stay for subjects coming from the lands in which diseased people are present) and at international level (foreclosure of landing of Italian tourists in some foreign countries). There was also incorrect medical information (confusion between infected - asymptomatic and/or non-hospitalized paucisymptomatic -, real patients with important symptoms - hospitalized - and sometimes in need of intensive care, subjects - the elderly and carriers of other serious diseases - died not for but with the Covid-19 infection) generated and amplified also by the pounding informative role of the mass media and by the news (often inaccurate and generating fake-news) spread in real time through social media. Key messages Irrational reactions must be avoided. Correct medical information are indispensable.


Drugs & Aging ◽  
1995 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Yoshiaki Fujita
Keyword(s):  

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.


Drugs & Aging ◽  
2003 ◽  
Vol 20 (6) ◽  
pp. 445-463 ◽  
Author(s):  
Bradley R Williams ◽  
Jiwon Kim

Author(s):  
В. М. Волкова ◽  
Е. И. Скирмонт ◽  
Л. М. Смирнова ◽  
С. Б. Климашева ◽  
Е. Л. Зимина ◽  
...  

По данным ВОЗ, за последнее столетие продолжительность жизни человека значительно увеличилась во всем мире, но этот процесс неизбежно сопровождается старением. Поэтому лица, достигшие пожилого и старческого возраста, нередко становятся немощными, особенно в физическом плане. В итоге, таким людям всё труднее даются движения, связанные с самообслуживанием и передвижением, при пользовании типовой одеждой и обувью. В процессе обследования 55 пациентов 60-87 лет, проведённого впервые с позиций медико-социальной реабилитации, получены данные о характере ограничений физических возможностей этого контингента людей, существенно осложняющих использование ими типовой одежды и обуви. Основной вывод работы заключается в актуальности разработки медико-технических требований, предъявляемых к проектированию и производству одежды и обуви специально для данной категории людей с учетом их измененных антропометрических параметров и характерных для них функциональных ограничений. According to the World Health Organization, human life expectancy has increased signifi cantly around the world over the past century, but this process is inevitably accompanied by aging. Therefore, persons who have reached the elderly and senile age often become infirm, especially physically. As a result, such people find it increasingly difficult to make movements related to self-service and movement when using standard clothing and shoes. In a study of 55 patients (from 60 to 87 years), conducted for the first time from the point of view of medical and social rehabilitation, data were obtained that reveal the nature of physical limitations of this group of people, which significantly complicate them use of standard clothing and shoes. The main conclusion of the work is the relevance of the development of medical and technical requirements for the design and production of clothing and footwear specifically for the elderly and senile taking into account their changed anthropometric parameters and their characteristic functional limitations.


2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett

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.


2012 ◽  
Vol 24 (4) ◽  
pp. 247-250
Author(s):  
József Simkó ◽  
Gabriella Nagy ◽  
Anikó Dózsa ◽  
István Lörincz

Background: Although sinus node dysfunction is primarily related to degenerative fibrosis of nodal tissue in the elderly, it may occur at any age secondary to other cardiac abnormalities or extrinsic causes. Pharmacologic agents including psychotropic drug therapy may also play a role.Method: We present the case of a 53-year-old woman with bipolar affective disorder in whom antipsychotic agents were suspected of inducing sinus node dysfunction.Result: The combination of psychotropic agents including lithium, quetiapine and carbamazepine (first occasion) or escitalopram (second occasion) has been implicated as a cause for sinus node dysfunction.Conclusion: Patients with severe mental illness usually require long-term psychotropic drug therapy, often in combination. This may enhance efficacy but also involves an increased risk of adverse effects including cardiotoxicity.


DICP ◽  
1990 ◽  
Vol 24 (5) ◽  
pp. 460-463
Author(s):  
David P. Elliott ◽  
Pamela A. Harvit

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