摘要:

Thirty‐eight patients with dementia of various etiologies were studied longitudinally to determine the change in cognition over time in subjects with and without hearing impairment. Hearing impaired subjects were older (P<.0001), but subject groups were otherwise comparable with respect to living arrangements, medical illness, number of drugs taken, mood, years of education, and cognitive functioning at the beginning of the study period. Decline in cognitive functioning at follow‐up was greater in hearing impaired subjects and this difference persisted after adjustment for the greater age of hearing impaired subjects (P<.009). Further division of subjects by diagnosis showed that only in the Alzheimer's group did hearing impairment predict more rapid cognitive decline at follow

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04363.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Thirty‐one elderly fibromyalgia (EFM) patients (60 years of age and older) were studied by protocol and compared with 63 younger fibromyalgia (YFM) patients with this syndrome. Common and characteristic features of fibromyalgia among the elderly included diffuse musculoskeletal aching and stiffness at multiple sites; modulation of aches and pains by physical fatigue, poor sleep and weather factors; associated symptoms of general fatigue, poor sleep, anxiety/tension and subjective soft tissue swelling; and multiple tender points on physical examination. These features were similar to those among the younger patients, with the exception of chronic functional headaches, self‐assessed anxiety/tension, and symptom aggravation by weather factors, mental stress, and by poor sleep, all of which were significantly less common among the elderly (P<.05). Importantly, fibromyalgia was recognized by referring physicians in only 17% of the elderly patients with this condition. Misdiagnoses and inappropriate treatment were common among these patients, with corticosteroid therapy in 40% before their rheumatology consultat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04364.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The cross‐sectional associations between clinical variables and biomechanics platform measures of balance (sway) were determined in a random sample of 50 aged single women living in high rise apartment buildings. A history of falling in the previous year was associated with increased areas of sway. Increased body mass was associated with decreased velocity of sway. Poor near, but not far, visual acuity was associated with increased areas of sway. A postural drop of 10 mmHg or more in diastolic pressure was associated with increased velocity of sway. The associations between these variables and the balance measures persisted after adjustment for age and each other to adjust for potential confounding.Slower hand reaction times and poor hearing were associated with increased areas of sway, but these associations were removed after adjustment for age and near visual acuity. There were no associations between any of the balance measures and postural changes in systolic pressure and heart rate. There were no associations between balance measures and base of support. The observed associations, if causal, can aid in development and testing of effective interventions to improve balance and prevent falls in the elderl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04365.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Meprobamate use was studied in an ambulatory elderly population in Dunedin, Florida. All participants taking this medication were mailed a questionnaire concerning their pattern of use. From 2,278 subjects, 30(1.3%) reported the use of this drug. The average age of participants using this drug was 81.3 years. Five participants began using the drug over 27 years ago and over one‐half of the respondents reported using the drug on a regular basis for over 10 years. With this type of history of meprobamate use, one might expect to encounter a large number of patients in the future who, in a similar manner, have been using benzodiazepines for many decade

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04366.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The drugs prescribed for 280 women with hip fractures (mean age 83 years) were compared with those prescribed for 145 women controls (mean age 81 years) as recorded in a family practice age‐sex register. Thirty‐three precent of the fracture patients were taking diuretics compared with 24% of the controls (.10>P>.05). Forty‐six percent of these diuretics taken by the fracture group (compared with 40% taken by the controls) were either loop or potassium sparing diuretics in combination with another diuretic. Twenty‐five percent of the controls (compared with 9% of the fracture patients) were taking nonsteroidal anti‐inflammatory drugs (NSAIDs) (P<.001). The greater use of NSAIDs by control subjects may be due to the small overlap between osteoporosis and osteoarthritis. No significant differences were found for digoxin, anti‐hypertensive drugs, and those taking no drugs. Thirty percent of fracture patients were taking sedatives and hypnotics compared with 28% of controls. Within this category, 54% of the fracture patients and 80% controls were receiving drugs (mainly benzodiazepines) with half‐lives longer than 24 hours. Thus, this population did not confirm a previously identified association between long‐acting sedatives and the risk of fracture. As only 3.5% of fracture patients and 2.1% controls were receiving phenothiazines, a role for these drugs in hip fracture cannot be ruled out. In summary, hip fracture patients were slightly more likely to be taking diuretics and somewhat less likely to be taking NSAIDs than controls but there were no differences with respect

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04367.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Subcutaneous daily or bidaily administration of synthetic salmon calcitonin is an effective form of therapy for Paget's disease, but the requirement for parenteral injection deters geriatric patients from using the drug. This study compares a new intranasal preparation of salmon calcitonin to subcutaneous drug in 18 patients with Paget's disease using two different protocols. In the first protocol, 15 patients not previously treated with salmon calcitonin were given the agent for 3 months by either the intranasal or subcutaneous route. Seven patients treated with intranasal calcitonin had a mean fall in the serum alkaline phosphatase of 33% over a 3‐month period compared to a fall of 40% in the subcutaneously treated group; the difference between the two treatment groups was not statistically significant. In the second protocol, three patients previously stabilized on subcutaneous calcitonin were switched to the nasal spray with no subsequent change in alkaline phosphatase values during 6 months of treatment. These results demonstrate that intranasal salmon calcitonin is effective in lowering the serum alkaline phosphatase in Paget's disease. Ease of administration and patient acceptance make intranasal calcitonin a reasonable alternative for geriatric patient

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04368.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The Systolic Hypertension in the Elderly Program (SHEP) was designed as a feasibility study and in part dealt with the effects of the treatment of isolated systolic hypertension on cognitive status and depression. Subjects were 60 years of age or older with a systolic blood pressure of 160 mmHg or greater and diastolic of less than 90 mmHg; free of several specified illnesses or chronic conditions. These volunteers were randomly assigned to treatment (n = 443) and placebo (n = 108) groups. The behavioral assessments at baseline and 1 year later were the SHORT‐CARE instrument for depression, cognitive impairment, and disability and other tests of cognitive status (Digit Symbol Substitution and the Trail Making tests). Although the treatment regime was highly successful in controlling the hypertension, it did not have a significant impact on changes in cognitive function or level of depression; a behavioral benefit was not evident but the results are consistent with the view that an effective treatment regime for isolated systolic hypertension in the elderly can be behaviorally saf

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04369.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Risk factors for coronary heart disease were examined in 2,501 individuals in the Framingham Heart Study who survived to the age of 65 without evidence of coronary artery disease. We used a proportional hazards (Cox) analysis that examined risk factors over time and included events through the 16th biennial examination. The independently significant multivariate correlates of the development of coronary heart disease after the age of 65 were sex (incidence rate ratio [RR] for males of 1.7 [95% confidence interval of 1.4,2.0]), left ventricular hypertrophy (RR = 2.4 [1.7,3.5]), systolic blood pressure (RR = 2.2 [1.4,3.3]for systolic blood pressure of 160 mmHg or higher as compared with less than 120 mmHg), casual blood glucose (RR = 2.2 [1.5,3.4] for 175 mg/dL or more as compared with less than 90 mg/dL), Metropolitan relative weight from examination 1 (RR = 1.3 [1.0,1.6]for those 130% or more of ideal weight compared with those less than 110% of ideal), and total serum cholesterol (RR = 1.8 [1.3,2.5] for cholesterol in the 90th percentile or higher compared with less than 200 mg/dL). Controlling for all these risk factors, those smoking 20 cigarettes a day or more were at slightly increased risk of coronary heart disease (RR = 1.2 [.9,1.6]) compared with nonsmokers. These analyses suggest that older persons share the same risk factors for coronary artery disease that are significant in younger populations.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04370.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Falls are a leading cause of fatal and nonfatal injuries among the elderly in the United States. Despite the importance of fall injuries, epidemiological studies of falls among the elderly have identified neither their causes nor the methods to prevent them. Therefore, we established a community‐based surveillance system in Miami Beach, Florida, as part of a study to assess falls among the elderly. A total of 1,827 fall injury events occurred in this community between July 1985 and June 1986. More than 85% (1,567) of the persons who fell and received care were seen in an emergency room. The remaining cases were identified from one of the three other sources used: fire rescue reports, inpatient medical records, or medical examiner reports. Most falls (97%) were coded as accidental (E880–E888). More than 100 people sought medical assistance for a fall each month. The time of the injury was known for 68% (1,244) of the people who fell. Seventy‐four percent of these falls (921) occurred during daylight hours. Fifty‐four percent of the falls (986) occurred in and around the home, and 38% of these had a particular area of the home recorded: 42% occurred in the bedroom, 34% in the bathroom, 9% in the kitchen, 5% on the stairs, 4% in the living room, and the remaining 6% in other areas. This surveillance system will help us use the study to clarify the causes of falls in the elderly and identify and evaluate appropriate prevention efforts. It will also help others in designing and implementing other injury surveillance

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04371.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb04372.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY