Geriatrics on the run: rationale, implementation, and preliminary findings of a Belgian internal liaison team.

This article describes the rationale, implementation, interventions and preliminary findings of a Belgian interdisciplinary internal liaison team in a 1470-bed teaching hospital. The motive to start the team was threefold: the ageing of the inhospital population, the conclusion that health care professionals working on non-geriatric wards often lack the necessary skills to deal with older patients' needs and Belgian law, obliging each general hospital to set up an internal liaison team. Our team aims at detecting geriatric patients at risk, assisting health care professionals in caring for older patients and sensitizing them regarding optimal geriatric care.

Fall prediction in inpatients by bedside nurses using the St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) instrument: a multicenter study.

Objectives: To assess the predictive value of the St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) instrument, a simple fall-risk assessment tool, when administered at a patient's hospital bedside by nurses.

Design: Prospective multicenter study.

Process evaluation of a nurse-led multifactorial intervention protocol for risk screening and assessment of fall problems among community-dwelling older persons: a pilot-study.

This pilot study investigated the feasibility of a nurse-led fall prevention strategy in community-dwelling older persons. The sample included 126 subjects (mean age = 76 years) who could rise from a chair and transfer independently. During a home visit, a research nurse identified individuals at risk: a history of >or= 2 falls in the previous year or difficulties in gait and/or balance.

Primary hyperparathyroidism: diagnosis and management in the older individual.

As more and more cases of primary hyperparathyroidism are being detected by screening for serum calcium concentration, the majority of patients are older individuals who are asymptomatic or have symptoms which are difficult to ascribe to hyperparathyroidism. Long-term follow-up has provided evidence that most asymptomatic patients who do not undergo parathyroidectomy will not develop symptomatic complications. Some asymptomatic patients, however, have progression of disease over time.

[Falls among community-dwelling elderly: a pilot study of prevalence, circumstances and consequences in Flanders].

This pilot study was designed to examine prevalence, circumstances and consequences of falls among 131 community-dwelling elderly (mean age = 76.7 y.; SD = 5.

Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards.

Background: Heart failure represents a growing epidemic, primarily in the elderly. Development and implementation of management programs designed for use in daily clinical practice remains a major challenge.

Aims: This study aimed at profiling a hospitalized heart failure population in view of medical, behavioral, educational, psychosocial and health resources utilization parameters stratified by admission to cardiology and geriatric wards.

Serum transferrin receptor in the evaluation of the iron status in elderly hospitalized patients with anemia.

The aim of the present study is to evaluate in an elderly hospitalized population the diagnostic value of the serum transferrin receptor (sTfR) in distinguishing IDA (iron deficiency anemia) from ACD (anemia of chronic disease) as compared to conventional laboratory tests of iron metabolism, especially serum ferritin. In a prospective study, 34 patients with IDA and 38 patients with ACD (a chronic disorder in 23 and an acute infection in 15) were evaluated using iron status tests including serum transferrin receptor assay. The iron stores were assessed by bone marrow examination.

[Introduction. General aspects of medical problems of the aging patient].

It is a common mistake to bring older people together in one group of the population. This age group is, however, remarkably heterogeneous; it covers a wide range of ages and the changes of senescence, appearing during this period of life are quite divergent. In some aged patients diseases may present in a different way, the so-called "geriatric profile".

The effect of different diagnostic criteria on the prevalence of malnutrition in a hospitalized geriatric population.

Malnutrition is considered an important clinical problem in geriatric hospitalized patients, but no standard diagnostic criteria are available. The aim of this study was to investigate the effect of 7 different sets of diagnostic criteria (6 in hospitalized elderly and 1 in healthy elderly) from nutritional research studies on the prevalence of malnutrition in 151 elderly patients (49 men, 102 women, mean age 82.8 years) consecutively admitted to an acute geriatric ward.

Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient.

Purpose: Iron deficiency anemia is commonly caused by chronic gastrointestinal blood loss, and a thorough examination of the gastrointestinal tract has become standard practice. In contrast, iron deficiency without anemia has hardly been studied, and its causes are less certain. The aim of the present study was to determine the diagnostic value of upper and lower gastrointestinal evaluation in elderly hospitalized patients with iron deficiency, irrespective of the hemoglobin level.

Relationship between age-associated endocrine deficiencies and muscle function in elderly women: a cross-sectional study.

Objective: Muscle receptors and selected anabolic effects have been identified for both insulin-like growth factor I (IGF-I) and 1,25-dihydroxyvitamin D (1,25(OH)2D3). The aim of the present study was to test the hypothesis that the decreasing concentrations of these endocrine factors might be involved in the decline in muscle function that characterizes normal human ageing.

Design: Cross-sectional study.

A randomized trial of geriatric liaison intervention in elderly medical inpatients.

Objective: The aim of this study was to examine the effect of psychogeriatric intervention in a group of elderly medical inpatients over 75 years of age. In addition to usual care, intervention consisted of multidisciplinary joint treatment by a psychogeriatric team. The main purpose of intervention was to obtain the optimal level of physical functioning.

[Medical students' image of the elderly and the effect of medical education: a literature review].

In American studies in the sixties and seventies caregivers, including physicians, showed a negative attitude towards the elderly. There are indications that such a negative attitude affects the quality of care and the communication with the elderly. Based on predominantly American literature this article reviews research on medical students' knowledge about and attitudes towards older people as well as the impact of geriatric training on the image of older patients and physician-patient communication.

[Risk of hip fractures in the elderly: biomechanical aspects of the falling process].

Age-related fractures are considered to be primarily the consequence of bone loss and increased bone fragility. In line with this dominant view on fracture etiology, prevention studies have primarily focused on pharmacologic interventions to increase bone density of the femoral neck. However, osteoporotic fracture occurrence is not entirely accounted for by bone strength but also related to the incidence and impact of falls.

Mechanisms involved in postdeglutition retention in the elderly.

This study examines possible quantifiable causes of postdeglutition pharyngeal retention in the elderly. Manofluorography and computer processing of video images are performed. Retention in the valleculae and in the piriform sinuses is associated with a markedly reduced pharyngeal shortening, a low tongue driving force (TDF), and a diminished amplitude of the pharyngeal contraction.

[Acute intestinal obstruction in an elderly patient].

The correct diagnosis of an acute abdomen in the aged is difficult, because of its varying presentation. Intestinal obstruction as a cause of acute abdomen is five times more common in the elderly as compared to younger patients. Acute intestinal obstruction in elderly patients may be due to intestinal or gynaecologic malignancies, or more frequently to incancerated hernias, peritoneal adhesions or faecal impaction.

Relationship between baseline insulin-like growth factor-I (IGF-I) and femoral bone density in women aged over 70 years: potential implications for the prevention of age-related bone loss.

Objective: To test the hypothesis that the decline in femoral bone mass associated with healthy aging is partially accounted for by deficiency of the growth hormone-insulin-like growth factor-I (IGF-I) axis.

Design: Cross-sectional study.

Study Participants: A sample of 245 community-dwelling healthy women aged 70 and older.

Swallowing and the duration of the hyoid movement in normal adults of different ages.

Normal swallows were examined using ultrasound imaging. Durational data of the hyoid movement were obtained from frame-by-frame analysis. The duration of the hyoid movement of three consecutive unstimulated (= dry) swallows was compared to that of stimulated (= wet) swallows in 120 subjects equally distributed among both sexes and four different age groups.

Deficiency of the growth hormone-insulin-like growth factor-I axis potentially involved in age-related alterations in body composition.

Because the body composition effects of growth hormone and insulin-like growth factor-I (IGF-I) are opposite to those of advancing age, it has been hypothesized that the decreased activity of the growth hormone-IGF-I axis is partly responsible for the loss of bone and muscle mass that characterizes normal human aging. The aim of the present cross-sectional analysis was to test this hypothesis in a well-defined community-based sample of 245 healthy elderly women. Dual-energy X-ray absorptiometry was used to measure body composition.

Hearing in hospitalised geriatric patients. A descriptive study.

A descriptive audiometric study was performed on 394 patients hospitalised in the geriatric department of our hospital. The mean age of these patients was 82 years. No significant correlation could be found between hearing thresholds and age of the patients.

Age-related bone loss and senile osteoporosis: evidence for both secondary hyperparathyroidism and skeletal growth factor deficiency in the elderly.

Aging is characterized by a decrease in bone volume, implying that net bone resorption exceeds net bone formation. This age-related bone loss can be regarded as the main determinant of hip fracture risk in the elderly. In the concept of senile osteoporosis, a key role has been attributed to vitamin D deficiency.

[Gait disorders and repeated falls in Steele-Richardson-Olszewski syndrome].

Progressive supranuclear palsy (syndrome of Steele-Richardson-Olszewski) represents one of the neuro-degenerative diseases, difficult to distinguish from other forms of parkinsonism. Although uncommon, the syndrome should be included in the differential diagnosis of recurrent falls in the elderly, especially in cases of parkinsonism presenting with axial rigidity and associated with gaze paralysis and/or poor response to L-dopa-therapy. The diagnosis is mainly based on the clinical findings.