Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyThe value of glycosylated hemoglobin (HbA1c) as a predictive risk factor in the diagnosis of diabetes mellitus (DM) in the elderly.
In order to evaluate the significance of HbA1c in the diagnosis of Diabetes Mellitus (DM) and the risk of future DM in the elderly, the HbA1c and the fasting glycemia of 2167 elderly subjects of 65-84 years were determined, taking part in the epidemiological Italian Longitudinal Study on Aging (ILSA). The subjects were divided in 3 groups according to their glycemic values, namely those with normal fasting glucose (NFG), with impaired fasting glucose (IFG), and diabetics. ⋯ The identification of new cases of DM in a follow-up of 3 years was modest: in the NFG group (2.35% among those who had an HbA1c<7.02 and of 2.99% of those who had HbA1c>7.02%), while in the IFG group the same analysis gave 14.14% of those with normal HbA1c, increasing progressively in parallel with the increase of the HbA1c values above 7.02%, reaching 19.59%. It is evident from these results, in agreement with the multifactorial characteristics of type 2 DM that one has to look for other predictive factors, such as the dysmetabolic lipid components, and first of all the genetic ones in the predictive diagnosis of DM.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyUrinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities.
Numerous risk factors of falls, including urinary incontinence and behavioral symptoms have been identified among elderly people in long-term care settings. However, it remains uncertain whether incontinence or behavioral symptoms are associated with recurrent falls and injurious falls. The purpose of this research was to examine the association between various types of falls and urinary incontinence or behavioral symptoms among the residents of long-term care facilities using the Cox proportional hazards models. ⋯ However, urinary incontinence was a risk factor for recurrent falls but not for injurious falls. In contrast, behavioral symptoms were an independent risk factor for injurious but not for recurrent falls. The results suggested that treatment or management of urinary incontinence and behavioral symptoms should be considered to prevent falls in long-term care settings.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyGender differences influence the outcome of geriatric rehabilitation following hip fracture.
Hip fracture represents the most dramatic expression of the disease, in terms of morbidity, medical cost and mortality. The incidence of hip fracture increases substantially with age. The purpose of this study was to evaluate the association between gender and geriatric rehabilitation outcome after traumatic hip fracture. ⋯ Recovery after hip fracture depends in large part on the pre-fracture health and functional ability of the patient. Gender differences in functional recovery may affect therapeutic and rehabilitative decision making. Functional recovery after traumatic hip fracture was better in men in comparison with women.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyRisk factors for postoperative infections in patients with hip fracture treated by means of Thompson arthroplasty.
Specific conditions associated with surgery may predispose elderly people to septic complications after hip fracture surgery. This study investigated the risk factors predisposing infection in aged patients with subcapital hip fracture. We performed a prospective study of 290 patients with displaced subcapital hip fracture, operated by means of Thompson hip hemi-arthroplasty (83.5% fractures in women). ⋯ Transfusion appeared to be correlated with superficial wound infection (OR=1.96), urinary infection (OR=1.76) and pneumonia (OR=2.85). Higher number of days waiting for surgery were related significantly with pneumonia (9.8+/-7.44 days vs. 6.39+/-3.75), or urinary tract infection (7.76+/-4.39 days vs. 6.17+/-4.14). We concluded that the transfusion and longer waiting time for surgery have been associated with the septic complications in elderly patients treated surgically for hip fracture.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyThe effect of increasing age on nocturnal joint pain in patients about to undergo hip or knee joint arthroplasty.
Many hip and knee joint scores rate nocturnal symptoms as important in their scoring systems. The aim of this study was to determine if being woken up with pain disappears with advancing age in patients with arthritic hip or knee joints. Data was collected from 60 patients with an average of age of 69.0 years through a questionnaire conducted at the time of their pre-operative assessment, 36 of them were awaiting hip replacements, 24 knee replacement surgery. ⋯ The average ages of those patients reporting night pain was 65.7 years and of those who did not report night pain 75.5 years. This is almost certainly because of a change in sleep pattern and nociceptive inputs. Although elderly patients may score more highly on other areas of a joint score they may be under assessed if nocturnal symptoms are relied upon.