Geriatrics
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.
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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:
- It may moderately reduce the pain in your knee.
- Consider the cost.
- Try a variety of therapies before you settle on one.
- 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.