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Over the past 60 years, many documents, including the 1948 Universal Declaration of Human Rights, have addressed the rights of all persons. But it was not until the Declaration on Social Progress and Development in 1969 that the human rights of the elderly were specifically mentioned in an international rights document (Office of the United Nations High Commissioner for Human Rights). The United Nations adopted the first International Plan of Action on Ageing in 1987 and the General Assembly of the United Nations adopted the Principles for Older Persons in 1991. (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…)

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…)

Pacemaker therapy is indicated in patients with symptomatic bradycardia (syncope, presyncope, dyspnea, and exercise intolerance) correlated to sinus node dysfunction (pauses, persistent bradycardia, or chronotropic incompetence). In elderly patients, sinus node dysfunction is often associated with atrial tachyarrhythmias, including AF. Because of the frequent association of sinus node dysfunction with AF, VVI and VVIR pacing were once considered the preferred pacing modes. Recent studies suggest that atrial-based pacing in patients with sinus node dysfunction is beneficial for preventing progression of AF. (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…)

In older patients without apparent cardiovascular disease, the number of cardiac myocytes declines, while residual myocytes enlarge. Concurrently, there is an increase in elastic and collagenous tissue in all parts of the interstitial matrix and conduction system with advancing age. (more…)

The majority associated with leading cause of deaths in America are due to medical health issues, not accidents, regardless of what your mother told you. The National Center for Health Statistics compiles the listing of killers and leading causes of death in America. A number of on the list you can not manage but others you can. There are several things that you can do to minimize getting the risk of the leading causes of death. If you eat right, exercise, don’t smoke, keep your weight under control, and manage your stress, then you are having a big change to live longer and having prolonged life than average American. (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…)