Depression is the most common mental health problem in the elderly. While the incidence in community-dwelling older adults is no higher than in the general population, the risk increases significantly with medical illness or institutionalization. Depression is probably the best researched of the psychiatric disorders in the elderly, with epidemiological evidence indicating that older adults have the highest suicide rate of any age group (one-fourth of all suicides are carried out by persons age 60 or older by taking sleeping pills suicide). (more…)

” class=”index-image” width=”120″ />

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…)

Elder maltreatment and abuse of the elderly is found in almost all countries of the world. According to the World Health Organization, elderly abuse is expected to continue to increase, particularly as many countries experience rapidly aging populations. Throughout the world, both elderly men and women are at high risk of abuse, neglect, and exploitation. Although older men are at risk of abuse in about the same proportion as women, elderly women are at higher risk of abuse, neglect, and exploitation in cultures where women are devalued. (more…)

Obsessive-compulsive disorder (OCD) is a common neuropsychiatric condition that is frequently unrecognized and untreated, resulting in significant personal suffering and functional impairment. This article reviews the current state of knowledge of OCD epidemiology, clinical features and natural history, differential Obsessive-compulsive disorder diagnosis, and Obsessive Compulsive Disorders treatment options, focusing on how Obsessive Compulsive affects elderly. (more…)

Carotid sinus hypersensitivity ( more than 3-second pause or a decrease in systolic blood pressure = 50 mm Hg during carotid sinus massage) predominantly affects elderly patients, although the prevalence in the general population has not been precisely defined. In elderly patients with recurrent syncope, carotid sinus hypersensitivity has been reported in up to 35% of cases. Permanent pacing in patients with carotid sinus syndrome (carotid sinus hypersensitivity associated with syncope) is indicated. Observational and randomized studies have shown that recurrent symptoms are significantly reduced after permanent pacemaker implantation in patients with carotid sinus syndrome. (more…)

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…)

Neuroimaging is widely used in the evaluation of Alzheimer’s disease (AD). Traditionally, imaging in Alzheimer’s disease has been used to exclude other diseases and neurological conditions that produce similar cognitive symptoms. Recently, however, neuroimaging has been explored for its potential in predicting clinical outcomes in subjects before the onset of Alzheimer’s disease or as surrogate markers for monitoring the course of treatment. While these experimental uses tend to be more exploratory than of current clinical application, the diagnosis of Alzheimer’s disease has unquestionably been advanced with the inclusion of neuroimaging. (more…)

Cancer occurrence rates in a period of time for a given population is expressed in various ways. The incidence rate is a direct measure of the probability of developing cancer and is usually expressed per year. Incidence rates may be crude (all ages) or age specific. Since cancer is very age dependent, age specific rates are usually more informative. Cancer in elderly is more prevalent compare to cancer in younger age. When comparing population groups with different age distributions (such as the United States vs. China), the incidence rate should be age adjusted by multiplying each age-specific rate by the percent of individuals in a population with the same ages and then summing these to produce a single value. For etiological studies, incidence rates tend to be more informative than mortality rates, as they identify all diagnosed cases. (more…)

Some genetic mutations appear to accelerate certain features of aging only within a single tissue. There are a very large number of these conditions, which might be referred to as unimodal progeroid syndromes. Here only three examples are considered: one that has a major impact on sun-exposed skin, one that results in an early onset of the most common form of dementia alzheimer, Alzheimer’s disease, and another that results in early-onset Parkinson’s disease. (more…)

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…)