Aging clinical and experimental research
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Randomized Controlled Trial
Dexmedetomidine reduces postoperative delirium after joint replacement in elderly patients with mild cognitive impairment.
Postoperative delirium (POD) is a common and serious surgical complication among the elderly, especially in those with amnestic mild cognitive impairment (aMCI). Dexmedetomidine (DEX) is neuroprotective for delirium. In this study, we determined the effect of intravenously administered DEX during general anesthesia on POD in elderly aMCI patients undergoing elective hip joint or knee joint or shoulder joint replacement surgery. ⋯ These findings suggested that DEX treatment during surgery significantly reduced POD incidence in both normal and aMCI elderly patients, suggesting that it may be an effective option for the prevention of POD.
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Advanced age is associated with increased severity of acute critical illnesses and admission to ICU. Despite advances in the support for older critically ill patients, the short- and long-term mortality rates remain substantial. The purpose of this study is to analyze the factors influencing the outcome of a geriatric population admitted to the ICU. ⋯ Advanced age, needs for vasopressor therapy, and mechanical ventilation are independent predictive factors of adverse outcome. Pre-admission functional status was not independently associated with unfavorable outcome.
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Fresh information on various low-trauma fractures of elderly adults is sparse. ⋯ The rise in the incidence of low-trauma knee fractures in Finnish older women from early 1970s until late 1990s has been followed by a continuous decline in the fracture rate. Reasons for the decline are unknown, but a cohort effect toward a healthier aging female population with improved functionality and decreased risk of injurious slips, trips, and falls could partly explain the observation.