scholarly journals Osteoporotic Hip Fractures: The Burden of Fixation Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
J. M. Broderick ◽  
R. Bruce-Brand ◽  
E. Stanley ◽  
K. J. Mulhall
Keyword(s):  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Fragility Fractures ◽  
The Elderly ◽  
Osteoporotic Bone ◽  
Ageing Population ◽  
Fixation Failure ◽  
Implant Anchorage

Osteoporotic hip fractures are a major cause of morbidity and mortality in the elderly. Furthermore, reduced implant anchorage in osteoporotic bone predisposes towards fixation failure and with an ageing population, even low failure rates represent a significant challenge to healthcare systems. Fixation failure in fragility fractures of the hip ranges from 5% in peritrochanteric fractures through to 15% and 41% in undisplaced and displaced fractures of the femoral neck, respectively. Our findings, in general, support the view that failed internal fixation of these fragility fractures carries a poor prognosis: it leads to a twofold increase in the length of hospital stay and a doubling of healthcare costs. Patients are more likely to suffer a downgrade in their residential status upon discharge with a consequent increase in social dependency. Furthermore, the marked disability and reduction in quality of life evident before salvage procedures may persist at long-term followup. The risk, of course, for the elderly patient with a prolonged period of decreased functioning is that the disability becomes permanent. Despite this, however, no clear link between revision surgery and an increase in mortality has been demonstrated in the literature.

scholarly journals Delirium as a marker of vulnerability in the elderly

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Giuseppe Bellelli ◽  
Paolo Mazzola ◽  
Alessandro Morandi
Keyword(s):  
Clinical Practice ◽  
Clinical Status ◽  
Hospital Setting ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Cerebral Dysfunction ◽  
Clinical Instability ◽  
Short And Long Term

Delirium is the clinical expression of an acute cerebral dysfunction caused by various noxious insults. Its prevalence is very high in the elderly, especially in the hospital setting, and in geriatric patients it can be the clinical manifestation of almost every acute disease. Delirium is associated to a number of adverse clinical and functional outcomes, to a higher risk of cognitive decline, institutionalization, and short- and long-term mortality. It is thus necessary to increase the attention on this issue: in fact, it is clearly demonstrated that delirium can be prevented in a large proportion of cases. Delirium is not only a marker of patient vulnerability and clinical instability, but also an index of the quality of care and the efficiency of its organization. By systematically assessing the presence of delirium during the whole length of hospital stay, physicians may closely monitor the patient’s clinical status. The aims of this review are to review the current clinical practice in delirium, focusing particularly on elderly individuals. The topics covered include epidemiology and outcomes, causes, clinical features and diagnosis, prevention and treatment. Finally, implications for clinical practice are discussed.

Ageing and Elderly Care in Kerala

China Report ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 354-373
Author(s):  
S. Irudaya Rajan ◽  
Aneeta Shajan ◽  
S. Sunitha
Keyword(s):  
Elderly Care ◽  
The Elderly ◽  
Social Contexts ◽  
Ageing Population ◽  
Care For The Elderly ◽  
Basic Care ◽  
Care Response ◽  
Suitable Environment

This article presents an overview of the elderly in Kerala and describes various dimensions of elderly care and concerns, based on data from the Kerala Ageing Survey (KAS) 2013, conducted by the Centre for Development Studies (CDS), Thiruvananthapuram, Kerala. The article looks into the main issues, policies and programmes related to ageing and elderly care practices in Kerala and also addresses the basic care response at three levels: household, institutional and society. The ageing process in Kerala is witnessing an increase in the ratio of elderly population along with fundamental changes in families and communities. Hence, in order to accommodate the needs of the ageing population in society, various systems need to be reconstructed. The concerns and issues surrounding the ageing population requires long-term attentiveness and forward planning, where policies must be adopted with consideration for cultural and social contexts. Care for the elderly should focus on a holistic combination of health care, socio-economic protection and provision of a suitable environment for better quality of life.

scholarly journals Risk factors for high length of hospital stay and in-hospital mortality in hip fractures in the elderly

2021 ◽  
Vol 65 (5) ◽  
pp. 322-330
Author(s):  
J. Salvador Marín ◽  
F.J. Ferrández Martínez ◽  
C. Fuster Such ◽  
J.M. Seguí Ripoll ◽  
D. Orozco Beltrán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
High Length

scholarly journals Sarcopenia, obesity, osteoporosis and old age

2021 ◽  
Vol 11 (4) ◽  
pp. 23-35
Author(s):  
S. V. Topolyanskaya
Keyword(s):  
Body Composition ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Mineral Density ◽  
Term Care ◽  
Visceral Fat Accumulation ◽  
Age Related ◽  
Diagnostic Approaches

Modern concepts about body composition in the elderly are described in the review. Particular attention is paid to possible causes and pathogenetic aspects of sarcopenia, as well as modern diagnostic approaches to its recognition. The ageing process is inevitably combined with diverse changes in body composition. This age-related evolution can be described by three main processes: a decrease in the growth and mineral density of bone tissue (osteopenia and osteoporosis); progressive decrease in muscle mass; an increase in adipose tissue (sarcopenia and sarcopenic obesity) with its redistribution towards central and visceral fat accumulation. Sarcopenia and osteoporosis are considered the main geriatric syndromes. These pathological conditions contribute to a significant decrease in the quality of life in the elderly; create conditions for the loss of independence and require long-term care, increase the frequency of hospitalizations and ultimately result in adverse outcomes.

Turkey

2019 ◽  
pp. 279-282
Author(s):  
Özlem Kuman Tunçel ◽  
Hayriye Elbi
Keyword(s):  
Informal Care ◽  
Family Caregiving ◽  
The Elderly ◽  
Legal Regulation ◽  
Dementia Care ◽  
Ageing Population ◽  
Care Services ◽  
The Social ◽  
Living Together

Turkey has a rapidly ageing population, the issues of which are new to the country. To date, there is no National Dementia Strategy. The strong tradition of family caregiving in Turkey has perhaps influenced the demand for access to formal care services. Informal care provided by families, which includes living together with the elders and providing the most comfort, is one of the strongest aspects of dementia care in Turkey. Another positive aspect is new legal regulation of the social security system for the elderly. Moreover, there is an increasing awareness of dementia and dementia care, which will hopefully give new impetus to further advancements in dementia care. The future of dementia care in Turkey should ideally include: (1) the development of a National Dementia Strategy, (2) improvement of informal care, including support for caregivers, and (3) an increase in the number, as well as improved quality, of in-hospital geriatric services.

scholarly journals Biomechanics of Osteoporotic Fracture Fixation

2019 ◽  
Vol 17 (6) ◽  
pp. 363-374 ◽  
Author(s):  
Marianne Hollensteiner ◽  
Sabrina Sandriesser ◽  
Emily Bliven ◽  
Christian von Rüden ◽  
Peter Augat
Keyword(s):  
Fracture Fixation ◽  
Mechanical Stability ◽  
Weight Bearing ◽  
Osteoporotic Bone ◽  
Fixation Failure ◽  
Early Weight Bearing ◽  
Elderly Individuals ◽  
Fixation Stability ◽  
Correct Application

Abstract Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holding capacity for metallic implants and is thus associated with a considerable fracture fixation failure rate both short term and long term. Modern implant technologies with dedicated modifications provide sufficient mechanical stability to allow immediate weight-bearing for elderly individuals. Depending on fracture location and fracture severity, various options are available to reinforce or augment standard fracture fixation systems. Summary Correct application of the basic principles of fracture fixation and the use of modern implant technologies enables mechanically stable fracture fixation that allows early weight-bearing and results in timely fracture healing even in patients with osteoporosis.

scholarly journals Patterns of long-term conditions in older age and subsequent mortality: a national study of inequalities in health

2019 ◽  
Vol 30 (3) ◽  
pp. 572-578
Author(s):  
T Paul de Cock ◽  
Michael Rosato ◽  
Finola Ferry ◽  
Emma Curran ◽  
Gerard Leavey
Keyword(s):  
Demographic Factors ◽  
The Elderly ◽  
Health Conditions ◽  
National Study ◽  
Latent Classes ◽  
Ageing Population ◽  
Long Term Conditions ◽  
Specific Mortality ◽  
Socio Demographic Factors

Abstract Background Multiple long-term health conditions in older people are associated with increased mortality. The study aims to identify patterns of long-term health in a national ageing population using a census-based self-reported indicator of long-term health conditions. We assessed associations with subsequent mortality and socio-economic and demographic risk factors. Methods Using linked administrative data from the Northern Ireland Mortality Study, we assessed the presence of latent classes of morbidity in self-reported data on 11 long-term health conditions in a population aged 65 or more (N = 244 349). These classes were associated with demographic and socio-economic predictors using multi-nomial logistic regression. In a 3.75-year follow-up, all-cause and cause-specific mortality were regressed on morbidity patterns. Results Four latent classes of long-term ill-health conditions were derived, and labelled: ‘low impairment’; ‘pain/mobility’; ‘cognitive/mental’; ‘sensory impairment’. Groupings reflecting higher levels of long-term ill-health were associated with class-specific increases in all-cause and cause-specific mortality. Strongest effects were found for the ‘cognitive/mental’ group, which predicted all-cause mortality [hazard ratio (HR) = 2.96: 95% confidence interval (CI) = 2.83, 3.10) as well as some cause-specific mortality (i.e. dementia-related death: HR = 10.78: 95% CI = 9.39, 12.15). Class membership was predicted by a range of socio-demographic factors. Lower socio-economic status was associated with poorer health. Conclusion Results indicate that long-term ill-health clusters in specific patterns, which are both predicted by socio-demographic factors and are themselves predictive of mortality in the elderly. The syndromic nature of long-term ill-health and functioning in ageing populations has implications for healthcare planning and public health policy in older populations.

Chronic kidney disease in older people: diagnosis, pathogenesis and management

2008 ◽  
Vol 18 (4) ◽  
pp. 245-256
Author(s):  
Claire C Beeson ◽  
Edmund J Lamb ◽  
Shelagh E O'Riordan
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Older People ◽  
Significant Risk ◽  
Public Health Problem ◽  
Ageing Population ◽  
Risk Of Progression

Chronic kidney disease (CKD) refers to long-term impairment of renal function. It is predominantly a disease of older people and the true extent of this has only recently been recognized. CKD has a number of implications including increased cardiovascular risk, secondary complications such as renal anaemia and bone disease and a small but significant risk of progression to established renal failure (ERF). It is associated with significant morbidity, mortality and healthcare costs and, against the background of an ageing population and the rising prevalence of type 2 diabetes, represents a growing public health problem. Evidence that specific interventions can reduce the cardiovascular risk associated with CKD and the risk of progressive CKD, as well as improving quality of life, has highlighted the importance of early detection of this disease.

Radiofrequency exposure in young and old: different sensitivities in light of age-relevant natural differences

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Mary Redmayne ◽  
Olle Johansson
Keyword(s):  
Age Groups ◽  
Well Being ◽  
The Elderly ◽  
Ageing Population ◽  
Economic Implications ◽  
Population Means ◽  
Increased Risk ◽  
Study Results ◽  
Comparative Risk

AbstractOur environment is now permeated by anthropogenic radiofrequency electromagnetic radiation, and individuals of all ages are exposed for most of each 24 h period from transmitting devices. Despite claims that children are more likely to be vulnerable than healthy adults to unwanted effects of this exposure, there has been no recent examination of this, nor of comparative risk to the elderly or ill. We sought to clarify whether research supports the claim of increased risk in specific age-groups. First, we identified the literature which has explored age-specific pathophysiological impacts of RF-EMR. Natural life-span changes relevant to these different impacts provides context for our review of the selected literature, followed by discussion of health and well-being implications. We conclude that age-dependent RF-EMR study results, when considered in the context of developmental stage, indicate increased specific vulnerabilities in the young (fetus to adolescent), the elderly, and those with cancer. There appears to be at least one mechanism other than the known thermal mechanism causing different responses to RF-EMR depending upon the exposure parameters, the cell/physiological process involved, and according to age and health status. As well as personal health and quality-of-life impacts, an ageing population means there are economic implications for public health and policy.

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