Pub Date : 2014-05-01DOI: 10.1017/S0959259814000057
P. Newton, R. Reeves, E. West, P. Schofield
Evidence suggests that there is a greater prevalence of pain, particularly chronic pain, in the older than in the younger population. This review looks at how dementia affects older people's ability to report pain, and indicates that pain is poorly assessed and managed in people living with dementia, in particular in care and acute settings. The review also reports findings from two recent studies looking at ways of improving the assessment and management of pain in acute settings. Multi-dimensional, patient-centred approaches to assessing and managing pain in those living with dementia are required, and future research should focus on innovative and practical approaches that can be applied in care home and acute settings.
{"title":"Patient-centred assessment and management of pain for older adults with dementia in care home and acute settings","authors":"P. Newton, R. Reeves, E. West, P. Schofield","doi":"10.1017/S0959259814000057","DOIUrl":"https://doi.org/10.1017/S0959259814000057","url":null,"abstract":"Evidence suggests that there is a greater prevalence of pain, particularly chronic pain, in the older than in the younger population. This review looks at how dementia affects older people's ability to report pain, and indicates that pain is poorly assessed and managed in people living with dementia, in particular in care and acute settings. The review also reports findings from two recent studies looking at ways of improving the assessment and management of pain in acute settings. Multi-dimensional, patient-centred approaches to assessing and managing pain in those living with dementia are required, and future research should focus on innovative and practical approaches that can be applied in care home and acute settings.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"24 1","pages":"139-144"},"PeriodicalIF":0.0,"publicationDate":"2014-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259814000057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57030282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-01DOI: 10.1017/S0959259813000208
T. Levett, Julie Wright, M. Fisher
The transformation of human immunodeficiency virus (HIV) from a rapidly fatal disease to a chronic manageable illness has resulted in annual increases in the numbers of people living with HIV. The HIV cohort is therefore ageing, with numbers of older adults with HIV climbing, through both prolonged survival and late acquisition of the disease. Associated with ageing is an accumulation of HIV-associated non-AIDS related co-morbidities, creating a complex patient group affected by multi-morbidity along with polypharmacy, functional decline and complex social issues. With this in mind, this review seeks to explore areas where HIV (diagnosed or undetected) may impact on the work of clinical geriatricians.
{"title":"HIV and ageing: what the geriatrician needs to know","authors":"T. Levett, Julie Wright, M. Fisher","doi":"10.1017/S0959259813000208","DOIUrl":"https://doi.org/10.1017/S0959259813000208","url":null,"abstract":"The transformation of human immunodeficiency virus (HIV) from a rapidly fatal disease to a chronic manageable illness has resulted in annual increases in the numbers of people living with HIV. The HIV cohort is therefore ageing, with numbers of older adults with HIV climbing, through both prolonged survival and late acquisition of the disease. Associated with ageing is an accumulation of HIV-associated non-AIDS related co-morbidities, creating a complex patient group affected by multi-morbidity along with polypharmacy, functional decline and complex social issues. With this in mind, this review seeks to explore areas where HIV (diagnosed or undetected) may impact on the work of clinical geriatricians.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"24 1","pages":"10-24"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-01DOI: 10.1017/S0959259813000245
Gemma Wright
{"title":"Urinary incontinence in older women: a review of conservative therapeutic interventions","authors":"Gemma Wright","doi":"10.1017/S0959259813000245","DOIUrl":"https://doi.org/10.1017/S0959259813000245","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"134 1","pages":"93-104"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57030397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-01DOI: 10.1017/S0959259813000191
C. McEvoy, C. Neville, N. Temple, J. Woodside
Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the Western world in older people. Diet and lifestyle change can reduce CVD risk in older people, and this evidence base is reviewed. For example, diets low in trans fats can reduce CVD risk, while for saturated fats the CVD-lowering effect depends on what is substituted for the saturated fat. Diets rich in fish reduce CVD risk, although n-3 supplements have not been shown to have a consistent effect on CVD end-points. Antioxidant and B-group vitamin supplementation are unlikely to reduce CVD risk, but diets rich in these micronutrients (e.g. rich in fruits and vegetables and the Mediterranean diet) are associated with lower CVD risk, while, for the Mediterranean diet, this has been supported by randomized controlled trials. Maintaining a healthy weight and being physically active reduce CVD risk factors and CVD incidence and mortality.
{"title":"Effect of diet on vascular health","authors":"C. McEvoy, C. Neville, N. Temple, J. Woodside","doi":"10.1017/S0959259813000191","DOIUrl":"https://doi.org/10.1017/S0959259813000191","url":null,"abstract":"Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the Western world in older people. Diet and lifestyle change can reduce CVD risk in older people, and this evidence base is reviewed. For example, diets low in trans fats can reduce CVD risk, while for saturated fats the CVD-lowering effect depends on what is substituted for the saturated fat. Diets rich in fish reduce CVD risk, although n-3 supplements have not been shown to have a consistent effect on CVD end-points. Antioxidant and B-group vitamin supplementation are unlikely to reduce CVD risk, but diets rich in these micronutrients (e.g. rich in fruits and vegetables and the Mediterranean diet) are associated with lower CVD risk, while, for the Mediterranean diet, this has been supported by randomized controlled trials. Maintaining a healthy weight and being physically active reduce CVD risk factors and CVD incidence and mortality.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"24 1","pages":"25-40"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-01DOI: 10.1017/S095925981300018X
D. Shipway, D. Harari, J. Dhesi
{"title":"Peri-operative management of older people undergoing surgery","authors":"D. Shipway, D. Harari, J. Dhesi","doi":"10.1017/S095925981300018X","DOIUrl":"https://doi.org/10.1017/S095925981300018X","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"24 1","pages":"78-92"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S095925981300018X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-02-01DOI: 10.1017/S0959259813000233
J. Desborough, M. Twigg
Medication reviews in primary care are now an established and important part of the care of patients on multiple medications. In the current NHS this review has demonstrated that pharmacist-led medication reviews can reduce inappropriate prescribing and offer an efficient approach to ensuring reviews are completed. These reviews appear best operationalized with experienced pharmacists who are closely aligned with the patients and prescribers through joined up services. Further developments in pharmacists’ communication skills with patient and prescribers may offer greater benefits in the future.
{"title":"Pharmacist-led medication reviews in primary care","authors":"J. Desborough, M. Twigg","doi":"10.1017/S0959259813000233","DOIUrl":"https://doi.org/10.1017/S0959259813000233","url":null,"abstract":"Medication reviews in primary care are now an established and important part of the care of patients on multiple medications. In the current NHS this review has demonstrated that pharmacist-led medication reviews can reduce inappropriate prescribing and offer an efficient approach to ensuring reviews are completed. These reviews appear best operationalized with experienced pharmacists who are closely aligned with the patients and prescribers through joined up services. Further developments in pharmacists’ communication skills with patient and prescribers may offer greater benefits in the future.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"24 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57030268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-06DOI: 10.1017/S0959259813000129
J. Yates, L. Clare, R. Woods
Summary This systematic review, with meta-analyses conducted where data were available, aimed to investigate the prevalence of symptoms of depression and anxiety in mild cognitive impairment (MCI), and to establish how symptoms of depression and anxiety relate to the progression from no cognitive impairment to MCI, and from MCI to dementia. Sixty studies were included in the review. Meta-analyses indicated that symptoms of depression and anxiety were more prevalent in people with MCI than in people with normal cognitive function, and increased the risk of progression from no cognitive impairment to MCI. There were mixed results regarding the effect of such symptoms on progression from MCI to dementia. The findings highlight the need for more research in this area, which can inform attempts to slow or halt the progression of cognitive impairment in later life, with resulting benefits for quality of life.
{"title":"Mild cognitive impairment and mood: a systematic review","authors":"J. Yates, L. Clare, R. Woods","doi":"10.1017/S0959259813000129","DOIUrl":"https://doi.org/10.1017/S0959259813000129","url":null,"abstract":"Summary This systematic review, with meta-analyses conducted where data were available, aimed to investigate the prevalence of symptoms of depression and anxiety in mild cognitive impairment (MCI), and to establish how symptoms of depression and anxiety relate to the progression from no cognitive impairment to MCI, and from MCI to dementia. Sixty studies were included in the review. Meta-analyses indicated that symptoms of depression and anxiety were more prevalent in people with MCI than in people with normal cognitive function, and increased the risk of progression from no cognitive impairment to MCI. There were mixed results regarding the effect of such symptoms on progression from MCI to dementia. The findings highlight the need for more research in this area, which can inform attempts to slow or halt the progression of cognitive impairment in later life, with resulting benefits for quality of life.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"317-356"},"PeriodicalIF":0.0,"publicationDate":"2013-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-01DOI: 10.1017/S0959259813000178
M. Aurora Viloria Jiménez, Mónica Chung Jaén, Marta Vigara García, Helena Barahona‐Alvarez
Dementia is a syndrome characterized by a progressive impairment in cognition, function and behaviour, with a considerable burden in terms of health and social care, and economic costs. As Alzheimer's disease and other dementias advance, the patient's capacity, competence and possibility of participation in decision-making decrease. Key points in managing people with dementia include screening of cognitive impairment, neuropsychological assessment, laboratory tests and neuroimaging, genetic tests, informed consent, inclusion in clinical trials and discussion of advance directives, driving, managing finances and testamentary capacity, pharmolocogical and non-pharmacological treatment and also palliative and end-of-life care. In this article we review these crucial points in decision-making for people with dementia and their families and caregivers.
{"title":"Decision-making in older people with dementia","authors":"M. Aurora Viloria Jiménez, Mónica Chung Jaén, Marta Vigara García, Helena Barahona‐Alvarez","doi":"10.1017/S0959259813000178","DOIUrl":"https://doi.org/10.1017/S0959259813000178","url":null,"abstract":"Dementia is a syndrome characterized by a progressive impairment in cognition, function and behaviour, with a considerable burden in terms of health and social care, and economic costs. As Alzheimer's disease and other dementias advance, the patient's capacity, competence and possibility of participation in decision-making decrease. Key points in managing people with dementia include screening of cognitive impairment, neuropsychological assessment, laboratory tests and neuroimaging, genetic tests, informed consent, inclusion in clinical trials and discussion of advance directives, driving, managing finances and testamentary capacity, pharmolocogical and non-pharmacological treatment and also palliative and end-of-life care. In this article we review these crucial points in decision-making for people with dementia and their families and caregivers.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"307-316"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-01DOI: 10.1017/S0959259813000142
C. Fernández-Alonso, F. Martín-Sánchez
Emergency care of elderly patients is frequent and complex in the emergency department. Frail older patients have a high risk of poor short-term results following emergency care. There is no practical universal or standardized tool defining frailty. It must be systematically identified in older patients at risk using a screening test, and in those who are positive, a diagnostic scale of frailty or preferably a geriatric scale adapted to emergency care is carried out. An adapted geriatric assessment including brief scales related to clinical, mental, functional and social aspects has been proposed. There are currently no geriatric intervention models with sufficient evidence in frail older patients.
{"title":"Geriatric assessment in frail older patients in the emergency department","authors":"C. Fernández-Alonso, F. Martín-Sánchez","doi":"10.1017/S0959259813000142","DOIUrl":"https://doi.org/10.1017/S0959259813000142","url":null,"abstract":"Emergency care of elderly patients is frequent and complex in the emergency department. Frail older patients have a high risk of poor short-term results following emergency care. There is no practical universal or standardized tool defining frailty. It must be systematically identified in older patients at risk using a screening test, and in those who are positive, a diagnostic scale of frailty or preferably a geriatric scale adapted to emergency care is carried out. An adapted geriatric assessment including brief scales related to clinical, mental, functional and social aspects has been proposed. There are currently no geriatric intervention models with sufficient evidence in frail older patients.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"275-282"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-01DOI: 10.1017/S0959259813000117
M. Valencia, E. Calvo
Shoulder disorders are very common in the older population. These can be traumatic injuries such as proximal humerus fractures, or degenerative pathology, with rotator cuff disease being the most frequently diagnosed. Lower functional demands along with the presence of co-morbidities means that conservative management is usual. However, surgery can provide pain relief and improve functional outcomes in selected patients. A thorough pre-operative assessment should be performed to avoid surgical or post-operative complications. Osteoporosis is the major concern when undertaking bone fixation in orthopaedic implants and should be routinely ruled out and treated in order to achieve better results.
{"title":"Shoulder surgery in older patients: recommendations and techniques","authors":"M. Valencia, E. Calvo","doi":"10.1017/S0959259813000117","DOIUrl":"https://doi.org/10.1017/S0959259813000117","url":null,"abstract":"Shoulder disorders are very common in the older population. These can be traumatic injuries such as proximal humerus fractures, or degenerative pathology, with rotator cuff disease being the most frequently diagnosed. Lower functional demands along with the presence of co-morbidities means that conservative management is usual. However, surgery can provide pain relief and improve functional outcomes in selected patients. A thorough pre-operative assessment should be performed to avoid surgical or post-operative complications. Osteoporosis is the major concern when undertaking bone fixation in orthopaedic implants and should be routinely ruled out and treated in order to achieve better results.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"295-306"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：