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The proportion of elderly at any age without any chronic conditions is small, and disease can trigger a cascade of events resulting in functional deficits and disability. An increase in the number of activities with which an elder has difficulty increases linearly with comorbidity, that is, coexistent medical conditions that further complicate not only the genesis of a functional deficit but also its treatment. For example, rehabilitation for a stroke for an individual who also has painful, degenerative changes in the foot and a low tolerance for stressful activity secondary to angina with exertion would present a particular rehabilitation challenge. Yet, this example encapsulates geriatric rehabilitation specialist’s emphasis on care and function, not cure and disease. (more…)
The overarching goal of physical therapy rehabilitation is to return the individual to as close to the premorbid level of funct ...
There are numerous basic Activities of Daily Living instruments that seek to quantify basic physical functions and obtain a numeric ...
Beneficiaries of the Medicare program have three rehabilitation-related benefits established by federal statute: physical thera ...
Most older adults adapt successfully to the multiple developmental and social changes and late life depression that are common ...
There are a number of issues that must be considered in geriatric pain assessment. The major issues that merit attention are pr ...
Cardiac Resynchronization Therapy improves functional capacity and quality of life in patients with persistent class III and IV heart failure despite optimal medical therapy, and there is also evidence that Cardiac Resynchronization Therapy may reverse structural remodeling in selected patients. Although individual trials of Cardiac Resynchronization Therapy were underpowered to assess survival, a meta-analysis of outcomes from four randomized trials involving more than 800 patients found that Cardiac Resynchronization Therapy reduces mortality from heart failure. (more…)
Results from several recently completed trials have important implications for the primary prevention of Sudden Cardiac Death Preve ...
Supraventricular Tachyarrhythmia
The principles of drug and non-drug management of supraventricular tachyarrhythmia (SVT) are si ...
Pacemaker therapy is indicated in patients with symptomatic bradycardia (syncope, presyncope, dyspnea, and exercise intolerance) co ...
Atrial Fibrillation affects approximately 2.3 million people in the United States and is the most common rhythm disorder among U.S. ...
There are intrinsic changes in the cardiac pacemaker cells and the cardiac conduction system associated with aging, which increase ...
Several clinical tools are available for identification of patients at risk of cardiac arrhythmias or its consequences that may benefit from interventions to reduce morbidity and risk of sudden death. These include noninvasive tests, such as a standard (more…)
Results from several recently completed trials have important implications for the primary prevention of Sudden Cardiac Death Preve ...
Supraventricular Tachyarrhythmia
The principles of drug and non-drug management of supraventricular tachyarrhythmia (SVT) are si ...
Aging is associated with progressive fibrosis of the sinoatrial node and AV conduction system, resulting in bradycardia, which may ...
In older patients without apparent cardiovascular disease, the number of cardiac myocytes declines, while residual myocytes enlarge ...
Carotid sinus hypersensitivity ( more than 3-second pause or a decrease in systolic blood pressure = 50 mm Hg during carotid sinus ...
Atrial Fibrillation affects approximately 2.3 million people in the United States and is the most common rhythm disorder among U.S. patients hospitalized with a primary diagnosis of an cardiac arrhythmia. The median age of Atrial Fibrillation patients is 75 years; 84% are older than 65 years. Pooled data from studies of chronic Atrial Fibrillation in North America, Britain, and Iceland suggest a prevalence of 0.5% to 1% in the general population. (more…)
Cardiac Resynchronization Therapy improves functional capacity and quality of life in patients with persistent class III and IV hea ...
Supraventricular Tachyarrhythmia
The principles of drug and non-drug management of supraventricular tachyarrhythmia (SVT) are si ...
Pacemaker therapy is indicated in patients with symptomatic bradycardia (syncope, presyncope, dyspnea, and exercise intolerance) co ...
Results from several recently completed trials have important implications for the primary prevention of Sudden Cardiac Death Preve ...
In older patients without apparent cardiovascular disease, the number of cardiac myocytes declines, while residual myocytes enlarge ...
There are a number of issues that must be considered in geriatric pain assessment. The major issues that merit attention are presence of comorbidities, mental status, depression in late life, limitations in ADLs, medications, and the importance of family and other support systems (see Depression; Social Networks, Support, and Integration). (more…)
Using the right medications can help in the treating of acute and chronic back pain. There are good drugs which physicians pres ...
The principal reversible dementias are metabolic. Hypothyroidism and exposure to industrial or environmental toxins should be c ...
Most older adults adapt successfully to the multiple developmental and social changes and late life depression that are common ...
Unfortunately, many dementias are partially or completely biologically irreversible. However, as mentioned previously, it is im ...
Cognitive-Behavioral Interventions Research documenting the efficacy of Cognitive-Behavioral Interventions in treating the psyc ...
Unfortunately, many dementias are partially or completely biologically irreversible. However, as mentioned previously, it is important to recognize that all dementias are treatable. Some of these irreversible dementias are preventable. For example, automobile accidents in civilian populations and projectile wounds in military populations are common causes of brain damage that cause dementia. Some improvements can occur in these conditions for a period of time after the initial insult, but affected individuals are left with varying degrees of impairment and often severe limitations in function. (more…)
Alzheimer’s disease is a concept in evolution; it is considered by most to be a degenerative brain disease that was first describe ...
The principal reversible dementias are metabolic. Hypothyroidism and exposure to industrial or environmental toxins should be c ...
It is always important in the treatment of dementia to have clear therapeutic goals established in partnership with the patient ...
Neuroimaging is widely used in the evaluation of Alzheimer’s disease (AD). Traditionally, imaging in Alzheimer’s disease has be ...
There are a number of issues that must be considered in geriatric pain assessment. The major issues that merit attention are pr ...
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Obesity results from an imbalance between caloric consumption and caloric expenditure over a prolonged period. Weight gain occurs when there is a greater consumption of calories than expenditure. The expenditure of calories is complex and results from likely combinations of metabolic, genetic, and individual factors. Genetics and environment may predispose to weight gain, but it is only the consumption of calories in excess of utilization that can cause weight gain. (more…)
Weight loss improves many of the adverse health outcomes associated with obesity, including preventing or delaying the onset of ...
Adipose tissue fat is not simply a reservoir for excess nutrients, but rather an active and dynamic organ capable of expressing ...
Some medications exist for weight loss. These medications are moderately effective, although they often have side effects that ...
Concomitant with the global increase in obesity is the increase in the metabolic syndrome. The metabolic syndrome, also known ...
There are new strategies to address the 3 critical factors for body health: blood sugar, insulin and inflammation. These formul ...
Complications of Adverse Drug Reactions may include hospitalization, increased hospital stays and health care expenditures, morbidity, and death. The incidence of Adverse Drug Reactions varies by type of health care setting (e.g., ambulatory clinic, hospital, nursing home). In a cohort of older Medicare enrollees, the rate of Adverse Drug Reactions was 50.1 per 1,000 person years. In long-term care facilities, the rates of Adverse Drug Reactions were reported as 1.9 to 9.8 per 100 resident-months. Adverse Drug Reactions are a common cause of hospital admission of older adults and were responsible for 6% to 24% of all hospital admissions. Of all Adverse Drug Reactions, 23% to 28% were categorized as serious.
Approximately one quarter to one half of Adverse Drug Reactions are considered to be preventable. Errors are most likely to occur at the time of prescribing a medication or during monitoring of therapy. Prescribing errors include choosing an inappropriate medication, prescribing a medication that interacts with another medication in the individual’s regimen, and prescribing a drug in the face of an established drug allergy. Errors in monitoring of therapy may include failing to obtain necessary laboratory values to monitor drug therapy and not responding promptly to signs, symptoms, or laboratory evidence of drug toxicity.
Many researchers have attempted to identify risk factors for Adverse Drug Reactions, an endeavor that has been disappointing. The most persistent risk factor for Adverse Drug Reactions is use of multiple medications; thus, it is important that patients be maintained on the fewest number of medications needed to manage their health conditions. Researchers have not found Adverse Drug Reactions to vary substantially according to age or sex. Several factors are important to keep in consideration to minimize Adverse Drug Reactions, even though they have not been identified as independent risk factors. (more…)
Pharmacodynamics describes the course of action of a drugs and aging at the effector organ level, in terms of duration and magnitud ...
There are several important changes in pharmacokinetics metabolism associated with aging that predispose the elderly to increas ...
Something you and your doctor should appreciate is that getting older influences the way you react to drugs. Elderly patients are t ...
Abuse of drugs and alcohol is not uncommon among the elderly. The high rate of prescribed medication use, increased physiologic ...
Osteoporosis is disease affecting the bones, making them fragile and prone to fracture. Osteoporosis is defined as a systemic s ...
For trained physicians, aging is often defined by the age-related diseases and disorders people experience as they grow older. In fact, aging is often portrayed as a disease that is amenable to treatment, just like any other elderly chronic diseases that physicians are trained to diagnose and treat. This is not an unexpected view of aging given the Western disease-oriented model of medical education. Examples of the conditions that anti-aging practitioners endeavor to treat or postpone include cardiovascular disease, cancer, sensory impairments, muscle and bone loss, loss of skin elasticity, and decline in sexual activity in elderly function. (more…)
HGH is the current buzz word in anti aging circles. It has gained wide media coverage and is being hailed as the ultimate in an ...
Many people believe that if you are aging and your face has some damage on them because of this, you can not reverse the aging ...
The prevalence of sexual dysfunction in women approaches 43%, and age is an important correlate. The underlying etiology of sexual ...
When approaching menopause or during post-menopause period, most women suffered from menopausal symptoms irritability like ...
The systemic benefits of exogenous Growth Hormone therapy in the healthy elderly remain unclear and controversial. Studies have ...
Involuntary weight loss is the result of many chronic progressive diseases, often leading to diminished lean body mass, frailty, susceptibility to illness, and increased mortality. Various anabolic agents have been used to combat weight loss with mixed results. Similar to the frustration experienced by advocates of weight loss in the obese, none of the pharmacological appetite stimulants available at the current time have been uniformly successful in combating involuntary weight loss in the elderly population. (more…)
The systemic benefits of exogenous Growth Hormone therapy in the healthy elderly remain unclear and controversial. Studies have ...
When approaching menopause or during post-menopause period, most women suffered from menopausal symptoms irritability like ...
Potential benefits of T treatment in older men must be weighed against risks of adverse effects. In young hypogonadal men, physiolo ...
As you probably know, sex hormone in women is declining with age. Men also experiencing the same, even though the declining rat ...
Altered cellular metabolism and intracellular and intercellular signaling with advancing age result in widespread changes in endocr ...
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