scholarly journals The pattern of substance abuse in Thai elderly: Ramathibodi Poison Center

2019 ◽  
Vol 7 ◽  
pp. 205031211987351 ◽  
Author(s):  
Sirasa Ruangritchankul ◽  
Sahaphume Srisuma

Objective: To describe substances, clinical manifestations, treatment, and medical outcomes of substance abuse exposures among older adults in Thailand. Method: This is a retrospective study of individuals aged 60 years or older with intentional abuse exposures reported to the Ramathibodi Poison Center from 1 January 2010 to 31 December 2017. Results: Forty-four cases were reported. The most common manifestation was somnolence (20, 45.5%). The most common substance used was kratom. There were 12 severe and fatal cases. Only one died due to methadone abuse. The most frequent manifestation among severe cases was respiratory failure (8 of 12 cases, 66.7%). Two cases had severe metabolic acidosis and were treated with hemodialysis. Three cases received norepinephrine. Conclusion: Substance abuse in the elderly is a serious problem that is often overlooked. Health personnel should promptly recognize and address this issue in order to reduce morbidity and mortality in the elderly population.

2015 ◽  
Vol 46 (4) ◽  
pp. 11-17 ◽  
Author(s):  
Amani A. Kettaneh

The number of older adults in the United States is increasing dramatically. Increased life expectancy worldwide has led to greater populations of older adults and greater populations of older adults with alcohol use disorders. Hence, professionals in the health services need to have increased awareness about appropriate screening and treatment methods and services for working with older people with these conditions. A review of the literature was conducted to identify the impact of substance abuse on older adults. This paper provides an overview of the addictive disorders among older adults, with details about the impact of addiction, risk and protective factors, the relationship between addiction and demographics variables, and finally, the rehabilitation counselor's role in helping older adults with alcohol and substance use disorders.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.


2021 ◽  
Vol 15 ◽  
Author(s):  
Anne Sophie Grenier ◽  
Louise Lafontaine ◽  
Andréanne Sharp

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.


2021 ◽  
Author(s):  
Gabriela Ferreira Kalkmann ◽  
Carlos Umberto Pereira ◽  
Francisco de Assis Pereira ◽  
Débora Moura da Paixão Oliveira ◽  
Nicollas Nunes Rabelo

Introduction: The clinical manifestations of chronic subdural hematoma (CSDH) are often confused with other medical entities in the elderly, making their early diagnosis difficult or difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological state, thus resulting in a worse vital and functional prognosis. Objectives: Report through a literature review the clinical manifestations of CSDH in the elderly population. Methods: Literature review, with the search terms: “Signs and Symptoms”, “Chronic Subdural Hematoma”, Aged, Diagnosis and Prognosis. In which PubMed, Lilacs, Scielo, Cochrane and TripDataBase data platforms were used. The inclusion criteria were: original studies published in any language. Articles in which full reading was prevented were excluded. With the application of the inclusion and exclusion criteria, 110 articles were included in the study. Results: Clinical presentation depends on the location, volume of the hematoma, rapid growth, the location of the CSDH, whether unilateral or bilateral, and the clinical conditions of the patient. Because the forms of clinical presentation of CSDH are variable, it is necessary that health professionals linked to the elderly (geriatrician, psychiatrist, general practitioner) have knowledge of this clinical entity. Conclusions: The recognition of classic forms as well as the identification of risk factors in the elderly favors the timely diagnosis and treatment of CSDH in the elderly population.


Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.


Author(s):  
Jovana Sibalija ◽  
Mallory L. Ciminsky ◽  
Katharine Fuchigami ◽  
Marie-Helene L.S. He ◽  
Yuyuan Chen ◽  
...  

In December 2013, Canada Post announced they would be converting approximately five million households from door-to-door mail delivery to community mailboxes (CMB). The decision was made to address decreasing letter mail volume and operating losses experienced by the crown corporation. The CMBs will be phased in over the five years mainly in urban areas across the country. The decision to convert to CMBs makes Canada the only among the G8 countries to end home delivery of mail. As a result, no research exists on the implications of the change. Particular concern has been raised over how the conversion will affect older adults. One area that needs examination is the consequences of the CMBs delivery model on fall rates among older adults in the winter. Falls are common among seniors, with 20-30% community dwelling older adults falling each year. The risk of falling is increased in the winter when there is snow and ice on the ground. Injuries dues to falls consume a great deal of healthcare resources. The purpose of this scoping literature review was to determine: What are the implications for the elderly population of Canada Post’s decision to convert home delivery of mail to community mailbox delivery? Specifically, the review focused on how the conversion may impact fall rates among older adults in the winter.


2017 ◽  
Vol 12 (2) ◽  
pp. 12-15
Author(s):  
Camelia C. DIACONU ◽  
◽  
Denisa BUCUR ◽  
Daniel BERCEANU ◽  
Ovidiu Gabriel BRATU ◽  
...  

Orthostatic hypotension is a persistent decrease of systolic blood pressure by at least 20 mm Hg and/or diastolic blood pressure by at least 10 mm Hg in the first 3 minutes upon standing. Orthostatic hypotension is more common in the elderly patients, being one of relatively frequent causes of hospitalization in the elderly population. Orthostatic hypotension may be primary or secondary, acute or chronic. Its etiology is represented in most cases by the primary or secondary autonomic failure. Clinical manifestations of orthostatic hypotension occur after the transition from supine to standing, and are due to cerebral hypoperfusion. These consist of nausea, dizziness, generalized weakness, postural instability, fatigue, blurred vision. Cardiological and neurological consult are necessary for diagnosis. Pharmacological treatment of orthostatic hypotension is often unsatisfactory, imposing combination with non-pharmacological measures.


2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Yu-Kai Chang ◽  
I-Hua Chu ◽  
Jen-Hao Liu ◽  
Chih-Han Wu ◽  
Chien-Heng Chu ◽  
...  

This study explored the effects of exercise modality and type of fitness index on cognitive function in the older adults as assessed via behavioral and neuroelectrical approaches. Sixty older adults were assigned to an aerobic exercise, a coordination exercise, or a control group based on their previous exercise experience. The participants completed congruent and incongruent trials of a modified Stroop Test, during which, event-related potentials were recorded. The participants also completed multiple physical tests that assessed health- and skill-related fitness. Our findings suggest that, in general, both aerobic and coordination exercise, as well as higher scores on health- and skill-related fitness indices, are positively associated with better performance of various cognitive functions in the elderly population. The mechanisms underlying these relationships may be differentially related to specific neuroelectrical processes involved in neurocognitive control.


2013 ◽  
Vol 680 ◽  
pp. 466-472 ◽  
Author(s):  
Hsin Chang Lo ◽  
Pin Chang Lin ◽  
Kang Ping Lin

Similar to many other countries in the world, the elderly population in Taiwan is now growing rapidly. Some older adults are found to have difficulty controlling their emotion, which may later develop into psychological diseases such as anxiety disorder. Therefore, emotional control is an important issue for elderly citizens. This study proposed a wearable biofeedback emotional control device, FeelVest, which integrates electrocardiography acquisition with heart rate variability analyzing techniques to detect user’s emotion. When a user is nervous and unstable, FeelVest would analyze the emotional state of the user. If the user’s emotional condition is judged as abnormal, the control module would remind the user to relax through vocal notification, or broadcast relaxation melodies to ease the user’s nerve. With this vest, older adults are able to monitor and regulate their own emotion and have a healthier life style.


2017 ◽  
Vol 28 (01) ◽  
pp. 005-013 ◽  
Author(s):  
Bruna S. S. Mussoi ◽  
Ruth A. Bentler

AbstractThe existence of binaural interference, defined here as poorer speech recognition with both ears than with the better ear alone, is well documented. Studies have suggested that its prevalence may be higher in the elderly population. However, no study to date has explored binaural interference in groups of younger and older adults in conditions that favor binaural processing (i.e., in spatially separated noise). Also, the effects of hearing loss have not been studied.To examine binaural interference through speech perception tests, in groups of younger adults with normal hearing, older adults with normal hearing for their age, and older adults with hearing loss.A cross-sectional study.Thirty-three participants with symmetric thresholds were recruited from the University of Iowa community. Participants were grouped as follows: younger with normal hearing (18–28 yr, n = 12), older with normal hearing for their age (73–87 yr, n = 9), and older with hearing loss (78–94 yr, n = 12). Prior noise exposure was ruled out.The Connected Speech Test (CST) and Hearing in Noise Test (HINT) were administered to all participants bilaterally, and to each ear separately. Test materials were presented in the sound field with speech at 0° azimuth and the noise at 180°. The Dichotic Digits Test (DDT) was administered to all participants through earphones. Hearing aids were not used during testing. Group results were compared with repeated measures and one-way analysis of variances, as appropriate. Within-subject analyses using pre-established critical differences for each test were also performed.The HINT revealed no effect of condition (individual ear versus bilateral presentation) using group analysis, although within-subject analysis showed that 27% of the participants had binaural interference (18% had binaural advantage). On the CST, there was significant binaural advantage across all groups with group data analysis, as well as for 12% of the participants at each of the two signal-to-babble ratios (SBRs) tested. One participant had binaural interference at each SBR. Finally, on the DDT, a significant right-ear advantage was found with group data, and for at least some participants. Regarding age effects, more participants in the pooled elderly groups had binaural interference (33.3%) than in the younger group (16.7%), on the HINT. The presence of hearing loss yielded overall lower scores, but none of the comparisons between bilateral and unilateral performance were affected by hearing loss.Results of within-subject analyses on the HINT agree with previous findings of binaural interference in ≥17% of listeners. Across all groups, a significant right-ear advantage was also seen on the DDT. HINT results support the notion that the prevalence of binaural interference is likely higher in the elderly population. Hearing loss, however, did not affect the differences between bilateral and better unilateral scores. The possibility of binaural interference should be considered when fitting hearing aids to listeners with symmetric hearing loss. Comparing bilateral to unilateral (unaided) performance on tests such as the HINT may provide the clinician with objective data to support subjective preference for one hearing aid as opposed to two.


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