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 postprandial hypotension are not defined fully; however, a number of pathologic processes likely are involved, including abnormal sympathetic function, baroreceptor function, and vasoactive peptide release and activity. The precise relationship between symptoms and postprandial reductions in blood pressure is unclear. Blood pressure maintenance after a meal may depend on the interaction of some or all of the mechanisms outlined previously to compensate for the increase in bowel blood volume. The impairment of one or more of these mechanisms could result in inadequate compensation that leads to hypotension. If so, the presence of symptoms depends on that individual patient's ability to exercise adequate compensatory cerebral autoregulation. A hypertensive elderly patient may experience symptoms with only a small reduction in blood pressure, whereas a patient with autonomic failure may require a much larger fall in blood pressure to occur before they become symptomatic. The current definition of postprandial hypotension uses a threshold of 20 mm Hg as a cut off for diagnosis, but this may not be relevant to the presence or absence of symptoms. Further epidemiologic data are needed. Additionally, there is a lack of controlled trial evidence for the drugs that are used to treat this condition, and treatment often is carried out on a trial-and-error basis. Further research must be performed to identify the specific pathophysiology in certain patient groups, such as elderly hypertensive patients and those with autonomic failure, and to identify effective pharmacologic therapies that can be supported by randomized, placebo-controlled trials.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
O'Mara G,Lyons Ddoi
10.1016/s0749-0690(02)00012-5subject
Has Abstractpub_date
2002-05-01 00:00:00pages
307-21issue
2eissn
0749-0690issn
1879-8853pii
S0749-0690(02)00012-5journal_volume
18pub_type
杂志文章,评审abstract::Norovirus infection usually results in acute gastroenteritis, often with incapacitating nausea, vomiting, and diarrhea. It is highly contagious and resistant to eradication with alcohol-based hand sanitizer. Appropriate preventative and infection control measures can mitigate the morbidity and mortality associated wit...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2016.02.008
更新日期:2016-08-01 00:00:00
abstract::Both primary and secondary cancer prevention may improve cancer control among older persons. Although chemoprevention of cancer is feasible, the agents currently used for chemoprevention have several complications. As a result, the use of these substances should be individualized based on risk-benefit ratio. It is rea...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00028-9
更新日期:2002-08-01 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::Lower intestinal bleeding in the elderly is a common problem with numerous and varied causes. Its diagnosis and treatment require a careful, systematic approach by physicians with special expertise. Under the proper circumstances, elderly patients with lower intestinal bleeding do well, even when surgery is required. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-05-01 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::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::Patients often present for evaluation of a suspicious cancer symptom after a delay. They appear to tolerate cancer treatment as well as younger patients, and, in studies comparing them on psychosocial parameters of adaptation, they appear to adjust better than younger patients. Attention to pre-existing social problem...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-08-01 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
abstract::The concept of cognitive reserve (CR) was proposed to account for the discrepancy between levels of brain pathologic process or damage and clinical and cognitive function. We provide a detailed review of prospective longitudinal studies that have investigated the interaction between CR and Alzheimer disease (AD) bioma...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2019.11.006
更新日期:2020-05-01 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::Environmental change offers an attractive approach to falls prevention, particularly as part of multidimensional intervention strategies. This article reviews and summarizes prior research that has examined environmental factors in falls experienced by older people in community and long-term care settings. Limitations...
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::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
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::Over one-third of Medicare stroke patients are admitted to nursing homes for rehabilitation. Patients with stroke who are admitted to nursing homes are extremely heterogeneous, including both those with minimal physical and cognitive impairment and those who are totally physically dependent. Quality measures that are ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract::Most Americans will be afflicted by some form of spine-related pain in their lifetime. In older patients, the most frequent source of back pain is lumbar spinal stenosis or vertebral compression fracture. Although most back pain is self-limited, some patients will require interventional techniques. This article review...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2007.12.006
更新日期:2008-05-01 00:00:00
abstract::The majority of patients with acute diverticulitis can be managed medically. Some will have a complication of diverticulitis such as free perforation with peritonitis, abscess formation, obstruction, or fistula formation. Perhaps even a larger number will develop recurrent diverticulitis, which is associated with an i...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1985-05-01 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::All evidence suggests that the elderly population of today and tomorrow will continue to depend on the private car to give them freedom, independence, and choice--as do younger travellers. Given the demographic changes in the United States, it seems very unlikely that other modes or options can provide anywhere near t...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-05-01 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::Schizophrenia in late life includes both chronic early-onset schizophrenia and late-onset schizophrenia. Treatment with neuroleptics in relatively low doses is often useful in controlling psychotic symptoms in these patients. The value of neuroleptics is limited, however, by the risks of side effects such as tardive d...
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::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::The pathophysiology of stone disorder in older adults, as compared to their younger counterparts, has not been thoroughly investigated. This article examines the differences in serum and urine chemistries between groups that are younger and older than 60 years of age. The principal finding is that stone formation occu...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 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::Falls are a major health concern for elderly people and cause substantial health care costs. The authors used meta-analytic findings on the effectiveness of fall prevention interventions to determine cost-effectiveness of a proposed Medicare fall prevention program for people who experience a recent fall. Using publis...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,meta分析
doi:10.1016/j.cger.2010.07.005
更新日期:2010-11-01 00:00:00
abstract::This article discusses the usefulness of neuropsychological testing in AD, as an adjunct to the diagnosis, as a means of the evaluation of progression, and response to treatment. Clinical neuropsychological tests that have direct relevance to AD are reviewed, with particular emphasis on recently developed tests of mem...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 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::The elderly have few bleeding disorders related exclusively to the aging process. However, abnormalities of coagulation are seen frequently in this group as complications of other illnesses. Thus a good understanding of basic coagulation physiology and testing will provide the necessary tools for therapeutic guidance....
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract::Intraperitoneal infections or inflammatory disease in elderly patients are a diagnostic challenge that will be encountered with increasing frequency in the aging population of the United States. Diagnostic clues are not overt and frequently appear late in the course of the disease. Confusion and subtle changes in clin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-11-01 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