scholarly journals Nosology of the Sexual Dysfunctions: Are They Appropriate to Older Adults?

2020 ◽  
Vol 2 (2) ◽  
pp. 139-145
Author(s):  
Migita D’cruz ◽  
Chittaranjan Andrade
Keyword(s):  
Older Adults ◽  
Sexual Dysfunction ◽  
Medical Training ◽  
The Elderly ◽  
Sexual Pleasure ◽  
Sexual Response ◽  
Sexual Life ◽  
Diagnostic Systems ◽  
Dsm 5 ◽  
Age Related

The International Classification of Diseases, Tenth Revision ( ICD-10), describes sexual dysfunction on the basis of the inability of the individual to participate in a sexual relationship. On the other hand, the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5) describes it as the inability to respond sexually or experience sexual pleasure. Neither diagnostic manual addresses age as a contextual factor in sexual response, though DSM-5 notes that aging may be associated with a normative decrease in sexual response. In this review, we argue that the diagnosis of sexual dysfunction in the elderly should be based on age-related expectations. As examples, in older women, diagnostic criteria should factor in the considerations that vaginal dryness is associated with genital pain on penetration and with anorgasmia, as components of the genitourinary syndrome of menopause. In older men, the criteria for rigidity of erection and time to ejaculation may be unduly stringent and are not calibrated to changes in autonomic function with age. The lack of consideration of aging physiology in diagnostic systems and the predominance of ageist stereotypes restrict the validity of diagnoses of sexual dysfunction in older adults; there is the possibility of both under and over diagnosis, based upon the attribution models of the patient and the clinician. Age sensitivity during medical training would help reduce ageist stereotyping in clinical practice. Sexual health education in older adults would help familiarize them with and relieve distress related to body changes that may be distressing and that may impact their quality of sexual life.

scholarly journals Sex After Menopause: Why Not?

2016 ◽  
Vol 9 (1) ◽  
pp. 106-106
Author(s):  
R. Hamilton ◽  
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Health ◽  
Sexual Pleasure ◽  
Sexual Life ◽  
Clinical Psychologist ◽  
Menopausal Woman ◽  
Health History ◽  
Age Related ◽  
Menopausal Women ◽  
Post Menopausal

Objective: Why do we care whether the menopausal woman engages in – let alone enjoys – sexual pleasure or not? It is surely a very individual area and should be addressed on an individual basis. Today, the majority of menopausal women are busy with work, looking after children and grandchildren and lead fulfilling, busy lives. Why not a great sexual life too? Design and Method: Retrospective analysis of peri and post-menopausal women, experiencing problems related to sexual dysfunction. Detailed sexual health history was obtained, detailing specifics around gynaecological and sexual health screenings and interventions. This gave rise to key factors that displayed sexual dysfunction elements, but once addressed, diminished or resolved the dysfunction. Results: It was found that the majority of women were guarded in discussing sexual problems from a psychosexual framework, however, it remained less challenging to subscribe to the perceived problem being a medical/gynaecological problem. Awareness of age-related health issues and discussion around this influenced appropriate management. Conclusions: Adequate baseline screening is a key concept to address practical impediments and discuss these from a normal aging process. A direct approach, practical information, engagement with the partner and awareness of options around sexual positions and exploration drive these consultations positively. Support and education via linking with a Clinical Psychologist during this process was found to be a key aspect to outcome.

DSM-5 alcohol use disorder features among treatment-seeking older adults

2018 ◽  
Vol 64 (4) ◽  
pp. 185-196 ◽  
Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
The Elderly ◽  
Treatment Seeking ◽  
Controlled Clinical Trial ◽  
Dsm 5 ◽  
Wide Range ◽  
And Gender ◽  
International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

scholarly journals Muscular Atrophy and Sarcopenia in the Elderly: Is There a Role for Creatine Supplementation?

Biomolecules ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 642 ◽  
Author(s):  
Dolan ◽  
Artioli ◽  
Pereira ◽  
Gualano
Keyword(s):  
Older Adults ◽  
Exercise Training ◽  
Energy Demand ◽  
Muscular Atrophy ◽  
Training Stimulus ◽  
Creatine Supplementation ◽  
The Elderly ◽  
High Energy ◽  
Age Related ◽  
And Function

Sarcopenia is characterized by a loss of muscle mass, quality, and function, and negatively impacts health, functionality, and quality of life for numerous populations, particularly older adults. Creatine is an endogenously produced metabolite, which has the theoretical potential to counteract many of the morphological and metabolic parameters underpinning sarcopenia. This can occur through a range of direct and indirect mechanisms, including temporal and spatial functions that accelerate ATP regeneration during times of high energy demand, direct anabolic and anti-catabolic functions, and enhanced muscle regenerating capacity through positively impacting muscle stem cell availability. Studies conducted in older adults show little benefit of creatine supplementation alone on muscle function or mass. In contrast, creatine supplementation as an adjunct to exercise training seems to augment the muscle adaptive response to the training stimulus, potentially through increasing capacity for higher intensity exercise, and/or by enhancing post-exercise recovery and adaptation. As such, creatine may be an effective dietary strategy to combat age-related muscle atrophy and sarcopenia when used to complement the benefits of exercise training.

scholarly journals Study of adverse drug reactions and clinical profile of elderly in relation to polypharmacy

2019 ◽  
Vol 10 (6) ◽  
pp. 80-84
Author(s):  
Nagaraja BS ◽  
Keerthana Sharma
Keyword(s):  
Older Adults ◽  
Adverse Drug Reactions ◽  
The Elderly ◽  
Control Group ◽  
Case Group ◽  
Drug Reactions ◽  
Age Related ◽  
Improve Compliance ◽  
Clinical Conditions

Background: Polypharmacy is a becoming more prevalent in older adults and adverse risk increases with age-related change. Adverse drug reactions (ADRs) are common in older adults and worrisome aspect of treatment in elderly. Aims and Objective: The study aimed to identify the common clinical conditions leading to polypharmacy and to compare the adverse drug profiles of the 2 groups. Materials and Methods: This case-control study was conducted in Hospitals attached to BMCRI, where 200 patients aged 65 or more were interviewed. 100 elderly patients using 5 or more drugs were identified as cases and assessed against a control group of 100 patients. Results: Our study found that ADRs were found to be three times higher in individuals on polypharmacy compared to the control group (OR 3.4675 95% CI 1.6241 to 7.4035). The most commonly occurring ADRs were dyspepsia (OR 1.9259), drowsiness (OR 3.5926) and fatigue (OR 1.5319) with increased incidence in the case group. The most common conditions associated with polypharmacy were found to be hypertension (53%), diabetes mellitus(46%), COPD(14%) and IHD(14%). 66% of the study group had two or more of the above diseases, whereas in the control group only 32% had multiple illnesses. The most commonly prescribed medications were antihypertensives (61%), hypolipidemics (44%), antiplatelets (41%) and antibiotics(40%). Conclusion: Polypharmacy in the elderly comes with a significant increase in adverse effects. The reduced pill burden will not only decrease ADRs and improve compliance, but will also result in greater patient satisfaction and mental health, thereby improving the quality of geriatric care.

Conclusion

2016 ◽  
Author(s):  
Maria A. Sullivan
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
The Elderly ◽  
Social Consequences ◽  
Individual Therapy ◽  
Older Individuals ◽  
Prescribing Practices ◽  
Elderly Age ◽  
Age Related ◽  
The Impact

Addiction in older adults very often goes unrecognized, for several reasons: social biases about the elderly, age-related metabolic changes, and the inappropriate use of prescription benzodiazepines and opioids to address untreated anxiety and mood conditions. Alcohol or substance-use disorders (SUDs) in older individuals may present in subtle and atypical ways. Strategies to overcome such difficulties include systematic screening using validated instruments, patient education regarding the impact of psychoactive substances on health, and cautious prescribing practices. Relying on standard DSM criteria may result in a failure to detect an SUD that presents with cognitive symptoms or physical injury, as well as the absence of work or social consequences. Older individuals can benefit from the application of risk-stratification measures, and they can be referred, e.g., to age-appropriate group therapy and non-confrontational individual therapy focusing on late-life issues of loss and sources of social support, as well as be offered medication management for alcohol or substance use disorder. Although research has been limited in this population, treatment outcomes have been found to be superior in older adults than younger adults.

scholarly journals Dizziness and prevention of falls in the elderly

2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Augusto P. Casani ◽  
Elena Navari
Keyword(s):  
Older Adults ◽  
The Elderly ◽  
Western Society ◽  
Physiological Changes ◽  
Vestibular Disorders ◽  
Great Role ◽  
Risk Of Falling ◽  
Old Adults ◽  
Age Related ◽  
Treatable Condition

Disequilibrium is one of the most common complaints that older adults bring to their physician and falling is a frequent complication; because of the increasing number of elderly patients in western society the problem grows. The increasing susceptibility to falling can be consequence of age-related physiological changes and of a higher prevalence of comorbidities causing dizziness, vertigo and imbalance; these symptoms can worse the already poor balance of old adults increasing the risk of falling. Among the major reasons of vertigo and dizziness, central vertigo and orthostatic vertigo are very common; also vestibular disorders have a great role and are currently thought to account for 48% of dizziness reported by older adults. An early identification of the treatable condition underlying dizziness in elderly would surely ameliorate the outcome of these patients.

scholarly journals Age-Related Changes in the 25-Hydroxyvitamin D Versus Parathyroid Hormone Relationship Suggest a Different Reason Why Older Adults Require More Vitamin D

2003 ◽  
Vol 88 (1) ◽  
pp. 185-191 ◽  
Author(s):  
Reinhold Vieth ◽  
Yasmin Ladak ◽  
Paul G. Walfish
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Age Groups ◽  
The Elderly ◽  
Age Group ◽  
Hydroxyvitamin D ◽  
Age Related ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Vitamin D requirements are thought to vary with age, but there is little comparative evidence for this. One goal in establishing a vitamin D requirement is to avoid secondary hyperparathyroidism. We studied 1741 euthyroid, thyroid clinic outpatients without evidence of calcium abnormalities, ranging in age from 19 to 97 yr, whose serum and urine had been analyzed for calcium, vitamin D, and parathyroid status. We found no effect of age on the 25-hydroxyvitamin D [25(OH)D] concentration associated with specific vitamin D intakes, and there was no relationship between 25(OH)D and 1,25hydroxyvitamin D [1,25(OH)2D]. In every age group, serum 1,25(OH)2D declined with increasing creatinine (P < 0.001). What changed with age included creatinine, which correlated with 25(OH)D (r = 0.146, P < 0.001) only in the youngest age group (19–50 yr) but not in the older age groups (P > 0.1). Creatinine did not correlate with PTH in the youngest age group, but the relationship became significant as age increased (e.g. for the elderly, r = 0.365, P < 0.001). Linear regression of log PTH vs. log 25(OH)D agreed with the natural shape of the relationship observed with scatterplot smoothing, and this showed no plateau in PTH as 25(OH)D increased. We compared PTH concentrations among age groups, based on 20 nmol/liter increments in 25(OH)D. Mean PTH in adults older than 70 yr was consistently higher than in adults younger than 50 yr (P < 0.05 by ANOVA and Dunnett’s t test). PTH levels of the elderly who had 25(OH)D concentrations greater than 100 nmol/liter matched PTH of younger adults having 25(OH)D concentrations near 70 nmol/liter. This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function.

When estimating reachability in space, young children and the elderly are similar

1970 ◽  
Vol 6 (3) ◽  
Author(s):  
Carl Gabbard ◽  
Priscila Caçola
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Motor Imagery ◽  
Mental Representation ◽  
Brain Structure ◽  
The Elderly ◽  
Extrapersonal Space ◽  
Age Related ◽  
Reach Space ◽  
Total Accuracy

Abstract: This study examined the age-related ability to mentally represent action in the context of reach estimation via use of motor imagery in children, young adults, and a group of older adults. Participants were instructed to estimate whether randomly presented targets in peripersonal (within actual reach) and extrapersonal (beyond reach) space were within or out of reach of their dominant limb while seated. In regard to total accuracy, results indicated that children and older adults were similar, but scores were significantly lower than those of young adults. Whereas all groups displayed greater error in extrapersonal space, once again children and older adults were similar, but significantly different than young adults. That is, children and older adults displayed greater overestimation responses. Although other factors are discussed, the literature provides a hint that differences are due in part to distinctions in brain structure and functioning. Key Words: Mental representation, motor imagery, action processing. 

When estimating reachability in space, young children and the elderly are similar

2011 ◽  
Vol 6 (3) ◽  
pp. 7-13
Author(s):  
Carl Gabbard ◽  
Priscila Caçola
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Young Children ◽  
Motor Imagery ◽  
Brain Structure ◽  
The Elderly ◽  
Extrapersonal Space ◽  
Age Related ◽  
Reach Space ◽  
Total Accuracy

This study examined the age-related ability to mentally represent action in the context of reach estimation via use of motor imagery in children, young adults, and a group of older adults. Participants were instructed to estimate whether randomly presented targets in peripersonal (within actual reach) and extrapersonal (beyond reach) space were within or out of reach of their dominant limb while seated. In regard to total accuracy, results indicated that children and older adults were similar, but scores were significantly lower than those of young adults. Whereas all groups displayed greater error in extrapersonal space, once again children and older adults were similar, but significantly different than young adults. That is, children and older adults displayed greater overestimation responses. Although other factors are discussed, the literature provides a hint that differences are due in part to distinctions in brain structure and functioning.

Only social feedback reduces age-related prospective memory deficits in “Virtual Week”

2014 ◽  
Vol 26 (5) ◽  
pp. 759-767 ◽  
Author(s):  
Agnieszka Niedźwieńska ◽  
Peter G. Rendell ◽  
Krystian Barzykowski ◽  
Alicja Leszczyńska
Keyword(s):  
Older Adults ◽  
Prospective Memory ◽  
Independent Living ◽  
Memory Performance ◽  
The Elderly ◽  
Control Group ◽  
Social Feedback ◽  
Feedback Group ◽  
Age Related ◽  
Memory For Intentions

ABSTRACTBackground:Prospective memory, or remembering to do things in the future, is crucial for independent living in old age. Although there is evidence of substantial age-related deficits in memory for intentions, older adults have demonstrated the ability to compensate for their deficits in everyday life. The present study investigated feedback as a strategy for facilitating prospective memory in the elderly.Method:Young and older adults played a computer-based task, Virtual Week, in which they had to remember to carry out life-like intentions. After each virtual day, specific feedback on prospective memory performance was automatically provided on the computer screen that participants either proceeded through by themselves (non-social feedback) or were taken through by an experimenter (social feedback). The control group received no feedback.Results:We found that, compared with no-feedback group, only social feedback substantially reduced the age-related deficit in prospective memory. Older adults significantly benefited from feedback provided by the experimenter on the tasks of intermediate difficulty. Unexpectedly, prospective memory with non-social feedback was not only worse than with social feedback, but it was not any better than without any feedback at all.Conclusions:The results extended previous findings on the effectiveness of feedback in improving the memory performance of older adults to include memory for intentions. Despite the feedback meeting the critical recommendations of being specific, objective, and well-targeted, it was ineffective when the feedback displayed on the computer was not introduced by the experimenter. This has implications for computerized training tasks where automated feedback is considered crucial.

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