2024-03-29T10:54:44Zhttp://open-archive.highwire.org/handler
oai:open-archive.highwire.org:ageing:21/1/12015-05-19HighWireOUPageing:21:1
Clinical Significance of Bacterial Overgrowth in Elderly People
HOLT, PETER R.
Commentary
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/1
http://dx.doi.org/10.1093/ageing/21.1.1
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/132015-05-19HighWireOUPageing:21:1
Small-bowel Bacterial Overgrowth in Elderly People: Clinical Significance and Response to Treatment
HABOUBI, N. Y.
MONTGOMERY, R. D.
Articles
Duodenal-jejunal bacterial overgrowth is increasingly recognized in old age but its clinical significance is poorly defined. In this study, 16 elderly subjects were selected on the basis of an abnormal lactulose breath hydrogen test from a series of 27 in whom there was some reason to suspect malabsorption. In 12 of these 16 cases, pentagastrin tests showed normal gastric acid secretion and in 12 cases the small bowel was radiologically normal. Nutritional assessment, anthropometric measurements, culture of small-bowel aspirates, 14C-triolein breath tests and blood xylose tests were performed before and after 4 to 6 months of cyclical antibiotic therapy. Initially all patients except two showed evidence of malabsorption. After antibiotic treatment alone, 13 patients gained in weight and body fat. There were significant rises in the mean levels of haemoglobin, serum protein and calcium. Blood xylose test levels increased in 14 cases, reaching normal in all except one, whereas 14C-triolein excretion also increased in 14 and reached normal in 12 out of 16 cases. The breath hydrogen test reverted to normal in all cases and bacterial overgrowth was eliminated in 10 out of 11. The mouth-to-caecum transit time was prolonged initially (mean 190 min) and was unaffected by therapy (mean 196 min). Malabsorption and undernutrition are significant features of small-bowel overgrowth in the elderly and can be specifically corrected by antibiotic treatment. The clinical effect can be equally severe in elderly patients with or without an anatomical defect of the small bowel. In the absence of pernicious anaemia or previous gastric surgery, a prolonged mouth-to-caecum transit time appears to be the common causal factor in this syndrome.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/13
http://dx.doi.org/10.1093/ageing/21.1.13
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/202015-05-19HighWireOUPageing:21:1
Coffee Drinking: A Minor Risk Factor for Bone Loss and Fractures
JOHANSSON, CHRISTER
MELLSTRÖM, DAN
LERNER, ULF
ÖSTERBERG, TOR
Articles
The influence of coffee drinking as a possible risk factor for loss of bone mass was assessed in a cohort of 619 70-year-old men and women who were examined with dual photon absorptiometry of the right calcaneum. A high consumption of coffee was significantly associated with a lower bone mass, deteriorated dental state, lower socio-economic level and a higher consumption of tobacco. In non-smoking women a bivariate relationship was found between the daily consumption of three or more cups of coffee and a low bone mass (p<0.01). However, in a stepwise logistic regression model, only tobacco smoking, body mass index, body height, physical activity and a deteriorated dental state were found to be significant predictive factors for a low bone mineral content. Bone mass and tobacco smoking were the only significant predictive factors for fractures before the ages of 70 and 76 years. Coffee drinking was not a contributory independent risk factor for loss of bone mass and fractures in this population study.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/20
http://dx.doi.org/10.1093/ageing/21.1.20
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/272015-05-19HighWireOUPageing:21:1
The Pharmacokinetics and Effects of Prochlorperazine in Elderly Female Volunteers
ISAH, A. O.
RAWLINS, M. D.
BATEMAN, D. N.
Articles
The pharmacokinetics and effects of prochlorperazine (PCZ) have been studied in six healthy elderly female volunteers in a double-blind placebo-controlled study of 3.125 mg intravenous (IV) and 25 mg oral PCZ. The pharmacokinetics of IV PCZ in elderly subjects appear similar to those previously obtained in young subjects, with a terminal half-life of 7.5±1.8 h after intravenous dosing. Oral bioavailability was low (14.7±1.5%). The pharmacological actions of prochlorperazine in elderly people appear to include antidopaminergic (prolactin rise) and anticholinergic (reduced salivary flow) effects. At the dose of PCZ used in this study, no significant haemodynamic or psychomotor changes were observed though there was a trend to prolongation of the movement component of the reaction time.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/27
http://dx.doi.org/10.1093/ageing/21.1.27
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/322015-05-19HighWireOUPageing:21:1
Fracture Risk in Patients with Parkinsonism: A Population-based Study in Olmsted County, Minnesota
JOHNELL, OLOF
MELTON, L. JOSEPH
ATKINSON, ELIZABETH J.
O'FALLON, W. MICHAEL
KURLAND, LEONARD T.
Articles
In this population-based retrospective cohort study, the 138 Olmsted County, Minnesota residents first diagnosed with Parkinson's disease during 1967–79 were matched by age and sex to an equal number of control subjects from the community. Fractures were assessed through review of each subject's complete (inpatient and outpatient) medical records. At the time of diagnosis, County residents with parkinsonism were no more likely to have a history of selected fractures than control subjects (32% in each group). Subsequently, 33% of cases and 20% of controls experienced one or more new fractures during 696 person-years of follow-up (p=0.008). The greatest increase in risk was seen for proximal femur fractures, confirming previous case-control studies. By 10 years after diagnosis, an estimated 27% of the parkinsonism cohort had experienced a new hip fracture. The pattern of fractures that was observed suggested that the increased risk was due more to specific types of falls than to disuse osteoporosis.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/32
http://dx.doi.org/10.1093/ageing/21.1.32
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/392015-05-19HighWireOUPageing:21:1
Renal Prostaglandins, Effective Renal Plasma Flow and Glomerular Filtration Rate in Healthy Elderly Subjects
ASOKAN, A.
FANCOURT, G. J.
BENNETT, S. E.
CASTLEDEN, C. M.
Articles
This study tests the hypothesis that the age-associated reduction in glomerular filtration rate (GFR) and the presence of glomerulosclerosis renders effective renal plasma flow (ERPF) prostaglandin dependent. Ten healthy elderly volunteers were studied in a single-blind placebo-controlled manner using indomethacin to suppress the renal prostaglandins. There was no significant difference in ERPF or GFR following indomethacin when compared with placebo. These results suggest that blocking renal prostaglandins does not significantly alter ERPF or GFR in healthy elderly people.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/39
http://dx.doi.org/10.1093/ageing/21.1.39
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/432015-05-19HighWireOUPageing:21:1
Clinical Significance of Crepitations in Elderly Patients Following Acute Hospital Admission: A Prospective Study
CONNOLLY, MARTIN J.
CROWLEY, JOSEPH J.
VESTAL, ROBERT E.
Articles
Because of a clinical impression that lung crepitations are a common, non-specific sign in acutely ill elderly people, two investigators, blinded to each other's findings and to subject case notes, prospectively examined 207 consecutive elderly [aged 70–98 (mean 77) years] and 75 young patients [24–50 (41) years] acutely admitted to hospital. Crepitations and persistent crepitations (PCs) were commoner in the elderly patients (p<0.001) but agreement over their presence/absence was reduced (p<0.05). Both investigators agreed PCs were absent in 35% of elderly subjects suffering from conditions classically associated with their presence, and, conversely, were present in 29 elderly subjects in whom no cause for their presence was discovered (14% of the total elderly group or 42% of those with PCs). PCs without obvious cause were unrelated to smoking history and did not predict outcome, length of stay or development of cardiorespiratory complications. In view of poor sensitivity and specificity of crepitations in elderly patients undergoing acute hospital admission we caution against over-reliance on this sign in isolation in these circumstances.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/43
http://dx.doi.org/10.1093/ageing/21.1.43
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/492015-05-19HighWireOUPageing:21:1
Survival of Elderly Men with Congestive Heart Failure
TAFFET, GEORGE E.
TEASDALE, THOMAS A.
BLEYER, ANTHONY J.
KUTKA, NICHOLAS J.
LUCHI, ROBERT J.
Articles
Congestive heart failure (CHF) is the most common discharge diagnosis for elderly patients. The survival of elderly (age ≥75 years) patients with CHF has not recently been reported, especially with reference to left ventricular ejection fraction (LVEF). A patient database was searched for the diagnosis of CHF and then screened for age ≥75, Framingham Criteria for CHF and an LVEF evaluation. Ninety-four men fitted all criteria, including a minimum potential follow-up of 3 years. Life-table analysis was employed to compare their survival experience to an expected survival based on a sex- and age-equivalent subset of the 1980 Census data. Causes of death were determined from autopsy, medical records or death certificates. Mean age at onset of CHF was 82.5. Forty-three per cent had an LVEF ≥0.45. There was no difference in the prevalence of potential aetiologies between those with LVEF ≥0.45 versus LVEF <0.45. Life-table analysis revealed that CHF patients had a worse survival than controls for the first 5 years after diagnosis, attributable primarily to a high first-year mortality (28%) for the CHF group. There was no difference in survival between the LVEF ≥0.45 and LVEF <0.45 groups.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/49
http://dx.doi.org/10.1093/ageing/21.1.49
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/52015-05-19HighWireOUPageing:21:1
Bacterial Contamination of the Small Bowel in Elderly People: Is it Necessarily Pathological?
LIPSKI, PETER S.
KELLY, PETER J.
JAMES, OLIVER F. W.
Articles
Bacterial contamination of the small bowel is probably the commonest cause of occult malabsorption in the elderly. It may occur in patients without a ‘blind loop’ or suggestive symptoms of diarrhoea and weight loss. We have prospectively studied the apparent prevalence of presumed bacterial contamination of the small bowel and its effect on nutritional state. Subjects were divided into three groups: (A) 54 young fit subjects; (B) 103 fit community elderly subjects; (C) 73 elderly long-stay hospital patients. All subjects had simultaneous lactulose hydrogen breath test and 14C-glychocholic acid breath test. Nutritional state was assessed by anthropometry, haematology and biochemistry. There were significantly fewer positive 14C-glycocholic acid breath tests in the young than in the elderly subjects (3% vs. 20% and 17%, p<0.0001) but no difference in the number of positive hydrogen breath tests between groups. There was no association between positive breath tests and anthropometry, haematology and biochemistry except for a lower albumin in group B and a lower red blood cell folate in group C with positive breath tests. These abnormal breath tests indicate that bacterial contamination of the small bowel may be common in normal fit elderly people and in elderly long-stay hospital patients and may be a concomitant of ‘normal’ ageing, not necessarily leading to ill-health.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/5
http://dx.doi.org/10.1093/ageing/21.1.5
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/562015-05-19HighWireOUPageing:21:1
Influence of Age on Plasma Osmolality: A Community Study
McLEAN, K. A.
O'NEILL, P. A.
DAVIES, I.
MORRIS, J.
Articles
We have shown an age-associated increase in plasma osmolality (p <0.001) in 152 randomly selected subjects, living in the community. In the old [mean age 78.0 (7.5) years] the plasma osmolality was 302.2 (300.6–303.8) mOsmol/kg compared with 291.2 (290.0–292.3) mOsmol/kg in the young [39.2 (11.2) years] (p <0.0001). In a further group of 20 screened, health status defined, elderly subjects the plasma osmolality was 298.1 (295.9–300.3) mOsmol/kg, which was significantly higher than the young group (p< 0.0001) but lower than the unscreened old subjects (p=0.005). The variance was also significantly lower (p=0.03). The results may reflect a loosening of homoeostatic control and highlight the need for care in subject selection in studies of ageing.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/56
http://dx.doi.org/10.1093/ageing/21.1.56
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/612015-05-19HighWireOUPageing:21:1
Is Relocation Harmful to Institutionalized Elderly People?
HARWOOD, ROWAN H.
EBRAHIM, SHAH
Articles
One hundred and one elderly continuing-care residents were relocated, from a hospital which closed, to new or refurbished accommodation at another hospital. Barthel and CAPE scores were used to assess changes in disability. Small improvements in disability over the relocation period were seen compared with changes seen over a subsequent, 2-month control period. The monthly mortality rate in the 6 months after relocation was not statistically different from that in the corresponding 6 months the previous year. Relocation to more appropriate accommodation may have had overall beneficial effects on disability.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/61
http://dx.doi.org/10.1093/ageing/21.1.61
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/672015-05-19HighWireOUPageing:21:1
Thiamine Status of Elderly Patients with Cardiac Failure
KWOK, T.
FALCONER-SMITH, J. F.
POTTER, J. F.
IVES, D. R.
Articles
This study compared the thiamine status of 37 elderly patients admitted with cardiac failure (CF) with that of 35 unselected elderly patients with other diagnoses (Non-CF), and with that of 41 apparently healthy elderly people. The thiamine pyrophosphate effect (TPPE) on erythrocyte transketolase activity was used to estimate thiamine status. The prevalence of thiamine deficiency (TPPE >19%) on admission in the CF and Non-CF groups was 13% and 29%, respectively. The TPPE of the CF group was significantly lower than that of the Non-CF group, and was not significantly different from that of the elderly control group. The results indicate that thiamine deficiency is not common in an unselected group of elderly inpatients with cardiac failure, but a potential benefit of thiamine supplementation in such patients cannot be ruled out.
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/67
http://dx.doi.org/10.1093/ageing/21.1.67
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/722015-05-19HighWireOUPageing:21:1
Statistical Significance and Clinical Significance
LEHMANN, ANTHEA
Letter to the Editor
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/72
http://dx.doi.org/10.1093/ageing/21.1.72
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/73-a2015-05-19HighWireOUPageing:21:1
Book Reviews
ARIE, T.
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/73-a
http://dx.doi.org/10.1093/ageing/21.1.73-a
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/73-b2015-05-19HighWireOUPageing:21:1
Book Reviews
LINDESAY, JAMES
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/73-b
http://dx.doi.org/10.1093/ageing/21.1.73-b
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/732015-05-19HighWireOUPageing:21:1
Book Reviews
BURNS, ALISTAIR
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/73
http://dx.doi.org/10.1093/ageing/21.1.73
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/74-a2015-05-19HighWireOUPageing:21:1
Book Reviews
VETTER, NORMAN
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/74-a
http://dx.doi.org/10.1093/ageing/21.1.74-a
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/74-b2015-05-19HighWireOUPageing:21:1
Book Reviews
SMITH, NIGEL
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/74-b
http://dx.doi.org/10.1093/ageing/21.1.74-b
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/742015-05-19HighWireOUPageing:21:1
Book Reviews
EVANS, MAVIS
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/74
http://dx.doi.org/10.1093/ageing/21.1.74
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/752015-05-19HighWireOUPageing:21:1
Book Reviews
MIDWINTER, ERIC
Book Reviews
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/75
http://dx.doi.org/10.1093/ageing/21.1.75
en
Copyright (C) 1992, British Geriatrics Society
oai:open-archive.highwire.org:ageing:21/1/762015-05-19HighWireOUPageing:21:1
Books Received
Books Received
Oxford University Press
1992-01-01 00:00:00.0
TEXT
text/html
http://ageing.oxfordjournals.org/cgi/content/short/21/1/76
http://dx.doi.org/10.1093/ageing/21.1.76
en
Copyright (C) 1992, British Geriatrics Society