Pub Date : 2007-08-22DOI: 10.2217/1745509X.3.4.457
S. Rogers, Christine Kang, K. Miller
This review presents some of the current research and thinking regarding the neuropsychological features associated with aging and aging-related conditions. In the context of the current longevity revolution, many older adults are increasingly concerned about their cognitive performance and the risk for cognitive decline. This makes it critically important to understand the neuropsychological profiles of normal aging and the cognitive features of conditions associated with aging, such as age-associated memory impairment, mild cognitive impairment and dementia. There are also several factors that can modify the neuropsychological abilities and outcomes associated with aging, including gender, genetic status, lifestyle issues and education. The authors point to the importance for future research to embrace a fluid or multifactorial approach to neuropsychology, to focus on those factors contributing to healthy cognition and successful aging, and to correlate neuropsychological changes with the results of neu...
{"title":"Cognitive profiles of aging and aging-related conditions","authors":"S. Rogers, Christine Kang, K. Miller","doi":"10.2217/1745509X.3.4.457","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.457","url":null,"abstract":"This review presents some of the current research and thinking regarding the neuropsychological features associated with aging and aging-related conditions. In the context of the current longevity revolution, many older adults are increasingly concerned about their cognitive performance and the risk for cognitive decline. This makes it critically important to understand the neuropsychological profiles of normal aging and the cognitive features of conditions associated with aging, such as age-associated memory impairment, mild cognitive impairment and dementia. There are also several factors that can modify the neuropsychological abilities and outcomes associated with aging, including gender, genetic status, lifestyle issues and education. The authors point to the importance for future research to embrace a fluid or multifactorial approach to neuropsychology, to focus on those factors contributing to healthy cognition and successful aging, and to correlate neuropsychological changes with the results of neu...","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"457-470"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187052","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.517
R. Peters, C. Martin-Marero, Elisabete Pinto, N. Beckett
The world population is aging and disorders that are more prevalent in the elderly are of increasing importance. Hypertension falls into this category and has been linked to many adverse outcomes from stroke to mortality and dementia. Antihypertensive treatment has been shown to be successful in younger age groups but in those aged 80 years and over its benefits are not yet proven, and the risks and benefits of hypertension and antihypertensive treatment are unclear. Given this, it is useful to examine hypertension in the very elderly, the epidemiology, the likely impact of hypertension in this population, both physical and mental, and the as yet unclear issue of treatment. An ongoing, randomized, controlled trial in this age group will aid resolution of these issues and our understanding of this very elderly group.
{"title":"Hypertension in the very elderly","authors":"R. Peters, C. Martin-Marero, Elisabete Pinto, N. Beckett","doi":"10.2217/1745509X.3.4.517","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.517","url":null,"abstract":"The world population is aging and disorders that are more prevalent in the elderly are of increasing importance. Hypertension falls into this category and has been linked to many adverse outcomes from stroke to mortality and dementia. Antihypertensive treatment has been shown to be successful in younger age groups but in those aged 80 years and over its benefits are not yet proven, and the risks and benefits of hypertension and antihypertensive treatment are unclear. Given this, it is useful to examine hypertension in the very elderly, the epidemiology, the likely impact of hypertension in this population, both physical and mental, and the as yet unclear issue of treatment. An ongoing, randomized, controlled trial in this age group will aid resolution of these issues and our understanding of this very elderly group.","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"517-525"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187579","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.449
B. Seltzer
Early detection of Alzheimer’s disease is important because it increases the chances of early treatment and may, in the future, enable pre-emptive and even preventative therapies. Groups at risk for Alzheimer’s disease include individuals with mild cognitive impairment, elderly people with subjective memory complaint, first-degree relatives of Alzheimer’s disease patients, people with Down’s syndrome and those who have had a serious traumatic brain injury. Populations with multiple cardiovascular risk factors and low educational attainment also appear to be more susceptible. Cognitive testing, neuroimaging and various blood and cerebrospinal fluid assays may help identify those individuals who are most at risk. At present, the only approved therapy for mild Alzheimer’s disease is the use of cholinesterase inhibitors, but additional therapeutic options for mild Alzheimer’s disease and mild cognitive impairment, including proactive treatment strategies, are likely to be available in the future, making early...
{"title":"Early detection of Alzheimer’s disease","authors":"B. Seltzer","doi":"10.2217/1745509X.3.4.449","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.449","url":null,"abstract":"Early detection of Alzheimer’s disease is important because it increases the chances of early treatment and may, in the future, enable pre-emptive and even preventative therapies. Groups at risk for Alzheimer’s disease include individuals with mild cognitive impairment, elderly people with subjective memory complaint, first-degree relatives of Alzheimer’s disease patients, people with Down’s syndrome and those who have had a serious traumatic brain injury. Populations with multiple cardiovascular risk factors and low educational attainment also appear to be more susceptible. Cognitive testing, neuroimaging and various blood and cerebrospinal fluid assays may help identify those individuals who are most at risk. At present, the only approved therapy for mild Alzheimer’s disease is the use of cholinesterase inhibitors, but additional therapeutic options for mild Alzheimer’s disease and mild cognitive impairment, including proactive treatment strategies, are likely to be available in the future, making early...","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"449-456"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187043","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.483
D. Geldmacher
Acetylcholinesterase inhibitor drugs are now a mature treatment approach for Alzheimer’s disease, although they remain controversial. This review addresses the available data on acetylcholinesterase inhibitor treatment in patients with Alzheimer’s disease across multiple outcome types. It addresses rational and evidence-based expectations for treatment in this population.
{"title":"Acetylcholinesterase inhibitors for Alzheimer’s disease","authors":"D. Geldmacher","doi":"10.2217/1745509X.3.4.483","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.483","url":null,"abstract":"Acetylcholinesterase inhibitor drugs are now a mature treatment approach for Alzheimer’s disease, although they remain controversial. This review addresses the available data on acetylcholinesterase inhibitor treatment in patients with Alzheimer’s disease across multiple outcome types. It addresses rational and evidence-based expectations for treatment in this population.","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"483-494"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187104","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.495
M. Siamouli, S. Magiria, P. Panagiotidis, S. Spyridi, S. Sokolaki, K. Fountoulakis, G. Kaprinis
Late-life depression is a rather difficult and complicated issue. Although there have been significant advances in our knowledge in this area, a large number of questions still remain unanswered. The aim of this review is a critical presentation of the current evidence for treatment of depression in the elderly. We summarize the evidence for the effectiveness and safety of a range of proposed treatments, including pharmacological, psychological and alternative therapies and lifestyle changes. The treatments with best evidence of effectiveness are antidepressant pharmacotherapy, electroconvulsive therapy, cognitive–behavioral therapy, psychodynamic psychotherapy, reminiscence therapy, problem-solving therapy and exercise. Implications for future research are discussed.
{"title":"Advances in the treatment of geriatric depression","authors":"M. Siamouli, S. Magiria, P. Panagiotidis, S. Spyridi, S. Sokolaki, K. Fountoulakis, G. Kaprinis","doi":"10.2217/1745509X.3.4.495","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.495","url":null,"abstract":"Late-life depression is a rather difficult and complicated issue. Although there have been significant advances in our knowledge in this area, a large number of questions still remain unanswered. The aim of this review is a critical presentation of the current evidence for treatment of depression in the elderly. We summarize the evidence for the effectiveness and safety of a range of proposed treatments, including pharmacological, psychological and alternative therapies and lifestyle changes. The treatments with best evidence of effectiveness are antidepressant pharmacotherapy, electroconvulsive therapy, cognitive–behavioral therapy, psychodynamic psychotherapy, reminiscence therapy, problem-solving therapy and exercise. Implications for future research are discussed.","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"495-507"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187149","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.551
F. Iacopini, A. Bizzotto, I. Boškoski, M. Bulajić, G. Costamagna
The aim of this review is mainly to show the high prevalence of diverticulosis and the clinical relevance of uncomplicated and complicated diverticular disease worldwide. The prevalence of diverticular disease is directly related to the aging of the population and in western countries is diagnosed in approximately 50–65% of adult subjects. The often more frequent adoption of an incorrect dietary style, such as a low-fiber diet, and the progressive increase in the average age of western populations will increase the prevalence of this pathology and the economic burden for health systems even more so. Furthermore, the management of uncomplicated diverticular disease, segmental colitis associated to diverticula and diverticulitis, which represent the different manifestations of the symptomatic spectrum of colonic diverticulosis, are reported.
{"title":"Epidemiology and management of diverticular disease of the colon","authors":"F. Iacopini, A. Bizzotto, I. Boškoski, M. Bulajić, G. Costamagna","doi":"10.2217/1745509X.3.4.551","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.551","url":null,"abstract":"The aim of this review is mainly to show the high prevalence of diverticulosis and the clinical relevance of uncomplicated and complicated diverticular disease worldwide. The prevalence of diverticular disease is directly related to the aging of the population and in western countries is diagnosed in approximately 50–65% of adult subjects. The often more frequent adoption of an incorrect dietary style, such as a low-fiber diet, and the progressive increase in the average age of western populations will increase the prevalence of this pathology and the economic burden for health systems even more so. Furthermore, the management of uncomplicated diverticular disease, segmental colitis associated to diverticula and diverticulitis, which represent the different manifestations of the symptomatic spectrum of colonic diverticulosis, are reported.","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"551-566"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187645","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.437
J. Dall'era, L. Byrne, A. Barqawi
The incidence of benign prostatic hyperplasia and resulting lower urinary tract symptoms increases with age. This constellation of symptoms, including urinary frequency, urinary urgency and nocturia, has been the source of much morbidity in the aging male, and the focus of many pharmaceutical developments. Understanding the progressive disease process and treatment guidelines for lower urinary tract symptoms resulting from benign prostatic hyperplasia is crucial for urologists and primary-care physicians managing the aging population. Multiple large, randomized, controlled studies have been performed to evaluate the benefits of two of the currently used medications in the treatment of benign prostatic hyperplasia: finasteride and doxazosin. The advantages of each medication used alone or in combination have been well described in these trials. The scope of this review is to present a concise summary of these important trials with special emphasis on the long-term safety profile of these medications. Furth...
{"title":"Use of finasteride plus doxazosin combination therapy for treatment of LUTS related to benign prostatic hyperplasia","authors":"J. Dall'era, L. Byrne, A. Barqawi","doi":"10.2217/1745509X.3.4.437","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.437","url":null,"abstract":"The incidence of benign prostatic hyperplasia and resulting lower urinary tract symptoms increases with age. This constellation of symptoms, including urinary frequency, urinary urgency and nocturia, has been the source of much morbidity in the aging male, and the focus of many pharmaceutical developments. Understanding the progressive disease process and treatment guidelines for lower urinary tract symptoms resulting from benign prostatic hyperplasia is crucial for urologists and primary-care physicians managing the aging population. Multiple large, randomized, controlled studies have been performed to evaluate the benefits of two of the currently used medications in the treatment of benign prostatic hyperplasia: finasteride and doxazosin. The advantages of each medication used alone or in combination have been well described in these trials. The scope of this review is to present a concise summary of these important trials with special emphasis on the long-term safety profile of these medications. Furth...","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"437-443"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186995","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.445
J. Kuret
{"title":"New treatments for Alzheimer’s disease: how close are we?","authors":"J. Kuret","doi":"10.2217/1745509X.3.4.445","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.445","url":null,"abstract":"","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"445-448"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187031","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.411
M. Gordon, C. Kohm
Nursing homes are one component of the longterm care (LTC) health system that also includes retirement homes, with and without assisted living, personal-care homes and in some jurisdictions what are referred to as complex continuing care units. The unifying theme for all of these organizational components is that most but not all individuals entering these facilities are elderly and many are, therefore, in the last phase of their lives [1]. For those whose experience in such facilities includes the final period of their lives, it is critical that the organizations address the clinical, psychosocial and spiritual needs of these residents. One’s end-of-life (EOL) period and the terminal phase of that experience should promote the best of clinical care and the essential features of nurturing and support for patients, residents and their families. Quality of EOL care should be integral to the LTC system.
{"title":"Improving end-of-life care in nursing homes","authors":"M. Gordon, C. Kohm","doi":"10.2217/1745509X.3.4.411","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.411","url":null,"abstract":"Nursing homes are one component of the longterm care (LTC) health system that also includes retirement homes, with and without assisted living, personal-care homes and in some jurisdictions what are referred to as complex continuing care units. The unifying theme for all of these organizational components is that most but not all individuals entering these facilities are elderly and many are, therefore, in the last phase of their lives [1]. For those whose experience in such facilities includes the final period of their lives, it is critical that the organizations address the clinical, psychosocial and spiritual needs of these residents. One’s end-of-life (EOL) period and the terminal phase of that experience should promote the best of clinical care and the essential features of nurturing and support for patients, residents and their families. Quality of EOL care should be integral to the LTC system.","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"15 1","pages":"411-414"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186944","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 : 2007-08-22DOI: 10.2217/1745509X.3.4.527
W. Brant, G. Brock, T. Lue, R. Gerridzen, A. Bella
This article reviews contemporary treatment strategies for the aging male who does not demonstrate a satisfactory response to first-line oral phosphodiesterase-5 inhibitor agents for erectile dysfunction. More than half of men aged 40–70 years are unable to attain or maintain a penile erection sufficient for satisfactory sexual performance, with the prevalence of erectile dysfunction climbing to more than 75% among those aged over 70 years. However, the aging male may fail to respond to or express dissatisfaction with oral on-demand treatment. Clinically effective phosphodiesterase-5 inhibitor salvage strategies include patient re-education, lifestyle changes, correction of risk factors, dose adjustment, agent switching, androgen replacement and/or psychosexual or relationship counseling. Important new data supporting the safe and efficacious use of daily phosphodiesterase-5 inhibitor dosing schedules are reviewed. If required, progression to second- and third-line treatments is appropriate for most men, ...
{"title":"Salvage strategies for nonresponders to phosphodiesterase-5 inhibitor treatment for erectile dysfunction in the aging male","authors":"W. Brant, G. Brock, T. Lue, R. Gerridzen, A. Bella","doi":"10.2217/1745509X.3.4.527","DOIUrl":"https://doi.org/10.2217/1745509X.3.4.527","url":null,"abstract":"This article reviews contemporary treatment strategies for the aging male who does not demonstrate a satisfactory response to first-line oral phosphodiesterase-5 inhibitor agents for erectile dysfunction. More than half of men aged 40–70 years are unable to attain or maintain a penile erection sufficient for satisfactory sexual performance, with the prevalence of erectile dysfunction climbing to more than 75% among those aged over 70 years. However, the aging male may fail to respond to or express dissatisfaction with oral on-demand treatment. Clinically effective phosphodiesterase-5 inhibitor salvage strategies include patient re-education, lifestyle changes, correction of risk factors, dose adjustment, agent switching, androgen replacement and/or psychosexual or relationship counseling. Important new data supporting the safe and efficacious use of daily phosphodiesterase-5 inhibitor dosing schedules are reviewed. If required, progression to second- and third-line treatments is appropriate for most men, ...","PeriodicalId":88353,"journal":{"name":"Aging health","volume":"3 1","pages":"527-542"},"PeriodicalIF":0.0,"publicationDate":"2007-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/1745509X.3.4.527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187615","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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