Aging clinical and experimental research
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With increasing life expectancy, fragility fractures of the pelvic ring (FFP) are becoming frequent. In elderly, osteoporosis leads to a decrease of bone strength and resistance to the ligament's traction; this represents the most important difference between FFP and fractures in young patients. Usually, these fractures are underestimated and treatment is often conservative. ⋯ Our study shows encouraging results and demonstrates that minimally or less invasive osteosynthesis technique could lead to good outcome in these patients.
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High-quality education and training standards in geriatric medicine are important to develop the profession of geriatric medicine. The objective of the study was to give a structured update on postgraduate specialty training in geriatric medicine throughout Europe to assess the need for further developments in postgraduate education. ⋯ The survey tries to give an actual condensed picture of postgraduate specialty training in geriatric medicine across Europe. Results show a consistent improvement in the recognition of geriatric medicine as independent specialty over the last decade. Continuous development of specialty training in geriatric medicine is required to medical address the public health needs of an aging population. Competence-based educational models including adequate forms of assessment should be targeted throughout Europe. To emphasize the importance of postgraduate geriatric training, it should be a mission to harmonize training standards across Europe.
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Randomized Controlled Trial
Feasibility study of dual-task-managing training to improve gait performance of older adults.
Dual task (DT) training is becoming prominent in fall prevention. However, DT training should include task-managing strategies like task switching or task prioritization to be beneficial to improve gait performance under DT conditions. The aim of this pilot study was to evaluate the effect of a task managing training on gait stability. ⋯ The training successfully improved gait performance and therefore might be a promising approach to prevent falls. Additional fall prevention studies should focus on motor-cognitive performance and reinforce outcomes of task managing strategies.
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Sarcopenia staging systems have been proposed, but little is known on their application in hip-fracture patients. Our aim was to assess the prevalence of presarcopenia and sarcopenia and their association with ability to function in activities of daily living in hip-fracture women. ⋯ The prevalence of presarcopenia and sarcopenia was high in hip-fracture women. Presarcopenic women had higher ability to function in activities of daily living than sarcopenic women.
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The aim of this study was to compare the efficacy of four analgesia techniques on postoperative pain after per-trochanteric femur fracture. A retrospective cohort study was conducted on 131 consecutive patients older than 75 years enrolled in an 18-month period and who underwent per-trochanteric fracture repair under spinal analgesia. ⋯ The greater effectiveness was achieved by preventing the onset of pain with drugs administered at time intervals (rescue dose of analgesic in 48 % of patients in G3, 58 % in G1 and 48 % in G4 vs. 22 % in G2 in the first day and rescue dose of analgesic in 32 % of patients in G3, 67 % in G1 and 76 % in G4 vs. 18 % in G2 in the second day; p < 0.05). Our study does not confirm the effectiveness of a single shot femoral nerve block on postoperative pain in per-trochanteric femur fracture (PAIN VAS score > 3 at t1 in 23 % of patients in G1 and 19 % in G4 vs. 10 % in G2 and G3; p < 0.05).