Geriatrics

From Citizendium
Revision as of 05:47, 15 May 2008 by imported>Robert Badgett
Jump to navigation Jump to search
This article is developing and not approved.
 Main Article
 Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
https://en.citizendium.org/wiki/index.php?title=Geriatrics&printable=yes
This editable Main Article is under development and subject to a disclaimer.

Geriatrics is defined as "the branch of medicine concerned with the physiological and pathological aspects of the aged, including the clinical problems of senescence and senility."[1]

Healthy aging

Maintenance of leisure activities that involve cognitive or physical-activity is associated with reduced risk of dementia.[2]

Physical fitness, as measured by maximal treadmill exercise test duration, correlates with longevity in the elderly.[3]

Common clinical issues

Common and important clinical issues for elders have been proposed.[3] These issues are advance care planning, health maintenance, medication management, difficulty walking/falls, chronic pain, urinary incontinence, depression, hearing loss, visual impairment, malnutrition or weight loss, dementia, and caregiver burden. Protocols for these issues are available.[4]

The ACOVE project has created indicators for the quality of care for 22 impactful issues in geriatrics.[5][6] These topics include depression, diabetes mellitus type 2, heart failure, hypertension, coronary heart disease, osteoarthritis, osteoporosis, pain management, pneumonia, pressure ulcers, preventive care, stroke and atrial fibrillation. In addition, the list includes the following (with the inclusion of caregiver burden) that are more specific to geriatric care:

Accidental falls

For more information, see: Accidental fall.

Caregiver burden

Continuity and coordination of care

Dementia

For more information, see: Dementia.

End-of-life care

For more information, see: Death.

Hearing loss

Hospital care

Restraints in the hospital or nursing home

The effect of educating health care providers is not clear. One randomized controlled trial found that an "educational program for nurses combined with consultation with a nurse specialist" did not improve care.[7] However, another controlled trial of a more intensive education program combined with consultation did reduce restraints.[8] However, this study did not account for clustering effect and should be considered a controlled before and after study which is less rigorous. A third trial which used the "A.G.E. dementia care program" (Activities, Guidelines for psychotropic medications, and Educational rounds) showed a reduction in restraints.[9]

Malnutrition

A normal hospital diet plus 400-mL oral nutritional supplements daily for 6 week improved quality of life among hospitalized elders.[10]

Medicine use

For more information, see: drug.

Adverse drug reaction

For more information, see: Adverse drug reaction.

Polypharmacy

For more information, see: Polypharmacy.

Urinary incontinence

Vision care

Interventions

It is not clear that home health care helps.[11]

References

  1. ↑ National Library of Medicine. Geriatrics. Retrieved on 2007-12-05.
  2. ↑ Verghese J, Lipton RB, Katz MJ, et al (2003). "Leisure activities and the risk of dementia in the elderly". N. Engl. J. Med. 348 (25): 2508–16. DOI:10.1056/NEJMoa022252. PMID 12815136. Research Blogging.
  3. ↑ 3.0 3.1 Xuemei Sui et al., “Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults,” JAMA 298, no. 21 (December 5, 2007), http://jama.ama-assn.org/cgi/content/abstract/298/21/2507 (accessed December 5, 2007). Cite error: Invalid <ref> tag; name "pmidpending" defined multiple times with different content
  4. ↑ GRACE Team Suggestions. Retrieved on 2007-12-11. (complete pdf)
  5. ↑ Shekelle PG, MacLean CH, Morton SC, Wenger NS (2001). "Acove quality indicators". Ann. Intern. Med. 135 (8 Pt 2): 653–67. PMID 11601948. [e]
  6. ↑ Wenger NS, Shekelle PG (2001). "Assessing care of vulnerable elders: ACOVE project overview". Ann. Intern. Med. 135 (8 Pt 2): 642–6. PMID 11601946. [e]
  7. ↑ Huizing AR, Hamers JP, Gulpers MJ, Berger MP (2006). "Short-term effects of an educational intervention on physical restraint use: a cluster randomized trial". BMC Geriatr 6: 17. DOI:10.1186/1471-2318-6-17. PMID 17067376. Research Blogging.
  8. ↑ Evans LK, Strumpf NE, Allen-Taylor SL, Capezuti E, Maislin G, Jacobsen B (1997). "A clinical trial to reduce restraints in nursing homes". J Am Geriatr Soc 45 (6): 675–81. PMID 9180659. [e]
  9. ↑ Rovner BW, Steele CD, Shmuely Y, Folstein MF (1996). "A randomized trial of dementia care in nursing homes". J Am Geriatr Soc 44 (1): 7–13. PMID 8537594. [e]
  10. ↑ Gariballa S, Forster S (2007). "Dietary supplementation and quality of life of older patients: a randomized, double-blind, placebo-controlled trial". J Am Geriatr Soc 55 (12): 2030–4. DOI:10.1111/j.1532-5415.2007.01435.x. PMID 17944893. Research Blogging.
  11. ↑ Effects of a home visiting program for older people with poor health status: a randomized, clinical trial in The Netherlands.J Am Geriatr Soc. 2008 Mar;56(3):397-404. Epub 2007 Dec 27. PMID: 18179482
Retrieved from "https://citizendium.org/wiki/index.php?title=Geriatrics&oldid=351252"