Abstract：
:The aging kidney suffers reduction both in mass and in glomerular filtration rate. These changes may be totally or partially due to atherosclerosis and hypertension, which reduce renal blood flow. Superimposed on these processes, and perhaps responsible for primary loss of renal mass irrespective of renal vascular disease, is glomerular damage and involution that is a consequence of adaptive increases in glomerular perfusion pressure that occurs as the number of nephrons decline with age. The data available at this time do not allow us to distinguish between these two potential mechanisms of renal senescence. The decline in GFR is in turn responsible for reduced renal acidification and the reduced renal clearance of drugs that are normally removed by the kidney. Certain renal functions, however, are depressed to a greater extent than is GFR. Both the ability to maximally dilute the urine and to maximally concentrate it are controlled by serum ADH concentrations and by the action of that hormone on the collecting duct. Aged rats do not maximally secrete ADH under conditions of dehydration and the effect of ADH on the kidney is also attenuated. Elderly humans also cannot maximally suppress ADH secretion when serum osmolality is reduced. Likewise, the renin-angiotensin-aldosterone axis is poorly responsive to volume depletion in aging subjects. As a result, elderly individuals cannot maximally retain sodium under conditions of plasma volume contraction out of proportion to reduction in GFR. The kidney is the site of vitamin D1 hydroxylation. Hydroxylation of vitamin D is reduced out of proportion to any reduction in GFR in the rat. There are no data as yet available on the effect of aging and the production of erythropoietin, a principal regulator of red blood cell mass. Neither are there data available on changes that might occur with advancing age in the ability of the aging kidney to metabolize various hormones, such as parathyroid hormone, glucagon, and insulin. The mechanisms and the full biochemical and physiologic consequences of renal senescence remain to be fully elucidated.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Kaysen GA,Myers BDsubject
Has Abstractpub_date
1985-02-01 00:00:00pages
207-22issue
1eissn
0749-0690issn
1879-8853journal_volume
1pub_type
杂志文章,评审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：:Older patients with cancer are best served by a multidisciplinary approach with palliative care (PC) playing an integral role. PC focuses on symptom control irrespective of its cause and should not be associated only with terminal care. It provides an additional layer of support in the care of patients with cancer wit...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2015.08.004
更新日期：2016-02-01 00:00:00
abstract：:American health-care practitioners are faced with a rapidly growing, geriatric, Hispanic-American population. This group shares certain cultural links but is largely heterogeneous and comprised of many subgroups, the largest of which are Mexican Americans, Puerto Ricans, and Cuban Americans. Health-care practitioners ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-02-01 00:00:00
abstract：:Despite the considerable challenges to providing high-quality rehabilitation in a long-term care facility, growing demographic and fiscal pressures are likely to push the nursing home into the forefront of rehabilitation for the frail elderly. Model programs have been implemented in recent years that present alternati...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
abstract：:Falls, syncope, and the associated complications are among the most serious problems that face the elderly population. The most common underlying causes and risk factors for falls include muscle weakness, gait and balance problems, visual impairment, cognitive impairment, depression, functional decline, and particular...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(02)00002-2
更新日期：2002-05-01 00:00:00
abstract：:Treatment of alcohol dependence among older alcoholic patients should be multidimensional to address as many potential relapse factors as possible. As the literature suggests, alcohol-related disorders often are under diagnosed and under treated. More efforts are needed to identify and improve diagnosis of these disor...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(03)00045-4
更新日期：2003-11-01 00:00:00
abstract：:New data have shown that sebum secretion is highest in young adults and then declines steadily throughout life in both men and women. This parallels the decline in androgen levels, but this cannot be the sole factor because there is so much overlap in sebaceous gland activity between men and women. The increased occur...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:Physical activity protects against the development of chronic disease and disability. There appears to be little risk of damage to joints from regular, moderate-level exercise. Patients with arthritis can safely participate in exercise programs and often have relief of pain and disability. The most difficult problem f...
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：: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：: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：:Hypoglycemia is a serious problem in older patients with diabetes mellitus. This chapter discusses risk factors associated with hypoglycemia and approaches to mitigation of the risk for hypoglycemia. Specific considerations include selection of glucose lowering agents, comorbid conditions and the implications of decli...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2020.04.001
更新日期：2020-08-01 00:00:00
abstract：:Falling is often a multifactorial syndrome that can be viewed from several perspectives, including pathophysiologic, biomedical, functional, and ecologic models. The history, physical examination, and performance testing are the cornerstones of evaluation. Diagnostic testing in selected cases and environmental evaluat...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1996-11-01 00:00:00
abstract：:Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. I...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.08.005
更新日期：2014-11-01 00:00:00
abstract：:In this article we have attempted to review basic aspects of the respiratory immune system and some of what is known about the effects of aging on immunity. We have discussed the more common forms of interstitial lung disease as they relate to the elderly patient and have outlined a general method of approaching inter...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1986-05-01 00:00:00
abstract：:The routine prescription of hormone replacement therapy for elderly women to prevent heart disease is not indicated. Until better data are available, the use of estrogens primarily to prevent heart disease probably should be reserved for women at high risk by virtue of their LDL/HDL ratio or the presence of manifest c...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-02-01 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：:More than half of all lymphomas occur in patients aged 60 years or older. This article reviews the management of low-grade and aggressive histology lymphomas in patients older than age 65. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy is well tolerated in patients who have a good perfo...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1997-05-01 00:00:00
abstract：:This article reviews and summarizes more than 200 studies regarding key issues surrounding the transition of elderly patients to or from the emergency department (ED), with particular attention paid to the relationship between the ED and nursing homes. Transfers of care often occur with incomplete information, which r...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2012.10.005
更新日期：2013-02-01 00:00:00
abstract：:Elderly individuals, worldwide, are on the rise, posing new challenges to care providers. Hypertension is highly prevalent in elderly individuals, and multiple challenges face care providers while managing it. In addition to treating hypertension, the physician must treat other modifiable cardiovascular risk factors i...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2013.05.002
更新日期：2013-08-01 00:00:00
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：:Epidemiological data suggests that the prevalence of musculoskeletal and neuropathic pain increases with age until at least late mid-life, though the pattern is somewhat unclear beyond this point. And though the prevalence of some types of pain may peak in late midlife, pain is still a substantial and common complaint...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2016.06.005
更新日期：2016-11-01 00:00:00
abstract：:Many health care professionals lack knowledge about artificial nutrition and hydration at the end of life or may hold different attitudes about artificial nutrition and hydration compared with other treatments. Consequently, they may convey inaccurate or misleading information to patients or their surrogate decision m...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70058-6
更新日期：2000-05-01 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：: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：:Older adults receive care from various settings, including acute care hospitals, skilled nursing facilities, nursing homes, group homes, outpatient primary care, specialty clinics, and home. In these various settings, older adults are exposed to pathogens, which makes them "vectors" that transport pathogens from one s...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2007.02.001
更新日期：2007-08-01 00:00:00
abstract：:Older women may experience sexual dysfunction due to many different causes. Some problems related to menopausal hormonal change may be easily treated with estrogen supplements. Other problems involve intricate interpersonal relations between the woman and her sexual partner and may require a combination of medical the...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-02-01 00:00:00
abstract：:Constipation and irritable bowel syndrome are very common in older persons. Constipation is over diagnosed and over treated in older persons. Lifestyle changes, osmotic laxatives, and lubiprostone are the approaches of choice for the management of constipation. Irritable bowel syndrome should be considered in the diff...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2007.06.008
更新日期：2007-11-01 00:00:00
abstract：:The oral cavity is responsible for two essential functions: the production of speech and the initiation of alimentation. All of the specialized oral tissues and sensory systems that allow for the execution of these functions are susceptible to age-, disease-, and treatment-related changes, and alterations in any one o...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-08-01 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：: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 v...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1996-08-01 00:00:00
