scholarly journals Treating overactive bladder in the elderly

2013 ◽  
Vol 5 (5-S2) ◽  
pp. 149
Author(s):  
Adrian Wagg
Keyword(s):  
Cognitive Impairment ◽  
Overactive Bladder ◽  
Older People ◽  
Older Patients ◽  
Conventional Treatment ◽  
The Elderly ◽  
Lifestyle Measures ◽  
Cognitively Intact

The prevalence of the overactive bladder (OAB) symptom complexincreases with age. Older people also appear to experience moresevere incontinence syndromes, including OAB, than their youngercounterparts. Older patients are more likely than younger individualsto ask for medication for bladder problems and to requirehigher doses of medication. Conventional treatment for OAB withconservative and lifestyle measures in combination with antimuscarinicpharmacotherapy is effective in older people. Althoughthere is a theoretical potential for cognitive impairment with antimuscarinicagents, the newer antimuscarinics are cognitively safein cognitively intact older people.

Cognitive Impairment and Depression in Older Patients

2017 ◽  
Author(s):  
Martin Steinberg ◽  
Paul B. Rosenberg
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Vascular Dementia ◽  
Psychosocial Functioning ◽  
Older Patients ◽  
The Elderly ◽  
Office Setting ◽  
Early Manifestation

Depression, mild cognitive impairment (MCI) and dementia in the elderly can present with similar features such as cognitive complaints, loss of initiative, and difficulties with psychosocial functioning. These can be difficult to distinguish in the office setting, especially when mild in severity. The relationships between the three syndromes remains incompletely understood. Patients with MCI are at high risk for conversion to dementia. Depression may be either a risk factor for or early manifestation of MCI. Depression in late life is associated with Alzheimer’s disease (AD) and other dementias, but the causal relationship remains controversial. Depression may also increase the risk of conversion from MCI to dementia and be more strongly associated with conversion to Vascular dementia (VaD) than to AD. This book will provide guidance to clinicians in the diagnosis and management of these complex conditions in the office setting.

scholarly journals How Much Is One Life Worth? The Right to Equity Healthcare for Improving Older Patients’ Health Infected by COVID-19

2020 ◽  
Vol 12 (17) ◽  
pp. 6848
Author(s):  
Guiomar Merodio ◽  
Mimar Ramis-Salas ◽  
Diana Valero ◽  
Adriana Aubert
Keyword(s):  
Older People ◽  
Family Relationships ◽  
Older Patients ◽  
Social Inequalities ◽  
Negative Impact ◽  
Well Being ◽  
The Elderly ◽  
Resource Scarcity ◽  
Elderly Persons ◽  
Old Patients

Ageism has a tremendous negative impact on elderly persons and society. Discrimination against the elderly is a driver of health and social inequalities. The COVID-19 pandemic has posed new social and health challenges regarding resource scarcity and shortfalls. Under these difficult circumstances, discourses excluding, and discrimination against, older people have aroused. This article gathers evidence on hospital healthcare experiences of older people infected by COVID-19 during the pandemic outbreak in Spain and it analyzes elements that have positively influenced older patients’ perceived health and well-being. We conducted nine qualitative in-depth interviews in Madrid—one of the regions of Spain most affected by COVID-19—with older people that were hospitalized and recovered from COVID-19, family members of old patients infected with COVID-19, and nurses that attended infected older patients. Findings show the challenging experiences faced by older people who were hospitalized due to COVID-19, on the one hand, and the relevance of transformative aspects related to family relationships, solidarity actions, and humanized care that overcame age discrimination, favoring social and equity healthcare for the elderly on the other hand.

scholarly journals Social Assistant Humanoid Robots for Dementia of the Elderly: A Scoping Review

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Xiangyu Liu
Keyword(s):  
Qualitative Research ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Older People ◽  
Research Method ◽  
The Elderly ◽  
Humanoid Robots ◽  
Future Research ◽  
Future Studies ◽  
Method Analysis

In recent years, many cognitive care robots have been developed. There is also a form of the companion pet, and there are also robots that can be personified and talk with the elderly. Also, some telecommunications equipment can be replaced to help older people connect to the telecommunications community. However, the need for such robots is still unclear in the focus of this area of being able to interact, talk to, and connect with family and society. Although many studies in the existing literature that tell how to research to verify their efficacy, methods of defining effects can pave the way for future studies. This is what this article will show. The article included qualitative research searches and screenings, effect summaries, and research method analysis. The problem to be solved in this article is how to use and measure the effectiveness of conversational humanoids in nursing elderly patients with cognitive impairment. We also hope to provide some guidance for future research on cognitive impairment.

scholarly journals Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Kułak-Bejda ◽  
Grzegorz Bejda ◽  
Napoleon Waszkiewicz
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Older People ◽  
Mood Disorders ◽  
The Elderly ◽  
Increased Risk ◽  
The World

More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.

Effectiveness of an Ambient Intelligent Geriatric Management system (AmbIGeM) to prevent falls in older people in hospitals: protocol for the AmbIGeM stepped wedge pragmatic trial

2017 ◽  
Vol 25 (3) ◽  
pp. 157-165 ◽  
Author(s):  
Renuka Visvanathan ◽  
Damith C Ranasinghe ◽  
Anne Wilson ◽  
Kylie Lange ◽  
Joanne Dollard ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Older Patients ◽  
Pragmatic Trial ◽  
Falls Prevention ◽  
Secondary Outcome ◽  
Stepped Wedge ◽  
Clinical Trial Registry ◽  
Injury Rates ◽  
Ambient Intelligent

BackgroundAlthough current best practice recommendations contribute to falls prevention in hospital, falls and injury rates remain high. There is a need to explore new interventions to reduce falls rates, especially in geriatric and general medical wards where older patients and those with cognitive impairment are managed.Design and methodsA three-cluster stepped wedge pragmatic trial, with an embedded qualitative process, of the Ambient Intelligent Geriatric Management (AmbIGeM) system (wearable sensor device to alert staff of patients undertaking at-risk activities), for preventing falls in older patients compared with standard care. The trial will occur on three acute/subacute wards in two hospitals in Adelaide and Perth, Australia.ParticipantsPatients aged >65 years admitted to study wards. A waiver (Perth) and opt-out of consent (Adelaide) was obtained for this study. Patients requiring palliative care will be excluded.OutcomesThe primary outcome is falls rate; secondary outcome measures are: (1) proportion of participants falling; (2) rate of injurious inpatient falls/1000 participant bed-days; (3) acceptability and safety of the interventions from patients and clinical staff perspectives; and (4) hospital costs, mortality and use of residential care to 3 months postdischarge.DiscussionThis study investigates a novel technological approach to preventing falls in hospitalised older people. We hypothesise that the AmbIGeM intervention will reduce falls and injury rates, with an economic benefit attributable to the intervention. If successful, the AmbIGeM system will be a useful addition to falls prevention in hospital wards with high proportions of older people and people with cognitive impairment.Trial registration numberAustralian and New Zealand Clinical Trial Registry: ACTRN 12617000981325; Pre-results.

scholarly journals Outcomes and interventions in the elderly with and without cognitive impairment: a longitudinal study

2020 ◽  
Vol 14 (4) ◽  
pp. 394-402
Author(s):  
Anne Caroline Soares da Silva ◽  
Juliana Hotta Ansai ◽  
Natália Oiring de Castro Cezar ◽  
Francisco Assis Carvalho Vale ◽  
Julimara Gomes dos Santos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Clinical Outcomes ◽  
Daily Living ◽  
Home Visit ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Dwelling ◽  
Community Dwelling Older People

ABSTRACT. Background: Clinical follow-up studies are necessary for a better understanding of the evolution of cognitive impairment as well as the development of better assessment and intervention tools. Objective: To investigate whether older people with preserved cognition (PC), mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) show differences in clinical outcomes and interventions after a 32-month period. Methods: One hundred twenty-four community-dwelling older people were included and classified in one of three groups (PC, MCI and mild AD). Information on clinical outcomes (deaths, new diagnoses, falls, need for assistance or changes in routine and hospitalizations) and interventions (increased use of medication, physiotherapeutic intervention, practice of physical exercise, etc.) in the 32-month period were collected by telephone or during a home visit on a single day. Results: Ninety-five participants (35 with PC, 33 with MCI and 27 with AD) were reevaluated after 32 months. The need for assistance/changes in routine was significantly higher in the AD group, especially with regard to basic activities of daily living. Unlike the other groups, the PC group did not show “other diagnoses” (urinary incontinence, prolapse, change in vision or autoimmune disease). No significant differences were found regarding other variables. Conclusions: Older people with and without cognitive impairment exhibited differences in some clinical outcomes after 32 months, such as need for assistance or changes in their routine and new diagnoses of specific diseases. Therefore, the multidimensionality of geriatric patients should be considered when planning assessments and interventions.

scholarly journals Appropriateness of pharmacological treatment in older people with dementia

2015 ◽  
Vol 9 (3) ◽  
pp. 212 ◽  
Author(s):  
Eleonora Meloni ◽  
Davide Liborio Vetrano ◽  
Roberto Bernabei ◽  
Graziano Onder
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Older People ◽  
Cognitive Deficits ◽  
The Elderly ◽  
Inappropriate Drug ◽  
Limited Life Expectancy ◽  
Inappropriate Drugs ◽  
People With Dementia ◽  
Limited Life

Dementia is associated with a number of comorbidities often observed in older people, including hypertension, cardiovascular disease, stroke and diabetes. Treating these comorbidities in older adults with dementia results challenging for many reasons. First, older adults with dementia are generally excluded from clinical trials, so application of clinical guidelines for treatment of chronic diseases in this population might lead to polypharmacy and adverse drugs effects. Second, memory, intellectual function, judgment and language are commonly impaired in patients with cognitive deficits, compromising the compliance to complex pharmacological regimens, increasing the risk of adverse drug reactions. Third, cognitive impairment is associated with limited life expectancy and therefore limits the efficacy of pharmacological treatments and questions the appropriateness of treatment. In the present study we examine most relevant concerns related to the treatment of comorbidities in demented patients, referring also to the existing criteria for inappropriate drugs in the elderly. The application of such instruments, along with the comprehensive geriatric assessment of the older adult with cognitive impairment, could result useful to reduce the burden of polypharmacy and inappropriate drug prescriptions.

Gastroenterology

2018 ◽  
Author(s):  
Lesley K. Bowker ◽  
James D. Price ◽  
Ku Shah ◽  
Sarah C. Smith
Keyword(s):  
Inflammatory Bowel Disease ◽  
Peptic Ulcer ◽  
Gall Bladder ◽  
Older People ◽  
Enteral Feeding ◽  
Bowel Disease ◽  
Older Patients ◽  
The Elderly ◽  
Ulcer Disease ◽  
Inflammatory Bowel

This chapter provides information on the ageing gastrointestinal system, the elderly mouth, nutrition, enteral feeding, the ethics of clinically assisted feeding, oesophageal disease, dysphagia, peptic ulcer disease, the liver and gall bladder, constipation, diverticular disease, inflammatory bowel disease, diarrhoea in older patients, other colonic conditions, the ‘acute surgical abdomen’, obstructed bowel in older patients, and obesity in older people.

scholarly journals Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Laia Rofes ◽  
Viridiana Arreola ◽  
Jordi Almirall ◽  
Mateu Cabré ◽  
Lluís Campins ◽  
...  
Keyword(s):  
At Risk ◽  
Older People ◽  
Older Patients ◽  
Multidisciplinary Approach ◽  
Oropharyngeal Dysphagia ◽  
The Elderly ◽  
Screening Methods ◽  
Respiratory Complications ◽  
Diagnosis And Management ◽  
Risk Of Aspiration

Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration—half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach.

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