Depression, Dementia and Disability in the Elderly

1987 ◽  
Vol 150 (4) ◽  
pp. 482-493 ◽  
Author(s):  
R. A. Griffiths ◽  
W. R. Good ◽  
N. P. Watson ◽  
H. F. O'Donnell ◽  
P. J. Fell ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Rural Community ◽  
Test Score ◽  
Rating Scales ◽  
The Elderly ◽  
Community Practice ◽  
Mental Test ◽  
Mental Test Score ◽  
Age Related ◽  
Prevalence Of Depression

A structured sample of mobile elderly patients in a rural community practice was assessed on validated rating scales for depression, dementia and disability. A total of 62% of the sample was abnormal on at least one variable. The overall prevalence of depression was 13%; the overall prevalence of dementia was either 10 or 18% depending on the criterion of Mental Test Score (MTS). Depression and dementia were related, depression being more common in females. In depressed and demented patients, MTS was age-related in those over 60 years; in depression alone, MTS was not age-related. Dementia was age-related, particularly over the age of 75. Disability increased with age and was more common in females. Disability was associated with both depression and dementia.

scholarly journals How nurses' attire affects elderly psychiatric patients' ability to recognise them

1998 ◽  
Vol 22 (4) ◽  
pp. 236-238
Author(s):  
Hugh Joseph McCreedy ◽  
Peter William Bentham
Keyword(s):  
Elderly Patients ◽  
Test Score ◽  
Psychiatric Patients ◽  
Mental Test ◽  
Mental Test Score ◽  
Abbreviated Mental Test

The ability of elderly patients to identify a nurse wearing a uniform as opposed to mufti was investigated together with the effect of administrator attire on the Abbreviated Mental Test score (AMT). Thirty-six out of 71 patients identified a nurse wearing mufti increasing to 59/71 when wearing uniform (P < 0.005). Patients rated by a uniformed nurse had significantly higher mean AMT scores (6.1) than when rated by a nurse in mufti (5.6) (P < 0.01), and this also had a significant effect on the sensitivity in predicting an organic diagnosis.

scholarly journals Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Pain Control ◽  
The Elderly ◽  
Surgical Patient ◽  
Cochrane Central Register ◽  
Promising Alternative ◽  
Age Related

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.

Abstract P329: White Matter Score Does Not Predict Post-tPA Hemorrhage in Elderly Patients Evaluated Acutely via Telestroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad Bilal Tariq ◽  
Shekhar Khanpara ◽  
Eliana Bonfante Mejia ◽  
Liang Zhu ◽  
Christy T Ankrom ◽  
...  
Keyword(s):  
White Matter ◽  
Elderly Patients ◽  
The Elderly ◽  
Periventricular White Matter ◽  
Severe Stroke ◽  
Age Related ◽  
Increased Risk ◽  
Symptomatic Intracranial Hemorrhage ◽  
Relationship Of ◽  
Patient Presentation

Background: While tPA may be safe in the elderly, increasing age appears to augment risk of post-tPA symptomatic intracranial hemorrhage (sICH). Age-related white matter changes (ARWMC) are associated with increased sICH. Patients evaluated for acute ischemic stroke (AIS) via telestroke (TS) may not have access to MRI to allow incorporation of microbleeds in tPA decisions. We assessed if increased CT-based ARWMC was associated with increased sICH in elderly patients. Methods: Patients 80 years and older who received tPA for AIS at spoke hospitals were selected from our TS network registry from 9/2015 to 12/2018. TS spoke CT scans from patient presentation were reviewed by three of the authors for periventricular white matter (PWMC) and deep white matter (DWMC) changes. Total ARWMC score, based on the Fazekas score, was collected. Total ARWMC score was either mild (0-2), moderate (3-4), or severe (5-6). PWMC and DWMC were either mild (0-1) or moderate-severe (2-3). Logistic regression adjusted for age, sex, race, ethnicity, NIHSS and premorbid mRS was used to analyze relationship of ARWMC scores with sICH and patient-outcomes. Results: Of 241 patients, median age overall was 86 years (IQR 83-90), and 66% were female. The overall median ARWMC score was 3 (IQR 2-5). Regression analysis showed that more severe ARWMC scores did not lead to higher frequency of post-tPA ICH (moderate OR 0.57, CI 0.19-1.71; severe OR 1.32, CI 0.48-3.65) including sICH (moderate OR 0.78, CI 0.21-2.94; severe OR 2.09, CI 0.62-7.02). Similarly, severe PWMC and DWMC were not associated with increased risk of post-tPA ICH (PWMC OR 1.31, CI 0.51-3.38; DWMC OR 1.25, CI 0.52-3.01), including sICH (PWMC OR 1.61, CI 0.51-5.08; DWMC OR 1.81, CI 0.65-5.01). In our cohort, older patients had no difference in hemorrhage (ICH OR 0.93 CI 0.85-1.00: sICH OR 0.95 CI 0.86-1.04), and patients with less severe stroke were more likely to have hemorrhage (ICH OR 1.06 CI 1.02-1.10; sICH OR 1.08 CI 1.03-1.13). IRR among the CT scan readers was moderate (k=0.504). Conclusions: ARWMC scores were not associated with post-tPA ICH in the elderly. Our analysis lends support for the use of tPA despite severity of white matter disease. ARWMC should not be used to assist in tPA decision-making in elderly patients via telestroke.

Optimizing Antiepileptic Drug Therapy in the Elderly

2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Antiepileptic Drug ◽  
Age Groups ◽  
The Elderly ◽  
Complex Partial Seizures ◽  
Medline Search ◽  
Age Related ◽  
Epilepsy In The Elderly ◽  
Clonic Seizures

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

Regional Density and Survival in Senile Dementia

1985 ◽  
Vol 147 (1) ◽  
pp. 63-66 ◽  
Author(s):  
John Colgan
Keyword(s):  
Prospective Study ◽  
Ct Scan ◽  
Test Score ◽  
Senile Dementia ◽  
Alzheimer Type ◽  
Cognitive Measures ◽  
Mental Test ◽  
Mental Test Score ◽  
Senile Dementia Of The

SummaryComputed cranial tomography was performed on 48 patients with Senile Dementia of the Alzheimer Type (SDAT) who have since been followed up in a continuing prospective study. At six-months follow-up, ten patients had died; these did not differ significantly from the survivors either in mean age or duration of dementia, although the latter tended to have been shorter in the deceased. Despite having shorter histories, the deceased had performed worse on initial testing with several cognitive measures, and this was significant for the mental test score; this suggests some patients may have a more rapidly progressive form of SDAT. In a comparison between the CT scan of the deceased and survivors, the deceased were found to have significantly lower mean attenuation densities in the parietal, occipital, and left thalamic regions. The hypothesis that low attenuation density in the parietal regions of the CT scan in SDAT is associated with a more rapid demise is supported for the present period of follow-up.

Age-Related Variances in Patients with Tibial Plateau Fractures

2019 ◽  
Vol 33 (06) ◽  
pp. 611-615 ◽  
Author(s):  
Lasun O. Oladeji ◽  
John R. Worley ◽  
Brett D. Crist
Keyword(s):  
Elderly Patients ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
The Elderly ◽  
Tibial Plateau Fractures ◽  
Mechanism Of Injury ◽  
Younger Patients ◽  
Age Related ◽  
Comorbidity Burden ◽  
Plateau Fracture

AbstractTibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who received treatment for a tibial plateau fracture. There were 351 patients (360 tibial plateau fractures) who were identified and subsequently stratified according to their age at the time of injury. Patients were classified as elderly if they were 65 years of age or older at the time of injury; all other patients were included in the control cohort. These two cohorts were analyzed using bivariate analysis to isolate for age-related variations with respect to risk factors, mechanism of injury, and complications. There were 351 patients (360 tibial plateau fractures) with a median follow-up of 1.84 ± 2.44 years who met inclusion criteria. There were a greater proportion of women in the elderly cohort as compared with the younger cohort (60.0 vs. 43.4%, p = 0.06). Elderly patients were significantly more likely to present with diabetes (33.3 vs. 16.1%, p = 0.01) or osteoporosis (14.3 vs. 1.6%, p = 0.001). Younger patients were significantly more likely to require further surgery to address ligament (12.6 vs. 0%, p = 0.008), meniscus (20.9 vs. 7.1%, p = 0.036), or cartilage pathology (13.6 vs. 0%, p = 0.005). There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.

Mental illness in an elderly rural population in Ireland: a prevalence study

1998 ◽  
Vol 15 (4) ◽  
pp. 139-141 ◽  
Author(s):  
Margaret Kelleher ◽  
Mary O'Sullivan ◽  
Nuala McMahon
Keyword(s):  
Mental Illness ◽  
Rural Community ◽  
Rural Areas ◽  
Psychiatric Morbidity ◽  
Nursing Home Residents ◽  
Total Sample ◽  
Community Dwelling ◽  
Prevalence Data ◽  
Age Related ◽  
Prevalence Of Depression

AbstractObjectives: The aim of this study was to provide the first Irish prevalence data on mental illness in an elderly, rural, community dwelling population.Method: Subjects were identified from four general practitioners' lists. This included GMS patients, private patients and nursing home residents. Six hundred and fifty people aged 65 years or over were interviewed in their own homes using GMS-AGECAT, a standardised diagnostic instrument.Results: The overall prevalence of mental illness was 14.6%. The prevalence of depression was 9.4%. There was a significantly higher rate among women (13.2%) than men (4.3%). Depression in women was not age related. Of the total sample, 3.7% were classified as organic cases. Of the remaining cases, anxiety disorders occurred most frequently and represented 0.9% of all cases.Conclusions: Elderly people in rural areas experience similar levels of psychiatric morbidity as those in urban centres.

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