Early and late age-related macular degeneration (AMD) have a high prevalence in elderly patients but may be differentiated by medical or environmental factors, eg, hypertension, geographic area, or antioxidant agents. Because nuclear sclerotic cataract is associated with AMD both aging changes may share a common pathogenesis. The genetic predisposition for ...

Management is not as straightforward as it appears. Patients often have associated conditions that predispose to or result from constipation. An OTC laxative habit may confound the workup and frustrate treatment. Overall evaluation is required, lest constipation progress to a medical crisis that requires hospital admission.

Correlates of self-reported memory for adherence to prescription drug regimens in noninstitutionalized elderly persons were studied. Independently living persons at least 55 years of age participated in a "brown-bag" medication review. A structured interview consisting of background questions and medication-related questions was conducted. Included in the interview were questions about ...

The purpose of this study was to explore hospital discharge preparation for elderly patients returning to their homes, and to examine knowledge and satisfaction outcomes. A descriptive correlational design was used in an urban health maintenance organization medical center. The convenience sample included 140 English-speaking patients with medical diagnoses. Knowledge ...

Evidence that dying occurs as a natural, final event in the wholeness of human life is culturally, artistically, and scientifically persuasive. Very elderly patients eventually undergo a process of functional declines, progressive apathy, and loss of willingness to eat and drink that culminates in death, even in the absence of ...

In spite of a geriatric team's offer to intervene in what was perceived to be a case of psychologic and financial abuse, an elderly patient who was being discharged from hospital chose to remain in her home. Frustration and concern about the victim prompted medical student Kim Curtin to write ...

The possible influence of chronic indometacin (CAS 53-86-1) medication on nimodipine (CAS 66085-59-4) pharmacokinetics was investigated in 24 elderly healthy subjects. Both drugs were orally administered in a non-blinded, randomized, twofold crossover design. The study periods with a 5-day treatment each were separated by a 2-week washout period. The Css,max ...

This article describes a geriatric medical/psychiatry inpatient unit (GMPU) in a small community general hospital. A program description and data from the second year of the unit's operation are presented. The GMPU provides comprehensive geriatric assessment and interdisciplinary treatment for frail, medically ill elderly patients with neuropsychiatric disorders. Many of ...

The technical and diagnostic performance of the Amerlite-MAB enhanced luminescence assay for free thyroxine (FT4) was assessed in a multicenter evaluation trial. The euthyroid central 95% reference range for FT4 (1393 subjects) was 11.5-27.7 pmol/L (by cumulative frequency plot with two-tailed 2.5% cutoffs). Results (y) agreed with those of similar ...

OBJECTIVE: To review changes associated with aging that affect medication use and to outline medication-monitoring guidelines. DATA SOURCES: Recent medical literature including journals and texts. STUDY SELECTION: Determined by the author. DATA EXTRACTION: By the author. DATA SYNTHESIS: There are many changes that occur in the aging individual that may ...

Although anxiety disorders appear to occur less frequently in elderly persons, subsyndromal anxiety and anxiety associated with other medical and psychiatric disorders are significant sources of morbidity. Theories of etiology of anxiety range from the psychodynamic to the neurobiologic. Treatment of anxiety syndromes hinges on a thorough diagnostic evaluation, with ...

OBJECTIVE: The Beth Israel/UCLA Functional Status Questionnaire (FSQ) is a multidimensional self-report instrument used for assessing the physical, social, and psychological status of children and adults. This study assessed the appropriateness of the FSQ for use with geriatric (at least 65 years of age) ambulatory medical patients. METHOD: Concurrent cohort ...

OBJECTIVE: To determine the efficacy of intracavernosal injection of prostaglandin E1 (alprostadil) in elderly men with erectile failure. DESIGN: Prospective study. SETTING: Outpatients at a university-affiliated VA Medical Center. PARTICIPANTS: Ten subjects aged 65 years and older with duration of erectile failure of 6 months or longer. INTERVENTIONS: Subjects received ...

Great care in prescribing and monitoring psychotropic medications for elderly patients must be taken because of their increased sensitivity to toxic side effects; their decreased physical resiliency, as compared to younger patients; and the risk of dependency and withdrawal when taking psychotropic medication. Psychosocial and psychotherapeutic interventions should be administered ...

Delirium is characterized by a sudden deterioration in cognitive function and an inability to sustain attention. It is a medical emergency that occurs in more than 20 percent of hospitalized elderly patients. Misdiagnosis is common and contributes to high morbidity and mortality. Patients may present in hypoactive, hyperactive or mixed ...

Birthweight is a broad indicator of health and socio-economic development in a population. This study was designed to examine small area patterns in the incidence of low birthweight in Dublin for the years 1986-89 and to explore the relationship between low birthweight and socio-economic factors. A number of district electoral ...

The ability of elderly people to self-medicate is a critical function for successful independent living. The current research investigated the predictive value of three aspects of memory potentially related to success or failure in a self-medication program. Results show that a combination of memory measures successfully discriminated between those subjects ...

Fifty cases of orthostatic hypotension in the elderly are analysed. Three main modes of presentation were identified: (1) falls or mobility problems; (2) mental confusion or dementia; or (3) predominantly cardiac symptoms. Selected case histories are given to illustrate diagnostic difficulties. Medication was responsible for orthostatic hypotension in 66% of ...

Inappropriate medication prescribing is an important problem in the elderly, but is difficult to measure. As part of a randomized controlled trial to evaluate the effectiveness of a pharmacist intervention among elderly veterans using many medications, we developed the Medication Appropriateness Index (MAI), which uses implicit criteria to measure elements ...

A case-control study was conducted in Quebec elderly men in order to document the risk of road accidents associated with impairments or chronic medical conditions. All 1,400 drivers who had had an accident with either mild bodily injury or only property damage during their 70th year in 1988 and 1989 ...

In this retrospective study of 489 consecutive elderly admissions to a general hospital psychiatry ward, the main aim was to describe the stressors precipitating admission, psychiatric and medical diagnoses, physical treatments used, length of hospitalisation, and clinical and social outcome. Depression was the predominant diagnosis, with length of stay being ...

Medication knowledge and compliance among the elderly was examined using a color-coded method, which was designed to tailor the medication regimen to the person's daily schedule. Data were collected from 80 elderly, predominantly indigent, and individuals of low literacy. Group 1 of the study received verbal teaching only, whereas Group ...

The purpose of this paper is to review the mechanism of the action, safety, and side-effects of chlorhexidine, and to provide guidelines for its use in special populations. Chlorhexidine has been used orally since 1959, primarily for the control of dental plaque. Chlorhexidine is a safe material, with low toxicity ...

Treating hypertension reduces morbidity and mortality. Unfortunately, hypertension often exists in patients with other medical conditions. In these patients, the selection of an antihypertensive agent is often influenced by the presence of the coexisting condition. Conversely, the treatment of the coexisting medical condition may be influenced by the presence of ...

The prevalence of salivary mutans streptococci and lactobacilli, salivary flow rate, and the type of dentition were studied in connection with a medical survey of 76-, 81-, and 86-yr-old inhabitants of Helsinki living at home. High bacterial counts were associated with low salivary flow rates. High counts of mutans streptococci ...

Two hundred and twenty six consecutive patients aged over 75 years discharged following an acute medical admission to a district general hospital were followed up six months later. 46 (20.3%) required emergency admission within three months of discharge. 19 had a diagnosis related to their original admission, and 27 an ...

This study measured the prevalence of difficulty experienced by elderly inpatients in opening and removing tablets from a range of common commercial medication packagings and in breaking a bar-scored tablet in half. One hundred and twenty elderly patients admitted to a teaching hospital acute geriatric service were tested for their ...

Of all medications consumed in the U.S., the percentage used by the elderly is greater than can be justified by their numbers. Many medications have adverse effects. This paper reviews the 50 medications most used by the elderly and discusses adverse reactions which may present in the oral cavity or ...

Elderly dental patients often complain of mouth dryness. This complaint is most often caused by xerogenic medications or, less often, by systemic diseases. Aging per se has no significant clinical impact on salivary gland output. Salivary gland hypofunction, whether caused by medications or systemic disorders, have a strong negative impact ...

This study compares agreement between telephone survey and ambulatory medical record data for an elderly patient population. Medical records and telephone survey responses are used to compare health status (chronic medical condition, symptomatology, and functional status) of 142 elderly patients randomly selected from a family practice residency and a geriatric ...

Although numerous studies have identified medical antecedents of falls among the elderly (premonitory), few have examined falls as a possible predictor of subsequent disease onset (prodromal falling). This study compared disease incidence (up to 12 months after the first fall) among fallers (n = 42) and nonfallers (n = 20) ...

OBJECTIVE: To determine whether commonly used medications increase the risk of falling in elderly Australians living in nursing homes. DESIGN: Case-control study. SETTING: A 104-bed nursing home in western Sydney during 1990-1991. SUBJECTS: The cases comprised 71 people who had at least one fall during the 12-month study period; 55 ...

Dry mouth is a common disorder in elderly individuals. It is not, however, necessarily related to decreased salivary flow rate, since subjective feelings of oral dryness have also been found in those with normal flow rates. The aim of this study was to examine in elderly individuals the prevalence of ...

The resident population in facilities changes over time. In some facilities there may be a large turnover of residents; in other types of facilities some residents will remain, age in place and become more frail. In addition, some medical conditions and intrinsic factors cannot be changed. Since there is not ...

Oxcarbazepine (OCBZ, Trileptal) is registered in several countries and has been well received by patients and physicians. However, newer standards in many other countries require additional data before registration can be achieved. For this reason, Ciba has implemented further clinical studies. OCBZ has a chemical structure that is closely related ...

An elderly nondiabetic woman was found stuporous and unresponsive at home. In the emergency department, testing revealed that she had a serum glucose of 40 mg/dL (2.2 mmol/L). No underlying metabolic cause could be determined. An inspection of her medications disclosed a professional medication sample bottle labeled as containing a ...

Polypharmacy, the use of multiple medications concurrently, is common among the elderly. Beers and Ouslander report that older North Americans consume 4.5 medications on average at any one time. In Canada, seniors take 25 per cent of all prescriptions but comprise only 12 per cent of the population. And according ...

This study describes the quality of antidepressant medication use at hospital discharge for depressed elderly inpatients and compares quality of care before and after implementation of Medicare's Prospective Payment System (PPS). The study reviewed data from medical records of 2746 depressed, elderly, hospitalized patients in acute-care general medical hospitals in ...

Little is known about the disease profiles in Chinese living in an urbanized community like Hong Kong. Accordingly, the discharge summaries of 561 acute hospital medical admissions were reviewed and the primary diagnoses (the main reason for admission or the most important clinical problem) were coded according to the International ...

OBJECTIVE: To determine if older patients undergo fewer cardiovascular imaging procedures (CIPs) than younger patients when admitted to a tertiary care academic medical center for an acute myocardial infarction (MI), after adjusting for disease severity and comorbidities. DESIGN: Non-current prospective cohort study. SETTING: Urban tertiary care academic medical center. PATIENTS: ...

The competence of elderly people to participate in medical decision-making is often called into question. This article explores the concept of competence as it relates to elderly people, and outlines the guiding ethical principles of autonomy and beneficence. Practical guidelines are offered on how competence can be assessed and some ...

Due to the changes within the respiratory system that occur physiologically with aging as well as preexisting medical conditions, elderly persons are less tolerant of the insults discussed in this article. For this reason, clinicians must be particularly vigilant in their approach to the diagnosis and management of pulmonary complaints ...

Prevalence and indicators of medication use with potential oral health implications among 4,163 people from the Duke Established Populations for Epidemiologic Studies of the Elderly were studied. Medications were grouped into seven potential oral adverse drug reaction (POADR) categories. Eighty percent of participants were taking at least one medication from ...

AIM: (1) To estimate the prevalence of use of different medication categories; (2) to estimate the prevalence of xerostomia (dry mouth); and (3) to estimate the effects of xerostomic medication upon perceived dry mouth among institutionalised elderly people. SUBJECTS: A two-stage stratified random sample of three hundred and fifty-nine people ...

We interviewed 120 Bedouin men to elicit their views about the traditional Bedouin support system for the elderly (a collective family fund) and the more recent welfare support allowances that all Israeli elders are entitled to. Desire to maintain or return to the traditional system varied with the respondent's place ...

Physicians should question their elderly patients and those who know their life-styles and habits best (ie, family, friends, caretakers) regarding use of over-the-counter medications. Salicylates are commonly used by the elderly, and long-term unsupervised use may lead to salicylate toxicity that can cause delirium. In the southern United States, BC ...

The use of psychotropic agents to treat anxiety in medically ill elderly patients requires consideration of special pharmacokinetic and pharmacodynamic factors in drug selection. In this review, the use of seven general classes of psychotropic drugs with anxiolytic activity will be considered for use in the medically ill: benzodiazepines, azapirones, ...

All evidence suggests that the elderly population of today and tomorrow will continue to depend on the private car to give them freedom, independence, and choice--as do younger travellers. Given the demographic changes in the United States, it seems very unlikely that other modes or options can provide anywhere near ...

Sections from 65 gastrectomy specimens obtained from operations performed for peptic ulcer or adenocarcinoma in Caucasian patients living in Hawaii were retrieved from the files of the Queen's Medical Center (n = 45) and the Kuakini Medical Center (n = 20). The sections were examined under high-power light microscopy for ...

Delirium is more common in older adults because of normal physiologic changes, increased incidence of medical illnesses, and increased medication use in this population. Older dementing patients are particularly predisposed to delirium because of associated neurologic abnormalities. Delirium often is superimposed on a dementing condition and may be difficult to ...