Elderly Populations

To date, only nonrandomized smdies of hemicraniectomy in massive hemispheric stroke have been performed. Rieke et al. found that mortality was reduced from 79% in control patients to 34% in those who underwent DC, with a concomitant reduction in poor functional outcome from 95% to 50%. The mean time interval from stroke to surgery was 39 hours in this study, relatively early in the time course, which may have prevented the patients from having secondary injury due to herniation. Schwab et al. reduced mortality with DC to 16%. Both of these studies, however, found that functional outcome was consistently less improved in the elderly population. The Swedish Malignant Middle Cerebral Artery Infarction Study looked at the long-term (median 3.4 years) outcome... 

Durham, L. K., Webb, S. M., Milos, P. M., Clary, C. M. Seymour, A. B. (2004). The serotonin transporter polymorphism, 5HTTLPR, is associated with a faster response time to sertraline in an elderly population with major depressive disorder. Psychopharmacology, 174, 525-9. 

Chronological Age. Because of this wide variation within the elderly population, it is difficult to devise a catch-all age one must attain to be considered elderly. Within the government, there also appears to be a problem of consistently defining this age group. Table 2, which lists a variety of federally funded programs and their corresponding age criteria, illustrates this point quite well. Table 3 lists what seems to be one of the better classification systems that has been devised [5], As well as being the system currently used by the U.S. Bureau of the Census, it is often implemented in studies that specifically deal with elderly populations [6,7]. 

Table 9 lists the top 10 chronic conditions prevailing in the elderly population [136], Many of these conditions severely limit the range of activities that one can... 

Forsell Y and Fastbom J (2000). Psychotropic drug use in relation to psychiatric syndromes in a very elderly population. International Journal of Geriatric Psychopharmacology, 2, 86-89. 

H. pylori is now recognized as the main cause of selective gastric hypochlorhydria, which today is highly prevalent (more than 50%) in the normal elderly population of western countries and predominant in developing countries with prevalence often exceeding 90%. The in-... 

Colditz GA, Branch LG and Lipnic RJ. 1985. Increased green and yellow vegetables intake and lowered cancer death in an elderly population. Am J Clin Nutr 41 32-36. 

Landi F, Russo A, Liperoti R et al. (2007) Impact of inappropriate drag use on physical performance among a frail elderly population living in the community. Eur J Clin Pharmacol 63(8) 791-799... 

Johnson DA and Fennerty MB (2004) Heartburn severity underestimates erosive esophagitis severity in elderly patients with gastroesophageal reflux disease. Gastroenterology 126(3) 660-664 Jonsson R, Sixt E, Landahl S et al. (2004) Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res 14(1) 47-52... 

The pharmaceutical industries, universities, various institutes etcetera invest hundreds of billions every year for research and development of new drugs or drug candidates. The investment for researching improvement of the actual use of drugs in the society and in individual patients is very limited compared to this. It is important to stress that a new treatment, even if more effective, not automatically improves health, especially not in the elderly population and when the practical use and handling, including compliance, is problematic. Instead of focusing on new... 

Improved disease reporting, surveillance, and epidemiologic studies of these diseases are needed. Little information exists about either the chronic effects of acute exposure to these marine toxins or about the long-term effects of chronic exposures, e.g., elderly populations in coastal retirement communities experiencing annual HABs. Little information is available about the environmental health effects, e.g., asthma exacerbations, from exposure to these toxins. 

Make a list of potential questions including mechanism of action, safety profile, use in paediatric and elderly populations, benefit or lack of benefit in pregnancy. Write standard answers to these questions to ensure that the response to questions from physicians, pharmacists, government agency physicians and research workers represents the best currently available scientific and medical opinion and provides a response that is consistent throughout the world. 

Debilitated or small elderly patients - Consider a starting dose of 0.5 mg, although this is only marginally effective in the overall elderly population. 

Elderly No overall differences in safety or effectiveness were observed in clinical trials between elderly and younger patients. However, because there is a higher incidence of infections in the elderly population in general, use caution in treating the elderly. 

Elderly Because there is a higher incidence of infections in the elderly population in general, use caution in treating the elderly. 

Fig. 1.12 Projection of US elderly population. Adapted from reference [7]...

The prevalence of hypo- and achlorhydria is high in the elderly population (Bo-Linn et ah, 1984). Furthermore, sufficient food consumption in the elderly is not always possible and in some situations potent gastric antisecretory medications may be prescribed for long-term use in older people (Bo-Lirm et ah, 1984 Evenepoel, 2001). A source of Ca that is more... 

In recent years, several pilot clinical trials, assessing the elfects of GH administration to ageing adults, have been carried out. Typically, trial duration is 4-6 months. A 7% increase in lean body mass and skin thickness, along with a 14% drop in body fat, was observed in one trial, although results recorded in other trials were less striking. More detailed clinical trials and cost benefit analysis must be carried out in order to fully assess the potential of GH to counteract some of the elfects of ageing in the elderly population. 

Ohmit, S. E., A. Furumotodawson, A. S. Monto, andN. Fasano. 1995. Influenza Vaccine Use among an Elderly Population in a Community Intervention. American Journal of Preventive Medicine 11 (4) 271-276. 

Silagy CA, McNeil JJ, Donnan GA, Tonkin AM, Wor-sam B, Campion K. Adverse effects of low-dose aspirin in a healthy elderly population. Chn Pharmacol Ther 1993 54(l) 84-9. 

One should consider infiuenza- and pneumococcal-vaccination in patients with increased risk for lower RTI including patients with chronic obstructive pulmonary disease like chronic bronchitis or emphysema and cystic fibrosis patients. It should be considered for the elderly population in general. There is no role for prophylactic antibiotic therapy in patients with frequent RTI. Attempts should be made to have those patients that smoke stop doing so. 

Lipton RB. Assessment of cognitive function of the elderly population effects of darifenacin. J Urol 2005 i73 493. 

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