Gerontology
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The prevalence of malnutrition in institutionalized elderly people is generally high. A good nutritional status is related to a decrease in mortality and costs of morbidity treatments. Therefore, it is essential to know the nutritional status in order to establish action policies. However, there are not enough studies about malnutrition in institutionalized elderly in Spain. ⋯ The prevalence of malnutrition and risk of malnutrition was 40.1%. Female gender and living in institutions located in the main city were identified as malnutrition risk factors. In general, an increase in malnutrition with age was detected, except for people in the last years of their lives. The MNA questions that best predicted the nutritional status were the ones relating to the anthropometrical and self-assessments.
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To study whether geriatric patients with mild-to-moderate hyponatremia (≤131 mmol/l) reveal different outcomes in structured tests for functional and cognitive impairments, depression and malnutrition compared to normonatremic patients. ⋯ We were able to demonstrate that geriatric patients with mild-to-moderate hyponatremia revealed a significantly worse outcome in all standardized tests of the geriatric assessment compared to a normonatremic control group. Serum sodium levels should therefore be considered when interpreting common tests of geriatric assessment.
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N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma levels are associated with congestive heart failure severity, and are an important diagnostic tool for assessing patients with acute dyspnea. Reduced renal function increases NT-proBNP concentrations, and therefore it might be a confounding factor in chronic kidney disease (CKD) patients. ⋯ NT-proBNP plasma levels progressively increase with worsening of renal function, and appear to be related to the five K/DOQI stages of CKD. For this purpose, GFR assessed with the GFR(MAYO) formula appears to better stratify NT-proBNP in older adult subjects. Renal function should be considered when interpreting NT-proBNP levels in older adult patients admitted for dyspnoea.
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Prostate cancer, like many diseases, is more common in older men. Although an estimated 1 in 7 men will be diagnosed with it, the majority of these men will not die from prostate cancer. ⋯ As the US population continues to age, prostate cancer screening and disease management presents an increasingly important public health issue. We discuss the current PSA screening recommendations and practices in the USA and the benefits and harms of screening older populations.
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The goals of a post-stroke rehabilitation plan are very specific to each patient. The side of the body affected by hemiplegia can influence the rehabilitation plan, as people with right-sided hemiplegia may also have difficulties with speech and language (aphasia). Because of the aphasia, drawing may remain a crucial instrument of creative expression and the clinical case presented highlights how this goal may also be successfully achieved in the elderly by using the left hand.