Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO Registry.

Purpose: Predicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician's and patient's-self assessment of fitness for treatment, and the course of treatment in patients within a treatment decision aged ≥ 70 years.

Patients And Methods: The registry included 3169 patients from 93 centres and evaluated clinical course and treatment outcomes 2-3 and 6 months after initial assessment.

[Challenges of implementing a geriatric trauma network : A regional structure].

Background: At present, there is a high percentage and increasing tendency of patients presenting with orthogeriatric injuries. Moreover, significant comorbidities often exist, requiring increased interdisciplinary treatment. These developments have led the German Society of Trauma Surgery, in cooperation with the German Society of Geriatrics, to establish geriatric trauma centers.

Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score.

Objective: The management of community-acquired pneumonia (CAP) continues to be a challenge, especially in older people. To enable better risk stratification, a variation of the severity scores CRB-65 and CURB-65, called CURB-age, has been suggested. We compared the association between risk groups as defined by the scores and 30-day mortality for a cohort of mainly older inpatients with CAP.

Pneumonia severity, comorbidity and 1-year mortality in predominantly older adults with community-acquired pneumonia: a cohort study.

Background: In patients with community-acquired pneumonia (CAP), short-term mortality is largely dependent on pneumonia severity, whereas long-term mortality is considered to depend on comorbidity. However, evidence indicates that severity scores used to assist management decisions at disease onset may also be associated with long-term mortality. Therefore, the objective of the study was to investigate the performance of the pneumonia severity scores CURB-65 and CRB-65 compared to the Charlson Comorbidity Index (CCI) for predicting 1-year mortality in adults discharged from hospital after inpatient treatment for CAP.

External validation of the CURSI criteria (confusion, urea, respiratory rate and shock index) in adults hospitalised for community-acquired pneumonia.

Background: For patients hospitalised due to community-acquired pneumonia (CAP), mortality risk is usually estimated with prognostic scores such as CRB-65 or CURB-65. For elderly patients, a new score referred to as CURSI has been proposed which uses shock index (SI) instead of the blood pressure (B) and age (65) criteria. The new score has not been externally validated to date.

Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study.

Background: Although recommended for use in studies investigating falls in the elderly, the European Quality of Life Group instrument, EQ-5D, has not been widely used to assess the impact of falls on quality of life. The aim of this study was to investigate the association of single and frequent falls with EQ-5D rated quality of life in a sample of German community-dwelling seniors in primary care suffering a variety of concurrent chronic diseases and conditions.

Methods: In a cross-sectional study, a sample of community-dwelling seniors aged ≥ 72 years was interviewed by means of a standardised telephone interview.

The prevalence of falls in adults aged 40 years or older in an urban, German population. Results from a telephone survey.

Background: Single or frequent falls lead to increased morbidity due to fall-related injury, fear of falling, impairments in quality of life and loss of independence. To assess the impact of falls, prevalence data are essential.

Methods: In 2006, a telephone survey was performed in a random sample of 1270 inhabitants of the city of Herne, Germany, aged 40 years or older.

Prevalence of self-reported pain, joint complaints and knee or hip complaints in adults aged ≥ 40 years: a cross-sectional survey in Herne, Germany.

Background: Pain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce.

Methods: A cross-sectional survey of a random sample of citizens of Herne, Germany, aged ≥ 40 years was performed.

A review of the major vascular risk factors related to Alzheimer's disease.

The present review is dedicated to the epidemiology of vascular risk factors proven to play a role in facilitating onset and progression of cognitive impairment. These include hypertension, hypercholesterolemia, diabetes, obesity, atherosclerosis, and cardiac diseases. The targeted, chance-free identification and management of traditional vascular risk factors in midlife is a general public health strategy against the onset of mild to severe cognitive impairment in advanced age.

Conflict of evidence: carotenoids and other micronutrients in the prevention and treatment of cognitive impairment.

Cognitive impairment is a common age-related disorder which affects in the stadium and type Alzheimer's Disease (AD) a steadily growing number of patients. AD is not curable and is not being easily diagnosed in its preclinical phase. This work aims at highlighting the complex though promising rationale for the use of selected micronutrients against age-related cognitive impairment and its progression.

[Prerequisites for a new health care model for elderly people with multiple morbidities: results and conclusions from 3 years of research in the PRISCUS consortium].

Background: The concurrent presence or manifestation of multiple chronic conditions, i.e. multimorbidity, poses a challenge to affected patients and their relatives, physicians, and practitioners, and to the health care system in general.

[Influence of vascular comorbidities on the antioxidant defense system in Alzheimer's disease].

Background And Aim: Oxidative stress is a critical factor in the pathophysiology of dementia, but the role of oxidant/antioxidant imbalance in relation to vascular pathology in the onset and progression of Alzheimer's disease (AD) is poorly understood. The aim of this study was the identification of an association between vascular comorbidities/vascular risk factors and plasma levels of antioxidant micronutrients in patients with AD.

Patients And Methods: 41 patients with AD  and 34 controls were included in the study.

A brief update on dementia prevention.

A large number of published overview and original articles provide evidence and declare the need for immediate, appropriate preventive lifestyle measures to prevent the development of dementia and Alzheimer's disease (AD). However, despite this, there are great difficulties in drafting effective guidelines in this field. This is mainly due to a lack of not only (comparable) randomized controlled trials but also a lack of homogeneous measures of type and degree of managed risk.

Bridging the pathophysiology of Alzheimer's disease with vascular pathology: the feed-back, the feed-forward, and oxidative stress.

Alzheimer's disease (AD) is slowly but steadily undergoing a profound reshaping of the definition and approach caused by the frustrating gap between poorly controlled AD epidemiology and repeated lack of success in finding a cure. The frequently reported and currently accepted role of vascular pathology and vascular risk factors in AD pathophysiology in recent years is one major aspect of this need for a severe adjustment in the modus operandi in AD. A clue into the importance that the interdependence between AD and vascularity has gained in scientific opinion is the large amount of recent reviews, almost reaching that of original papers, on the topic.

[Pneumonia Severity Index (PSI), CURB-65, and mortality in hospitalized elderly patients with aspiration pneumonia].

Background: Aspiration pneumonia is associated with a high morbidity and mortality in elderly patients. In order to provide risk-adapted medical care, it is necessary to establish valid prognostic tools for these patients.

Objective: The value of two well-established scores to assess prognosis in community-acquired pneumonia (CAP), i.

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

Background: To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed.

Material And Methods: Participants were recruited in the offices of nine primary care physicians.

Elderly patients with community-acquired pneumonia: optimal treatment strategies.

Community-acquired pneumonia (CAP) is a common infectious disease that still causes substantial morbidity and mortality. Elderly people are frequently affected, and several issues related to care of this condition in the elderly have to be considered. This article reviews current recommendations of guidelines with a special focus on aspects of the care of elderly patients with CAP.

Prerequisites for a new health care model for elderly people with multimorbidity: the PRISCUS research consortium.

Background: Multimorbidity, the concurrent manifestation or presence of multiple chronic conditions, poses huge challenges to affected patients, their relatives, physicians, and practitioners alike. The growing number of affected persons and the complexity of their needs places just as much of a burden on the health care system as does the plethora of often poorly coordinated interventions. The Chronic Care Model developed for different chronic diseases is suited for improving medical care.

Prevention of dementia: focus on lifestyle.

The objective of this paper is to summarize current knowledge on the possible advantages of lifestyle interventions, with particular attention to physical fitness, cognitive activity, leisure and social activity as well as nutrition. There is a large amount of published papers providing partial evidence and asserting the need for immediate, appropriate preventive lifestyle measures against dementia and AD development. Nevertheless, there are currently great difficulties in drafting effective guidelines in this field.

Modulation of cholesterol in midlife affords cognitive advantage during ageing - a role for altered redox balance.

General practitioners, geriatricians, neurologists and health care professionals all over the world will be facing by 2040 the diagnostic, therapeutic and socioeconomic challenges of over 80 million people with dementia. Dementia is one of the most common diseases in the elderly which drastically affects daily life and everyday personal activities, is often associated with behavioural symptoms, personality change and numerous clinical complications and increases the risk for urinary incontinence, hip fracture, and - most markedly - the dependence on nursing care. The costs of care for patients with dementia are therefore immense.

Bone T-scores and functional status: a cross-sectional study on German elderly.

Background: We explore the association between bone T-scores, used in osteoporosis diagnosis, and functional status since we hypothesized that bone health can impact elderly functional status and indirectly independence.

Methods: In a cross-sectional study (2005-2006) on community dwelling elderly (> = 75 years) from Herne, Germany we measured bone T-scores with Dual-energy X-ray Absorptiometry, and functional status indexed by five geriatric tests: activities of daily living, instrumental activities of daily living, test of dementia, geriatric depression score and the timed-up-and-go test, and two pooled indexes: raw and standardized. Generalized linear regression was used to determine the relationship between T-scores and functional status.

Association of polymorphisms in CYP19A1 and CYP3A4 genes with lower urinary tract symptoms, prostate volume, uroflow and PSA in a population-based sample.

Purpose: The known importance of testosterone for the development of benign prostatic hyperplasia (BPH) prompted us to test the hypothesis whether polymorphisms of two genes (CYP19A1 and CYP3A4) involved in testosterone metabolism are associated with clinical BPH-parameters.

Methods: A random sample of the population-based Herne lower urinary tract symptoms cohort was analysed. All these men underwent a detailed urological work-up.

[The geriatric assessment].

Due to demographic changes there is an increasing number of elderly and old patients with cancer. This group of patients shows a significant heterogeneity and differs from the average young patient. Identification of relevant functional deficits and comorbidities remains crucial for an efficient treatment strategy of this patient group.