Abstract：
:To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Parmelee PAsubject
Has Abstractpub_date
1996-08-01 00:00:00pages
473-87issue
3eissn
0749-0690issn
1879-8853journal_volume
12pub_type
杂志文章,评审abstract：:Urinary infection is the most common infection in elderly populations. There is a high prevalence of asymptomatic bacteriuria, but this is benign and does not require treatment. A urine specimen for culture should be obtained before initiating antimicrobial therapy for symptomatic infection. Antimicrobial treatment re...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2009.04.005
更新日期：2009-08-01 00:00:00
abstract：:This review describes the effect of type 2 diabetes on fat mass, fat distribution, and lean mass, and changes in these parameters, in older adults, focusing on observational studies. Studies show that type 2 diabetes is associated with an unfavorable body composition characterized by more visceral fat, less thigh subc...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.08.020
更新日期：2015-02-01 00:00:00
abstract：:Aging implies changes in joint components over a continuum of time that contribute later in life to an increasing frequency of clinical complaints and impairments in function and mobility. This article considers how aging appears to modify the articular cartilage, subchondral bone, muscle, the soft tissues, synovial m...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1998-08-01 00:00:00
abstract：:This article summarizes the common, superficial, cutaneous, fungal infections that are found in older adults. The epidemiology, classic appearance, and current treatments of these fungal infections are discussed. These common skin pathogens occur in many older adults. ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2013.01.001
更新日期：2013-05-01 00:00:00
abstract：:This article attempts to summarize some of the pertinent literature in the context of the authors' clinical experience and suggests that a comprehensive psychiatric and medical evaluation, as well as a combined behavioral/environmental approach together with appropriate pharmacotherapy, are important tools in the mana...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1998-02-01 00:00:00
abstract：:Patients commonly are left to suffer from pain that affects their daily lives. The prevalence of undertreated, moderate to severe pain is a public health problem in many countries, including the United States. In many cases, opioids should be the mainstay for the treatment of this level of pain, but they often are not...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70085-9
更新日期：2001-08-01 00:00:00
abstract：:Behavioral signs and symptoms in dementia are common, morbid, classifiable, and treatable. The current state-of-the-art approach is to evaluate carefully for social or environmental causes, intercurrent medical conditions, or other triggers of the behavior and attempt to deal with those directly. When these conservati...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70073-2
更新日期：2001-05-01 00:00:00
abstract：:Colorectal cancer is one of the leading causes of death in older men and women. Therefore, this age-related cancer is of particular importance to geriatricians. The high incidence of this cancer may be decreased by dietary modifications recommended by the American Cancer Society. Early cancer detection is important to...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1987-11-01 00:00:00
abstract：:What are the dermatologic needs of aging and skin disease in the elderly in the new millennium? This question may be impossible to answer, but predictions may be derived from current sources of data. Data from the US Census Bureau and the National Ambulatory Medical Care Survey are used to characterize current use of ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/s0749-0690(05)70090-2
更新日期：2001-11-01 00:00:00
abstract：:A large percentage of subjects receiving a normal calcium intake of 800 mg per day was in negative calcium balance and increasing the calcium intake to various levels up to 2200 mg per day showed a plateau of the calcium balance at the 1200 mg per day intake, indicating a threshold of calcium absorption at this intake...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:This article provides a brief overview of the challenges and opportunities of new technologies in the area of geriatric pain management. It also reviews emerging evidence to demonstrate the role technology may play in improving and advancing assessment and management of pain in older adults. ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2016.06.011
更新日期：2016-11-01 00:00:00
abstract：:Depression is common in geriatric patients, especially in those with multiple comorbidities and polypharmacy. Depression in older adults is often underdiagnosed and undertreated. Initial screening for depression can easily be accomplished in the waiting room. Yet the clinical interview still remains the gold standard ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2017.03.007
更新日期：2017-08-01 00:00:00
abstract：:Older adults disproportionately sustain morbidity and mortality due to vaccine-preventable illnesses. Despite this observation, adult immunization rates continue to lag behind national goals. Reduced vaccine efficacy in older adults leading to apathy regarding the need for vaccine administration, unrealistic expectati...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2007.03.007
更新日期：2007-08-01 00:00:00
abstract：:Urinary incontinence is a prevalent condition in elderly women with significant associated morbidity. Incontinence can by grouped into several types: stress incontinence, urgency incontinence, overflow incontinence, functional incontinence, and mixed urinary incontinence. Careful evaluation, including history and phys...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2015.07.003
更新日期：2015-11-01 00:00:00
abstract：:This review focuses on studies that pertain to obesity and aging. The prevalence of obesity in the elderly is discussed, with an emphasis on body-fat distribution as it relates to morbidity and mortality rates. Treatment options, such as physical activity, growth hormones, and drug therapy, are briefly mentioned. A se...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-01 00:00:00
abstract：:The aging of a population replete with risk factors for heart failure(HF) (coronary heart disease, diabetes, and hypertension) coupled with a declining age-adjusted mortality rate for coronary artery and hypertensive heart diseases has created, and will continue to create, a literal explosion in the prevalence of HF i...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2006.09.003
更新日期：2007-02-01 00:00:00
abstract：:Aspirin in a dose of 160 to 325 mg should be administered on day 1 of an acute MI and continued indefinitely on a daily basis. Thrombolytic therapy should be administered within 6 to 12 hours after the onset of an acute MI with ST segment elevation or with left bundle branch block. Primary coronary angioplasty when av...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70113-0
更新日期：2001-02-01 00:00:00
abstract：:Balance disorders are common in the elderly and can lead to falls, with resultant severe morbidity and even mortality. Progressive loss of vestibular function begins in middle age and is affected by multiple disease processes. Polypharmacy impacts many disease processes in the elderly, with balance function being one ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2018.01.002
更新日期：2018-05-01 00:00:00
abstract：:The anorexia of aging is common, leading to adverse health consequences. As populations age, the impacts from anorexia in the older population are set to increase. Only greater awareness will allow for prevention or early intervention. This article discusses the physiologic anorexia of aging, highlights contributing f...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2015.04.012
更新日期：2015-08-01 00:00:00
abstract：:Transitions in care are a vulnerable time period for patients during which unintended errors may occur. This article discusses potential risks that could occur during care transitions, suggested improvements, and the transition from hospital to skilled nursing facilities for patients needing rehabilitation after their...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.01.017
更新日期：2014-05-01 00:00:00
abstract：:Tests of performance and alertness in normal older subjects undergoing sleep loss reveal loss of performance and alertness similar to that seen in younger individuals. Recovery of performance ability occurs with one night of normal sleep, even following periods of sleep loss up to 64 hours in length. Older individuals...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-05-01 00:00:00
abstract：:To a considerable extent, the advent of the term sarcopenia has contributed to the focus on this important condition and its effects on the quality of life and care of older persons. It is hoped that the advances in our understanding of the etiology and treatment of sarcopenia will further contribute to placing this d...
journal_title：Clinics in geriatric medicine
pub_type： 历史文章,杂志文章
doi：10.1016/j.cger.2011.03.003
更新日期：2011-08-01 00:00:00
abstract：:Collaboration of professionals from diverse disciplines is required to address the multiple, complex issues and needs of community-dwelling elders who are abused or neglected. Reporting suspected elder abuse or neglect cases to Adult Protective Service (APS) agencies provides access to services that address the social...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2004.10.007
更新日期：2005-05-01 00:00:00
abstract：:Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.01.002
更新日期：2014-05-01 00:00:00
abstract：:Normal aging is associated with a multitude of changes in the cardiovascular system, including decreased compliance of blood vessels, mild concentric left ventricular hypertrophy, an increased contribution of atrial contraction to left ventricular filling, and a higher incidence of many cardiac arrhythmias, both brady...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2012.07.003
更新日期：2012-11-01 00:00:00
abstract：:A wide array of clinical trials over the past two decades has established that aspirin is indicated to prevent myocardial infarction in patients with clinically evident coronary artery disease, and to prevent stroke in patients with a history of stroke or TIAs. The most likely mechanism by which aspirin decreases the ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-02-01 00:00:00
abstract：:The geriatric population has become a major component in the practice of medical speech-language pathology. This article discusses normal and abnormal functions of speech, voicing, language, cognition, and swallowing. Particular attention is given to disorders affecting the geriatric population. Evaluation, treatment,...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2005.12.008
更新日期：2006-05-01 00:00:00
abstract：:Major focuses of geriatric medicine are cardiovascular diseases with increases in prevalence in older people and how aging might modify the risk factors, clinical manifestations, treatment strategies, and prognoses of these diseases. Quantitative information on age-associated alterations in cardiovascular structure an...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70021-5
更新日期：2000-08-01 00:00:00
abstract：:In hematopoiesis, mature blood cells, granulocytes, erythrocytes, and megakaryocytes originate from hematopoietic stem cells. With age, changes in hematopoiesis may have clinical consequences: defective immune responses, cytopenias (most commonly anemia and lymphopenia), hematological malignancy, and effects mediated ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2019.03.001
更新日期：2019-08-01 00:00:00
abstract：:Although dementias are defined by their cognitive and functional deficits, psychiatric problems are common, contribute to patient distress and caregiver burden, and precipitate institutionalization. Successful treatment involves understanding that physiologic, psychological, and environmental factors can contribute to...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.04.002
更新日期：2014-08-01 00:00:00
