Dizziness and vertigo

2017 ◽  
pp. 1177-1182
Author(s):  
Declan Lyons ◽  
Avril Beirne ◽  
Joanna Lawson
Keyword(s):  
Functional Decline ◽  
Careful Examination ◽  
History Taking ◽  
Motor Systems ◽  
Age Related ◽  
Treatment Plans ◽  
Red Flag ◽  
Normal Ageing ◽  
Physiological Systems

Dizziness is one of the commonest symptoms described by older adults, particularly women, and is associated with reduced quality of life, functional decline, and falls. The term dizziness is used by patients to describe a variety of symptoms, including a hallucination of movement (vertigo), light-headedness, and a true appreciation of unsteadiness associated with gait disorders. Although there are age-related decrements in the somatosensory, visual, vestibular, and motor systems, dizziness should not be regarded as part of normal ageing. Diagnosis can usually be reached without specialist investigations, through focused history taking and bedside clinical assessment, including careful examination of eye movements and the Dix-Hallpike test. The underlying cause may be in one or several physiological systems and this will guide treatment plans. Benign paroxysmal positional vertigo (BPPV) and neuritis are more common than Meniere’s. The presence of red flag symptoms or signs suggesting central vestibular disease will require further imaging.

scholarly journals Sensory impairments and cognitive disorders in older age

2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Giancarlo Logroscino ◽  
Francesco Panza
Keyword(s):  
Oldest Old ◽  
Cognitive Disorders ◽  
Motor Systems ◽  
Age Related ◽  
Dementia Risk ◽  
Sensory Impairments ◽  
Health Related ◽  
Older Subjects ◽  
The Impact

Age-related and neuropathological changes in the olfactory, visual, auditory, and motor systems suggesting that sensory and motor changes may precede the cognitive symptoms of Alzheimer’s disease (AD) by several years and may signify increase the risk of developing AD. In particular, peripheral age-related hearing impairment and social isolation have been identified as potentially modifiable dementia risk factors. The impact of age-related hearing and vision impairments on cognition appeared to be especially important among the oldest old suggesting a strong link of these connections with frailty, a critical intermediate status of the aging process at higher risk for negative health-related outcomes. The link among age-related hearing and vision impairments and cognition suggested the potential for correcting hearing and vision losses so that older subjects can function better cognitively with improved social involvement, quality of life, and lifetime cognitive health.

scholarly journals Promoting neuroplasticity and neuropsychological functioning in frailty through an app-based sensorimotor training: study protocol for a randomized trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Florian Beier ◽  
Martin Löffler ◽  
Frauke Nees ◽  
Lucrezia Hausner ◽  
Lutz Frölich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Trial ◽  
Relaxation Training ◽  
Neuropsychological Functioning ◽  
Functional Decline ◽  
Serum Levels ◽  
Sensorimotor Training ◽  
Training Environment ◽  
Age Related

Abstract Background Frailty is characterized by an age-related decline in multiple physiological systems, leading to a high vulnerability to stressors, adverse health outcomes, and low quality of life. Neuroscientific models of pathological aging emphasize the loss of sensorimotor stimulation and reduced neuromodulatory capacities as core processes in age-related cognitive and bodily decline, which may be associated with maladaptive plastic changes in the brain. We plan to increase sensorimotor stimulation in frail persons through a newly developed app-based training program and link the training trials to biological and psychological correlates of age-associated vulnerability and health indices. Methods We will conduct a randomized trial, applying an app-based sensorimotor home training (N = 30) in people suffering from frailty. An app-based relaxation training will serve as an active control condition (N = 30). Both interventions will last for 90 days each. The sensorimotor training includes unimodal and multimodal sensory discrimination tasks in the visual, auditory, and tactile domain, as well as sensorimotor precision tasks. The tasks will be implemented using an adaptive training algorithm and enriched with motivational components embedded in a virtual training environment. We expect a pre-post reduction of frailty status and associated functional decline related to refinement of representational maps within the sensorimotor system and improved sensorimotor function such as extremity function. Secondary analyses will study the influence of BDNF genotype as moderating variable. Additional outcomes will include measures of perceptual and cognitive functioning, quality of life as well as BDNF serum levels. Measurements will take place before training (baseline), after 60 days (assessment 1), and at the end of the training after 90 days (assessment 2). Discussion In our randomized trial, we aim to characterize a multidimensional concept of frailty and to target maladaptive behaviors and neuroplasticity using an app-based sensorimotor training. This type of intervention might provide further knowledge and new possibilities for preventing decline and preserving function in older adults. Trial registration ClinicalTrials.gov NCT03666039. Registered 11 September 2018 – Retrospectively registered. Protocol version: Version 4 revised (issue date: 19 May 2021).

Eye disease in older people

2013 ◽  
Vol 23 (3) ◽  
pp. 234-250 ◽  
Author(s):  
Robert MJ Purbrick ◽  
John J Ah-Chan ◽  
Susan M Downes
Keyword(s):  
Older People ◽  
Physical Disability ◽  
Eye Disease ◽  
Pathological Changes ◽  
Poor Vision ◽  
Age Related ◽  
Quality Of Vision ◽  
Normal Ageing ◽  
Age Related Changes

SummaryAge-related changes affect all structures of the eye, and while age-related changes may influence the quality of vision, it is important to distinguish age-related physiological changes from pathological changes. This is important particularly when identifying pathological changes that may be treatable. The prevalence of visual loss increases substantially after 60 years of age and poor vision is the second most prevalent physical disability in older people. This review describes the normal ageing changes of the eye and outlines common ophthalmic diseases affecting older people. We refer to recent advances in diagnosis and treatment, and relevant current research.

scholarly journals Discussing age-related functional decline in family medicine: a qualitative study that explores both patient and physician perceptions

2019 ◽  
Vol 49 (2) ◽  
pp. 292-299
Author(s):  
Ophélie Viret ◽  
Joëlle Schwarz ◽  
Nicolas Senn ◽  
Yolanda Mueller
Keyword(s):  
Qualitative Study ◽  
Older People ◽  
Functional Limitations ◽  
Functional Decline ◽  
Management Tool ◽  
Geriatric Syndrome ◽  
Geriatric Syndromes ◽  
Age Related ◽  
Normal Ageing ◽  
Primary Care Practices

Abstract Background evaluating a patient’s functional status and screening for geriatric syndromes by general practitioners (GPs) are increasingly encouraged. This study aimed to explore how older people and GPs define and perceive autonomy and functional decline, patients’ propensity to discuss age-related issues and integration of such topics into routine medical consultations. Methods this qualitative study was conducted in Western Switzerland with older people followed in primary care practices and who participated in a trial assessing the effectiveness of a screening and management tool for geriatric syndromes to prevent functional decline. We interviewed 15 participants (patients ≥75 years old) and five GPs about their screening experience. We used semi-structured grids for data collection and an inductive thematic approach for data analysis. Results participants gave several definitions of autonomy, directly depending on their health status and functional limitations. Implementing various coping strategies, participants also expressed contrasted feelings related to functional decline such as fear, inability to accept and resilience. Functional decline was often perceived as normal ageing; participants were therefore not prompt at discussing age-related issues with their GP. However, screening was perceived positively by both participants and GPs, making addressing sensitive issues and detecting new problems possible. Conclusions a geriatric syndrome-screening intervention was well accepted by both patients and physicians. This type of initiative may be an opportunity to address various age-related issues and to inform patients of existing solutions.

scholarly journals A Preliminary Study of Tinnitus Subgroups based on Self-reported Presbyacusis and Noise Induced Hearing Loss

2020 ◽  
Author(s):  
Yu Wang ◽  
Tao Pan ◽  
Richard Tyler
Keyword(s):  
Hearing Loss ◽  
Online Survey ◽  
Noise Induced Hearing Loss ◽  
Noise Environment ◽  
Age Related ◽  
Lack Of Sleep ◽  
Related Group ◽  
Red Flag ◽  
Preliminary Study

Objective: To compare some characteristics of two subgroups of tinnitus, noise-induced tinnitus and age-related tinnitus. Design: An online survey from the Iowa Tinnitus Website was reviewed. The participants were divided into two subgroups according to their reported cause of tinnitus—noise or aging. Their answers to the questions about loudness, qualities, worsening and reducing factors of tinnitus were analyzed. Study sample: There were 16 patients of age-related tinnitus and 147 of noise-induced tinnitus. Results: Two groups did not differ significantly in loudness (U = 887.5, p > 0.05), qualities (X2 = 1.164, p > 0.05) or reducing factors (X2 = 1.984, p > 0.05). Ringing/whistling was the most common quality of both age-related (37.5%) and noise-induced tinnitus (51.7%). 42.9% of participants of noise-induced tinnitus and 31.3% of age-related tinnitus felt that nothing made tinnitus better. The main worsening factors for noise-induced tinnitus included being in a noisy place (44.2%) and lack of sleep (42.9%) , which differed from the age-related group (X2 = 6.169, p < 0.05). Conclusions: There was a great deal of overlap between two subgroups, with some differences in worsening factors, including noise environment and lack of sleep. This is an important ‘red flag’ in counseling, and should be considered by doctors when choosing therapy.

Oxford Cases in Medicine and Surgery

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Chest Pain ◽  
Case History ◽  
Clinical Medicine ◽  
Real Life ◽  
General Medicine ◽  
Diagnostic Approach ◽  
History Taking ◽  
Presenting Symptoms ◽  
Essential Resource ◽  
Physiological Systems

Oxford Cases in Medicine and Surgery, second edition, teaches students a logical step-by-step diagnostic approach to common patient presentations. This approach mirrors that used by successful clinicians on the wards, challenging students with questions at each stage of a case (history-taking, examination, investigation, management). In tackling these questions, students understand how to critically analyse information and learn to integrate their existing knowledge to a real-life scenario from start to finish. Each chapter focuses on a common presenting symptom (e.g. chest pain). By starting with a symptom, mirroring real life settings, students learn to draw on their knowledge of different physiological systems - for example, cardiology, respiratory, gastroenterology - at the same time. All the major presenting symptoms in general medicine and surgery are covered, together with a broad range of pathologies. This book is an essential resource for all medicine students, and provides a modern, well-rounded introduction to life on the wards. Ideal for those starting out in clinical medicine and an ideal refresher for those revising for OSCEs and finals.

scholarly journals Spontaneous Eye Blinks Predict Executive Functioning in Seniors

2021 ◽  
Author(s):  
Jessika I. V. Buitenweg ◽  
Jaap M. J. Murre ◽  
K. Richard Ridderinkhof
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Executive Functioning ◽  
Cognitive Training ◽  
Functional Decline ◽  
Future Research ◽  
Blink Rate ◽  
Memory Updating ◽  
Age Related ◽  
Working Memory Updating

AbstractAs the world’s population is aging rapidly, cognitive training is an extensively used approach to attempt improvement of age-related cognitive functioning. With increasing numbers of older adults required to remain in the workforce, it is important to be able to reliably predict future functional decline, as well as the individual advantages of cognitive training. Given the correlation between age-related decline and striatal dopaminergic function, we investigated whether eye blink rate (EBR), a non-invasive, indirect indicator of dopaminergic activity, could predict executive functioning (response inhibition, switching and working memory updating) as well as trainability of executive functioning in older adults. EBR was collected before and after a cognitive flexibility training, cognitive training without flexibility, or a mock training. EBR predicted working memory updating performance on two measures of updating, as well as trainability of working memory updating, whereas performance and trainability in inhibition and switching tasks could not be predicted by EBR. Our findings tentatively indicate that EBR permits prediction of working memory performance in older adults. To fully interpret the relationship with executive functioning, we suggest future research should assess both EBR and dopamine receptor availability among seniors.

scholarly journals Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 96-96
Author(s):  
Victoria Raveis ◽  
Simona Kwon
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivor ◽  
Breast Cancer Survivors ◽  
Cancer Survival ◽  
Survival Rates ◽  
Extended Period ◽  
Health Issues ◽  
Age Related

Abstract Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”

Changes in alcohol history taking by psychiatric junior doctors: an audit

1995 ◽  
Vol 12 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Simon J Taylor
Keyword(s):  
Illicit Drug ◽  
Statistical Significance ◽  
Inpatient Admission ◽  
Junior Doctors ◽  
History Taking ◽  
Drug Usage ◽  
Acute Psychiatric Wards ◽  
First Time

AbstractObjective: In recent years a number of articles have highlighted deficiencies in drinking histories taken by junior doctors. This study examines whether standards have improved as a result. It also examines for the first time: 1. the quality of drinking histories taken from patients following parasuicide; and 2. the quality of illicit drug usage histories.Method: An audit of case notes was undertaken of 114 patients admitted to a district hospital's acute psychiatric wards or assessed following overdose. Two periods were considered; one preceding many of the articles, and the second four years later.Results: There was an overall improvement from 58% of histories in 1988 having no mention of alcohol usage to 25% in 1992. (X2MH=10.57, p<0.01). There was, however, insufficient improvement of quantitative histories to reach statistical significance. Histories taken as part of an overdose assessment were not significantly different from those taken for inpatient admission. In 1992, 27% of patients had any illicit drug usage history recorded which represented a statistically significant improvement (X2MH=5.91, p<0.02) compared with four years earlier.Conclusions: Although improvements have been noted, alcohol and drug histories remain inadequate.

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