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Many Older People (many + older_people)
Selected AbstractsPotential for Alcohol and Prescription Drug Interactions in Older PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2005Kristine E. Pringle PhD Objectives: To examine the patterns and prevalence of concomitant alcohol and alcohol-interactive (AI) drug use in older people. Design: Cross-sectional analysis of survey and prescription claims data. Setting: The Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PA-PACE) program, a state-funded program providing prescription benefits to older people with low to moderate incomes. Participants: A total of 83,321 PA-PACE cardholders (age range 65,106) who were using any prescription medications at the time of survey completion. Measurements: All AI drugs were identified using a database of medication warning labels obtained from First DataBank. Prescription drug claims were used to characterize AI drug exposure according to therapeutic class of prescription drug use. A mail survey of PA-PACE cardholders was used to examine alcohol use, as well as sociodemographic and health factors associated with concomitant use of alcohol and AI drugs. Results: Seventy-seven percent of all prescription drug users were exposed to AI medications, with significant variation in exposure and concomitant alcohol use according to therapeutic class. Overall, 19% of AI drug users reported concomitant alcohol use, compared with 26% of non-AI drug users (P<.001). Multinomial logistic regression analyses showed that certain groups of older people, including younger older people, men, and those with higher educational levels, were at greater risk for concomitant exposure to alcohol and AI drugs. Conclusion: Many older people use alcohol in combination with AI prescription drugs. Clinicians should warn every patient who is prescribed an AI drug about alcohol,drug interactions, especially those at high risk for concomitant exposure. [source] Prevalence of vision, hearing, and combined vision and hearing impairments in patients with hip fracturesJOURNAL OF CLINICAL NURSING, Issue 21 2009Else Vengnes Grue Aims and objectives., To examine the prevalence of hearing and vision impairments in 65+ year-old patients with hip fractures. Background., Many older people believe sensory problems are inevitable and thus avoid medical assessment and assistance. Furthermore, health professionals often overlook sensory problems, though it is known that sensory impairments can increase the risk of falling and sustaining hip fractures. Design., A prospective, observational study. Methods., We admitted 544 consecutive patients to an orthogeriatric ward from October 2004,July 2006; 332 were screened for study inclusion with the Resident Assessment Instrument for Acute Care (InterRAI-AC) and a questionnaire (KAS-Screen). We conducted patient interviews, objective assessments, explored hospital records and interviewed the family and staff. Impairments were defined as problems with seeing, reading regular print or hearing normal speech. Results., Sixteen per cent of the patients had no sensory impairments, 15·4% had vision impairments, 38·6% had hearing impairments and 30·1% had combined sensory impairments. Among the impaired, 80·6% were female, the mean age was 84·3 years (SD 6·8), 79·9% were living alone, 48·0% had cognitive impairments, 89·6% had impaired activities of daily living, 70·6% had impaired instrument activities in daily living, 51·0% had bladder incontinence and 26·.8% were underweight. Comorbidity and polypharmacy were common. Delirium was detected in 17·9% on day three after surgery. Results showed the prevalence of combined sensory impairments was: 32·8% none; 52·2% moderate/severe; and 15·1% severe. Conclusion., Patients with hip fractures frequently have hearing, vision and combined impairments. Relevance to clinical practice., We recommend routine screening for sensory impairments in patients with hip fractures. Most sensory problems can be treated or relieved with environmental adjustments. Patients should be encouraged to seek treatment and training for adapting to sensory deficiencies. This approach may reduce the number of falls and improve the ability to sustain independent living. [source] Perseverance by Older People in Their Management of Chronic Pain: A Qualitative StudyPAIN MEDICINE, Issue 3 2007Beatrice Sofaer-Bennett PhD, Cert Couns ABSTRACT Introduction., Many older people suffer from degenerative and chronic diseases resulting in chronic pain. It is important for health professionals and researchers to gain insights into experiences of chronic pain sufferers, so that they may understand the patient's perspective and instigate appropriate treatments. Aim., This study set out to gain insights into older people's perceptions about the effect of chronic pain on their lives and how they self-manage it. Design., A qualitative approach to generating data based on Grounded Theory was chosen. Sixty-three people between the ages of 60 and 87 years participated and were interviewed using audiotape. The interviews were transcribed and subsequently analyzed, and the material was coded and collapsed into themes constituting the final grounded theory. Results., As the data collection progressed, a major theme of perseverance emerged, supported by two subthemes: ,,keeping occupied, and ,,a focus on social activities. It became apparent that the participants were determined to get on with their lives. Those with strong social links appeared to have a more positive outlook on life. Conclusions., "Keeping going" was a priority for most of the participants. It may be beneficial to identify the ways in which older people persevere despite chronic pain. It is important for health professionals to appreciate the social factors which are important to, and valued by, older people who experience chronic pain. [source] The mind-body connection in elderlyNURSING & HEALTH SCIENCES, Issue 1 2005Oksoo Kim rn Depression is an illness affecting mind and body. Depression in people aged 65 years and older is a major public health problem. Because many older people are unaware that they need treatment for depression, as depression in the elderly is insidious. The consequences of undiagnosed depression can be fatal, as depression is a leading cause of suicide among elders. Late-life depression is particularly tricky in that the relationship between depression, disability and illness is very difficult to disentangle. Specific symptoms and signs of depression may impair some functions and not others. Medical disorders accompanying geriatric depression can cause disability, independent of the depressive syndrome or in synergy with it. There is growing evidence that treating depression in patients with a chronic physical condition may improve their medical condition, reduce the degree of pain, increase activity and lessen disability, enhance their quality of life and increase their ability to follow their treatment plan. Health care providers, elderly and their family should be aware of geriatric depression. [source] Mobility on discharge from an aged care unitPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2007Edward Gorgon Abstract Background and Purpose.,Independent mobility is a crucial element of independent living and quality of life. However, little is known about the mobility of older people around the time of discharge from inpatient rehabilitation. The present study aimed to describe mobility on discharge from an aged care rehabilitation unit. Method.,The study utilized a descriptive, cross-sectional design. Ninety-five patients (mean age 81 (±8) years; 60% female) with diverse chronic conditions (median 5) who were able to walk at least 10,m without weight-bearing restrictions were recruited from the aged care rehabilitation wards. Scores on the Barthel Index were obtained on admission and discharge to provide information about their overall level of function. Within the last week of rehabilitation stay, scores on the mobility and locomotion subsections of the Functional Independence Measure, gait velocity, and time and distance parameters of gait were obtained. Gait variables were measured by use of the GAITRiteTM, an instrumented walkway. Medians and interquartile ranges (IQR) were reported for mobility variables. Results.,Following inpatient rehabilitation, many patients achieved independence in bed or chair transfers (83%), toilet transfers (81%), shower transfers (60%) and level-surface walking (74%). Only 31% achieved independence in stair climbing. Patients walked slowly at a median (IQR) gait velocity of 45.96 (31.51) cm/s and with markedly diminished cadence and step length. Subjects with a low number of chronic conditions generally performed better on mobility measures than those with a high number of chronic conditions. Conclusions.,Although many older people are able to transfer and walk independently around the time of discharge from inpatient rehabilitation their mobility is still often impaired. For example, only 9.5% achieved a walking velocity considered to be adequate for street crossing and few demonstrated the ability to negotiate stairs. This highlights the need for ongoing rehabilitation for many of these older people. The possible cumulative effects of chronic conditions on mobility require further investigation. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||