The Pharmacology and Clinical Use of the Antidepressants Vilazodone, Levomilnacipran, and Vortioxetine for Depression in the Elderly
This article will examine the potential role in the elderly of the three latest antidepressants approved by the US Food and Drug Administration: vilazodone (January 2011), levomilnacipran (July 2013), and vortioxetine (September 2013). Thus far, vortioxetine was shown to be efficacious and tolerable in the elderly. Sub-group analyses involving vilazodone and levomilnacipran appear to show a similar efficacy in older compared with younger adults, although these are limited by small sample sizes. Issues related to pharmacodynamics, safety, tolerability, and the unique features associated with these drugs are further discusse...
Source: Current Geriatrics Reports - July 25, 2015 Category: Geriatrics Source Type: research
Paradoxical Low Flow/Low Gradient Severe Aortic Stenosis: an Emerging Phenotype in Older Adults with Valve Disease
Abstract
Aortic stenosis is a common disorder in older adults and is the second most common reason for open heart surgery. Paradoxical low flow/low gradient severe aortic stenosis, defined by a stroke volume index ≤35 mL/m2 with an left ventricular ejection fraction (EF) (LVEF) ≥50 %, is a recently recognized subset of aortic stenosis. It presents a unique challenge in diagnosis and management particularly in the elderly population. Physiologic changes of aging contribute to the development of this phenotype and its prevalence and true prognosis remains in dispute. Management options have expanded f...
Source: Current Geriatrics Reports - July 25, 2015 Category: Geriatrics Source Type: research
Obesity in Older Adults: Prevalence, Health Risk and Management of Care Among Nursing Home Residents
Abstract
The total number of older adults has increased markedly in recent decades with concurrent escalation in the proportion with a body mass index ≥30 kg/m2. Community-based studies indicate that obesity has a significant impact on the physical functioning and independence of older adults and increases the risk for nursing home admission. This review aims to describe the prevalence of obesity in nursing homes and the impact of such on individual health and aged care resources and to explore whether intervention strategies could improve obesity and quality of life in the nursing home population. (So...
Source: Current Geriatrics Reports - July 8, 2015 Category: Geriatrics Source Type: research
Current Standards and Advances in Diabetic Ulcer Prevention and Elderly Fall Prevention Using Wearable Technology
This article addresses the current and future trends of lower extremity risk prevention with an emphasis on the implications of wearable, transdermal, and implantable constant-monitoring devices and powered exoskeletons. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - July 8, 2015 Category: Geriatrics Source Type: research
Pressure Ulcers: Evidence-Based Prevention and Management
Abstract
There is limited good-quality research focused on the prevention and management of pressure ulcers. Current available evidence reveals that the following approaches may help to prevent pressure ulcers: the use of support surfaces such as specialized foam and specialized sheepskin overlays, mattress overlays on operating tables, consultation with a dietician to ensure adequate general nutrition, but it is not known whether any specific supplementation is useful, and moisturizing dry sacral skin. For management of existing pressure ulcers, it is unknown whether any specific support surface or dress...
Source: Current Geriatrics Reports - July 7, 2015 Category: Geriatrics Source Type: research
Management of Venous Stasis Ulcers in the Older Adult
Abstract
Venous stasis disease is common among older adults due to calf muscle pump failure, immobility, chronic edema, and obesity. Increased venous pressure increases the capillaries’ permeability allowing fluid, proteins, and blood cells to leak into the tissues. Ulceration is precipitated by reduced oxygen diffusion to the skin and microvasculature damages. While most chronic leg ulcers are caused by venous stasis disease, there is a need to rule out other underlying pathologies including arterial, neuropathic, metabolic, hematological, infectious, malignant, and inflammatory diseases. Compression t...
Source: Current Geriatrics Reports - July 7, 2015 Category: Geriatrics Source Type: research
Skin Manifestations of Internal Disease in Older Adults
Abstract
The skin is the largest and most visible organ in the body and can give diagnostic clues of systemic illness. These clues often become obscured through the normal aging process. The purpose of this review is to give an overview of the normal skin changes seen with aging and then discuss new findings with regards to cutaneous signs of systemic disease in the elderly. We performed a literature search on cutaneous manifestations of internal disease and limited our search to articles published within the last 5 years. We then narrowed down the articles on conditions that primarily affect the adults ...
Source: Current Geriatrics Reports - July 2, 2015 Category: Geriatrics Source Type: research
Management of Diabetic Foot Ulcers
Abstract
Diabetes is an increasing urgent global health issue, with an increasing prevalence in those aged 65 or over. Diabetic foot ulcers (DFUs) are a common complication, affecting up to 15 % of those diagnosed with diabetes; they can result in loss of employment, have a significant decrease on quality of life, may lead to limb loss and are costly to healthcare systems. In this paper, we discuss the recent advances in the various management options for diabetic foot ulcers. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - May 2, 2015 Category: Geriatrics Source Type: research
Foreign Body Aspiration in the Elderly Patient
We describe the epidemiology, clinical presentation, and treatment options in the elderly patient. A high index of suspicion and prompt multidisciplinary approach maximize the likelihood of a positive outcome. An assessment of the technological and human capital necessary to address this life-threatening condition will likely guide the decision to treat or transfer the patient to the appropriate facility. Flexible and rigid bronchoscopies are the cornerstones of the diagnosis and treatment and should always be offered to the patient, regardless of the overall clinical condition. The probability of successful foreign body r...
Source: Current Geriatrics Reports - May 1, 2015 Category: Geriatrics Source Type: research
The Role of Muscle Mass, Muscle Quality, and Body Composition in Risk for the Metabolic Syndrome and Functional Decline in Older Adults
Abstract
Age-related body composition changes include both loss of muscle mass (sarcopenia) and increase in fat mass, which jointly contribute to a decline in metabolic functions. Muscle quality is positively related to functional capacity and a lower risk for the development of the metabolic syndrome in aging populations. Muscle quality and muscle strength have become more reliable measures of functional capacity and mobility disability than muscle mass quantity. Recent reports also suggest that excess fat mass in older adults may impair muscle quality and that combination of excess body fat and muscle l...
Source: Current Geriatrics Reports - April 24, 2015 Category: Geriatrics Source Type: research
