摘要:

Loss of independent eating capacity is a major problem for the institutionalized elderly. Few studies have examined the factors associated with loss of functional eating capacity. The authors cross‐sectionally studied 240 residents of a skilled nursing facility, classified their functional eating status, identified correlated deficits, and followed these residents for six months. Information was gathered through questionnaires, chart review, and physical examinations. Residents were stratified into independent (68%, N = 264) and dependent (32%, N = 76) eating status groups according to the need for physical assistance during meals. Dependency status did not correlate with age (P = .88) or weight loss (P = .27). Loss of independence in eating was associated with impaired mobility (P =.0001), impaired cognition (P =.0001), modified consistency diets (P = .0001), upper extremity dysfunction (P = .0001), abnormal oral‐motor examinations (P = .0002), absence of teeth and dentures (P = .002), behavioral indicators of abnormal oral and pharyngeal stages of swallowing (P = .0001), and increased mortality within six months (P = .0001). Eating dependency is therefore associated with multiple impairments and early mortal

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04202.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

One hundred seventy‐one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically significant biochemical changes or side effects. The 50.0‐mg dose level enhanced efficacy only minimally over the 25.0‐mg dose level. Drug‐related side effects were significantly more prevalent in the chlorthalidone 50.0‐mg group than in the placebo group. The data suggest that most elderly patients with isolated systolic hypertension, regardless of the severity, could be treated effectively and safely with chlorthalidone 12.5 m

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04203.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Hearing impairment has been hypothesized as contributing to symptoms of dementia. Data from a longitudinal study were analyzed to determine if auditory status predicted cognitive functional decline in senile dementia of the Alzheimer's type (SDAT). As part of a larger study, 156 consecutive SDAT outpatients had received a comprehensive medical evaluation including baseline screening for hearing impairment with the finger friction test and serial assessment of cognitive function with the Mini‐Mental State examination. Age and cognitive function at entry to the study were greater among individuals with impaired hearing (N = 36) than with normal hearing (N = 120). The demographic profiles of the impaired and normal hearing groups were otherwise similar, as was the prevalence of depression. Intervening mortality rates were nearly identical. Decline in cognitive function one year later, however, was nearly twice as great in the impaired hearing group, a statistically significant difference (P<.05, by one‐tailed t test) even when controlled for age and initial cognitive function. These results, which need to be verified with sophisticated audiometric techniques, suggest that hearing impairment may be a prognostic indicator for subsequent cognitive dysfunction in SDAT. They are consistent with the hypothesized relationship between hearing impairment and dementia in SDAT as well as alternative hypotheses discussed in the t

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04204.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

All patients 65 years and older who had been living in an institution for at least six months had a measurement of red blood cell folate (RBCF), serum folate (SF), vitamin B12, hemoglobin, and mean corpuscular volume. Twenty‐two percent of the 97 studied subjects were found deficient in RBCF, although only 6% had anemia. Length of stay at the institution was significantly associated with deficiency in RBCF and this association was uncon‐founded by age. The proportion of RBCF deficiency among the studied subjects attributable to length of stay is 80%. The prophylactic administration of folate among long‐term nursing home type of patients should be consi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04205.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Depression is a major health problem in the elderly. The existing literature indicates that depression may be qualitatively different in this population. For example, a condition said to be prevalent among the elderly is masked depression which is marked by a cluster of vegetative symptoms without prominent dysphoria or guilt. Specific symptoms of depression reported most commonly in the elderly include loss of self‐esteem, feelings of helplessness, and complaints of cognitive deficit. Based on this information, the contents of six currently used depression rating scales were compared. It was found that although these scales are responsive to standard DSM‐III criteria for depression, for the most part they do not address the symptoms reported to be more common among depressed elderly. In addition, they had not been validated on the old old and therefore seem to have limited applicability as a sensitive screening tool for this rapidly growing segment of the populat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04206.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The interactions of cancer and malnutrition are discussed with the focus on aging. To establish whether the elderly are more likely to develop cancer cachexia and its complications, this review encompasses the pathogenesis of malnutrition in cancer; the age‐related alterations of appetite, gastrointestinal function, energy expenditure, and protein turnover; the diagnosis of malnutrition; and the effectiveness of nutritional support in the elderly. Although metabolic and physiologic changes induced by cancer and age appear synergistic in causing cachexia, more frequent complications of malnutrition have not been observed in the geriatric cancer patients. This may be due to only a small proportion of the elderly with cancer being enrolled in clinical studies or to a reduced cachexia‐inducing ability of tumors in these patients. A limited number of studies indicate nutritional replenishment is obtainable in malnourished elderly by hyperalimentation. As restoration of the lean body mass may be slower in older patients, early institution of nutritional support is recommended in malnourished elderly or elderly at risk for malnutrition during neoplastic treatm

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04207.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Myxoma of the atrium presents distinctive clinical profile, yet precise diagnosis of the tumor on the basis of clinical findings is often not made in the elderly patient as the symptoms are often attributed to “generalized arteriosclerosis of the elderly.” The authors report the clinical findings in four elderly patients with left atrial myxoma in whom the diagnosis had not been clinically suspected before echocardiographic evaluat

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04208.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04209.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04210.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb04211.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY