Hypnosis can reduce pain in hospitalized older patients: a randomized controlled study.

Background: Chronic pain is a common and serious health problem in older patients. Treatment often includes non pharmacological approaches despite a relatively modest evidence base in this population. Hypnosis has been used in younger adults with positive results.

Vitamin D is not associated with cognitive status in a cohort of very old hospitalized patients.

Background/objective: The association between vitamin D levels and cognitive function remains a controversial issue especially in the very old, highly comorbid patients. We address the relative contribution of vitamin D when taking into account potential confounders well known to be involved in cognitive decline.

Methods: We investigated, in a prospective study of 428 very old inpatients from the Geneva geriatric hospital (mean age 85.

Tooth loss, chewing efficiency and cognitive impairment in geriatric patients.

Background: Patients with dementia have poorer oral health and fewer teeth than their peers without cognitive impairment.

Objective: The hypothesis of this study is that the number of natural teeth and the chewing efficiency are associated with cognitive functioning.

Methods: This cross-sectional study included 29 patients diagnosed with dementia aged 75 years or older and 22 controls who were either cognitively normal (n = 19) or with mild cognitive impairment (n = 3).

Identification of older patients at risk of unplanned readmission after discharge from the emergency department - comparison of two screening tools.

Study Hypothesis: The Identification of Senior At Risk (ISAR) and the Triage Risk Stratification Tool (TRST) are the two most studied screening tools to detect high-risk patients for unplanned readmission after an emergency department (ED)-visit. Since their performance was unclear among ED-patients over 75 years, we evaluated their capacities to predict readmission at 1, 3, 6 and 12 months as well as their usefulness in avoiding unnecessary further comprehensive geriatric assessment (CGA) in negative screened patients.

Methods: Historical cohort study with systematic routine data collection of functional status, comorbid conditions and readmission rate of patients released home after an ED-visit between 2007 and 2009 at the Geneva University Hospitals.

Natural history of older adults with impaired kidney function: the InCHIANTI study.

The aim of this study was to assess the kidney function of an older community-dwelling population at baseline and appraise its evolution after 3 years of follow-up in terms of chronic kidney disease (CKD) stage progression, magnitude of glomerular filtration rate (GFR) changes, and value of serum creatinine. This was a prospective population-based study of 676 Italian participants, aged 65 years and older. GFR was estimated using the Cockcroft-Gault equation and the Modification of Diet in Renal Disease Study equation.

High levels of comorbidity and disability cancel out the dementia effect in predictions of long-term mortality after discharge in the very old.

Background/aims: The relative weight of various etiologies of dementia as predictors of long-term mortality after other risk factors have been taken into account remains unclear. We investigated the 5-year mortality risk associated with dementia in elderly people after discharge from acute care, taking into account comorbid conditions and functionality.

Methods: A prospective cohort study of 444 patients (mean age: 85 years; 74% female) discharged from the acute geriatric unit of Geneva University Hospitals.

Mild cognitive impairment, degenerative and vascular dementia as predictors of intra-hospital, short- and long-term mortality in the oldest old.

Background And Aims: The relative weight of various etiologies of dementia and mild cognitive impairment (MCI) as predictors of intra-hospital, short- and long-term mortality in very old acutely ill patients suffering from multiple comorbid conditions remains unclear. We investigated intra-hospital, 1- and 5-year mortality risk associated with dementia and its various etiologies in a very old population after discharge from acute care.

Methods: Prospective cohort study of 444 patients (mean age 85 years; 74% female) discharged from the acute geriatric unit of Geneva University Hospital.

Efficiency and applicability of comprehensive geriatric assessment in the emergency department: a systematic review.

Background And Aims: Comprehensive geriatric assessment (CGA) may benefit frail or chronically ill patients in the emergency department (ED), but take too much time to be performed routinely in ED. An alternative approach is to use first a screening tool to detect high-risk patients and then perform CGA in these patients only. This systematic review focuses on the use and value of CGA in ED for evaluation of older patients and its influence on adverse outcomes.

Predictivity of survival according to different equations for estimating renal function in community-dwelling elderly subjects.

Background: Detection of subjects with early chronic kidney disease (CKD) is important because some will progress up to stage 5 CKD, and most are at high risk of cardiovascular morbidity and mortality. While validity and precision of estimated glomerular filtration rate (eGFR) equations in tracking true GFR have been repeatedly investigated, their prognostic performance for mortality has not been hitherto compared. This is especially relevant in an elderly population in whom the risk of death is far more common than progression.

Magnitude of underascertainment of impaired kidney function in older adults with normal serum creatinine.

Objectives: To estimate in a community-dwelling elderly population the magnitude of renal function misclassification, occurring when persons with normal serum creatinine have reduced glomerular filtration rate (GFR), and to describe the participant characteristics related to misclassification.

Design: Cross-sectional.

Setting: Population-based study of older Italian people.

Hypercortisolemic depression is associated with the metabolic syndrome in late-life.

Introduction: Depression has been hypothesized to be associated with metabolic abnormalities which increase the risk of cardiovascular disease (CVD) and diabetes. Such a link could be due to increased HPA-axis activity. This study investigates the cross-sectional relationship between depression, urinary cortisol and metabolic syndrome in an older population.