Help or Hurt: Steroids, Human Growth Hormone for Elderly Hip and Knee Patients

  • Anabolic steroids and human growth hormone help people build muscle.
  • Could these drugs benefit some of your older hip and knee arthroplasty patients?
  • The drugs carry some risks of heart and bone disease.
  • Do these risks outweigh the risk of weakness and immobility?

What’s More Deadly than Smoking, Alcoholism, or Obesity?

  • Having social connections improves peoples’ odds of survival by 50% on average.
  • Living alone increased the likelihood of mortality the most, 32%, while social isolation raised the risk by 29% and loneliness by 26%.
  • Simply living with someone else increased survival by nearly 20%.
  • Extensive social integration nearly doubled the odds of survival.

Falls Increasingly Lead to Death in Older Americans

  • In 2012, there were 24,190 fatal and 3.2 million medically treated non-fatal fall related injuries.
  • Direct medical costs totaled $616.5 million for fatal and $30.3 billion for non-fatal injuries in 2012 and rose to $637.5 million and $31.3 billion, respectively, in 2015
  • During 2014, approximately 27,000 older adults died because of falls; 2.8 million were treated in emergency departments for fall-related injuries, and approximately 800,000 of these patients were subsequently hospitalized
  • The projected 2030 population would result in an estimated 48.8 million falls and 11.9 million fall injuries.

Exercise Benefits Patients with Memory Loss – For As Long As the Exercise is Continued

  • People who exercised showed cognitive improvement compared with those who didn't exercise.
  • Researchers found a time threshold for exercise efficacy in cognitive improvement.
  • All study patients showed mental decline caused by mild subcortical ischemic vascular cognitive impairment.

A 70-Year-Old Female Presents with Epistaxis, Fatigue, and Weight Loss.

An initial blood test reveals renal impairment and a serum calcium level of 13 mg/dL. An X-ray of her skull demonstrates numerous lytic lesions and a bone marrow biopsy is performed. What findings would you expect to see in this patient’s bone marrow aspirate?
(Image credit: @Lucy_A.)

Click here for answers to this clinical conundrum

Visit Figure 1 for more medical images and information.

Cochrane Analysis Finds Older NSCLC Pts Benefit from Chemo

  • Approximately 50% of NSCLC cases occur in patients aged ≥70 years.
  • Patients aged ≥70 years with non-small cell lung cancer can benefit from both platinum and non-platinum-based chemotherapy.
  • The increased survival rates that result from treatment with these regimens must be balanced against the higher the risk of major adverse events.
  • Older patients benefit from both platinum and non-platinum regimens.

Perceived Stress Increases Dementia Risk in Elderly

  • Highly stressed participants were 30% more likely to develop Alzheimer disease than those who were not stressed.
  • Study linked stress later in life with mild cognitive impairment, which can often progress to Alzheimer disease.
  • The good news is that perceived stress can be effectively treated with a number of modalities.
  • Study included more than 500 patients of which about 70 were diagnosed with amnestic mild cognitive impairment during the study.
  • Approximately 470,000 Americans are diagnosed with Alzheimer disease annually, according to the Centers for Disease Control and Prevention.

Chondroitin Offers Moderate Benefit in Osteoarthritis, According to Meta-Analysis

When a patient asks whether it makes sense to use chondroitin for osteoarthritis, the following are appropriate responses:

  1. It may moderately reduce the pain in your knee.
  2. Consider the cost.
  3. Try a variety of therapies before you settle on one.
  4. Over-the-counter analgesics can also be effective, as can physical therapy, weight loss, and exercise.

Pressure Ulcers Are Painful, Dangerous, Costly, and Preventable

  • Pressure ulcers are common throughout the world.
  • Many different types of pressure wounds and treatments exist.
  • The annual cost of pressure ulcers in the U.S. is about $11 billion.
  • Pressure ulcers are easily prevented.
  • Prevention is much less costly than treatment.

Can Feeling Younger Help Your Patients Live Longer?

  • Self-perception of young was linked to lower mortality rates among older adults.
  • Can you teach your patients to feel younger and live longer?
  • Help your patients feel younger and they’ll live longer.
  • Teach your patients the value of youthful active.

What to Tell Patients about Vitamin D

  • According to Institute of Medicine report, vitamin D supplementation does have some health benefits in adults.
  • No change in recommended RDA since 2010 report.
  • Deficiency associated with significantly increased risk of stroke or myocardial infarction.
  • Problems have been identified with tested supplements often not containing any vitamin D.

JAMA Study Finds Cochlear Implants Improve Cognition in Elderly Patients

  • Elderly patients aged 65 to 94 years experienced improved speech perception.
  • Study included 94 patients, 81% of whom showed improved cognitive abilities following implantation.
  • Benefits were observable beginning at six months postop.

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