RedScrubs
The Resource for Medical Professionals

Studies on the utility of the diagnosis of metabolic syndrome in predicting cardiovascular mortality among older adults are not readily available. This study focused on evaluating the diagnosis of metabolic syndrome on participants’ mortality rate between 1989-2004 among 4258 US adults 65 years of age and older who were at the time of enrollment free from cardiovascular disease (CVD). The study was a multicenter, population-based, prospective cohort and was published in the Archives of Internal Medicine, May 12, 2008.

It is projected that by the year 2025 the majority of patients with diabetes will be aged 65 or older. Diabetes prevalence will increase by more than 200% in persons aged 65-74 and by more than 400% in those 75 and older. In patients with diabetes, the disease itself already accounts for 52% of nursing home admissions and 47% of deaths – percentages that only increase when corrected for related cardiovascular conditions.

The importance of lipid therapy in the cardioprotective and treatment aspects of heart disease is well documented, particularly in the elderly population. Statins have been used along with diet, to control lipids for years.

More recent studies have lowered the recommendations from < 100 for LDLs to < 80 or <70 mg/dl. The authors state that more intensive statin therapy has resulted in more marked cardiovascular event reduction. The authors, in particular, review the safety and efficacy of intensive vs. less intensive statin therapy. Their studies reviewed that safety and efficacy standards were met for dosages of 80 mg./day. Dietary intervention was not a variable considered here.

Reduced food intake and weight loss are normal features of advancing age. Evidence is increasing that non-demented elderly malnourished people benefit from nutritional supplements. Randomized trials are not evident in the literature on demented patients and benefits they may receive from nutritional supplements via tube. This article highlights two problems from the tube feeding of demented patients: 1) they lack the potential for physical or neurological rehabilitation and 2) they are not starving. They are, the article argues, in a state of physical homeostasis.

The old adage of “things will get worse before they get better” seems more and more to be the mantra of healthcare today. The troubles effecting today’s healthcare system are numerous and highly complex to the point that they must be hampering strategic planning. Several large issues are on the horizon for healthcare that if not addressed in the foreseeable future could spell out devastating problems.

Reducing the Risk of Aspiration Pneumonia among Elderly Patients in Long-Term Care Facilities through Oral Health Interventions Aspiration Pneumonia (AP) is a major reason for admission to the hospital from nursing homes and the second most common type of nosocomial infection in hospitalized patients. AP is also the leading cause of death with the risk for AP increasing with age and the presence of dysphagia.

“Hospital follow-up falls short”, was the headline from the Sunday’s (February 24th, 2008) Sacbee (Sacramento Bee News). The sordid story of how unsuccessfully hospitals are dealing with the transition process of discharging elderly patients home, or to a skilled nursing facility (SNF , aka: Nursing Home). The article tells of the inadequate planning carried out when discharging patients home, with a focus on the elderly. It is a story of fragmented care.

Dr. Bartali of Yale University recently unveiled a study that showed a relationship between low vitamin E levels and a subsequent physical decline in older adults. While other nutrients were also measured, vitamin E stood out as a culprit in the relationship to the decline in physical functioning of older Americans, particularly in the age group of 70-80 years and in those greater than 81 years.

Vitamin D supplementation at levels of 1,000 IU /day reduces risk of falls in elderly women with a history of falls regardless of the season of the year according to the Jan. 14, 2008 issue of a popular medical magazine, JAMA (Journal of the American Medical Association). This is an important finding as at least 1/3 of women over 65 sustain a fall within the year with about 6% of those women sustaining a fracture.