Prescribing of psychoactive drugs for chronically ill elderly patients.

The prescribing of psychoactive drugs for 1431 chronically ill elderly patients being assessed for long-term institutional or community care was surveyed. Psychoactive drugs had been prescribed for about one quarter of the patients; benzodiazepines were the most frequently prescribed group. Judging from the extensive prescribing of flurazepam and chloral hydrate, commonly used hypnotics, the main reason psychoactive drugs were prescribed was to provide night-time sedation. Antidepressants and drugs promoted as useful in improving cognitive function were infrequently prescribed. Commendable prescribing practices included the infrequent use of "cerebral vasodilators" and barbiturates. Questionable prescribing practices included the infrequent use of tricyclic antidepressants in severely depressed patients and the use of tranquilizers in patients described by their attending physician as markedly or extremely withdrawn.     

Management of confusion in elderly persons.

Confusional states in the elderly are not uncommon and demand a high level of diagnostic and therapeutic skills in the physician. An immediate requirement is to provide protection and care while the cause is being elucidated. Tranquilizing medication is useful but the dosage must be both sufficient for the patient to gain control and monitored to prevent overdosage. Confusion may be due to disorder in various body systems with effects on the brain, or to a primary brain disorder. Careful evaluation of general health and also of cognitive, affective and social factors is necessary to clarify diagnosis and management.     

Thyroid hormone status in apparently healthy elderly persons

Thyroid disorders are frequent in elderly population and difficult to recognize because of their atypical presentation, and the absence of classic signs and symptoms. Nonspecific symptoms, even in the absence of thyroid dysfunction, are common in this age group, including fatigue, anorexia, weight loss, failure to rehabilitate, and difficult to concentrate. Symptoms of aging can be confused easily with hypothyroidism. The interpretation of thyroid function tests is also cumbersome in aged individuals because of the difficulty in differentiating physiologic age-associated changes from alterations secondary to acute or chronic non-thyroidal illness. In the present study, a total 100 subjects were included. Subjects were divided into two groups: Group I - Control (n=50) and Group II - Case (n=50). Fifty apparently healthy young adults were taken as control (Group I) and 50 apparently healthy elderly subjects were included in case (Group II). Group I was subdivided into two groups- Group IA: young male (n=25) and Group IB: young female (n=25). Group II was also subdivided into two groups - Group IIA: elderly male (n=25) and Group IIB: elderly female (n=25). All the subjects were selected from the local community of Mymensingh Sadar, Mymensingh Medical College, Mymensingh and Community Based Medical College, Bangladesh, Mymensingh. In the present study, the difference of mean serum T3 concentration between Group I (control) and Group II (elderly subjects) was not found to be significant (p>0.05). Significant difference in serum TSH concentration between Group IA and Group IIA was to be found (p<0.001). The difference of mean serum T4 concentration between Group IB and Group IIB was not found significant (p>0.05). Significant difference in mean serum TSH concentration between Group IB and Group IIB was to be found (p<0.001).     

老年人餐后血脂测定及临床意义探讨

目的探讨老年人餐后血脂代谢情况及临床价值,真实反映老年人血脂代谢功能的变化,做好老年保健工作。方法对135例健康体检老年人餐前和餐后血液标本,测定TC、TG、LDL、HDL四个项目并进行对比分析。结果老年人餐后血脂高于空腹血脂,其中TG和LDL增高明显。结论老年人餐后血脂测定结果与心血管系统疾病有着重要的相关性,因此在健康体检中应重视老年人餐后血脂测定。