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991.
Beloosesky Y Hershkovitz A Solovey B Salai M Weiss A 《Archives of gerontology and geriatrics》2011,53(2):179-182
The aim of the study was to investigate Na+-course of hip fracture patients in relation to demographic and clinical parameters. Data on 155 older hip fracture patients were analyzed retrospectively. Clinical parameters and serum Na+ on admission (Na1), during 24 h pre-op. (Na2), during 24 h post-op. (Na3), and pre-discharge (Na4) were recorded. Hyponatremia and hypernatremia rates pre- and post-operation were 26.5%, 2.6%, 24.5% and 5.8%. Higher Na3 (138.76 ± 4.4 mEq/l) vs. Na1 (137.69 ± 4.5 mEq/l) (p = 0.004) and correlation between age and Na3 (p = 0.021) was found. Mean serum Na+ of impaired mental status (IMS) vs. normal patients and of partially/independent vs. dependent patients were higher (p < 0.05). More complications occurred in IMS patients tending to higher Na3 in patients with complications. No differences in Na+-courses were found according to sex or co-morbidities. Dysnatremia is highly prevalent in older hip fracture patients. A distinct post-operative increase in serum Na+ was found, higher in the cognitively and functionally impaired patients. It seems that the Na+ increase characterizes more IMS patients who suffer more complications, but does not necessarily indicate complications. We recommend surveillance of serum Na+, particularly in cognitively and functionally impaired older patients in whom the risk of hypernatremia and complications is higher. 相似文献
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Despite world-wide emphasis on falls prevention, falls and their consequences remain a major health issue for older people,
and their health care providers. Many systematic reviews have been undertaken to evaluate the impact of intervention programmes
on falls reduction, however, relatively little research provides a voice for older people’s own perceptions of such programmes.
To readdress this imbalance the current research utilized a purposive sampling method to recruit a hard to reach group of
older people who had received a post-fall health and social-care programme to investigate their experiences of the programme.
Semi-structured interviews with eight housebound people aged over 65 who had fallen were undertaken, and data analysed using
interpretative phenomenological analysis. Four themes were identified: losing independence; losing confidence; losing social
identity; managing a changed self. Despite a tailored intervention programme minimal improvement in participants’ psychological
adjustment to falls was noted. Outcomes from this study are of interest to health and social-care staff who deliver falls
prevention programmes. Staff need to enhance constructive adjustment to the older person’s altered circumstances and ensure
behaviours do not exacerbate their clients’ loss of independence. This should assist older people’s ability to positively
manage their sense of self, allowing them to find continuing meaning in their daily lives. 相似文献
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Purpose: To compare pharmacokinetics, tolerability, and efficacy of lamotrigine (LTG) in older versus younger adults. Methods: We studied 686 adult outpatients seen at our center over 5 years. We compared apparent clearance (CL) of LTG in the youngest (16–36 years; n = 247) and oldest (55–92 years; n = 155) tertiles. We analyzed one‐year retention for younger and older adults newly started on LTG, frequency of adverse effects causing intolerability, and rates of specific adverse effects. We also investigated 6‐month seizure freedom. Key Findings: Median LTG CL of older adults taking LTG in monotherapy was approximately 22% lower compared to younger adults (28.8 vs. 36.5 ml/h/kg; p < 0.001). LTG CL in older adults was lower compared to younger adults in patients on polytherapy and on polytherapy without enzyme inducers or valproate. One‐year retention for LTG was comparable in older (78.1%, 121/155) and younger (72.4%, 179/247) adults. Intolerability to LTG was higher in older (34.8%) versus younger adults (24.2%; p = 0.005). Imbalance, drowsiness, and dizziness were common intolerable side effects in both groups. Older patients had higher rates of intolerability due to imbalance (16% vs. 4%), drowsiness (13% vs. 7%), and tremor (5% vs. 2%) compared with younger patients. Rates of 6‐month seizure freedom were comparable, and small numbers of each group benefited from very high levels of LTG (>15 μg/ml). Significance: LTG CL in monotherapy in older adults is approximately 20% lower than in younger adults. For a given serum LTG level, older adults are twice as likely to have significant adverse effects compared to younger adults. Older patients are more likely to experience imbalance, drowsiness, and tremor than younger patients. Younger adults tolerate LTG better than older adults, but one‐year retention is comparable. Some patients may benefit from high serum levels of LTG. 相似文献
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BackgroundDuring the last decades scientific literature has focused on the positive relationships between Nature - Based Activities (NBA) and health. The aging of the population and the increasing costs of health services make it important to investigate the benefits for older people.ObjectiveThe purpose of this study was to systematically review the existing literature regarding Nature – Based Activities addressed to older people.MethodsA systematic search of the literature was made in PubMed, Web of Science and Scopus from 2005 till December 2018.ResultsWe identified 42 articles that satisfied the inclusion criteria. The results highlighted the multidisciplinary use of nature in many settings as well as a variety of different research designs, both quantitative and qualitative. The majority of experimental assessments were carried out in the setting of nursing homes and residential facilities. A variety of treatments, e.g. horticultural therapy, gardening, green visiting, green exercise and of settings, e.g. residential facilities or adult day services, participants’ homes, outdoor settings, and green care farms were examined.ConclusionsThe examined studies offered numerous examples of the healing power of nature for the health and well-being of older people. Occupational therapists could gain substantial insight from earlier experiences of NBA for application in their practices. 相似文献
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IntroductionDiabetes mellitus (DM) is a risk factor for periodontitis for over 40 years and novel evidence suggests that periodontitis has an impact on glycemic control in patients with diabetes. This study aimed to compare oral health complications in diabetic older patients from Brazil and France.MethodsThis cross-sectional study included 120 patients aged 65 and over diagnosed with type 2 diabetes. Sixty patients were admitted to a center for diabetes and hypertension care in Brazil and 60 patients were admitted to the Rouen University hospital. Dental conditions were assessed through the decayed, missing and filled teeth index and periodontal condition was assessed using the Community Periodontal Index. The significance threshold was p < 0.05.ResultsDecayed teeth differed statistically between the groups (p = 0.001). The French group presented more tooth mobility, gingival recession and furcation involvement (p < 0.001). Tooth brushing frequency differed significantly between the groups (p < 0.030). The main cause of missing teeth was periodontitis in the French group and caries and periodontitis in the Brazilian group (p < 0.001). Statistical significance was found for use of fixed upper (p = 0.013) and lower (p = 0.013) dentures in the French group. The French group needed upper denture rehabilitation (p = 0.010) while the Brazilian group needed lower denture rehabilitation (p = 0.003).ConclusionEdentulism was prevalent in diabetic older people in both countries. However, the French participants presented with better oral health. 相似文献
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Fusheng Fang Ning Wang Shuangtong Yan Liangchen Wang Yanhui Lu Jian Li Huifen Li Gabriel Pham Chunlin Li Sean Xiao Leng Hui Tian 《Primary Care Diabetes》2019,13(6):495-504
AimsTo investigate the potential association between impaired glucose tolerance (IGT) and all-cause mortality among older men at high risk for cardiovascular disease (CVD) in China.MethodsIn this prospective observational study, 460 older men aged ≥60 years were determined to have either IGT or normal glucose tolerance (NGT) based on an oral glucose tolerance test conducted between May 2005 and May 2007. IGT and NGT were diagnosed according to the 1999 WHO diagnostic criteria. All subjects were followed until March 2017. The primary outcome studied was all-cause mortality. Multivariate Cox models were used to estimate relative risk for all-cause mortality.ResultsDuring a mean follow-up of 11.2 years, forty-three (21.4%) subjects in the IGT group and twenty-nine (11.2%) subjects in the NGT group died (HR 2.05, 95% CI 1.28–3.28, P = 0.003). Multivariate Cox proportional-hazards analysis demonstated that IGT was significantly associated with increased risk for all-cause mortality, composite cardiovascular outcome, nonfatal stroke and heart failure after adjusting for potential confounding factors. Logistic regression analysis showed that IGT at baseline (P < 0.05) rather than incident type 2 diabetes was a risk factor of all-cause mortality.ConclusionsIGT was significantly associated with all-cause mortality in older Chinese men at high risk for CVD. 相似文献
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