Headaches in the elderly

There is a non-controversial definition about who is an elderly patient. The age group above 85 years is the fastest growing segment in the total population. Persisting pain is not rare in this patient group and the prevalence for persisting pain is 40–79%. Migraine prevalence declines gradually after the age of 40 years, but even in the age group of 60 years and older up to 5% complain of migraine and in some patients the symptoms change towards more tension type-like headaches. Tension-type headaches are thought to be the most prevalent primary headaches in the elderly, with a 1-year prevalence of about 36%; secondary headaches often present as tension type-like headaches. A typical age-bounded headache is hypnic headache, which is only seen in patients older than 55 years of age. In the treatment of headaches in the elderly, the pharmacokinetic changes with age should be considered; the distribution volume and elimination kinetics are different in the elderly. Therefore, treatment should be initiated as ‘slow and low’.

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Prognostic Factors of Endometrial Cancer In The Elderly Patient Group and Their Effects On Survival

Northern Clinics of Istanbul ◽

10.14744/nci.2020.47154 ◽

2020 ◽

Author(s):

Songul Alemdaroglu

Keyword(s):

Elderly Patient ◽

Endometrial Cancer ◽

Prognostic Factors ◽

Patient Group ◽

The Elderly

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Magnesium, Aging, and the Elderly Patient

The Scientific World JOURNAL ◽

10.1100/tsw.2004.114 ◽

2004 ◽

Vol 4 ◽

pp. 544-550 ◽

Cited By ~ 3

Author(s):

Mladen Davidovic ◽

Dejan Trailov ◽

Dragoslav Milosevic ◽

Branimir Radosavljevic ◽

Pavle Milanovic ◽

...

Keyword(s):

Elderly Patient ◽

Life Span ◽

Serum Magnesium ◽

The Elderly ◽

Loop Diuretics ◽

Control Group ◽

Elderly Persons ◽

Age Group ◽

Intracellular Magnesium

Magnesium, beyond any doubt, plays an important role in metabolism. Alterations of magnesium levels have an impact on many organs and systems, especially during aging. We had 156 participants aged 60–93 years (average 74.7 years) in our survey. Of them, 49 were men and 107 were women. Treatment with loop diuretics (Furosemid and Bumetanide) and magnesium levels was correlated, as well as the influence of magnesium levels on life span. Serum magnesium levels were measured in patients receiving diuretics and in the control group. Also, magnesium levels were measured in patients who passed away in the course of their disease and were compared with the control group. Magnesium levels in the diuretic group (100 patients) were 0.93 ± 0.094 mmol/l, while the average levels in the control group of 56 patients were 0.89 ± 0.075 mmol/l. In 29 patients who passed away, average magnesium levels were 0.92 ± 0.078 mmol/l, while in the control group (127 patients), magnesium levels were 0.93 ± 0.083 mmol/l. The differences were not statistically significant. There were no differences in serum magnesium of the elderly persons investigated regarding age group, gender, or type of diuretics. If methods of determining ionizing magnesium in serum or intracellular magnesium are not available, normal magnesium values in the serum are to be taken with a qualified acceptance.

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Silver Trauma- a true challenging entity

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i12.1585 ◽

2020 ◽

Vol 4 (12) ◽

Author(s):

D. Chowdhury

Keyword(s):

Elderly Patient ◽

Cervical Spine Injury ◽

Elderly Population ◽

Major Trauma ◽

Management Strategies ◽

The Elderly ◽

Spine Injury ◽

Retirement Age ◽

Age Group ◽

Initial Management

Historically trauma has been identified as the leading cause of death in the younger under 40’s population (1). However, with an aging population there is a higher incidence of trauma sustained in the elderly population. Silver trauma is defined as elderly patient of retirement age or over the age of 65 years. This has been taken into consideration when trauma guidelines have been incorporated. To name a few examples, the CCSR (Canadian C-spine rule) includes the at-risk population as those >/= 65 years of age in the context of potential cervical spine injury. In various major trauma trial tools, the >65 years of age group are considered to be a high risk of deteoriation group. Through clinical practice clinicians have noted that in this group of patients’ injuries can be missed which would be detrimental to the overall outcome of these patients. Through this article I aim to highlight the main issues that make the initial management of the elderly trauma patient at times challenging. Furthermore, suggestion for potential management strategies will also be highlighted.

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Primary Headache Disorder Among School Students in Kuwait

Frontiers in Neurology ◽

10.3389/fneur.2021.621017 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sameera Shuaibi ◽

Abdelrahman AlAshqar ◽

Samar Farouk Ahmed ◽

Raed Alroughani ◽

Hawraa AlThufairi ◽

...

Keyword(s):

Medication Overuse ◽

Primary Headache ◽

Primary Headaches ◽

Age Group ◽

School Students ◽

Primary Headache Disorders ◽

Migraine Headaches ◽

Middle Schoolers ◽

Chronic Headaches ◽

Tension Type Headaches

Background: Primary headaches are remarkably prevalent worldwide and are increasingly reported among children. However, the exact trend in this age group, particularly in the Gulf region, remains largely unknown.Aims and Objectives: To examine the prevalence of primary headache disorders among primary and middle school students in Kuwait.Methods: We conducted a cross-sectional study that included Kuwaiti primary and middle school children and adolescents of both genders in randomly selected schools located in two governorates in Kuwait in the 2018/2019 academic year. Prevalence and attributable burden of headaches, definite and probable migraines, definite and probable tension-type headaches, chronic headaches (≥15 days/month), and probable medication-overuse headaches were assessed using the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire for children and adolescents.Results: Of 1,485 questionnaires that were distributed, 1,089 students completed the questionnaire with a respondent rate of 73.4%. The study population consisted of 420 boys (38.56%) and 669 girls (61.43%) students with a mean age of 11.5 ± 2.11 years. The 1-year prevalence of primary headache disorders was 42.78%, with more middle schoolers reporting headaches than primary schoolers (50.37 vs. 30.48%; p < 0.02). The mean age of students with primary headaches was 11.98 ± 2.03 years in both genders. When stratified according to diagnostic criteria, migraine headaches were the most frequently reported (20.75%), followed by tension type headaches (18.8%), chronic headaches (2.75%), and probable medication-overuse headaches (0.46%). Primary headaches were significantly higher in girls compared to boys among middle schoolers (66.46 vs. 38.49%; p < 0.001); however, no significant difference between genders was noted among primary school students (33.12 vs. 22.33%; p < 0.118).Conclusion: Primary headaches are remarkably common in Kuwaiti school students, with migraine headaches being the most frequently reported type. Age and female gender may play a role in the development of primary headaches. These findings necessitate the direction of health services and research efforts toward this age group and warrant the need for further epidemiological studies.

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Prescription Dose Analysis of Quetiapine in the Elderly and Insomnia

Chronobiology in Medicine ◽

10.33069/cim.2021.0031 ◽

2021 ◽

Vol 3 (4) ◽

pp. 149-156

Author(s):

Ki Yong Lee ◽

Seung-Ho Ryu ◽

Jee Hyun Ha ◽

Hong Jun Jeon ◽

Doo-Heum Park

Keyword(s):

Elderly Patient ◽

Patient Group ◽

Depressive Disorders ◽

Drug Prescription ◽

Immediate Release ◽

The Elderly ◽

Health Department ◽

Prescription Dose ◽

Mental Health Department ◽

Higher Doses

Objective: The purpose of this study is to investigate the appropriate dose of quetiapine in clinical psychiatric diseases by examining the drug prescription dose in the elderly and insomnia group through an analysis of the tendency of quetiapine dose prescribed by psychiatric diagnosis.Methods: Among the patients who had been taking outpatient treatment to the mental health department for about 7 years and 8 months from May 1, 2010 to December 31, 2017, 2,794 patients who were continuously taking quetiapine immediate-release form drugs were retrospectively tested. In addition, all subjects were classified into a total of four groups according to their maintenance dose, four mental diseases that most commonly prescribe quetiapine were selected and grouped, and further analyzed whether there was a difference in prescription capacity by age and comorbidities for the insomnia group.Results: Prescription dose of quetiapine was found to be less than 50 mg in depressive disorders and insomnia, which is a relatively low dose prescribed compared to schizophrenia and bipolar disorder. In the case of insomnia, quetiapine prescribed in the elderly patient group was 30.03±9.14 mg, which was relatively high compared to the non-elderly group. And in the case of insomnia accompanied by depressive disorder, 50.28±11.41 mg was prescribed, more than 60% higher doses than that of primary insomnia.Conclusion: In the case of primary insomnia, quetiapine dose prescribed in the elderly patient group is higher than that in the non-elderly patient group.

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Nutrition Study People over 80 Years

European Journal of Investigation in Health, Psychology and Education ◽

10.3390/ejihpe2030007 ◽

2012 ◽

Vol 2 (3) ◽

pp. 77-89

Author(s):

Javier Benítez ◽

Nieves Perejón ◽

Marcelino Arriaza ◽

Pilar Bellanco

Keyword(s):

Quality Of Life ◽

The Elderly ◽

Blood Chemistry ◽

Living Alone ◽

Age Group ◽

Nutrition Study ◽

Geriatric Evaluation ◽

The Mean ◽

Elderly Living

Loneliness has always been associated and reported as a risk factor of malnutrition in the elderly. People over 80 who live alone have deserved this study to detect their situation and potential for action to improve their quality of life. Objectives: To determinate the nutritional status of people over 80 living alone in the area of “La Laguna”, Cádiz. Material and method: In PIAMLA`80 program analyse those parameters and their possible correlations in a group of 342 elderly living alone over 80 years old. Different parameters were measured: Integral Geriatric Evaluation, Barthel, Lawton-Brody, Lobo, Gijon, specific analytical blood chemistry and MNA. Results: In a population of 984 people, were selected 342 initially, but finally the group decreases to 247 people. The mean Barthel was 80.42 points, 5.76 Lawton and Gijon from 11.3 Lobo 26.48. The MNA for the whole population was 24.25/30 detecting only a risk age group in women of 85-95. Correlation between nutrition and the biochemical test values showed positive for haemoglobin (0.19), total protein (0.26), Fe (0.32) and albumin (0.46). Conclusions: In our research we have not detected malnutrition in any age group or gender. The use of nutrition test MNA and its MINI version must be generalized as an accurate, clear, quick and easy tool to use.

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Creating a Safer Patient Room Environment: The Contribution of Patient Bed Height

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101163 ◽

2021 ◽

Vol 10 (1) ◽

pp. 180-184

Author(s):

Dorothy Taylor ◽

Janice Morse ◽

Andrew Merryweather

Keyword(s):

Elderly Patient ◽

Fall Risk ◽

The Elderly ◽

Lower Leg ◽

Patient Specific ◽

Leg Length ◽

Patient Room ◽

Patient Falls ◽

Sit To Stand ◽

Bed Height

Elderly patient falls are expensive and may cause serious harm. Studies have identified the sit-to-stand-and-walk (STSW) task as the task where the greatest number of elderly patient falls occur. There is a great need to identify the particular movement and environmental conditions that lead to these elderly patient falls. This study begins to address this gap by evaluating the elderly patient during self-selected hospital bed egress. Using an observed fall risk episode (FRE) as a fall proxy, statistically significant parameters were identified which include bed height, pausing prior to initiating gait, level of fall risk, and Stand phase. Low bed height was identified as the least safe bed height. Patient-specific bed height (PSBH) using the patient’s lower leg length (LLL) is recommended. In addition, suggested guidelines are presented for clinical application in setting PSBH without measuring the patient’s LLL.

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Hip fractures among the elderly in Kyoto, Japan: a 10-year study

Archives of Osteoporosis ◽

10.1007/s11657-021-00888-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maki Asada ◽

Motoyuki Horii ◽

Kazuya Ikoma ◽

Tsuyoshi Goto ◽

Naoki Okubo ◽

...

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Incidence Rate ◽

Acute Care ◽

Hip Fractures ◽

Age Groups ◽

The Elderly ◽

Femoral Neck Fractures ◽

Age Group ◽

Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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