摘要:

ABSTRACT:Of 100 patients consecutively admitted to a rehabilitation hospital, 25 were cognitively impaired. On two brief tests of intellectual function, they scored below the criteria selected by the originators of those tests for clinically significant mental impairment. Nineteen of the 25 had vascular disease of the heart, brain, or peripheral vessels; two had cardiac valvular disease; three had head trauma; and one was mentally retarded. Mental impairment appears to be relatively common among the hospitalized elderly who do not carry the primary diagnosis of “dementia” or “organic brain syndrome.” It appears to be particularly common among those with cardiovascular disease, even without frank stroke. Brief mental status examinations should be part of the routine evaluation of such p

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02036.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:The records of a hospital psychiatric emergency department were reviewed for elderly and middle‐aged patients who were diagnosed with organic brain syndrome (OBS) or psychiatric disorder. These records were then compared with those of elderly patients from the medical emergency department. While elderly medical patients received routine physical evaluations and laboratory testing, elderly psychiatric patients with behavioral symptoms were often referred to psychiatry before they received tests necessary to differentiate physical disorders from functional psychiatric disorders. When tests were administered to psychiatric patients, many abnormal results were apparent, indicating the possible presence of physical disease. It is recommended that all elderly patients with psychiatric symptoms undergo adequate medical evaluations to screen for physical causes of the psychiatric symptom

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02037.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:Eighty‐seven community‐dwelling nonagenarians provided with extensive medical and social services as needed were followed for two years. Fifty‐one subjects were admitted to an acute care hospital at least once. Total durations of hospitalization for those who required it averaged 44 days per individual over the two years. This represents about 13 hospital days per year per nonagenarian. Since it is likely that few, if any, hospitalizations would have been preventable by additional services, these data suggest that at a minimum one hospital bed would be continuously occupied for every 28 persons of this age and of this degree of infirmity. In these times of fiscal restraint it is especially important that the government and third‐party payers determine the level of funding for expensive services such as acute hospitalization by assessing the needs of those who u

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02038.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:For the vast majority of elderly patients with chronic heart failure, clinically effective dietary sodium restriction can be achieved in a diet that remains nutritious and palatable. Obtaining a thorough diet history is the initial step in devising a low‐sodium regimen. Then, the nutritionist and patient can work together to develop a dietary regimen that is culturally, economically, and medically acceptable. Although the availability of potent medications has markedly altered the medical approach to chronic congestive heart failure, their use is not without risk. Thus, dietary management continues to be a useful strategy in the treatment of this conditio

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02039.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:Eighty‐one geriatric consultations conducted on behalf of 71 patients (mean patient age 78 years, range 59–99; M34, F37) at San Francisco General Hospital were analyzed. Seventy‐nine per cent of requests were for medical or psychiatric evaluation; 19 per cent social; and 3 per cent rehabilitation. The authors made 50 new diagnoses, many of which identified conditions that adversely affected patients' functional levels, including cardiovascular disorders (8), medication effects (8), malnutrition (7), misdiagnosis of dementia (7), and gait disorders (4). Recommendations focused on treating those conditions whose alleviation could improve self‐care ability: medication adjustment (62 per cent), management of dementia, delirium, or depression (59 per cent), rehabilitation (32 per cent), and treatment of malnutrition (30 per cent). Geriatric consultations resulted in rerouting 18 patients (51 per cent) from nursing homes to lower levels of care. Fourteen of these eventually returned home. By focusing on reversible conditions that affect patients' functional levels, geriatric consultation can improve the management of elderly patients and prevent unnecessary nursing home pl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02040.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:The records of 22 cases of family‐mediated abuse and neglect of elderly persons were retrospectively reviewed by the physician and nurse responsible for their care using a modification of the OARS Multidimensional Functional Assessment form. Cases were divided into three categories: Category I cases (n= 4) involved extremely impaired elders who received extensive care from the individuals responsible for the abuse or neglect. Category II cases (n= 9) involved impaired elders who received inadequate or intermittent care. Category III cases (n= 9) involved independent elders whose only care needs resulted from threats or violence from relatives. Among the statistically significant differences found between these categories were the age of the abuser, the manifestations of abuse or neglect, the interventions offered, the durations of abuse, and the outcomes of the cases. The results suggest that these three categories represent different subgroups of abused and neglected elderly persons, all with different implications for identification, intervention, and outcom

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02041.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:Atrophy of brain matter in hypertensive and normotensive subjects was studied by quantitative measurements of brain volume and cranial cavity volume using x‐ray computed tomography. The 123 normotensive subjects ranged in age from 20 to 79 years and were divided into six ten‐year age groups. The 67 hypertensive subjects ranged in age from 40 to 83 years and were divided into four age groups. Values of the brain volume index (BVI), the ratio of brain matter volume to cranial cavity volume, for hypertensives and normotensives in the same age groups were compared. Mean BVI values were significantly lower in hypertensives in the fifth (P<0.01), sixth (P<0.01), seventh (P<0.05) and eighth and ninth decades of life (P<0.001). Systemic hypertension, which may induce various diseases in the elderly, had a striking effect on atrophic changes of brain matter in elderly subje

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02042.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

ABSTRACT:Several studies have demonstrated that the uncontrolled diabetic state in both type I as well as type II diabetes mellitus is characterized by altered thyroid hormone metabolism, which results in the lowering of serum triiodothyronine (T3) levels and a reciprocal elevation of T3(rT3) levels. Because the majority of type II diabetics are over 50 years of age and because numerous previous reports have implicated aging as a cause of low T3and high rT3levels, we studied 220 type II diabetics from 40–85 years of age to assess the influence of aging and metabolic control on thyroid hormone levels. Serum thyroxine (T4) free T4, T3resin uptake, and thyroid‐stimulating hormone (TSH) measurements in diabetic patients were not significantly altered compared with 37 young normal control subjects, irrespective of age or the grade of metabolic control. Serum T3levels declined and rT3levels rose in the diabetic patients with worsening of the metabolic control. However, with comparable metabolic control, the levels were not significantly different from the younger patients. Therefore, low T3and high rT3levels observed in patients of any age who have type II diabetes mellitus may be exclusively caused by deranged metabolic control of their dise

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02043.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02044.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1984.tb02045.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY