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 expectations for disease prevention rather than reduced illness severity, and system issues that make vaccine administration and tracking difficult all contribute to this problem. In this review, the biologic and system-based causes for vaccine failure in aged adults are reviewed, issues of efficacy and cost-effectiveness in older adults are summarized for influenza and pneumococcal vaccine, and ways to improve vaccine effectiveness in older adults, now and in the future, are outlined.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
High Kdoi
10.1016/j.cger.2007.03.007subject
Has Abstractpub_date
2007-08-01 00:00:00pages
669-85, viii-ixissue
3eissn
0749-0690issn
1879-8853pii
S0749-0690(07)00026-2journal_volume
23pub_type
杂志文章,评审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::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::Delusional depression frequently is encountered in the treatment of older psychiatric patients. Although the pathogenesis of this disorder and its relationship to organic brain lesions remains unclear, somatic treatment, especially with ECT, leads to initial recovery in the majority of cases. High rates of relapse and...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 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::Psychomotor assessment is a collaborative effort between the neurologic and the neuropsychologic evaluation. Changes associated with normal aging must be differentiated from signs and symptoms that indicate abnormal functioning. Recent developments in computer-based technology should add to the precision and accuracy ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-08-01 00:00:00
abstract::There is strong evidence supporting the benefit of antihypertensive treatment in older patients. Blood pressure goal and drug selection in the elderly is similar to that in younger populations, but there are a few special considerations in these patients. A number of studies have been conducted to determine the drugs ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2009.03.001
更新日期:2009-05-01 00:00:00
abstract::There are three major obstacles to a recommendation for screening the elderly for NIDDM. The first is the conflicting evidence as to whether early detection and treatment reduce complications. The second is that treatment of hyperglycemia with attainment of euglycemia is difficult to achieve in the elderly. Nondrug th...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::Gait disorders in elderly individuals are a major cause of falls and their attendant morbidities. Ataxia is one of the neurologic components of fall risk, as are inattention or confusion, visual impairment, vestibular impairment, subcortical white matter disease, parkinsonism, weakness, sensory loss, orthostasis or ar...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2006.06.011
更新日期:2006-11-01 00:00:00
abstract::Pulmonary hypertension is a pathologic hemodynamic condition defined by a mean pulmonary arterial pressure of 25 mm Hg or greater at rest. Because of age-associated stiffening of the heart and the pulmonary vasculature and the higher prevalence in the elderly of comorbidities associated with the development of pulmona...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2017.06.007
更新日期:2017-11-01 00:00:00
abstract::A comprehensive practical approach to the diagnosis, staging, and treatment of carcinoma of the prostate is presented. Prostatic cancer in the elderly patient is not a benign clinical condition. The approach is designed to minimize the morbidity of the disease process and to allow the patient to live as normal a life ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1985-05-01 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::In summary, herbs are commonly used, and it is the physician's responsibility to have better documentation of this practice by encouraging patients to report use of herbs, and to look for any unusual side effects that can occur in terms of herb-drug or herb-herb interactions. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2004.02.009
更新日期:2004-05-01 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
abstract::Palliative care is a public health concern, because the problems faced by patients and their families represent a substantial burden of illness and cost to the society that is likely to increase markedly in the future as the world's population continues to age. There are also inequities in access to palliative care an...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2015.01.002
更新日期:2015-05-01 00:00:00
abstract::"Birth and death are the most singular events we experience and therefore the contemplation of death as of birth should be a thing of beauty." The hospice movement emerged out of an awareness that the needs of the dying patient were not being adequately met by the modern medical establishment. It has brought about a p...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-08-01 00:00:00
abstract::The importance of education in preventing and treating patients with pressure ulcers is evident by the inclusion of recommendations for educational objectives in the clinical guidelines by the Agency for Health Care Policy and Research. Both caregiver and client should be assessed for knowledge of pressure ulcers. Phy...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 00:00:00
abstract::Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.06.007
更新日期:2018-11-01 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::Lesbian, gay, bisexual, and transgender older adults require a comprehensive medical, behavioral, mental health, and social support evaluation as do all elders. Open communication and minimizing barriers in both the patient-provider relationship and throughout the continuum of care settings offer a safe environment fo...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00108-8
更新日期:2003-08-01 00:00:00
abstract::This article describes: the origin and evolution of house calls; what is uniquely gained from house calls for both patients and providers; key clinical issues managed at home; evidence that house calls improve outcomes; organization of house call practices; and changes in Medicare reimbursement, technology, and interd...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2008.10.005
更新日期:2009-02-01 00:00:00
abstract::Postprandial hypotension is a prevalent condition in the elderly population and seems to be more common in frail elderly individuals who may be more susceptible to complications such as syncope and falls. Diagnosis is relatively easy and may be reversible in many cases. The epidemiology and pathophysiology of postpran...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00012-5
更新日期:2002-05-01 00:00:00
abstract::The number of people in nursing homes is growing at a rapid rate as the population includes greater numbers of elderly Americans. Psychiatric disorders, including depression, anxiety, and paranoia, are commonly seen among this group. Recognition and treatment of these disorders by health care professionals can improve...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 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::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::Footwear is a modifiable risk factor for falls in older adults, including populations with metabolic disease, inflammatory arthritis, and neurodegenerative disease. Ill-fitting footwear, and specific design features, such as elevated heels and backless styles, can impair balance control and heighten the risk of fallin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.12.001
更新日期:2019-05-01 00:00:00
abstract::A basic medical director function is to help draft and implement policies and procedures. Physicians should not underestimate the knowledge and skills involved in doing it well. Instead of viewing this role as merely unpleasant paper work, they should look beneath the surface for the much broader implications. Effecti...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 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::The intent of this review is to highlight several difficult questions from a personal perspective while caring for debilitated elderly patients in a nursing home. These problems appear to be encountered less frequently in the acute-care setting. Where possible, supporting literature is cited and legal precedent is ind...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-08-01 00:00:00
abstract::Elder abuse and neglect is estimated to affect approximately 700,000 to 1.2 million elderly people a year with an estimated annual cost of tens of billions of dollars. Despite the large population at risk, its significant morbidity and mortality, and substantial cost to society, elder abuse continues to be underrecogn...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2012.09.004
更新日期:2013-02-01 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