Youth and old age (author's transl)

Gerohygiene as standard branch of socialist gerontology is faced with the short, medium and long-term preparation for an active old age. The foundations for a healthy ageing and a positive attitude towards old age must be laid as early as in childhood and youth. Investigations on juveniles indicate the ideological barriers that have to be overcome yet. Wrong attitudes of young people about old age might be overcome by means of improved contacts between young and old as well as by extending the competence of the respective role of generation. Theses for a further approach to the subject presented demand for the aspects of aid and care not to be overemphasized but to stimulate an activity-promoting behaviour up to the high age by understanding and loving affection on both sides. The development of self-confidence and personality of young and old people is promoted substantially by mutual fruitful relations.     

Indications for orthopedic procedures in old people (author's transl)]

Advancements in general medicine and anesthesiology have enabled surgical procedures in old people with diminished risks. With reference to special problems the absolute indication for orthopedic procedures particularly for the old can be demonstrated.     

Nutrition in old age (author's transl)

The present study on nutrition in old age was intended to make some of its fundamental problems a subject of discussion. It was meant to show that there still are some unclear and vague conceptions in this field. But the problems raised should not prevent the application of those recommendations in every-day work which seem to be justified on the basis of present knowledge. It appears to be essential that, in spite of the general character of such guidelines, the individual's specific situation should always be given priority when considering his case. Advice on nutrition should not resemble strict orders, but take into account both the physical and psychic as well as the social situation of the individual concerned. As is always the case in geriatrics, the precept holds good that elderly people should be allowed rather than fortbidden to do things they like.     

Therapy groups with patients and nursing staff in a geriatric hospital (author's transl)]

Within a very short time the non-demented, chronically hospitalized old person turns into a hospital-activity-oriented patient. He thereby gives up a considerablle part of his personality. In order to understand this process, special attention has to be paid to the intertwining of the dynamics of the chronic geriatric patient with the dynamics of the nursing staff. As a therapy experiment we have been conducting parallel talk-groups with patients and with their nursing staff for one year. As a result, the patients showed increased activity, increased dynamism, improved contact ability, increased interest in the outside world, and improved affect. The nursing staff also reported improvement of the group-patients' condition on the floor. With the nursing staff we found a reduction of the defensive mechanisms, a separation from old nursing-role definitions, acceptance and encouragement of the patients in their new role, and improved satisfaction with patient contact. On the other hand, the nursing staff expects more personal contact to come from the patients. The groups have shown to be useful and have to a large extent reached the therapy goals.     

The effects of the social security system on the life situation of old people (author's transl)]

The situation of old people is determined by the system of Social Security in a various way. A point of most importance are effects of pensions etc. on the distribution of income. It is shown, that distribution of old-age pensions follows the same scheme, which is dominating in the distribution of primary income. This is due to the basic principles of the Social Security System, which intensify inequality.     

Prophylaxis of suicide in old age (author's transl)

The author reports on sociopsychiatric care of old alone living peoples during Christmas-time and the end of year. This help of living was given under the primary aspects of suicide prevention. Nevertheless the conception of the arrangement is important for geropsychiatric prevention at all. The author gives informations about effects of this type of care. After the two weeks living in the hospital and getting special care the most of the old people looks from an active point of view to their biological and social conditions of aging, and better than before they can manage their life.     

Possibilities of rehabilitation in the geriatric hospital (author's transl)

Rehabilitation is with medicine and nursing care an inseparable part of the modern geriatrics. In opposition to other medical subjects there is no certain direction. Generally joy of life, self-confidence and independence should be the aim of geriatric rehabilitation. In the geriatric hospital a particular classification has been proved: Rehabilitation with the most serious sick, reduced and bedridden aged patient and actual rehabilitation-generally and at special diseases. A special care of the rehabilitated patients after discharge from hospital has to be wished.     

The heart of the old hemiplegic patient (author's transl)]

The heart of the old hemiplegic patient is examined as follows: 1. The preapoplectic situation of the heart which often induces in a conclusive manner the beginning of a stroke, 2. the occurrence of heart troubles with the stroke itself and 3. the influence of rehabilitation measures and the heart function. Preexistent heart troubles are very frequent (in ca. 80%). Thereby the hypertension with a left ventricular hypertrophy and later with heart failure play an important role. The stroke itself especially in subarachnoidal bleedings can cause severe electrocardiographic anomalies. The telemetric controlled heart shows specially while rehabilitation more extrasystoles and alterations of repolarisation but usually do not impair the rehabilitation. With a systematic rehabilitation (training) the heart is most favourably influenced.     

Circadian studies with young and old rats (author's transl)

8 and 28 months old, male Sprague-Dawley rats (36 animals in each group) were used to determine the rectal temperature, various organ weights (referred to the body weight and the brain weight), various blood parameters and the concentration of Ca and Mg in the plasma and the myocard as a function of the time of the day. The values were approximated to the function y = M + A cos (omega t + phi) (y = parameter value, M = mesor, mean value of the day, A = amplitude, omega = angular velocity, t = hour of the day, phi = acrophase, when y has its highest value). The approximations were significant at 6 out of 45 parameters in both groups (rectal) temperature, pancreas weight related to the body weight, leucocyte number/mm3, GPT, Mg and Ca/Mg in the plasma). 17 parameters could be approximated only at the young rats, 1 parameter only at the old animals. In some cases large age correlated alterations of the amplitude could be observed. The mesor changed only at the pancreas weight related to the body weight. The acrophase shifted only at the leucocyte number/mm3. These variations can lead to wrong interpretations when only mean values are used for age comparisons.     

Lipoprotein examination in old hyperlipemic persons (author's transl)

The fluorescence and thiobarbituric acid reaction of isolated beta lipoprotein (beta-LP) and alpha lipoprotein (alpha-LP) have been studied in young, old, and old hyperlipemic persons. Specific fluorescence showed no significant difference in the beta-LP of young and old individuals. However, the difference was signficant in the A:F 380:450 fluorescence (A= activation wavelength, F = fluorescence or emission wavelength) of the alpha-LP. On the effect of autooxidation the alpha-LP showed a significant increase in both the A:F 380:450 and the A:F 410:470 fluorescence. Absorption at 530 nm has been studied by the thiobarbituric acid (TBA) reaction. The malondialdehyde (MDA) content has been given as microgram/mg on the basis of the curve obtained by the known quantity of MDA. The MDA content of beta-LP in the young and old groups was less increased as compared to the substantial increase of alpha-LP. As opposed to results obtained in senile persons MDA increase of alpha-LP has been significant in old hyperlipemic individuals. In addition to the absorption peak at 530 nm, characteristic for MDA, a peak at 450 nm has been obtained by TBA. A yellow-brown substance associated with hyperlipemia did appear mainly in the protein fraction isolated from alpha-LP and has been named protein III. During oxidation in hydrochloric acid a yellow-brown substance appeared from protein III fraction and became unsoluble and dark brown in hyperlipemic persons. The substance was considered as a precursor of the atherofluorescent component (AFC) present in atherosclerotic aortas. The reaction in the alpha-LP, and particularly in its protein component, with MDA (originating from peroxidezed unsaturated fatty acids) leads to complexes which are, assumably, precursors of atheromatous lipid and calcium plaques.     

Heart and circulation in very old age (author's transl)

With increasing age a number of well established patho-anatomical changes take place in heart and blood vessels. We compared data from 90--100 year olds taken from the literature with results of our own investigations in 500 centenarians. Cardiac performance deteriorates in this age group but anginal attacks diminish. ECG and long term ECG investigations reveal a multitude of extrasystoles and of disturbances in impulse formation and propagation, which depend on the patient's vitality; this is also true for cardiac size. Coronary infarcts are rarely found in patients' history or ECG. Systolic blood pressure (taken from 118 centenarians) was at the upper limit of normal, diastolic BP was in the middle of the normal range (145/78 mm Hg). Cardiac polypathy (i.e., several abnormalities occurring in the same heart) demonstrated post mortem in one patient (probably the oldest patient so examined) is a small scale repetition of the polypathy of the whole organism. The increase in the number of physiological and pathological findings in single organs is a true aging process.     

Postoperative intestinal absorption in old age (author's transl)

The function of intestinal absorption was analysed in elderly patients before and after cholecystectomy by the help of the modified D-xylose-absorption test. A characteristic dependence upon the age for the process of intestinal absorption was demonstrated in the elderly not only preoperatively but also postoperatively. The effective intestinal absorption of D-xylose normalized postoperative by in freshly operated older patients more slowly than in younger ones.     

Elaboration and standardization of a series of psychometric tests for old people (author's transl)]

We had previously elaborated a series of psychometric tests for old people. The aim of this test series is to assess the effects of brain-stimulating drugs (vasodilatating drugs). A factorial analysis was then carried out which enables us to reduce the number of tests, on the one hand, and to indicate the most fundamental fields of activity in old people, on the other hand. Four factors were distinguished. They assess respectively: watchfulness, memory, fluidity, and precision in the task undertaken. These four factors are strongly correlated. This implies the presence of a general factor, close in kind to the first factor. Watchfulness, attention and concentration are, in fact, necessary but insufficient conditions for the performance of all cognitive activities. A total of 7 tests among the most representative of each factor were retained. They are described in detail: test conditions, instructions, scoring and standardization.     

Results concerning the sensitivity of old patients against digitalis (author's transl)]

It could be demonstrated that there was an age-dependent increase of digitalisintoxications in correlation with digitalisconcentrations in blood. This phenomenon can be explained with the frequently observed underweight in the senium. Some patients older than 70 years showed symptoms of intoxication in spite of a normal digitalisconcentration in serum. But the presented results did not demonstrate a significant difference between young and old patients concerning the sensitivity against digitalis. Therefore it is necessary to consider the bodyweight for digitalis therapy in older patients.