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Latest & greatest articles for elderly
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on elderly or other clinical topics then use Trip today.
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CT and MR imaging used in age estimation: a systematic review. Computer Tomography (CT) and Magnetic Resonance Imaging (MRI) may be useful tools in assessment of age of an individual. This article presents a review of published studies using CT or MRI in dental age estimation. They were published between July 2004 and September 2017 investigating different types of teeth, methods and formulae for age estimation. Twenty-seven articles were included. The different studies show good results
Efficacy and safety of drug-eluting stents in elderly patients: A meta-analysis of randomized trials. Current guidelines recommend newer generation drug-eluting stents (DES) over bare-metal stents (BMS) in patients with ischemic heart disease. However, there is no age-specific recommendation in elderly patients.Meta-analysis was performed of 6 randomized studies enrolling 5,042 elderly patients who underwent percutaneous coronary intervention (PCI) with stent implantation (DES, n = 2,579; BMS (...) not significantly different between groups. In a subgroup meta-analysis, short duration (1 or 6 months) dual antiplatelet therapy (DAPT) was associated with a significantly lower MACE rate (OR 0.49, 95% CI 0.34-0.80; p = 0.003) in elderly patients who underwent PCI with everolimus-eluting stent (EES) implantation, compared with that using long duration DAPT.This meta-analysis provides clinically relevant evidence that DES rather than BMS should be selected for elderly patients.
Fracture risk in young and middle-aged adults with type 1 diabetes mellitus: A systematic review and meta-analysis. Type 1 diabetes mellitus (T1DM) is associated with skeletal fragility. While previous meta-analyses have demonstrated an increased risk of fracture in individuals with T1DM, little is known about fracture risk in T1DM, in the absence of age-related confounders.To determine the risk of fracture in young and middle-aged adults with T1DM aged 18-50 years old.Systematic review (...) and meta-analysis.Ovid MEDLINE, PubMed, EMBASE, EBM reviews and relevant conference abstracts.Studies of adults aged between 18-50 years with type 1 diabetes mellitus, with reported fracture outcomes.Incident or prevalent fracture.Six studies were included in the meta-analysis. A total of 1724 fractures occurred in 35 925 patients with T1DM and 48 253 fractures occurred in 2 455 016 controls. RR for all fractures was 1.88 (95% CI 1.52-2.32, P < .001). Fifty-six hip fractures occurred among 34 707
Poor Sleep and Risk of Falls in Community-Dwelling Older Adults: A Systematic Review. Concerns about sleep problems and falls in older adults are significant. This article reviews the association between sleep problems and falls in community-dwelling adults aged 65 years or older. Multiple databases were searched from inception until 2015 using sleep, sleep disorders, and falls as keywords, limiting to studies published in English in peer-reviewed journals. After screening and assessing (...) for eligibility, 18 articles were selected based on the inclusion and exclusion criteria. Findings of an association between sleep problems and risk of falls are conflicting, but some specific sleep problems such as extremely short sleep duration, daytime sleepiness and naps appear to be significantly related to falls in older adults. Methodological limitations including variability in covariates included in the analyses and measurement of the exposure and outcome variables were identified. The results
Interventions that support major life transitions in older adulthood: a systematic review. ABSTRACTBackground:Major life transitions can negatively impact the emotional well-being of olderpeople. This study examined the effectiveness of interventions that target the three most common transitions in later life, namely bereavement, retirement, and relocation.A systematic search was performed via MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, and reference lists of retrieved non-randomized (...) and randomized controlled trials (RCTs) in English that studied the effectiveness of interventions addressing the three transitions in those >50 years of age. Two researchers independently selected the publications, piloted the data extraction form, and critically appraised studies specific to transition type and study design.A total of 11 studies (bereavement: 7; retirement: 2; relocation: 2) of 8 unique interventions met the inclusion criteria of which nine were RCTs and two were of quasi-experimental
Effectiveness of Combined Cognitive and Physical Interventions to Enhance Functioning in Older Adults With Mild Cognitive Impairment: A Systematic Review of Randomized Controlled Trials. Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in individuals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging (...) evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research.We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to individuals with MCI over the age of 50 were eligible. Our search yielded 10 eligible
Older adults' experiences of patient involvement in transitional care: a qualitative systematic review protocol. The objective of this review is to identify and synthesize older adult's experiences of patient involvement in transitional care between hospital and home. The purpose is to build theory to inform future research and clinical practice.The review will specifically address the following research questions.
Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review. The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population.Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity (...) . Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes.The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance.Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams
Effectiveness of interventions for non-specific low back pain in older adults. A systematic review and meta-analysis. Systematically review the literature about all available interventions to manage non-specific low back pain (NSLBP) in older adults (≥60 years).We searched the Medline, EMBASE, CINAHL, LILACS, PEDro, and Cochrane CENTRAL databases reference lists for randomized controlled trials (RCTs) testing interventions for NSLBP. Two independent reviewers extracted data, assessed the risk (...) of bias and completeness of the description of interventions.Eighteen (RCTs) fulfilled the eligibility criteria. Evidence about interventions to manage NSLBP in older adults is weak. Very low to moderate quality evidence showed that complementary health approach (i.e., manual therapy, acupuncture, mindfulness, yoga), percutaneous electrical nerve stimulation (PENS), education, exercise or pharmacological agents were not effective to produce a clinically significant reduction in pain and disability
Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice.Pragmatic, three armed, parallel group, individually randomised controlled trial.59 general (...) practices in the Netherlands.322 adults aged 50 and older with a chronic vestibular syndrome.Stand alone VR comprising a six week, internet based intervention with weekly online sessions and daily exercises (10-20 minutes a day). In the blended VR group, the same internet based intervention was supplemented by face-to-face physiotherapy support (home visits in weeks 1 and 3). Participants in the usual care group received standard care from a general practitioner, without any restrictions.The primary
The effect of a geriatric evaluation on treatment decisions and outcome for older cancer patients - A systematic review. The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome.A systematic search in MEDLINE and EMBASE for studies on the effect (...) of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancer patients.36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8-54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26-100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31
18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy treatment planning for oesophageal cancer (all ages) NHS England » 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy treatment planning for oesophageal cancer (all ages) Search Search Menu 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed-tomography (PET CT) as part of radical radiotherapy (...) treatment planning for oesophageal cancer (all ages) Document first published: 12 April 2019 Page updated: 12 April 2019 Topic: Publication type: , NHS England will not routinely commission 18F-FDG-PET CT as part of radical radiotherapy treatment planning for oesophageal cancer in accordance with the criteria outlined in this document. In creating this policy NHS England has reviewed this clinical condition and the options for its treatment. It has considered the place of this treatment in current
Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) NHS England » Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) Search Search Menu Pazopanib for inoperable and metastatic malignant granular cell tumour (all ages) Document first published: 12 April 2019 Page updated: 12 April 2019 Topic: Publication type: , This policy statement is to confirm that pazopanib is not recommended as a treatment option for inoperable and metastatic (...) malignant granular cell tumours (all ages). Document PDF 62 KB 3 pages Document PDF 58 KB 3 pages Document PDF 51 KB 4 pages Document PDF 87 KB 2 pages
Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) NHS England » Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) Search Search Menu Emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors (all ages) Document first published: 21 August 2019 Page updated: 21 August 2019 Topic: Publication type: , NHS England (...) will commission emicizumab as prophylaxis in people with severe congenital haemophilia A without factor VIII inhibitors in accordance with the criteria outlined in this policy. Document PDF 308 KB 22 pages Document PDF 446 KB 35 pages Document PDF 103 KB 4 pages Document PDF 103 KB 5 pages Document PDF 129 KB 2 pages
Brolucizumab–dbll (Beovu) - wet age-related macular degeneration CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 761125Orig1s000 CLINICAL PHARMACOLOGY REVIEW(S) 1 Office of Clinical Pharmacology Review BLA Number 761125 Link to EDR Link Submission Date 02/07/2019 Submission Type Priority Proposed Brand Name Beovu Generic Name Brolucizumab (RTH258) Dosage Form and Strength 120 mg/mL solution for intravitreal injection Route of Administration Local Proposed Indication Treatment (...) of neovascular age-related macular degeneration (AMD) Applicant Novartis Pharmaceuticals Corporation Associated IND IND 112023 OCP Review Team Abhay Joshi, Ph.D. Philip Colangelo, Pharm.D., Ph.D. OCP Final Signatory John A. Lazor, Pharm.D. Office of Clinical Pharmacology Division IV Director Reference ID: 44719932 Table of Contents Table of Contents 2 1. EXECUTIVE SUMMARY 3 1.1 Recommendations 3 1.2 Post-Marketing Requirements and Commitments 4 2. SUMMARY OF CLINICAL PHARMACOLOGY ASSESSMENT 4 2.1
Effect of Clinical Geriatric Assessments and Collaborative Medication Reviews by Geriatrician and Family Physician for Improving Health-Related Quality of Life in Home-Dwelling Older Patients Receiving Polypharmacy: A Cluster Randomized Clinical Trial Polypharmacy and inappropriate drug regimens are major health concerns among older adults. Various interventions focused on medication optimization strategies have been carried out, but the effect on patient-relevant outcomes remains uncertain.To (...) investigate the effect of clinical geriatric assessments and collaborative medication reviews by geriatrician and family physician (FP) on health-related quality of life and other patient-relevant outcomes in home-dwelling older patients receiving polypharmacy.Cluster randomized, single-blind, clinical trial. Norwegian FPs were recruited from March 17, 2015, to March 16, 2017, to participate in the trial with their eligible patients. Participants were home-dwelling patients 70 years or older, using
Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial Objectives. To evaluate the effectiveness of point-of-care informational interventions in general practitioner clinics to improve influenza and pneumococcal vaccination uptake among elderly patients.Methods. We conducted a pragmatic, cluster-randomized crossover trial in 22 private general practitioner (...) clinics in Singapore, from November 2017 to July 2018. We included all patients aged 65 years or older. Clinics were assigned to a 3-month intervention (flyers and posters encouraging vaccination) plus 1-month washout period, and a 4-month control period (usual care). Primary outcomes were differences in vaccination uptake rates between periods. Secondary outcomes were identification of other factors associated with vaccination uptake.Results. A total of 4378 and 4459 patients were included
Effect of the Tailored, Family-Involved Hospital Elder Life Program on Postoperative Delirium and Function in Older Adults: A Randomized Clinical Trial Postoperative delirium (POD) is a common condition for older adults, contributing to their functional decline.To investigate the effectiveness of the Tailored, Family-Involved Hospital Elder Life Program (t-HELP) for preventing POD and functional decline in older patients after a noncardiac surgical procedure.A 2-arm, parallel-group, single (...) . Secondary outcomes included the pattern of functional and cognitive changes (activities of daily living [ADLs], instrumental activities of daily living [IADLs], Short Portable Mental Status Questionnaire [SPMSQ]) from hospital admission to 30 days after discharge, and the length of hospital stay (LOS).Of the 475 patients screened for eligibility, 281 (171 [60.9%] male, mean [SD] age 74.7 [5.2] years) were enrolled and randomized to receive t-HELP (n = 152) or usual care (n = 129). Postoperative delirium