Older people dependency

The average basal metabolic rate for humans is about 65 keal/h, or 1600 keal/day. Obviously, the rate varies for different people depending ori sex, age, weight, and physical condition. As a rule, the BMR is Jow er for older people than for younger people, is lower for females than for males, and is lower for people in good physical condition than for those who are out of shape and overweight. A BMR substantially above the expected value indicates an unusually rapid metabolism, perhaps caused by a fever or some biochemical abnormality. 

However, aging is not related to a general decline in intellectual abilities. Losses occur mainly in areas of performance that are directly dependent on intact sensory and motor abilities. Older persons also tend to encounter difficulties when called upon to perform cognitive and other tasks under pressure of time. The subjective significance of a task and a person s familiarity with the conditions under which performance is evaluated are further factors that assume greater importance in older people than in the young. 

Berwaerts JJ, Verhelst JA, Verhaert GC, et al. Corticotropin-dependent Cushing s syndrome in older people Presentation of five cases and therapeutical use of ketoconazole. J Am Geriatr Soc 1998 46 880-884. 

Hypertension is defined as persistently high systemic arterial blood pressure above 140/90 mmHg, although this does depend on age. For older people, a more realistic... 

Clomethiazole is used as a hypnotic for older patients because of its lack of hangover effect but it can still produce dependence. It should be used as a hypnotic only in the short-term. Hypnotics generally should be avoided in older people because of the risk of confusion, ataxia and falls as a consequence. 

As a rule, cannabis-dependent patients prefer the natural product to pure synthetic A -tetrahydrocannabinol. In comparative human studies it was shown, especially for women and older people, that the cannabidiol contained in cannabis calms those states of anxiety, as they are caused by pure THC. 

Normal resting pulmonary artery mean pressure (PAMP) is less than 25 mm Hg. This value is the sum of the left atrial pressure (LAP) and the pressure gradient needed to shift blood from the pulmonary arteries to the left atrium (fig. 1). The latter is called transpulmonary gradient (TPG). Therefore, TPG = PAMP - LAP. Pulmonary artery pressure depends on pulmonary vascular resistance (PVR) and also on the CO. The latter may change due to various reasons, in particular due to physical exercise. According to hemodynamic studies [18], physical exercise in healthy older people (especially >70 years) leads to an acute increase in PAMP more than in younger people. If CO doubles (e.g. from 5 to 101/min), PAMP and LAP rise approximately twice. This phenomenon is likely due to the worsened diastolic function of the left ventricle in the elderly. As we already mentioned, left ventricular diastolic dysfunction is frequently associated also with ESRD. 

The degree of dependence on the private vehicle of older people is remarkably similar to that of younger people. However, their driving pattern differs significantly they rarely drink and drive, they do not drive to work, they tend to drive at off-peak hours and in the daytime, they do not speed, etc. Travel behavior for a representative sample of a whole country is practically impossible to measure directly, and therefore data are based on extrapolations from limited surveys. The most recent U.S. National Household Transportation Survey was conducted by the U.S. Department of Transportation, Bureau of Transportation Statistics in 2001, and it included 60,000 individuals from 26,000 households. The results presented below are based on that survey (Collia et aL, 2003 Memmot, 2006). 

Type 2, also known previously as non-insulin-dependent diabetes mellitus (NIDDM), accounts for 90 to 95 percent of persons with diabetes mellitus.19 This form of diabetes usually occurs in adults, especially in older individuals.35,102 Type 2 diabetes, however, can also occur in young people, and there is concern that the incidence of this disease is increasing dramatically in children and adolescents.9,83 Although the specific factors responsible for this disease are unknown, a genetic predisposition combined with poor diet, obesity, and lack of exercise all seem to contribute to the onset of type 2 diabetes.50,81,83 Increased body weight is common in patients with type 2 diabetes. 

Older adults and pregnant women should consider the risks associated with barbiturate use. When a person ages, the metabolization rate for drugs decreases. As a result, people over age 65 are at higher risk of the harmful effects of barbiturates. There is also greater risk for drug dependence. 

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