To meet the needs of older people most countries have moved toward community-based care as a means of providing adequate and cost-effective care. Community-based care focuses around an integrated and more comprehensive approach to the special needs of older persons, their families, and the community. This type of model involves and requires inter-organizational collaboration and interdisciplinary cooperation. A community-based approach in social services and in health care is a strategic approach to meet the mounting demands for integrated health and social services for the elderly. Community health care usually includes both the health and social services sectors. (more…)

Compulsive hoarding disorder consists of three components: acquiring a large number of possessions, storing of items and not discarding unused objects, and keeping or storing them in such a way that it interferes with daily living, with possible severe neglect of living space. This behavior was first described in 1975 in a sample of 30 individuals, all of whom were elderly and demonstrated extreme neglect of their home, appearance, and health, and was termed Diogenes syndrome. (more…)

Weight loss improves many of the adverse health outcomes associated with obesity, including preventing or delaying the onset of diabetes, improving blood sugar control in those with diabetes, reducing low-density lipoprotein (bad cholesterol), raising high-density lipoprotein (good cholesterol), improving hypertension, improving symptoms of osteoarthritis, and providing an improved sense of well-being. (more…)

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…)

Aging is associated with progressive fibrosis of the sinoatrial node and AV conduction system, resulting in bradycardia, which may be further exacerbated by disease and medications, resulting in symptoms requiring permanent pacemaker implantation. More than 80% of pacemaker recipients in the United States are older than 65 years, and the median age is 75 years. As the population ages, it is anticipated that the number of older persons requiring permanent cardiac pacemakers, as well as the associated costs, will continue to rise. (more…)

There is a keen interest in developing more direct measures of Alzheimer’s Disease-specific pathology, which has led to the emergence of several new PET ligands to measure amyloid deposition. Amyloid plaques, which are composed of Ab, and neurofibrillary tangles (NFTs) are the pathological hallmarks of Alzheimer’s Disease. NFTs are correlated with the stage of Alzheimer’s Disease, and both pathological deposits appear before symptoms show themselves, perhaps decades before. This observation using amyloid imaging suggests that these deposits may be a good early marker for the disease. Based on the presence of diffuse plaques in neurologically normal individuals, it may be that Ab accumulation precedes other pathological features of Alzheimer’s Disease. (more…)

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The same genetic and cell approaches used for treatment of bradyarrhythmia can potentially be modified for tachyarrhythmias treatment. Arrhythmogenesis typically results from increased automaticity, triggered activity, or reentry. Different genetic approaches can, therefore, be designed based on the individual mechanism. (more…)

Activities of Daily Living (ADLs) is the core daily personal care activities that are necessary in order for people to be able to live independently. Loss of mental functioning is measured by other standardized tests and referred to as cognitive impairment. Activities of Daily Livings are particularly important because along with cognitive impairment, and in some cases “medical necessity,” they are the mechanism used by the insurance industry to determine qualification for long-term care benefits and may also be used to determine qualification for admission to a nursing or assisted living home facility. (more…)

The overarching goal of physical therapy rehabilitation is to return the individual to as close to the premorbid level of function as possible or, alternatively, to maximize a person’s current potential for function and maintain it as long as possible. This goal is achieved by promoting changes in the individual, by altering his or her physical health elderly or social environments, or by implementing a combination of both strategies. (more…)

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…)