摘要:

Iron status was determined in 280 free‐living and healthy elderly men (n= 131) and women (n= 149) by assessing dietary and supplemental iron intake as well as ten biochemical measures of iron nutriture (erythrocyte count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, plasma iron level, total iron‐binding capacity, per cent transferrin saturation, and ferritin level). Subject ages ranged from 60 to 93 years with a median age of 72 years for both women and men. For comparison purposes, iron status measures in an unselected group of younger men (n= 107) and women (n= 164) between the ages of 20 and 39 years were also obtained. None of the elderly women and only two (1.2 per cent) of the younger women had low hemoglobin levels (less than 12.0 g/dl). Three (2.3 per cent) of the elderly men and none of the younger men had low hemoglobin levels (less than 14 g/dl). Other iron status measures revealed that anemia or iron deficiency was no more prevalent in the healthy elderly population than in the younger adult population when identical criteria were used to assess iron nutriture. The genesis of anemia often seen in the elderly is not completely understood. Reported evidence suggests the presence of anemia in the elderly is a result of overall reduction of hematopoietic reserves. Because of the potentially serious consequences of this assumption about anemia to the treatment of the elderly, the authors critically review some of the studies that have been designed in the past to determine the prevalence and etiology of anemia in the aged. They suggest that health status, race, socioeconomic status, diet, and region are more important than age as explanations for the high prevalence of anemia seen in many previous stud

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03712.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03713.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Patients aged 70 years and older who were admitted to a coronary care unit in 1976 with documented acute myocardial infarction were followed to April 30, 1982. At that time, of the 46 patients who had survived initial hospitalization, 28 had died, 16 were still living, and two were lost to follow up. The actuarial survival rates were 71 per cent, 60 per cent, and 44 per cent for one, three, and five years, respectively. Only two of the variables available by history, physical examination, and clinical course of the patient in the coronary care unit had prognostic significance—complex ventricular premature beats and congestive heart failure of any degree of severity. Patients who suffered congestive heart failure during their hospitalization had a five‐year survival rate of less than 25 per cent, compared with about 60 per cent for those who had neither heart failure nor complex ventricular premature beats. All five patients who had complex ventricular premature beats died within three ye

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03714.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A survey was conducted among the nursing staff of a 400‐bed extended‐care unit for aged men by questionnaire to find out what patient behaviors were identified as sexual by the staff and how they reacted to these behaviors. Three types of behavior were identified as sexual and as “causing problems”: sex talk (e.g., using foul language); sexual acts (e.g., touching or grabbing, exposing genitalia); and implied sexual behavior (e.g., openly reading pornographic magazines). As many as 25 per cent of the residents were thought to create such incidents. Acceptable sexual behavior identified by the staff were limited to hugging and kissing on the cheek, although their answers implied that residents could need more intimate touching and affection. The survey raised questions about the nature and causes of different types of sexual behavior in the institutionalized elderly and about the roles nursing staff, physicians, and administrators can play in recognizing individual needs while safeguarding both the residents and the staff from the consequences of unacceptable in

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03715.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

One hundred and two subjects (40 men and 62 women) neither having a history of neurologic deficits nor showing organic lesions on computed tomographic examination of the brain were studied. Ages of the subjects ranged from 26 to 81 years. Regional cerebral blood flow was measured by the xenon‐133 inhalation method, and the volume percentage of brain with respect to the cranial cavity (craniocerebral index) was calculated by means of computer programs. Regional cerebral blood flow was computed as the fast component of two‐compartmental analysis and as the initial slope index value. The percentage of each subject's craniocerebral index in relation to the standard for subjects with non‐atrophied brains (brain volume index) was calculated as the indicator of brain atrophy. Both the mean brain fast component values and the mean brain initial slope index values correlated closely with the brain volume index in the elderly (r= 0.60,r= 0.62; P<0.0001 in each correlation coefficient). Low cerebral blood flow values coincided with loss of brain substance in the final stage of age‐related brain atrophy, but not in the intermediat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03716.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The relationship between depression and complaints of physical disease in the elderly is often discussed but has received little documentation. The authors administered questionnaires to 88 elderly volunteers to assess two common psychologic diagnoses, affective disorders and organic brain syndrome, and three common cardiovascular symptoms, pain or numbness in the jaw or arm, pressure in the chest, and difficulty in breathing. Data on utilization of health care professionals and demographic information were also obtained. A significant correlation between reports of depression and complaints of cardiovascular symptoms was seen. While the volunteers with depressive symptoms also visited their physicians more often than did the other volunteers, they did not seek the help of mental health professionals. This raises the larger issue that elderly persons who have mild to moderate depression present to our health care system.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03717.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The progressive rise in systolic pressure throughout life is accepted as a phenomenon of “normative aging,” although elevated systolic pressure is established as an independent risk factor for untoward cardiovascular events. An analysis of published data for many thousands of individuals indicates comparable average systolic pressure increments of approximately 20 mm Hg between the ages of 40 and 65 years for both normotensives and hypertensives. In both groups there is a disproportionate rise in systolic pressure, that is, systolic increases more than mean and diastolic pressures. In a young person with a normally elastic arterial system an increase in total peripheral resistance (TPR) produces the same increments in systolic, diastolic, and mean arterial pressures; a decrease in arterial distensibility (AD), on the other hand, increases systolic pressure and decreases diastolic pressure to the same extent, leaving mean pressureunchanged.Thus, the proportion of the systolic pressure rise resulting from increased TPR is equal to the increase in the mean pressure (Δ mean); the remainder of the increase (Δ systolic minus Δ mean) is caused by the only other variable that could account for anadditionalincrease in systolic pressure with advancing age, a decrease in AD. Application of this formulation to published blood pressure data shows that in normotensives the ratio of the contribution toward rising systolic pressure of ↓ AD to ↑ TPR is 1:1 between the ages of 40 and 65 years, whereas in hypertensives it is 2:1. Thus, the natural history of essential hypertension, once established, is one of accelerated arterial stiffening, a mechanism that would contribute importantly to the increasing prevalence of “systolic hypertension” with

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03718.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03719.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

This study investigated the effects of an educational program in geriatrics on the attitudes of a group of third‐year medical students. A survey designed to measure attitudes toward geriatric patient care, aging, and older people was administered to all students before and after their participation in a 25‐hour geriatrics education component of a Family Practice Clerkship. Results showed the students' attitudes were significantly improved following the geriatrics training program. Prior training in geriatrics and their specialty preference were also found to have an impact on attitude. The implications of the study for medical education and research are discus

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03720.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb03721.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY