scholarly journals Neurologic and Neuroscientific Evidence in Aged COVID-19 Patients

2021 ◽  
Vol 13 ◽  
Author(s):  
Shraddha Mainali ◽  
Marin E. Darsie
Keyword(s):  
Elderly Patients ◽  
Systemic Disease ◽  
Respiratory Illness ◽  
The Elderly ◽  
Cerebrovascular Diseases ◽  
Medical Comorbidities ◽  
Viral Illness ◽  
Atypical Presentations ◽  
Severe Systemic Disease

The COVID-19 pandemic continues to prevail as a catastrophic wave infecting over 111 million people globally, claiming 2. 4 million lives to date. Aged individuals are particularly vulnerable to this disease due to their fraility, immune dysfunction, and higher rates of medical comorbidities, among other causes. Apart from the primary respiratory illness, this virus is known to cause multi-organ dysfunction including renal, cardiac, and neurologic injuries, particularly in the critically-ill cohorts. Elderly patients 65 years of age or older are known to have more severe systemic disease and higher rates of neurologic complications. Morbidity and mortality is very high in the elderly population with 6–930 times higher likelihood of death compared to younger cohorts, with the highest risk in elderly patients ≥85 years and especially those with medical comorbidities such as hypertension, diabetes, heart disease, and underlying respiratory illness. Commonly reported neurologic dysfunctions of COVID-19 include headache, fatigue, dizziness, and confusion. Elderly patients may manifest atypical presentations like fall or postural instability. Other important neurologic dysfunctions in the elderly include cerebrovascular diseases, cognitive impairment, and neuropsychiatric illnesses. Elderly patients with preexisting neurologic diseases are susceptibility to severe COVID-19 infection and higher rates of mortality. Treatment of neurologic dysfunction of COVID-19 is based on existing practice standards of specific neurologic condition in conjunction with systemic treatment of the viral illness. The physical, emotional, psychologic, and financial implications of COVID-19 pandemic have been severe. Long-term data are still needed to understand the lasting effects of this devastating pandemic.

scholarly journals Effects of 3-year GH replacement therapy on bone mineral density in younger and elderly adults with adult-onset GH deficiency

2012 ◽  
Vol 166 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Mariam Elbornsson ◽  
Galina Götherström ◽  
Celina Franco ◽  
Bengt-Åke Bengtsson ◽  
Gudmundur Johannsson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Elderly Patients ◽  
Bone Mineral ◽  
The Elderly ◽  
Marginal Effect ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Replacement ◽  
Femur Neck

ObjectiveLittle is known of the effects of long-term GH replacement on bone mineral content (BMC) and bone mineral density (BMD) in elderly GH-deficient (GHD) adults.Design/patients/methodsIn this prospective, single-center, open-label study, the effects of 3-year GH replacement were determined in 45 GHD patients >65 years and in 45 younger control GHD patients with a mean age of 39.5 (s.e.m.1.1) years. All patients had adult-onset disease and both groups were comparable in terms of number of anterior pituitary hormonal deficiencies, gender, body mass index, and waist:hip ratio.ResultsThe mean maintenance dose of GH was 0.24 (0.02) mg/day in the elderly patients and 0.33 (0.02) mg/day in the younger GHD patients (P<0.01). The 3 years of GH replacement induced a marginal effect on total body BMC and BMD, whereas femur neck and lumbar (L2–L4) spine BMC and BMD increased in both the elderly and the younger patients. The treatment response in femur neck BMC was less marked in the elderly patients (P<0.05 vs younger group). However, this difference disappeared after correction for the lower dose of GH in the elderly patients using an analysis of covariance. There were no between-group differences in responsiveness in BMC or BMD at other skeletal locations.ConclusionsThis study shows that GH replacement increases lumbar (L2–L4) spine and femur neck BMD and BMC in younger as well as elderly GHD patients. This supports the notion that long-term GH replacement is also useful in elderly GHD patients.

scholarly journals Liver and Pancreatic Resection in the Elderly

HPB Surgery ◽  
1997 ◽  
Vol 10 (4) ◽  
pp. 259-261 ◽  
Author(s):  
O. J. Garden
Keyword(s):  
Survival Rate ◽  
Liver Resection ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Complication Rate ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Term Survival ◽  
Pancreatic Resections

Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes.Methods: Five hundred seventy-seven liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies were identified in departmental data bases. Outcomes of patients younger than age 70 years were compared with those of patients age 70 years or older.Results: Liver resection for 128 patients age 70 years or older resulted in a 4% perioperative. mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the patients required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No difference were found between results for the elderly and those for younger patients who had undergone liver resection, except for a minimally shorter hospital stay fortheyoungerpatients (median, 12 days vs. 13 days p=0.003). Pancreatic resection for 138 elderly patients resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the patients required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly patients, with a 5-year survival rate of 21% compared with 29% for the younger cohort (p=0.03).Conclusions: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronologic age alone is not a contraindication to liver or pancreatic resection for malignancy.

scholarly journals Comparison of Outcomes Between McKeown and Sweet Esophagectomy in the Elderly Patients for Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482090470
Author(s):  
Dongni Chen ◽  
Yihuai Hu ◽  
Youfang Chen ◽  
Jia Hu ◽  
Zhesheng Wen
Keyword(s):  
Squamous Cell Carcinoma ◽  
Propensity Score ◽  
Esophageal Squamous Cell Carcinoma ◽  
Elderly Patients ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
The Elderly ◽  
Perioperative Outcomes ◽  
Term Survival

The aim of this study was to compare the perioperative outcomes and long-term survival rates of the McKeown and Sweet procedures in patients with esophageal cancer younger than 70 years or older than 70 years. A total of 1432 consecutive patients with esophageal squamous cell carcinoma (ESCC) who received surgery at Sun Yat-sen University Cancer Center from January 2009 to October 2012 were analyzed. Propensity score matching was used to balance the clinical characteristics of the patients who underwent different surgical approaches, and 275 and 71 paired cases were matched among those younger and older than 70 years, respectively. The prognosis and postoperative outcomes were compared between the McKeown and the Sweet esophagectomy. For patients younger than 70 years, those who underwent the McKeown procedure had better overall survival (OS) than those in the Sweet group (log rank = 4.467; P = .035). However, no significant difference in disease-free survival and OS was observed between two approaches for the elderly patients (log rank = 1.562; P = .211 and log rank = 0.668; P = .414, respectively). Cox regression analysis revealed that McKeown approach was a positive prognostic factor compared to the Sweet approach for patients younger than 70 years in univariable analysis (HR = 0.790; 95% CI, 0.625-0.997; P = .047), whereas the surgical approach was not significantly related to the prognosis in the elderly patients. For patients older than 70 years, the occurrence of anastomotic fistula increased in those who underwent the McKeown procedure (23.9% vs 11.3%, P = .038, for the McKeown and Sweet esophagectomy, respectively). The McKeown approach increases the OS in younger patients with ESCC. However, for patients older than 70 years, the Sweet approach was proven to be an effective therapy, given the better perioperative outcomes and similar long-term survival compared with patients in the McKeown group.

Associate Members: A Life Worth Living

1986 ◽  
Vol 49 (11) ◽  
pp. 362-364 ◽  
Author(s):  
Jean Parker
Keyword(s):  
Elderly Patients ◽  
Long Term Care ◽  
The Elderly ◽  
Worth Living ◽  
Term Care ◽  
Life Worth Living ◽  
Meaningful Existence ◽  
Time And Energy

Long-term care patients need a meaningful existence. It is our responsibility to ensure that time and energy are channelled into purposeful solutions for the disease of ‘time with nothing to do’. The author has taken up this challenge. Working as an activities organizer with the elderly for 11 years, she was determined never to take the role of a baby-sitter. The recreation unit has grown from its first eight guests to a purpose-built unit with approximately 1,500 attendances per month. A busy happy atmosphere now prevails where once there was a sea of dead faces. The choice to retain a sense of dignity and purpose should be available to all elderly patients who require long-term care.

scholarly journals Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients

2017 ◽  
Vol 126 (4) ◽  
pp. 1201-1211 ◽  
Author(s):  
Benjamin Brokinkel ◽  
Markus Holling ◽  
Dorothee Cäcilia Spille ◽  
Katharina Heß ◽  
Cristina Sauerland ◽  
...  
Keyword(s):  
General Population ◽  
Elderly Patients ◽  
Older Patients ◽  
The Elderly ◽  
Spinal Tumors ◽  
Subtotal Resection ◽  
High Grade ◽  
Younger Patients ◽  
Age And Sex

OBJECTIVE The purpose of this study was to compare long-term prognosis after meningioma surgery in elderly and younger patients as well as to compare survival of elderly patients with surgically treated meningioma to survival rates for the general population. METHODS Five hundred meningioma patients (median follow-up 90 months) who underwent surgery between 1994 and 2009 were subdivided into “elderly” (age ≥ 65 years, n = 162) and “younger” (age < 65 years, n = 338) groups for uni- and multivariate analyses. Mortality was compared with rates for the age- and sex-matched general population. RESULTS The median age at diagnosis was 71 in the elderly group and 51 years in the younger group. Sex, intracranial tumor location, grade of resection, radiotherapy, and histopathological subtypes were similar in the 2 groups. High-grade (WHO Grades II and III) and spinal tumors were more common in older patients than in younger patients (15% vs 8%, p = 0.017, and 12% vs 4%, p = 0.001, respectively). The progression-free interval (PFI) was similar in the 2 groups, whereas mortality at 3 months after surgery was higher and median overall survival (OS) was shorter in older patients (7%, 191 months) than in younger patients (1%, median not reached; HR 4.9, 95% CI 2.75–8.74; p < 0.001). Otherwise, the median OS in elderly patients did not differ from the anticipated general life expectancy (HR 1.03, 95% CI 0.70–1.50; p = 0.886). Within the older patient group, PFI was lower in patients with high-grade meningiomas (HR 24.74, 95% CI 4.23–144.66; p < 0.001) and after subtotal resection (HR 10.57, 95% CI 2.23–50.05; p = 0.003). Although extent of resection was independent of perioperative mortality, the median OS was longer after gross-total resection than after subtotal resection (HR 2.7, 95% CI 1.09–6.69; p = 0.032). CONCLUSIONS Elderly patients with surgically treated meningioma do not suffer from impaired survival compared with the age-matched general population, and their PFI is similar to that of younger meningioma patients. These data help mitigate fears concerning surgical treatment of elderly patients in an aging society.

Long-term mental activation activities in the practice of social and psychological ssistance gerontological patient

2020 ◽  
pp. 72-79
Author(s):  
Victoria Chupina ◽  
Natalia Tikhonova ◽  
Natalia Popenko
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Mental Activity ◽  
Necessary Condition ◽  
Psychological Care ◽  
Mental Processes ◽  
Environmental Practices ◽  
Mental Activation ◽  
Psychological Assistance

The problem of psychological assistance to the elderly continues to be relevant due to the peculiarities of the personal sphere and mental processes in patients of this age group. When providing medical and social assistance to an elderly patient, psychological support is required, which allows for more effective rehabilitation measures. The purpose of this work is to present modern approaches to psychological care that contribute to the long-term activation of mental activity of elderly patients. The results of the empirical study revealed violations of the dynamic and regulatory nature of all components of mental activity, emotional and volitional disorders in most patients. Therefore, normalization of indicators of mental processes in participants is a necessary condition for positive dynamics of changes in mental processes. Psychological assistance activities in a gerontology center allow you to use a variety of methods and tools that can help activate the mental activity of older people. As a rule, this effect is carried out only in the conditions of the gerontology center and is not long-term. Consequently, the activation of mental activity of elderly patients, achieved by specialists of the institution, may begin to decrease when the patient is discharged. In this regard, the institution introduces innovative forms of psychological and pedagogical influence, which allow the patient to be involved in prolonged projects, in which he can participate after discharge from the institution. The novelty of the work consists in the introduction of a long-term psychological and pedagogical project "Ecoletie", the purpose of which is to implement measures aimed at activating the mental activity of patients by increasing the level of their environmental culture and introducing environmental practices in the further daily activities of the elderly.

Clinical and pathological characteristics of elderly colorectal cancer patients over 70 years old and comparison with patients under 50 years old.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14174-e14174
Author(s):  
Betul Erismis ◽  
Nadire Kucukoztas ◽  
Samed Rahatli ◽  
Selim Yalcin ◽  
Omer Dizdar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Systemic Disease ◽  
Performance Status ◽  
The Elderly ◽  
University Hospital ◽  
Individual Treatment ◽  
Pathological Characteristics ◽  
Colorectal Cancer Patients

e14174 Background: Incidence of colon cancer increases with age and generally is diagnosed at the age of between 60-75. Because of comorbidities in elderly patients who are older 70 years of age, lower doses of adjuvant or metastatic therapy is given them or the other option can be the chemotherapeutics which had less side effects. Methods: We aim to identify clinical and pathological characteristics of elderly colorectal cancer patients over 70 years of age who were followed at Baskent University Hospital and compare with CRC patients under the 50 years of age. Results: 182 CRC patients were assigned to the study who were followed between 1998-2011. We classified the patients into two categories according to the age. 91 participants were over 70 years of age and 91 participants were under 50 years of age. There were no significant differences between two groups for gender and percentage of patients having surgery (p=0.65/0.732). History of having systemic disease was significantly higher in the elderly group (p<0.001). Adjvuvant chemotherapy was given to the 38 (53.5%) patients aged over 70 and 66 (91.7%) patients aged under 50 (p<0.001). We compared the both groups for progression free and overall survival time for all stages. However, there were no statistically significant differences between two groups. Conclusions: Our study confirms that elderly CRC patients get benefit from the adjuvant chemotherapy treatment as the same as patients under 50 years of age. Therefore, physcians should consider about performance status and systemic disease in elderly patients and give an individual treatment to them.

The Short- and Long-Term Outcomes of Pancreatic Resection for Pancreatic Adenocarcinoma in Patients Older Than 75 Years

2016 ◽  
Vol 101 (11-12) ◽  
pp. 554-561
Author(s):  
Toru Aoyama ◽  
Masaaki Murakawa ◽  
Yosuke Atsumi ◽  
Keisuke Kazama ◽  
Manabu Shiozawa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pancreatic Adenocarcinoma ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Surgical Mortality ◽  
Long Term Outcomes ◽  
Group A ◽  
Short And Long Term ◽  
Group B

The short- and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma have not been fully evaluated in elderly patients. This retrospective study selected patients who underwent curative surgery for pancreatic cancer at our institution. Patients were categorized into 2 groups: nonelderly patients (age &lt; 75 years; group A) and elderly patients (age ≥ 75 years; group B). The surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) rates in the 2 groups were compared. A total of 221 patients were evaluated in the study. The overall complication rates were 44.8% in group A and 52.6% in group B. Surgical mortality was observed in 2 patients due to an abdominal abscess and cardiovascular disease in group A (1.1%) and in 1 patient due to postoperative bleeding in group B (2.6%). There were no significant differences (P = 0.379 and P = 0.456, respectively). Furthermore, the 5-year OS and RFS rates were similar between the elderly patients and nonelderly patients (18.55 versus 20.2%, P = 0.946 and 13.1% versus 16.0%, P = 0.829, respectively). The short-term outcomes and long-term survival after pancreatic resection for pancreatic adenocarcinoma were almost equal in the elderly and the nonelderly patients in this study. Therefore, it is unnecessary to avoid pancreatic resection for pancreatic adenocarcinoma in elderly patients simply because of their age.

Sign in / Sign up

Export Citation Format

Share Document