#Cancer in #Elderly Onset Inflammatory Bowel Disease: A Population-Based Study
http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2016304a.html
CONCLUSIONS:
There is no increased risk for developing intestinal cancer among patients with elderly onset IBD in this population-based cohort. There are increased risks of developing lymphoproliferative and myeloproliferative disorders in all IBD. Thiopurines exposure was not found as associated with an increased risk to lymphoproliferative disorders. These data reinforce the difference between elderly onset IBD as compared with patients with younger age at IBD onset.
http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2016304a.html
CONCLUSIONS:
There is no increased risk for developing intestinal cancer among patients with elderly onset IBD in this population-based cohort. There are increased risks of developing lymphoproliferative and myeloproliferative disorders in all IBD. Thiopurines exposure was not found as associated with an increased risk to lymphoproliferative disorders. These data reinforce the difference between elderly onset IBD as compared with patients with younger age at IBD onset.
Effectiveness of Screening #Colonoscopy in the #Elderly
http://annals.org/mobile/article.aspx?articleid=2556139
Conclusion: Screening colonoscopy may have had a modest benefit in preventing CRC in beneficiaries aged 70 to 74 years and a smaller benefit in older beneficiaries. The risk for adverse events was low but greater among older persons
http://annals.org/mobile/article.aspx?articleid=2556139
Conclusion: Screening colonoscopy may have had a modest benefit in preventing CRC in beneficiaries aged 70 to 74 years and a smaller benefit in older beneficiaries. The risk for adverse events was low but greater among older persons
Subclinical #Hypothyroidism in #Elderly Individuals—Overdiagnosis and Overtreatment?
A Teachable Moment
http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2560378
A 72-year-old obese man with type 2 diabetes, hypertension, and coronary heart disease presented to the endocrinology clinic. His primary care clinician referred him to review the need for levothyroxine use
A Teachable Moment
http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2560378
A 72-year-old obese man with type 2 diabetes, hypertension, and coronary heart disease presented to the endocrinology clinic. His primary care clinician referred him to review the need for levothyroxine use
Jamanetwork
Subclinical Hypothyroidism in Elderly Individuals
This Teachable Moment describes levothyroxine therapy in elderly patients who might not have subclinical hypothyroidism.
Physician #age and outcomes in #elderly patients in hospital in the US: observational study
http://www.bmj.com/content/357/bmj.j1797
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.
Conclusions Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.
http://www.bmj.com/content/357/bmj.j1797
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.
Conclusions Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.
The BMJ
Physician age and outcomes in elderly patients in hospital in the US: observational study
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.
Design Observational study.
Setting US acute care hospitals.
Participants 20% random sample of Medicare…
Design Observational study.
Setting US acute care hospitals.
Participants 20% random sample of Medicare…
Psychological well-being in #elderly adults with extraordinary episodic #memory
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186413
The Northwestern University SuperAging Program studies a rare cohort of individuals over age 80 with episodic memory ability at least as good as middle-age adults to determine what factors contribute to their elite memory performance. As psychological well-being is positively correlated with cognitive performance in older adults, the present study examined whether aspects of psychological well-being distinguish cognitive SuperAgers from their cognitively average-for-age, same-age peers
The groups did not differ on demographic factors, including estimated premorbid intelligence. Consistent with inclusion criteria, SuperAgers had better episodic memory scores. Compared to cognitively average-for-age peers, SuperAgers endorsed greater levels of Positive Relations with Others. The groups did not differ on other PWB-42 subscales.
Discussion
While SuperAgers and their cognitively average-for-age peers reported similarly high levels of psychological well-being across multiple dimensions, SuperAgers endorsed greater levels of positive social relationships. This psychological feature could conceivably have a biological relationship to the greater thickness of the anterior cingulate gyrus and higher density of von Economo neurons previously reported in SuperAgers
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186413
The Northwestern University SuperAging Program studies a rare cohort of individuals over age 80 with episodic memory ability at least as good as middle-age adults to determine what factors contribute to their elite memory performance. As psychological well-being is positively correlated with cognitive performance in older adults, the present study examined whether aspects of psychological well-being distinguish cognitive SuperAgers from their cognitively average-for-age, same-age peers
The groups did not differ on demographic factors, including estimated premorbid intelligence. Consistent with inclusion criteria, SuperAgers had better episodic memory scores. Compared to cognitively average-for-age peers, SuperAgers endorsed greater levels of Positive Relations with Others. The groups did not differ on other PWB-42 subscales.
Discussion
While SuperAgers and their cognitively average-for-age peers reported similarly high levels of psychological well-being across multiple dimensions, SuperAgers endorsed greater levels of positive social relationships. This psychological feature could conceivably have a biological relationship to the greater thickness of the anterior cingulate gyrus and higher density of von Economo neurons previously reported in SuperAgers
journals.plos.org
Psychological well-being in elderly adults with extraordinary episodic memory
Objectives The Northwestern University SuperAging Program studies a rare cohort of individuals over age 80 with episodic memory ability at least as good as middle-age adults to determine what factors contribute to their elite memory performance. As psychological…
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Effect of #Aspirin on Disability-free Survival in the Healthy #Elderly
https://www.nejm.org/doi/full/10.1056/NEJMoa1800722
.. The rate of the composite of death, dementia, or persistent physical disability was 21.5 events per 1000 person-years in the aspirin group and 21.2 per 1000 person-years in the placebo group (hazard ratio, 1.01; 95% confidence interval CI, 0.92 to 1.11; P=0.79). The rate of adherence to the assigned intervention was 62.1% in the aspirin group and 64.1% in the placebo group in the final year of trial participation. Differences between the aspirin group and the placebo group were not substantial with regard to the secondary individual end points of death from any cause (12.7 events per 1000 person-years in the aspirin group and 11.1 events per 1000 person-years in the placebo group), dementia, or persistent physical disability. The rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%; hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001).
CONCLUSIONS
Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate
Effect of #Aspirin on Disability-free Survival in the Healthy #Elderly
https://www.nejm.org/doi/full/10.1056/NEJMoa1800722
.. The rate of the composite of death, dementia, or persistent physical disability was 21.5 events per 1000 person-years in the aspirin group and 21.2 per 1000 person-years in the placebo group (hazard ratio, 1.01; 95% confidence interval CI, 0.92 to 1.11; P=0.79). The rate of adherence to the assigned intervention was 62.1% in the aspirin group and 64.1% in the placebo group in the final year of trial participation. Differences between the aspirin group and the placebo group were not substantial with regard to the secondary individual end points of death from any cause (12.7 events per 1000 person-years in the aspirin group and 11.1 events per 1000 person-years in the placebo group), dementia, or persistent physical disability. The rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%; hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001).
CONCLUSIONS
Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate
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Antibiotic management of #urinary tract #infection in #elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study
https://www.bmj.com/content/364/bmj.l525
Bloodstream infection, hospital admission, and all cause mortality within 60 days after the index UTI diagnosis.
The rate of hospital admissions was about double among cases with no antibiotics (27.0%) and deferred antibiotics (26.8%) compared with those prescribed immediate antibiotics (14.8%; P=0.001). The risk of all cause mortality was significantly higher with deferred antibiotics and no antibiotics than with immediate antibiotics at any time during the 60 days follow-up (adjusted hazard ratio 1.16, 95% confidence interval 1.06 to 1.27 and 2.18, 2.04 to 2.33, respectively). Men older than 85 years were particularly at risk for both bloodstream infection and 60 day all cause mortality.
Conclusions In elderly patients with a diagnosis of UTI in primary care, no antibiotics and deferred antibiotics were associated with a significant increase in bloodstream infection and all cause mortality compared with immediate antibiotics. In the context of an increase of Escherichia coli bloodstream infections in England, early initiation of recommended first line antibiotics for UTI in the older population is advocated.
Antibiotic management of #urinary tract #infection in #elderly patients in primary care and its association with bloodstream infections and all cause mortality: population based cohort study
https://www.bmj.com/content/364/bmj.l525
Bloodstream infection, hospital admission, and all cause mortality within 60 days after the index UTI diagnosis.
The rate of hospital admissions was about double among cases with no antibiotics (27.0%) and deferred antibiotics (26.8%) compared with those prescribed immediate antibiotics (14.8%; P=0.001). The risk of all cause mortality was significantly higher with deferred antibiotics and no antibiotics than with immediate antibiotics at any time during the 60 days follow-up (adjusted hazard ratio 1.16, 95% confidence interval 1.06 to 1.27 and 2.18, 2.04 to 2.33, respectively). Men older than 85 years were particularly at risk for both bloodstream infection and 60 day all cause mortality.
Conclusions In elderly patients with a diagnosis of UTI in primary care, no antibiotics and deferred antibiotics were associated with a significant increase in bloodstream infection and all cause mortality compared with immediate antibiotics. In the context of an increase of Escherichia coli bloodstream infections in England, early initiation of recommended first line antibiotics for UTI in the older population is advocated.