Pub Date : 2012-11-01DOI: 10.1017/S0959259812000093
G. Macphee, D. Stewart
This review on Parkinson's disease (PD) considers pharmacological and surgical management and important non-motor symptoms (NMS) such as depression, dementia and sleep disorder. In the absence of a proven neuroprotective drug, therapy remains symptomatic and may be initiated with levodopa or a dopamine agonist or a monoamine oxidase inhibitor. Treatment should be tailored to the individual patient, with patient preference, extent of functional impairment and co-morbidity more important than age per se . As disease progresses, therapy usually becomes more complex and apomorphine, duodopa and surgical intervention may be useful. NMS may be present at any stage of illness but become more common in severity and frequency with advanced disease, when neuropsychiatric features such as dementia and psychosis dominate the clinical picture. NMS are often unrecognized and undeclared by patients and carers in clinic. Novel agents for treating non-motor features, which are often poorly responsive to dopaminergic therapy, are urgently required.
{"title":"Parkinson's disease: treatment and non-motor features","authors":"G. Macphee, D. Stewart","doi":"10.1017/S0959259812000093","DOIUrl":"https://doi.org/10.1017/S0959259812000093","url":null,"abstract":"This review on Parkinson's disease (PD) considers pharmacological and surgical management and important non-motor symptoms (NMS) such as depression, dementia and sleep disorder. In the absence of a proven neuroprotective drug, therapy remains symptomatic and may be initiated with levodopa or a dopamine agonist or a monoamine oxidase inhibitor. Treatment should be tailored to the individual patient, with patient preference, extent of functional impairment and co-morbidity more important than age per se . As disease progresses, therapy usually becomes more complex and apomorphine, duodopa and surgical intervention may be useful. NMS may be present at any stage of illness but become more common in severity and frequency with advanced disease, when neuropsychiatric features such as dementia and psychosis dominate the clinical picture. NMS are often unrecognized and undeclared by patients and carers in clinic. Novel agents for treating non-motor features, which are often poorly responsive to dopaminergic therapy, are urgently required.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"243-260"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028253","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 : 2012-11-01DOI: 10.1017/S095925981200010X
W. Heuvel
The increasing number of old people is becoming a growing policy concern. Negative attitudes towards old people raise questions about the extent to which discrimination against old people exists and elder abuse occurs. This paper describes the occurrence of discrimination against old people and elder abuse, as well as the factors related to it, based on a review of (scientific) literature, official documents and the actions of legal bodies. Frequent or regular age discrimination, as experienced by old people themselves, is reported by a quarter of European citizens. Data on elder abuse vary and are often not representative; the same goes for data on inequality. Nevertheless, the analysis shows that discrimination against old age and elder abuse occurs regularly in the ‘western world’. Vulnerable old people are especially at risk. National and regional, multi-component action plans are recommended to combat discrimination against old people.
{"title":"Discrimination against older people","authors":"W. Heuvel","doi":"10.1017/S095925981200010X","DOIUrl":"https://doi.org/10.1017/S095925981200010X","url":null,"abstract":"The increasing number of old people is becoming a growing policy concern. Negative attitudes towards old people raise questions about the extent to which discrimination against old people exists and elder abuse occurs. This paper describes the occurrence of discrimination against old people and elder abuse, as well as the factors related to it, based on a review of (scientific) literature, official documents and the actions of legal bodies. Frequent or regular age discrimination, as experienced by old people themselves, is reported by a quarter of European citizens. Data on elder abuse vary and are often not representative; the same goes for data on inequality. Nevertheless, the analysis shows that discrimination against old age and elder abuse occurs regularly in the ‘western world’. Vulnerable old people are especially at risk. National and regional, multi-component action plans are recommended to combat discrimination against old people.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"293-300"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S095925981200010X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028291","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 : 2012-11-01DOI: 10.1017/S0959259812000135
Abhaya R. Gupta
Published literature shows that evidence-based medical care can improve hip fracture outcomes. The orthogeriatrician plays a key role in providing this care, in collaboration with surgical and multidisciplinary professionals, managing pre-operative conditions and post-operative complications that may affect functional recovery, and ensuring co-ordinated effective management of hip fractures right from admission to discharge. Several management guidelines are available for this vulnerable group of elderly patients. Recent UK guidelines recommend that, from time of admission, hip fracture patients should be offered a formal acute orthogeriatric or orthopaedic ward-based ‘Hip Fracture Programme’, which includes orthogeriatric assessment as an essential key component.
{"title":"Medical management of hip fractures and the role of the orthogeriatrician","authors":"Abhaya R. Gupta","doi":"10.1017/S0959259812000135","DOIUrl":"https://doi.org/10.1017/S0959259812000135","url":null,"abstract":"Published literature shows that evidence-based medical care can improve hip fracture outcomes. The orthogeriatrician plays a key role in providing this care, in collaboration with surgical and multidisciplinary professionals, managing pre-operative conditions and post-operative complications that may affect functional recovery, and ensuring co-ordinated effective management of hip fractures right from admission to discharge. Several management guidelines are available for this vulnerable group of elderly patients. Recent UK guidelines recommend that, from time of admission, hip fracture patients should be offered a formal acute orthogeriatric or orthopaedic ward-based ‘Hip Fracture Programme’, which includes orthogeriatric assessment as an essential key component.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"261-273"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028312","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 : 2012-11-01DOI: 10.1017/S0959259812000147
J. Holder, D. Jolley
That transfer of older people from one institution to another is detrimental to well-being, health and survival has been reported for 50 years. This has led to fear, anger and legal challenges when closures occur. Previous reviews identified accounts of relocation followed by adverse outcomes and others where problems were avoided or benefits claimed. This paper reviews the last twelve years of literature on health outcomes following involuntary relocation between nursing homes. Reports of post-move mortality, physical or psychological health suggest and confirm that relocation without preparation carries higher risk of poor outcomes than moves that are orderly and include preparation. The literature on the care home closure process, admissions and individual transfers offers insights into practices that might help minimize adverse outcomes. A number of agencies have produced helpful guidelines. How these are implemented needs to be monitored and linked to in-depth studies of sample closures.
{"title":"Forced relocation between nursing homes: residents' health outcomes and potential moderators","authors":"J. Holder, D. Jolley","doi":"10.1017/S0959259812000147","DOIUrl":"https://doi.org/10.1017/S0959259812000147","url":null,"abstract":"That transfer of older people from one institution to another is detrimental to well-being, health and survival has been reported for 50 years. This has led to fear, anger and legal challenges when closures occur. Previous reviews identified accounts of relocation followed by adverse outcomes and others where problems were avoided or benefits claimed. This paper reviews the last twelve years of literature on health outcomes following involuntary relocation between nursing homes. Reports of post-move mortality, physical or psychological health suggest and confirm that relocation without preparation carries higher risk of poor outcomes than moves that are orderly and include preparation. The literature on the care home closure process, admissions and individual transfers offers insights into practices that might help minimize adverse outcomes. A number of agencies have produced helpful guidelines. How these are implemented needs to be monitored and linked to in-depth studies of sample closures.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"301-319"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028316","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 : 2012-11-01DOI: 10.1017/S0959259812000111
Katharine Cm Nash
The proportion of older people becoming frail will increase with the expanding older population. Apart from poor health, frailty is associated with loss of strength and functional dependency. Building on previous work in this area, this review investigates the effectiveness, sustainability and adverse effects of exercise interventions on muscle strength and physical performance in frail older people. Randomized controlled trials reporting physical outcomes in frail older people were identified from seven electronic databases. Thirteen trials involving 1652 participants met the inclusion criteria. There was wide heterogeneity in degree of frailty, types of intervention, outcome measures and results. However, evidence from this review suggests that exercise and some physical activity programmes, particularly moderate intensity and multi-component programmes, are safe and can improve strength and function in the majority of frail older people except highly frail individuals with multiple co-morbidities. There was limited evidence on transferability of improvements into everyday life, and sustainability could not be determined.
{"title":"The effects of exercise on strength and physical performance in frail older people: a systematic review","authors":"Katharine Cm Nash","doi":"10.1017/S0959259812000111","DOIUrl":"https://doi.org/10.1017/S0959259812000111","url":null,"abstract":"The proportion of older people becoming frail will increase with the expanding older population. Apart from poor health, frailty is associated with loss of strength and functional dependency. Building on previous work in this area, this review investigates the effectiveness, sustainability and adverse effects of exercise interventions on muscle strength and physical performance in frail older people. Randomized controlled trials reporting physical outcomes in frail older people were identified from seven electronic databases. Thirteen trials involving 1652 participants met the inclusion criteria. There was wide heterogeneity in degree of frailty, types of intervention, outcome measures and results. However, evidence from this review suggests that exercise and some physical activity programmes, particularly moderate intensity and multi-component programmes, are safe and can improve strength and function in the majority of frail older people except highly frail individuals with multiple co-morbidities. There was limited evidence on transferability of improvements into everyday life, and sustainability could not be determined.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"274-285"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028297","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 : 2012-08-01DOI: 10.1017/S0959259812000081
E. Tullo, J. Newton, A. Clapp
The expansion of e-learning in medical education is a reflection of the inherent advantages that technology can bring to teaching and learning. Geriatric medicine has taken advantage of some of the benefits associated with e-learning in terms of undergraduate education, specialty training and interdisciplinary training. However, there are further opportunities and challenges to be met for geriatric medicine to make the very most of e-learning. This review outlines the terminology associated with e-learning, summarizes the advantages and potential problems, and considers the evidence base for the efficacy of e-learning. Current use of e-learning amongst professional groups is summarized and recommendations made for expanding the use of e-learning for all healthcare professionals working with older people.
{"title":"What can e-learning offer geriatric medicine in the UK?","authors":"E. Tullo, J. Newton, A. Clapp","doi":"10.1017/S0959259812000081","DOIUrl":"https://doi.org/10.1017/S0959259812000081","url":null,"abstract":"The expansion of e-learning in medical education is a reflection of the inherent advantages that technology can bring to teaching and learning. Geriatric medicine has taken advantage of some of the benefits associated with e-learning in terms of undergraduate education, specialty training and interdisciplinary training. However, there are further opportunities and challenges to be met for geriatric medicine to make the very most of e-learning. This review outlines the terminology associated with e-learning, summarizes the advantages and potential problems, and considers the evidence base for the efficacy of e-learning. Current use of e-learning amongst professional groups is summarized and recommendations made for expanding the use of e-learning for all healthcare professionals working with older people.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"235-242"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028246","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 : 2012-08-01DOI: 10.1017/S095925981200007X
G. Macphee, D. Stewart
Parkinson's disease is a progressive neurodegenerative condition. There is an increasing incidence and prevalence with advancing age and more cases are predicted as the population ages. Because of likely differing aetiology, genetics and pathology in individual patients, as well as confounding co-morbidities, diagnosis can be difficult even for specialists. We present an overview of the pathology, aetiology and differential diagnosis of Parkinson's disease in older people. The importance of specialist medical input in diagnosis is emphasized.
{"title":"Parkinson's disease – pathology, aetiology and diagnosis","authors":"G. Macphee, D. Stewart","doi":"10.1017/S095925981200007X","DOIUrl":"https://doi.org/10.1017/S095925981200007X","url":null,"abstract":"Parkinson's disease is a progressive neurodegenerative condition. There is an increasing incidence and prevalence with advancing age and more cases are predicted as the population ages. Because of likely differing aetiology, genetics and pathology in individual patients, as well as confounding co-morbidities, diagnosis can be difficult even for specialists. We present an overview of the pathology, aetiology and differential diagnosis of Parkinson's disease in older people. The importance of specialist medical input in diagnosis is emphasized.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"165-178"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S095925981200007X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028169","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 : 2012-08-01DOI: 10.1017/S0959259812000019
J. Lindesay, R. Stewart, Jatinder Bisla
{"title":"Anxiety disorders in older people","authors":"J. Lindesay, R. Stewart, Jatinder Bisla","doi":"10.1017/S0959259812000019","DOIUrl":"https://doi.org/10.1017/S0959259812000019","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"204-217"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028273","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 : 2012-08-01DOI: 10.1017/S0959259812000044
Julian Hunt, Antonio Sánchez, W. Tadd, S. O'mahony
In recent years, there has been a growing understanding that organizational culture is an important characteristic that may influence the effectiveness of health care provision, not least for the growing numbers of older people needing care. The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that organizational culture in health care organizations is related, in terms of activity and outcome, to their performance. Searches identified 20 relevant papers published between 1993 and 2010. A number of studies reviewed claims to have uncovered evidence of a relationship in terms of activity, while others failed to find a clear relationship. None of the studies found much evidence against. In terms of outcomes, none of the studies reviewed found evidence of a relationship between culture and performance. It is clear that any relationship between culture and performance is highly unlikely to be simple: such relationships are more likely to be multiple, complex, contingent and dynamic.
{"title":"Organizational culture and performance in health care for older people: a systematic review","authors":"Julian Hunt, Antonio Sánchez, W. Tadd, S. O'mahony","doi":"10.1017/S0959259812000044","DOIUrl":"https://doi.org/10.1017/S0959259812000044","url":null,"abstract":"In recent years, there has been a growing understanding that organizational culture is an important characteristic that may influence the effectiveness of health care provision, not least for the growing numbers of older people needing care. The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that organizational culture in health care organizations is related, in terms of activity and outcome, to their performance. Searches identified 20 relevant papers published between 1993 and 2010. A number of studies reviewed claims to have uncovered evidence of a relationship in terms of activity, while others failed to find a clear relationship. None of the studies found much evidence against. In terms of outcomes, none of the studies reviewed found evidence of a relationship between culture and performance. It is clear that any relationship between culture and performance is highly unlikely to be simple: such relationships are more likely to be multiple, complex, contingent and dynamic.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"218-234"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028539","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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