scholarly journals Gastrointestinal Tract Disorders in Older Age

2019 ◽  
Vol 2019 ◽  
pp. 1-19 ◽  
Author(s):  
Igor Dumic ◽  
Terri Nordin ◽  
Mladen Jecmenica ◽  
Milica Stojkovic Lalosevic ◽  
Tomica Milosavljevic ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Elderly Population ◽  
The Elderly ◽  
Daily Basis ◽  
Clinical Implications ◽  
Age Group ◽  
Gi Tract ◽  
Age Related ◽  
Age Related Changes

Considering an increase in the life expectancy leading to a rise in the elderly population, it is important to recognize the changes that occur along the process of aging. Gastrointestinal (GI) changes in the elderly are common, and despite some GI disorders being more prevalent in the elderly, there is no GI disease that is limited to this age group. While some changes associated with aging GI system are physiologic, others are pathological and particularly more prevalent among those above age 65 years. This article reviews the most important GI disorders in the elderly that clinicians encounter on a daily basis. We highlight age-related changes of the oral cavity, esophagus, stomach, small and large bowels, and the clinical implications of these changes. We review epidemiology and pathophysiology of common diseases, especially as they relate to clinical manifestation in elderly. Details regarding management of specific disease are discussed in detail if they significantly differ from the management for younger groups or if they are associated with significant challenges due to side effects or polypharmacy. Cancers of GI tract are not included in the scope of this article.

Prevalence of opioid dispensings and concurrent gastrointestinal medications in an elderly population from Ontario, Canada

2018 ◽  
Vol 4 (4) ◽  
pp. 193 ◽  
Author(s):  
Rachel Williams, PhD, MS ◽  
Nevzeta Bosnic, BA ◽  
Ashlee W. Duncan, PhD, MS ◽  
Michael Brogan, BA ◽  
Suzanne F. Cook, PhD
Keyword(s):  
Side Effects ◽  
Elderly Population ◽  
Prophylactic Treatment ◽  
Opioid Analgesics ◽  
The Elderly ◽  
Therapeutic Agents ◽  
Drug Benefit ◽  
Cohort Design ◽  
Age Related ◽  
Prophylactic Use

Background: Although opioid analgesics are effective therapeutic agents, gastrointestinal (GI) side effects represent a challenging consequence of treatment. In an elderly population, age-related physiological changes, such as decreased GI functioning and dehydration, may compound the adverse effects of opioids; therefore, appropriate prophylactic treatment, utilizing laxatives and/or acid suppressants, is particularly important in an elderly population.Aim: This study describes the prevalence of outpatient opioid dispensings and the concomitant dispensing of opioids and GI medications in a population 65 years or older enrolled in the Ontario Drug Benefit Program in 2005.Methods: Using a retrospective cohort design, dispensings of opioids, laxatives, and acid suppressants were identified using claims reimbursement data. Concurrent dispensings were defined as having at least one “GI medication-dispensed day” overlapping an “opioid-dispensed day.”Results: More than 18 percent of the elderly, drug plan population was dispensed an opioid in 2005. Women had more opioid dispensings and were dispensed opioids for extended periods of time as compared with men. Approximately half of patients with an opioid dispensing were concomitantly dispensed a GI medication; these medications were dispensed nearly twice as frequently among people with chronic opioid dispensings when compared with people with nonchronic opioid dispensings.Conclusions: Although laxatives are commonly recommended in patients taking opioids, only half of the older adults in Ontario who were dispensed an opioid also received a concomitant GI medication dispensing. As the elderly are more likely to develop opioid-induced constipation, the prophylactic use of laxatives and/or acid suppressant medications is often necessary to mitigate the side effects associated with their pain management.

scholarly journals Age separation dramatically reduces COVID-19 mortality rate in a computational model of a large population

2020 ◽  
Author(s):  
Liron Mizrahi ◽  
Shani Stern
Keyword(s):  
Elderly Population ◽  
Large Population ◽  
Age Groups ◽  
The Elderly ◽  
Mortality Rates ◽  
Social Connections ◽  
Age Group ◽  
Efficient Treatment ◽  
Age Related ◽  
Total Death

AbstractCOVID-19 pandemic has caused a global lock down in many countries throughout the world. Faced with a new reality, and until a vaccine or efficient treatment is found, humanity must figure out ways to keep economy going on one hand, yet keep the population safe on the other hand, especially those that are susceptible to this virus. Here we use a network simulation, with parameters that were drawn from what is known about the virus, to explore 5 different scenarios of partial lock down release. We find that separating age groups by reducing interactions between age groups, protects the general population and reduces mortality rates. Furthermore, addition of new connections within the same age group to compensate for the lost connections outside the age group, still has a strong beneficial influence and reduces the total death toll by 66%. While complete isolation from society may be the most protective scenario for the elderly population, it would have an emotional and possibly cognitive impact that might outweigh its benefit. We therefore propose creating age-related social recommendations or even restrictions, thereby allowing social connections but still strong protection for the older population.

scholarly journals Age separation dramatically reduces COVID-19 mortality rate in a computational model of a large population

Open Biology ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 200213
Author(s):  
Liron Mizrahi ◽  
Huda Adwan Shekhidem ◽  
Shani Stern
Keyword(s):  
Elderly Population ◽  
Large Population ◽  
Age Groups ◽  
The Elderly ◽  
Social Connections ◽  
Age Group ◽  
Efficient Treatment ◽  
Age Related ◽  
Total Death ◽  
Geographical Locations

COVID-19 pandemic has caused a global lockdown in many countries throughout the world. Faced with a new reality, and until a vaccine or efficient treatment is found, humanity must figure out ways to keep the economy going, on one hand, while keeping the population safe, on the other hand, especially those that are susceptible to this virus. Here, we use a Watts–Strogatz network simulation, with parameters that were drawn from what is already known about the virus, to explore five different scenarios of partial lockdown release in two geographical locations with different age distributions. We find that separating age groups by reducing interactions between them protects the general population and reduces mortality rates. Furthermore, the addition of new connections within the same age group to compensate for the lost connections outside the age group still has a strong beneficial influence and reduces the total death toll by about 62%. While complete isolation from society may be the most protective scenario for the elderly population, it would have an emotional and possibly cognitive impact that might outweigh its benefit. Therefore, we propose creating age-related social recommendations or even restrictions, thereby allowing social connections while still offering strong protection for the older population.

scholarly journals Age-Related Changes in Trabecular and Cortical Bone Microstructure

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Huayue Chen ◽  
Xiangrong Zhou ◽  
Hiroshi Fujita ◽  
Minoru Onozuka ◽  
Kin-Ya Kubo
Keyword(s):  
Cortical Bone ◽  
Bone Strength ◽  
Elderly Population ◽  
Imaging Techniques ◽  
The Elderly ◽  
Bone Microstructure ◽  
Population Increase ◽  
Micro Ct ◽  
Age Related ◽  
Age Related Changes

The elderly population has substantially increased worldwide. Aging is a complex process, and the effects of aging are myriad and insidious, leading to progressive deterioration of various organs, including the skeleton. Age-related bone loss and resultant osteoporosis in the elderly population increase the risk for fractures and morbidity. Osteoporosis is one of the most common conditions associated with aging, and age is an independent risk factor for osteoporotic fractures. With the development of noninvasive imaging techniques such as computed tomography (CT), micro-CT, and high resolution peripheral quantitative CT (HR-pQCT), imaging of the bone architecture provides important information about age-related changes in bone microstructure and estimates of bone strength. In the past two decades, studies of human specimens using imaging techniques have revealed decreased bone strength in older adults compared with younger adults. The present paper addresses recently studied age-related changes in trabecular and cortical bone microstructure based primarily on HR-pQCT and micro-CT. We specifically focus on the three-dimensional microstructure of the vertebrae, femoral neck, and distal radius, which are common osteoporotic fracture sites.

Older substance misusers still deserve better diagnosis – an update (Part 2)

2005 ◽  
Vol 15 (3-4) ◽  
pp. 255-262 ◽  
Author(s):  
Ilana Crome ◽  
Roger Bloor
Keyword(s):  
Elderly Population ◽  
Substance Misuse ◽  
Age Groups ◽  
The Elderly ◽  
Drug Misuse ◽  
Age Group ◽  
Age Related ◽  
Co Morbidity ◽  
Specialist Treatment ◽  
The Impact

Substance misuse in the elderly population has been referred to as a silent epidemic. One of the factors that contributes to the appropriateness of this description is the difficulty of diagnosis in this age group. There is abundant evidence that substance misuse is under-diagnosed in elderly people and that this applies to both alcohol and drug misuse, although the general principles of a diagnostic approach are not age-related. The increased incidence of anxiety, depression, dementing illness, and physical illness in this population, independent of substance misuse, means that diagnoses can often be missed. The impact of co-morbidity (Figure 1) in older age groups is such that it remains the most important confounding factor in diagnosis. In this second section of the review we explore the range of psychiatric and physical illnesses that can coexist with, or be caused by, substance misuse in the elderly population. The issue of assessment as part of a treatment framework is considered in the third section of the review. The risk of missed diagnosis in this age group was illustrated in a study of diagnosis of substance misuse problems in patients aged 65 and over who had been admitted to hospital. Only three out of a total of 88 patients using benzodiazepines, 29 out of 76 smokers, and 33 out of 99 problem drinkers were correctly identified. Of those who were identified only a small proportion were referred on for specialist treatment.

scholarly journals Epigenetic Regulators Involved in Osteoclast Differentiation

2020 ◽  
Vol 21 (19) ◽  
pp. 7080
Author(s):  
Kristina Astleford ◽  
Emily Campbell ◽  
Andrew Norton ◽  
Kim C. Mansky
Keyword(s):  
Elderly Population ◽  
Molecular Mechanisms ◽  
Osteoclast Differentiation ◽  
The Elderly ◽  
Risk Of Fracture ◽  
Multinucleated Cells ◽  
Age Related ◽  
Epigenetic Regulators ◽  
Age Related Changes

Age related changes to the skeleton, such as osteoporosis, increase the risk of fracture and morbidity in the elderly population. In osteoporosis, bone remodeling becomes unbalanced with an increase in bone resorption and a decrease in bone formation. Osteoclasts are large multinucleated cells that secrete acid and proteases to degrade and resorb bone. Understanding the molecular mechanisms that regulate osteoclast differentiation and activity will provide insight as to how hyper-active osteoclasts lead to pathological bone loss, contributing to diseases such as osteoporosis. Reversible modifications to the DNA such as histone acetylation, methylation, phosphorylation and ubiquitylation alters the access of transcriptional machinery to DNA and regulates gene expression and osteoclast differentiation and activity. It is critical for the management of bone related diseases to understand the role of these chromatin modifying proteins during osteoclast differentiation, as potential therapies targeting these proteins are currently under development.

scholarly journals Diagnosis and management of pituitary tumours in the elderly: a review based on personal experience and evidence of literature

2005 ◽  
Vol 153 (6) ◽  
pp. 723-735 ◽  
Author(s):  
Giuseppe Minniti ◽  
Vincenzo Esposito ◽  
Manolo Piccirilli ◽  
Amato Fratticci ◽  
Antonio Santoro ◽  
...  
Keyword(s):  
Side Effects ◽  
Replacement Therapy ◽  
Pituitary Adenomas ◽  
Bone Mineralization ◽  
The Elderly ◽  
Hormone Deficiency ◽  
Primary Therapy ◽  
Age Group ◽  
Diagnosis And Management ◽  
Age Related

An increasing proportion of pituitary adenomas are recognized in the elderly, raising the question of their optimal diagnosis and management. Age-related endocrine changes and associated diseases may significantly modify the clinical presentation and hormonal evaluation of these patients. About 80% of pituitary adenomas in this age group are non-secreting, requiring careful differential diagnosis with non-adenomatous sellar lesions. In this group, visual deterioration and hypopituitarism remain the leading symptoms. Recognized secreting tumours are mainly GH-secreting, most of them intrasellar, followed by prolactinomas, which present as clinically non-secreting and are usually invasive. Cushing’s disease appears as a very rare eventuality in the elderly. Optimal therapeutic management should aim to control the disease while preserving or improving patient’s quality of life. Transsphenoidal surgery has proved to be an efficient and well-tolerated option for non-secreting adenomas with visual defects and intrasellar GH-secreting adenomas, being able to improve metabolic and cardiovascular complications of acromegaly even in this age group. In contrast, dopamine-agonist drugs can be proposed as a primary therapy for prolactinomas even in the presence of severe neurological complications. Because the use of radiotherapy is hampered by its delay of action and potential neurological side effects, its indications should be better defined in this age group. The clinical importance of hypopituitarism should not be underestimated, and thyroid- and adrenal-replacement therapy are mandatory in the presence of documented hormone deficiency, carefully avoiding overtreatment in order to limit possible side effects on the cardiovascular system and bone mineralization. Indications for GH- and sex steroid-replacement therapy still await age-specific guidelines.

scholarly journals A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 183
Author(s):  
Anna Izzo ◽  
Elena Massimino ◽  
Gabriele Riccardi ◽  
Giuseppe Della Pepa
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Elderly Population ◽  
The Elderly ◽  
Narrative Review ◽  
Macrovascular Complications ◽  
Diabetic Patients ◽  
Age Related

Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.

scholarly journals Considerations for a Respiratory Syncytial Virus Vaccine Targeting an Elderly Population

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Laura M. Stephens ◽  
Steven M. Varga
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Burden ◽  
Elderly Population ◽  
Vaccine Development ◽  
The Elderly ◽  
The United States ◽  
Susceptible Population ◽  
Age Related ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is most commonly associated with acute lower respiratory tract infections in infants and children. However, RSV also causes a high disease burden in the elderly that is often under recognized. Adults >65 years of age account for an estimated 80,000 RSV-associated hospitalizations and 14,000 deaths in the United States annually. RSV infection in aged individuals can result in more severe disease symptoms including pneumonia and bronchiolitis. Given the large disease burden caused by RSV in the aged, this population remains an important target for vaccine development. Aging results in lowered immune responsiveness characterized by impairments in both innate and adaptive immunity. This immune senescence poses a challenge when developing a vaccine targeting elderly individuals. An RSV vaccine tailored towards an elderly population will need to maximize the immune response elicited in order to overcome age-related defects in the immune system. In this article, we review the hurdles that must be overcome to successfully develop an RSV vaccine for use in the elderly, and discuss the vaccine candidates currently being tested in this highly susceptible population.

Sign in / Sign up

Export Citation Format

Share Document