[Improved hospital care for elderly patients: guidance on vulnerability and goal assessment].

Hospital care is highly disease-focused, tending towards further specialisation, and largely driven by technological innovations. Frail elderly, however, are an important and rapidly growing group of patients that is not best cared for in such a clinical environment. Case histories and the description of outcomes of an innovative programme called 'CareWell Primary Care' reveal that triage based on frailty and a global geriatric assessment of frail patients which is linked to goal-oriented hospital care and shared decision-making are the cornerstones of much needed improvement in delivering effective, safe, and sustainable hospital care to our ageing population.

Raloxifene and tibolone in elderly women: a randomized, double-blind, double-dummy, placebo-controlled trial.

Objectives: The authors' first aim was to study the effects of raloxifene and tibolone on body mass density, handgrip strength, and other secondary frailty components. The secondary aim was to compare the effects of raloxifene and tibolone and their safety in older women.

Design/setting/participants: A randomized, double-blind, double- dummy, placebo-controlled trial conducted in an academic hospital in the Netherlands among 318 community living women aged >70 were randomized; 290 received the allocated intervention: 97 placebo, 101 raloxifene, and 92 tibolone.

Raloxifene improves verbal memory in late postmenopausal women: a randomized, double-blind, placebo-controlled trial.

Objective: The aim of this study was to examine the effects of raloxifene compared with those of placebo on verbal memory, mental processing speed, depression, anxiety, and quality of life.

Methods: A randomized, double-blind, placebo-controlled trial of 213 healthy women 70 years or older was conducted between July 2003 and January 2008 at the University Medical Centre Utrecht, the Netherlands. Participants were randomly assigned to receive raloxifene (60 mg) or placebo daily for 12 months.

Raloxifene and body composition and muscle strength in postmenopausal women: a randomized, double-blind, placebo-controlled trial.

Objective: To compare the effects of raloxifene and placebo on body composition and muscle strength.

Design: Randomized, double-blind, placebo-controlled trial involving 198 healthy women aged 70 years or older conducted between July 2003 and January 2008 at the University Medical Centre, Utrecht, The Netherlands.

Methods: Participants were randomly assigned to receive raloxifene 60 mg or placebo daily for 12 months.

Efficacy of tibolone and raloxifene for the maintenance of skeletal muscle strength, bone mineral density, balance, body composition, cognitive function, mood/depression, anxiety and quality of life/well-being in late postmenopausal women >/= 70 years: study design of a randomized, double-blind, double-dummy, placebo-controlled, single-center trial.

Background: Postmenopausal women are prone to develop functional disabilities as a result of reduction in muscle strength and muscle mass caused by diminished levels of female sex hormones. While hormone replacement therapy may counteract these changes, conventional hormone replacement therapy is associated with potential harmful effects, such as an increased risk of breast cancer, and its prescription is not recommended. For this reason newer alternative drugs, such as tibolone, a synthetic steroid with estrogenic, progestogenic and androgenic activity, and raloxifene, a selective estrogen receptor modulator, may be more appropriate.