Gerontology is the science of human aging1, its implications and its involvement in the broadest sense. Its purpose is to study the modalities and the causes of the changes that age imparts to the functioning of living beings, on all levels (biological, psychological and social) and at all levels of complexity (molecule, cell, organ, organism and population). It is a meeting point of multiple disciplines.
Other disorders that affect people of all ages may cause different symptoms or complications in older people, for example; depression usually causes younger adults to become tearful, withdrawn, and noticeably unhappy.1 In older people, depression sometimes causes confusion, loss of memory, and apathy without a sense of sadness.1 Polypathology (co-existence of several chronic diseases in the same individual) is also common and therefore an understanding of polypharmacy (chronic consumption of more than four different drugs) is important.3
Geriatric medicine is not specifically defined by the age (of patients cared for), but must deal with the specific disease of the elderly. Most patients are over 65 years, but major challenges within geriatric medicine occur, particularly in terms of those patients who are 80 years and above.
1. Beers M. H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003 ;, 16-21.
2. van Balen R. et al. Hip Fracture in Elderly Patients: Outcomes for Function, Quality of Life, and Type of Residence. Clinical Orthopaedics & Related Research. September 2001 ; 390 : 232-243.
3. Crome P. What's different about older people ? Toxicology. October 2003 ; 192 (1) : 49-54.
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In the early stages in particular, dementia is often difficult to diagnose, since many symptoms are not recognized as such or are trivialized by the patient. 20% of actual dementia cases are reported to be incorrectly diagnosed as a different disease.
In early dementia the symptoms of Alzheimer’s disease include memory loss, disorientation and confusion. These symptoms are caused by the loss of neurons and worsen with continuous neurodegeneration. The pathology of dementia is not solely the result of a cholinergic deficit. It is known that, chronically and pathologically elevated glutamate concentrations play an important role.
In general two main groups of dementia can be distinguished, requiring different types of treatment:
Depending on the stage of the disease, clinical symptoms of varying intensity dominate. With the progression of AD, treatment is aimed particularly at improving and stabilizing personal everyday functions, so as to keep patients independent for as long as possible.
The last decade has seen an increase in the incidence and severity of Clostridium difficile infections (CDI), making it one of the most talked about disease topics with many recent congresses focusing on the disease.
As the leading cause of nosocomial diarrhoea in industrialised countries1 detection and treatment of CDI is extremely important. The ESCMID guidelines recommend that diagnosis is based upon both signs and symptoms and laboratory evidence of toxin producing C. difficile in stools.1,2 In addition antibiotic treatment to eradicate severe C. difficle infection is recommended in these guidelines.2
The management of systemic fungal infections is also a major challenge for healthcare professionals. Due to the invasive nature of fungal infections, many treatments are pre-emptive and are therefore initiated without identifying the specific fungus involved. Targeted approaches will become a more viable option as the speed and delivery of diagnostic methods improve.
The Anti-infectives Knowledge Centre aims to provide you with the most recent information in the areas of both CDI and systemic fungal infections with regularly updated content to help assist in the fight against these diseases.
The Knowledge Centre currently provides information on CDI, including:
- Prevalence – the incidence of CDI and the factors that have been attributed to the rise in these infections
- Symptoms – the symptoms of CDI, including how pseudomembranous colitis manifests
- Recurrence – the impact of recurring infection on patient outcomes
- Diagnosis – the importance of early diagnosis and the diagnostic tests available
- Treatment – treatment options recommended by the current ESCMID guidelines
Additional information on systemic fungal infections will be added soon.
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1. Crobach MJ, et al. Clin Microbiol Infect 2009; 15: 1053‐1066
2. Bauer MP, et al. Clin Microbiol Infect 2009; 15: 1067‐1079
Date of preparation November 2012 AI/12/0038/EUc
Baxter International Inc. has announced that its Phase III clinical study of immunoglobulin (IG) did not meet its co-primary endpoints of reducing cognitive decline and preserving functional abilities in patients with mild to moderate Alzheimer's disease. The Gammaglobulin Alzheimer's Partnership (GAP) study was conducted by Baxter in collaboration with the Alzheimer's Disease Cooperative...
Top-line data from a double-blind, randomized, controlled Phase IIb clinical study of CERE 120 (AAV-neurturin), from Ceregene, for Parkinson's disease failed to demonstrate statistically significant efficacy on its primary endpoint. Fifty-one patients with moderately advanced Parkinson's disease which could not be controlled with conventional medication were enrolled. Approximately half...
Lundbeck A/S and Otsuka Pharmaceutical company have announced a license and development agreement for Lu AE 58054, for the treatment of Alzheimer's disease. Under the terms of the agreement, Lundbeck will grant Otsuka co-development and co-commercialization rights to Lu AE58054 in the U.S., Canada, East Asia including Japan, major European countries and Nordic countries.
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Micolette is indicated whenever an enema is necessary for chronic and acute constipation in the rectum and sigmoid colon. Also indicated for use in constipation in geriatrics, pediatrics and...
Micralax is indicated whenever an enema is necessary to relieve constipation: in dyschezia, especially in bedridden patients; in geriatrics, paediatrics and obstetrics; and in preparation for X-ray...
The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for..
This chapter provides these scientifi cally supported treatment recommendations.
Both the pathogenesis and the treatment of osteoporosis may potentially interfere at different levels on the multi-stage complex cascade of events involved in bone healing/regeneration. To our knowledge no human studies have been performed to clarify the potential effect of osteoporosis on post-extraction alveolar..
Sensory Support Care for Elderly Patients Suffering From Alzheimer'S-type Neurodegenerative Disease (SensiCare)25-03-2013
The main objective of this study is to evaluate the effect of 3 months of "Snoezelen-type" multi-sensory care sessions on NeuroPsychiatric Inventory Questionnaire (NPI-Q) scores for patients with Alzheimer's-type neurodegenerative disease.
The aim of this study was to evaluate the quality of life of the empty nest elderly in China using meta-analytic techniques. Electronic databases were searched for studies concerning the quality of life of the empty nest elderly published before December 2011. Pooled weighted mean difference (WMD) and 95% confidence..
Determinants of emergency medical utilization among the elderly population in Taiwan: A national longitudinal cohort study
The aim of this study was to evaluate the potential determinants for emergency medical utilization by elderly patients in Taiwan. The data were drawn from the ‘Survey of Health and Living Status of the Elderly in Taiwan’, a population-based, longitudinal study of a nationally representative random sample of older..
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