Pub Date : 2013-05-01DOI: 10.1017/S095925981300004X
R. Payne, D. Forde, A. Vedio, A. Cope, G. Pratt, A. Tunbridge
{"title":"‘It's just a virus’ – viral illness in older people: prevention and management","authors":"R. Payne, D. Forde, A. Vedio, A. Cope, G. Pratt, A. Tunbridge","doi":"10.1017/S095925981300004X","DOIUrl":"https://doi.org/10.1017/S095925981300004X","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"131-141"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S095925981300004X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029180","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 : 2013-05-01DOI: 10.1017/S0959259812000226
D. Monkhouse
As the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.
{"title":"Advances in critical care for the older patient","authors":"D. Monkhouse","doi":"10.1017/S0959259812000226","DOIUrl":"https://doi.org/10.1017/S0959259812000226","url":null,"abstract":"As the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"118-130"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57029009","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 : 2013-05-01DOI: 10.1017/S0959259813000038
H. Slater, John B. Young
There is a rising prevalence of dementia in line with the continuing demographic transition. More timely diagnosis of dementia is recommended. Brief cognitive tests are useful as they provide a rapid assessment that can indicate the possibility of dementia and identify people for detailed cognitive assessment. Many brief cognitive tests have been developed and practitioners need information in order to select a test that performs well, is acceptable to patients, and is suitable for the relevant care setting. In a structured review, we identified twelve brief cognitive impairment tests, of which six have been sufficiently studied and can be recommended for use in routine care.
{"title":"A review of brief cognitive assessment tests","authors":"H. Slater, John B. Young","doi":"10.1017/S0959259813000038","DOIUrl":"https://doi.org/10.1017/S0959259813000038","url":null,"abstract":"There is a rising prevalence of dementia in line with the continuing demographic transition. More timely diagnosis of dementia is recommended. Brief cognitive tests are useful as they provide a rapid assessment that can indicate the possibility of dementia and identify people for detailed cognitive assessment. Many brief cognitive tests have been developed and practitioners need information in order to select a test that performs well, is acceptable to patients, and is suitable for the relevant care setting. In a structured review, we identified twelve brief cognitive impairment tests, of which six have been sufficiently studied and can be recommended for use in routine care.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"164-176"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259813000038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028783","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 : 2013-05-01DOI: 10.1017/S0959259812000238
N. Piller
The lymphatic system must have variation in tissue pressure to load it and to help flow. Being a low pressure system, external pressure must not be constantly high on any segment and there must be a pressure gradient along it. When the flow rate of lymph fails there can be compromised immunity, a tendency to deposit fat, fibrotic induration, and a vicious cycle of worsening of cellular and organ health often associated with recurrent infection. As we age we become less active, lose muscle tone, and increase our weight, develop a higher percentage of body fat, and may have poor skin care and be prescribed medications which impact on lymphatic load. Combined with this, the tendency to immobility, limb dependency and periods of time when high external pressures exist in small superficial areas increase the risk of or contribute to lymphoedema through reducing lymphatic flow. Older people are more likely to have had more radical surgery and radiotherapy for cancer with more significant damage to their lymphatic systems, again adding to lymphoedema risk. Immobility, hypertension, venous disease, kidney and liver failure can lead to oedema, while thyroid dysfunction can cause myxedema, and genetic or metabolic issues can cause lipoedema, compounding the clinical problems. A key point in good management is early identification and accurate diagnosis. Ideally, other issues that especially impact on lymphatic load should be managed prior to targeted and sequenced treatment for the swelling, with the aim being to improve patient comfort. Management can involve the patient, partner, family or carer as well as a range of health professionals to help reduce or maintain limb size, appearance and function as well as reduce symptoms of heaviness, tension and discomfort and a range of other issues that impact on quality of life and activities of living.
{"title":"Lymphoedema: causes, prevention and management in older people","authors":"N. Piller","doi":"10.1017/S0959259812000238","DOIUrl":"https://doi.org/10.1017/S0959259812000238","url":null,"abstract":"The lymphatic system must have variation in tissue pressure to load it and to help flow. Being a low pressure system, external pressure must not be constantly high on any segment and there must be a pressure gradient along it. When the flow rate of lymph fails there can be compromised immunity, a tendency to deposit fat, fibrotic induration, and a vicious cycle of worsening of cellular and organ health often associated with recurrent infection. As we age we become less active, lose muscle tone, and increase our weight, develop a higher percentage of body fat, and may have poor skin care and be prescribed medications which impact on lymphatic load. Combined with this, the tendency to immobility, limb dependency and periods of time when high external pressures exist in small superficial areas increase the risk of or contribute to lymphoedema through reducing lymphatic flow. Older people are more likely to have had more radical surgery and radiotherapy for cancer with more significant damage to their lymphatic systems, again adding to lymphoedema risk. Immobility, hypertension, venous disease, kidney and liver failure can lead to oedema, while thyroid dysfunction can cause myxedema, and genetic or metabolic issues can cause lipoedema, compounding the clinical problems. A key point in good management is early identification and accurate diagnosis. Ideally, other issues that especially impact on lymphatic load should be managed prior to targeted and sequenced treatment for the swelling, with the aim being to improve patient comfort. Management can involve the patient, partner, family or carer as well as a range of health professionals to help reduce or maintain limb size, appearance and function as well as reduce symptoms of heaviness, tension and discomfort and a range of other issues that impact on quality of life and activities of living.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"142-154"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028586","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 : 2013-02-01DOI: 10.1017/S0959259812000196
R. Ward, S. Manchip
Human sexuality is a complex interaction of biological, social and emotional factors. When any or all of these factors are disrupted by a progressive dementia it is unsurprising that sexual ‘problems’ are identified. Most sexual behaviour ‘problems’ relate to expressions of normal sexuality complicated by changes in relationships, care needs and cognitive function, and complex ethical and legal considerations emerge. Rarely, new and severe hypersexual or paraphilic behaviours arise de novo , usually due to damage to certain brain areas, and sometimes due to medication side-effects, psychiatric disorder or delirium. Evidence and approaches to assess and to manage sexual behaviour problems in dementia are discussed.
{"title":"‘Inappropriate’ sexual behaviours in dementia","authors":"R. Ward, S. Manchip","doi":"10.1017/S0959259812000196","DOIUrl":"https://doi.org/10.1017/S0959259812000196","url":null,"abstract":"Human sexuality is a complex interaction of biological, social and emotional factors. When any or all of these factors are disrupted by a progressive dementia it is unsurprising that sexual ‘problems’ are identified. Most sexual behaviour ‘problems’ relate to expressions of normal sexuality complicated by changes in relationships, care needs and cognitive function, and complex ethical and legal considerations emerge. Rarely, new and severe hypersexual or paraphilic behaviours arise de novo , usually due to damage to certain brain areas, and sometimes due to medication side-effects, psychiatric disorder or delirium. Evidence and approaches to assess and to manage sexual behaviour problems in dementia are discussed.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"75-87"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028813","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 : 2013-02-01DOI: 10.1017/S0959259812000214
K. Chen, P. Yesudian
Pruritus in older people is caused by a wide range of dermatological, systemic, neurological and psychogenic diseases. It can also be attributed to various cutaneous drug reactions. The dermatological, neurological and immunological changes associated with ageing predispose older people to pruritus of a wide range of aetiologies. The most common cause of pruritus in older people is xerosis, or dry skin. Regular use of emollients is the mainstay of treatment for pruritus of any cause, with general measures aiming to ensure optimal skin hydration and to prevent the itch–scratch cycle. Topical treatments are generally better tolerated for localized pruritus. Anti-histamines are the predominant agents to treat pruritus, but can be inadequate in many cases. Numerous other systemic agents have been demonstrated to alleviate pruritus depending on the cause, but may be limited by their adverse effects. This article reviews the current published literature on pruritus in older people, with a practical approach to its evaluation and management in non-specialist settings.
{"title":"Pruritus in older people","authors":"K. Chen, P. Yesudian","doi":"10.1017/S0959259812000214","DOIUrl":"https://doi.org/10.1017/S0959259812000214","url":null,"abstract":"Pruritus in older people is caused by a wide range of dermatological, systemic, neurological and psychogenic diseases. It can also be attributed to various cutaneous drug reactions. The dermatological, neurological and immunological changes associated with ageing predispose older people to pruritus of a wide range of aetiologies. The most common cause of pruritus in older people is xerosis, or dry skin. Regular use of emollients is the mainstay of treatment for pruritus of any cause, with general measures aiming to ensure optimal skin hydration and to prevent the itch–scratch cycle. Topical treatments are generally better tolerated for localized pruritus. Anti-histamines are the predominant agents to treat pruritus, but can be inadequate in many cases. Numerous other systemic agents have been demonstrated to alleviate pruritus depending on the cause, but may be limited by their adverse effects. This article reviews the current published literature on pruritus in older people, with a practical approach to its evaluation and management in non-specialist settings.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028922","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 : 2013-02-01DOI: 10.1017/S0959259812000159
S. Robinson, R. McLoughlin, S. O’Keeffe
{"title":"Coeliac disease in the older person","authors":"S. Robinson, R. McLoughlin, S. O’Keeffe","doi":"10.1017/S0959259812000159","DOIUrl":"https://doi.org/10.1017/S0959259812000159","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"32-42"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028649","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 : 2013-02-01DOI: 10.1017/S0959259812000160
Azhaar Ashraf, P. Mehta, P. Edison
A major advancement in the field of medicine has been the timely advent of amyloid imaging, which has allowed critical evaluation of the complex relationship between amyloid β peptide (Aβ) aggregation and Alzheimer's disease in vivo . Most importantly, amyloid imaging has the potential to detect Aβ in mildly affected as well as asymptomatic individuals, when the therapeutic window of opportunity might still be open to pharmacological intervention. It also shows significant promise in differential diagnosis of mild cognitive impairment or atypical dementias. Amyloid imaging studies support a model in which amyloid aggregation is considered an early event on the path of dementia, beginning insidiously in cognitively healthy individuals being accompanied by subtle cognitive, functional and structural brain alterations suggestive of incipient AD. As individuals progress to dementia, clinical decline and neurodegeneration accelerate and might proceed independently of amyloid accumulation. In this review we focus on amyloid imaging with particular emphasis on [ 11 C]PIB in AD, mild cognitive impairment and other dementias, and discuss the advances made in this perplexing field.
{"title":"Amyloid imaging in dementia","authors":"Azhaar Ashraf, P. Mehta, P. Edison","doi":"10.1017/S0959259812000160","DOIUrl":"https://doi.org/10.1017/S0959259812000160","url":null,"abstract":"A major advancement in the field of medicine has been the timely advent of amyloid imaging, which has allowed critical evaluation of the complex relationship between amyloid β peptide (Aβ) aggregation and Alzheimer's disease in vivo . Most importantly, amyloid imaging has the potential to detect Aβ in mildly affected as well as asymptomatic individuals, when the therapeutic window of opportunity might still be open to pharmacological intervention. It also shows significant promise in differential diagnosis of mild cognitive impairment or atypical dementias. Amyloid imaging studies support a model in which amyloid aggregation is considered an early event on the path of dementia, beginning insidiously in cognitively healthy individuals being accompanied by subtle cognitive, functional and structural brain alterations suggestive of incipient AD. As individuals progress to dementia, clinical decline and neurodegeneration accelerate and might proceed independently of amyloid accumulation. In this review we focus on amyloid imaging with particular emphasis on [ 11 C]PIB in AD, mild cognitive impairment and other dementias, and discuss the advances made in this perplexing field.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"43-60"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028655","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 : 2013-02-01DOI: 10.1017/S0959259812000184
Yu Chen, A. Hicks, A. While
{"title":"Quality of life of older people in China: A systematic review","authors":"Yu Chen, A. Hicks, A. While","doi":"10.1017/S0959259812000184","DOIUrl":"https://doi.org/10.1017/S0959259812000184","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"6 1","pages":"88-100"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028741","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 : 2013-02-01DOI: 10.1017/S0959259812000202
R. Mappilakkandy, I. Edwards
{"title":"Update on syncope in the older person – a clinical review","authors":"R. Mappilakkandy, I. Edwards","doi":"10.1017/S0959259812000202","DOIUrl":"https://doi.org/10.1017/S0959259812000202","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"23 1","pages":"15-31"},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028839","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}
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