Reviews in clinical gerontology最新文献

{"title":"Aortic stenosis: current treatment options for a common condition in old age","authors":"D. Tiwari, J. Radvan, S. Allen","doi":"10.1017/S0959259812000032","DOIUrl":"https://doi.org/10.1017/S0959259812000032","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"195-203"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small vessel cerebrovascular disease in older adults","authors":"H. Slavin, J. McManus, D. Stott","doi":"10.1017/S0959259812000056","DOIUrl":"https://doi.org/10.1017/S0959259812000056","url":null,"abstract":"‘Cerebral small vessel disease’ is common in older adults and is an important cause of morbidity, functional impairment and cognitive decline. Small vessel disease is a collective term used to describe a number of underlying pathological processes and neuroimaging findings, such as lacunar infarcts, white matter lesions and microhaemorrhages.With readily available neuroimaging, diagnostic accuracy has improved; however, the management of small vessel disease and prevention of cognitive decline remains uncertain. Treatment of conventional vascular risk factors may be appropriate, but future research is required to provide definitive answers. We have conducted a comprehensive literature review of cerebral small vessel disease in older adults. This highlights the clinical sequelae and underlying pathological processes, whilst discussing novel diagnostic neuroimaging and therapeutic strategies.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"184-194"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continence aids in the management of urinary incontinence","authors":"J. Browning, Z. Zaheer, A. Orzechowska, A. Mistri","doi":"10.1017/S0959259811000244","DOIUrl":"https://doi.org/10.1017/S0959259811000244","url":null,"abstract":"Urinary incontinence is a common problem, more so in older people and those in residential or nursing homes. Guidelines promote a structure to the management of incontinence, recommending non-pharmacological measures (including continence aids) as first-line options. Anticholinergic medications are used widely for urge incontinence, and surgical measures employed in selective cases.Whilst other treatments are being tried, or where incontinence is refractory to treatment (about 30% of cases), it is important to promote continence or contain incontinence with continence aids in order to minimize psychological complications. What can be a bewildering array of aids is available and choosing the right type of aid requires knowledge of these. Here, we suggest a classification of continence aids, describing individual characteristics and appropriate situations for use.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"85-98"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57027611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging older people in decisions about their healthcare: the case for shared decision making","authors":"J. Lally, E. Tullo","doi":"10.1017/S0959259811000281","DOIUrl":"https://doi.org/10.1017/S0959259811000281","url":null,"abstract":"Shared decision making in clinical practice involves both the healthcare professional, an expert in the clinical condition and the patient who is an expert in what is important to them. A consultation involving shared decision making enables an examination of the options available, consideration of the risks and benefits whilst incorporating the values of the patient into the decision making process. A decision is aimed at, which is both clinically appropriate and is congruent with the patient's values. Older people have been shown to value involvement, to varying degrees, in decisions about their care and treatment. The case of atrial fibrillation shows the opportunities for, and benefits of, sharing with older people decision making about their healthcare.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloproliferative disorders in older people","authors":"W. Osborne, G. Jones, G. Jackson, H. Marr","doi":"10.1017/S0959259811000256","DOIUrl":"https://doi.org/10.1017/S0959259811000256","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"108-118"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57027786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighbourhoods and dementia in the health and social care context: a realist review of the literature and implications for UK policy development","authors":"J. Keady, Sarah Campbell, H. Barnes, R. Ward, Xia Li, C. Swarbrick, S. Burrow, Ruth Elvish","doi":"10.1017/S0959259811000268","DOIUrl":"https://doi.org/10.1017/S0959259811000268","url":null,"abstract":"The National Dementia Strategy in England has performed an essential role in transforming health and social care services and improving the commissioning architecture. However, to date, little attention has been paid to understanding the ways in which the outdoor and built environment impacts and intersects with the lives of people with dementia and their carers. One way of better understanding the outdoor and built environment is through a focus on the 'neighbourhood' as this is an area of public policy where attempts are being made across disciplines to unpack its meanings, significance and identity. This paper adopts a realist review method to detail the key findings and messages from the body of work that links the experience of living with dementia to the neighbourhood. Our findings from this review are assimilated and defined/presented under three headings, namely: outdoor spaces, built environment, and everyday technologies. These headings and our definitions are not discrete properties and there is some overlap in content. We found no research that sets out to enquire about how people with dementia might define their neighbourhood or that explores everyday neighbourhood practices for those living with the condition. Emerging concepts such as citizenship and, in the UK, the Coalition Government advancement of the 'Big Society', promote a vision of civic responsibilities and networked, dementia-capable communities, but evaluation of such initiatives are virtually absent from the literature. The review did uncover some interesting and innovative research methods that extend neighbourhood working, such as the 'walking interview'. In order to develop a neighbourhood model for dementia, future research should examine the relationship and interaction between the neighbourhood as a social space and as a physical space alongside the active role of people with dementia as 'place-makers'. Copyright © Cambridge University Press 2012.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"150-163"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57027926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep in older people","authors":"M. Woodward","doi":"10.1017/S0959259811000232","DOIUrl":"https://doi.org/10.1017/S0959259811000232","url":null,"abstract":"Insomnia and other sleep disturbances are common in older people, with up to 40% reporting some difficulty sleeping. Insomnia is a syndrome with multiple causes including medications, other illnesses and environmental factors. An accurate diagnosis is needed for effective management. Sleep disturbances are associated with functional and cognitive impairment and excess mortality. Management should initially be non-pharmacological including sleep hygiene education and behavioural therapy. Medications, including benzodiazepines (BZDs), are second-line with little evidence to support long-term usage. BZD usage in older people is associated with a range of disorders including falls, accidents and cognitive impairment. The management of insomnia in specific situations such as residential care, those with dementia and depressed older people can be challenging. Additional research is needed, particularly on the risks/benefit of long-term pharmacotherapy and to determine whether therapy reduces the consequences of sleep disturbances.","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"524 1","pages":"130-149"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57027967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continence aids in the management of urinary incontinence – CORRIGENDUM","authors":"J. Browning, Z. Zaheer, A. Orzechowska, A. Mistri","doi":"10.1017/S0959259812000020","DOIUrl":"https://doi.org/10.1017/S0959259812000020","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"98-98"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259812000020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57028364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review.","authors":"Andrew P Clegg,&nbsp;Sally E Barber,&nbsp;John B Young,&nbsp;Anne Forster,&nbsp;Steve J Iliffe","doi":"10.1017/S0959259811000165","DOIUrl":"https://doi.org/10.1017/S0959259811000165","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and long-term care admission.</p><p><strong>Objectives: </strong>To evaluate whether home-based exercise interventions improve outcomes for frail older people.</p><p><strong>Data sources: </strong>We searched systematically for randomised controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010.</p><p><strong>Study selection: </strong>All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalisation.</p><p><strong>Results: </strong>Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies.</p><p><strong>Conclusions: </strong>There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.</p>","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"68-78"},"PeriodicalIF":0.0,"publicationDate":"2012-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34518679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular dementia: why pathology is still important","authors":"J. Neal","doi":"10.1017/S0959259811000207","DOIUrl":"https://doi.org/10.1017/S0959259811000207","url":null,"abstract":"","PeriodicalId":85413,"journal":{"name":"Reviews in clinical gerontology","volume":"22 1","pages":"35-51"},"PeriodicalIF":0.0,"publicationDate":"2012-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0959259811000207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57027579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}