bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
Authors: van de Glind Esther M. M. , van Munster Barbara C. , Hamaker Marije E. 
Published: December 2017

Abstract
Cardiopulmonary resuscitation (CPR) was developed in the 1950s as a treatment for cardiopulmonary arrest. Outcome of CPR remains poor, particularly in older people, as demonstrated by two recent meta-analyses. The first addressed out-of-hospital resuscitation in patients aged 70 years and over, and found pooled overall rates of survival to discharge of 4.1%. For in-hospital resuscitation, the overall pooled rate of survival to discharge was 18.7% for patients aged 70–79 years, 15.4% for patients aged 80–89 years and 11.6% for those aged 90 or over. It is not clear if age alone is a limiting factor, or rather a marker of comorbidity. Overall, information about the quality of life after surviving CPR is lacking. Older patients should be adequately informed about their chances of survival in good condition in order to make a decision about the desirability of CPR.
Traumatic brain injury and subdural haematoma
Authors: Bin Zahid Abdullah , Samadani Uzma 
Published: December 2017

Abstract
Traumatic brain injury (TBI) in elders is a common problem that is frequently accompanied by the other comorbidities. The advanced trauma life support (ATLS) protocol guides initial evaluation and stabilization. The cornerstone of management is to prevent secondary brain injury caused primarily by hypoxia and hypotension. TBI may be accompanied by intracranial haematomas, of which subdural haematoma (SDH) is the most common. SDH may also arise in the absence of TBI, and is easy to miss especially in its chronic form. Treatment is to drain the haematoma if large or symptomatic, otherwise simple observation is sufficient. Primary investigations in both TBI and SDH are CT head and coagulation profile. Prognosis in both is usually indicated by age and neurologic exam findings. Older people with chronic complications of TBI (e.g. chronic traumatic encephalopathy) may be seen. Diagnostics remain elusive for this condition and management is primarily symptomatic.
Assessment and diagnosis of the non-Alzheimer dementias
Authors: Onyike Chiadi U. 
Published: December 2017

Abstract
Non-Alzheimer dementias are commonly distinguished from Alzheimer disease by younger age at onset (midlife or earlier), positive family history, and presentations characterized by non-amnesic cognitive deficits, psychiatric states (such as depression, compulsions, paranoia, and hallucinations) and motor dysfunctions (like parkinsonism, ataxia, and apraxia). Missed diagnosis is a common problem, with the conditions being mistaken for psychiatric or movement disorder. Timely diagnosis depends on methodical examinations that characterize the chronology and tempo of key symptoms, family history, and neurological features, and brain images that reveal telltale patterns of atrophy or dysfunction. Genetic, blood, and CSF assays, and EEG are indicated where family history is positive or illness progression rapid. As non-Alzheimer dementias pose many clinical and psychosocial problems, optimal care requires a multidisciplinary team, empowered carers, and leverage of community resources. The latest discoveries in neuroimaging, particularly amyloid-PET, tau-PET, and clinical genetics, promise improvements in diagnostics and new therapeutic opportunities.
Non-pharmacologic behavioural activity interventions to prevent dementia
Authors: Carlson Michelle C. , Varma Vijay R. 
Published: December 2017

Abstract
Behavioural interventions to prevent and delay dementia onset and progression are on the rise. Physical, sensory, electrical, and multimodal lifestyle activity may impact cognitive and brain health in multiple ways that impact directly or indirectly the neuropathology and clinical symptoms of Alzheimer’s disease and dementias. Many of these programmes are scalable through existing clinical settings and community infrastructure, including schools, community and retirement centres, religious institutions, and other public and private non-profit organizations. At the same time, much remains to be learned about the specific physical and lifestyle activities that contribute to cognitive health or offer resilience to pathology, and the limits of their effectiveness. An important objective for these studies will be to explore the additive and interactive effects of different interventions, both behavioural and pharmacologic.
Mental health: epidemiology, pathophysiology, diagnosis, and management
Authors: Rozzini Renzo , Trabucchi Marco 
Published: December 2017

Abstract
Mental health of older people is one of the most challenging tasks for the society and medicine of our time. The epidemiology of the different psychogeriatric problems indicates that the well-being of a large part of population is jeopardized, and impose large scale specific programmes to prevent, cure, and rehabilitate the most prevalent and severe diseases in old age. Interventions should be directed to the multidimensional events determining and characterizing the specific pathological conditions, since mental health is influenced by biological factors, but also by living conditions (i.e. socioeconomic status, human relationship, available support). Mental health of population in advanced age must be the centre of interest of our society in order to create the conditions for age-friendly communities.
Elder abuse
Authors: Crome Peter , Arora Amit 
Published: December 2017

Abstract
The problem of elder abuse is still underreported and underrecognized in many cases. This chapter discusses various definitions of elder abuse and key issues related to this serious problem including barriers which prevent vulnerable older people seeking help. This chapter also examines the role of health professionals in early identification and management of elder abuse. It also explores some of the indicators of elder abuse which can help non-clinicians identify older people at risk of harm. This chapter describes the current procedure for management of elder abuse in England and some other countries. It also covers information about laws in relation to elder abuse. Support services and non-governmental organizations are an important resource for helping abused person and their role is described briefly in this chapter.
Common geriatric emergencies
Authors: Conroy Simon , McNamara Rosa 
Published: December 2017

Abstract
Older adults make up an increasing share of emergency department (ED) users, as the proportion of those aged 65 years and older increases in the general population. Older adults often have physical, physiological, psychological, and social considerations which demand a different approach to evaluation, management, and discharge planning compared to most younger adults using the ED. Older people are also more likely to have accumulated morbidity throughout their life course. Thus, a focus on geriatric emergency medicine has become an increasingly important as clinicians adapt to meet the challenges of population ageing. Here we outline the current trends in ED usage by older adults and give an overview of how care of older people is structured in emergency medicine.
Age-associated breathlessness
Authors: Won Won Chang , Kim Sunyoung 
Published: December 2017

Abstract
Breathlessness in older adults is a common symptom of cardiovascular, respiratory diseases, psychological disorders such as panic disorder, and respiratory muscle weakness, but this symptom is also prevalent during daily activities as a result of age-related changes. With ageing, physical fitness, the strength of respiratory muscles and elastic recoil of the small airways all decline, and, as a result, breathing becomes more difficult and gas exchange less efficient. Differentiation between cardiac and pulmonary cause of dyspneoa is very important and sometimes difficult. In acutely breathless elderly patients, an elevated level of brain natriuretic peptide is a sensitive and specific marker for the presence of ventricular failure. Once a diagnosis is made, the reversible factors contributing to the breathlessness should be corrected as far as possible, and the initial focus should be on optimizing treatment of the patient’s underlying disease, followed by reducing the impact of breathless on everyday activities and quality of life.
Anaemia
Authors: Fager Ammon M. , Cohen Harvey Jay 
Published: December 2017

Abstract
Anaemia is an important problem in the older population. As it is usually mild and insidious in onset, the symptoms of anemia are often overlooked by older adults who attribute their symptoms to an inevitable consequence of ageing while clinicians may ignore mild anaemia in favour of focusing on more prominent comorbidities. However, anaemia in older adults is associated with significant mortality and decreased quality of life due to functional decline. As our understanding of anaemia in elderly people on a biological and clinical level increases, our ability to impact the functional deficits associated with it will improve. However, quality clinical trial evidence on the impact of anaemia and its treatment on crucial outcomes in older patients is currently lacking. The completion of such trials will be critical to assure the safety and efficacy of future interventions designed to improve the treatment and quality of life for older adults.
Sexuality in older persons
Authors: Maggio Marcello , Lauretani Fulvio , Ceda Gian Paolo 
Published: December 2017

Abstract
Sexuality is defined as the dynamic outcome of physical capacity, motivation, attitudes, opportunity for partnership, and sexual conduct. Sexual health in older persons is a topic deserving increasing interest and attention for both a public audience and physicians. Over half of people over 65 years of age, report sexual dysfunction, women more so than men. Since sexual health is dependent on general health and can be considered a mirror of general health, its assessment should be part of the routine clinical assessment, even in older subjects. However, asking about sexual health especially in older persons is often a difficult or embarrassing task for many primary care physicians. In addition, many patients find difficult to raise sexual issues with their doctor. Early recognition of sexual symptoms is the first step to starting multimodal treatments aimed at improving sexual health and related quality of life in older persons.
Skin diseases more common in older adults
Authors: Trivalle Christophe , Wallach Daniel 
Published: December 2017

Abstract
In this chapter, we briefly survey the more common skin diseases seen in older adults. All elderly people have cutaneous lesions, and knowledge of the principles of dermatology is needed for their management, because some of these lesions have potentially severe and lethal consequences. Older people are rarely free from skin problems and a certain degree of dermatological expertise is required to distinguish between benign consequences of ageing, dermatitis requiring intervention, and life-threatening dermatoses. Older people do not usually have easy access to dermatologists. Preliminary experiments of telemedicine showed that for specific situations, such as leg ulcers or for an expert advice, remote consultations can be useful. Meanwhile, close attention and early referral may be needed to avoid unnecessary suffering.
Dizziness and vertigo
Authors: Lyons Declan , Beirne Avril , Lawson Joanna 
Published: December 2017

Abstract
Dizziness is one of the commonest symptoms described by older adults, particularly women, and is associated with reduced quality of life, functional decline, and falls. The term dizziness is used by patients to describe a variety of symptoms, including a hallucination of movement (vertigo), light-headedness, and a true appreciation of unsteadiness associated with gait disorders. Although there are age-related decrements in the somatosensory, visual, vestibular, and motor systems, dizziness should not be regarded as part of normal ageing. Diagnosis can usually be reached without specialist investigations, through focused history taking and bedside clinical assessment, including careful examination of eye movements and the Dix-Hallpike test. The underlying cause may be in one or several physiological systems and this will guide treatment plans. Benign paroxysmal positional vertigo (BPPV) and neuritis are more common than Meniere’s. The presence of red flag symptoms or signs suggesting central vestibular disease will require further imaging.
Pain assessment and management in cognitively intact and impaired patients
Authors: Van Den Noortgate Nele , Sampson Elizabeth 
Published: December 2017

Abstract
Pain is common in older people, affecting up to 60% of older community-dwelling older persons with and without dementia. Chronic pain has a significant impact on the quality of life of older people. Since pain is often underrecognized in the older population, systematic screening and assessment with appropriate tools for the target population, is recommended. A holistic, multidisciplinary approach may offer meaningful support. There are no neurophysiological arguments that pain perception and tolerance are affected by the ageing process. Dementia does not change the sensory perception of pain but can cause changes in the meaning and recognition of the sensation. It is possible to safely use non-pharmacological treatments and available analgesics, provided the clinician has a good knowledge of the side effects of the treatments. In patients with advanced dementia and patients at the end of life, alternative routes of administration of analgesics should be considered.
Rehabilitation: additional palliative care approaches
Authors: Maddocks Matthew , Payne Sheila 
Published: December 2017

Abstract
Palliative care and rehabilitation share many common traits. When codelivered, these specialties can provide a holistic, patient-centred approach to care that maximizes function irrespective of diagnosis. This chapter considers how palliative care and rehabilitation can be delivered together in practice, and outlines commonly used interventions with examples of evidence from hospice, acute, and community care settings. The text covers treatments offered by different allied health professionals, including physical activity and exercise, hydrotherapy, non-drug interventions for breathlessness, adaptations, and assistive devices, as well as speech and language, music, and art therapies. Thereafter, the chapter looks at how palliative rehabilitation treatments can be evaluated, both using conventional outcome measures and through the use of goal setting and goal attainment scaling. In addition to direct benefits to patients, rehabilitation approaches offer secondary benefits for family caregivers, especially when deterioration leads to the family assisting with physical caregiving and transfers.
Midlife risk factors of diseases and geriatric syndromes
Authors: Strandberg Timo E. 
Published: December 2017

Abstract
Environmental risk factors for adverse health outcomes are usually evident by midlife. Genes and the ageing process modify the risk factor actions, and together become the main causes of chronic non-communicable diseases, including cardiovascular diseases, diabetes, chronic kidney disease, and the most common forms of cancer (breast, prostate, colon) later in life. The most important lifestyle-related or environmental risk factors include diet, smoking, and physical inactivity, which often contribute to traditional or medical risk factors including hypertension, dyslipidemia, obesity, and hyperglycemia, which are the downstream antecedents of many other disease states. Further, it is increasingly evident that the occurrence of common geriatric syndromes, including frailty and mild cognitive impairment, can also be predicted by midlife risk factors. Current knowledge of risk factor development during the life course, and evidence-based prevention should be better utilized in the long-term prevention of health problems in old age.
Nutrition, ageing, and longevity
Authors: Cederholm Tommy , Hellénius Mai-Lis 
Published: December 2017

Abstract
Long-term food intake can have a profound impact on cellular and organ functions affecting the development of multiple chronic disease states as well as the rate of the ageing processes. Over the last two centuries, longevity of mankind has increased by two years per decade. Improved food habits are important contributing factors. Epidemiological, intervention and mechanistic studies (e.g. on traditional Mediterranean and Okinawa Island diets) provide a basis to recommend vegetables, legumes, fruits, non-tropical oils as basic fat, light meat (e.g. poultry) of moderate amounts, plenty of fish, and moderate beverage intakes of wine, coffee, and tea. Oxidative damage is suggested as one major reason for ageing. Healthy foods are often rich in antioxidant compounds, but there is no evidence that extra antioxidant supplementation has any beneficial effects.
Preserving mental health and well-being
Authors: Almeida Osvaldo P. 
Published: December 2017

Abstract
Well-being is a state characterized by contentment with one’s emotional, physical, and social circumstances that is undermined by the presence of depression, dementia, and frailty. Numerous potentially modifiable risk factors have been associated with these common conditions of later life, and there is growing evidence that multidomain interventions that target them in a systematic fashion hold potential to reduce the incidence and prevalence of frailty, dementia, and depression in older age. Some of the potential targets for interventions include physical inactivity, suboptimal education or cognitive activity, smoking, harmful alcohol use, obesity, diabetes, hypertension, high plasma homocysteine, low vitamin D, and testosterone. These interventions are still in their infancy, but preliminary data offer hope that an increasing number of people will be able to enjoy good health and well-being in their later years.
Clinical translation of interventions that target ageing: towards a longevity dividend
Authors: Palmer Allyson K. , Kirkland James L. 
Published: December 2017

Abstract
Exciting advances have been made recently in understanding the mechanistic underpinnings of ageing. Mounting evidence suggests that progression of ageing changes can be modulated. Interventions that extend healthspan and lifespan in model organisms have been developed. The time is approaching for translation of these interventions into clinical treatments. By targeting fundamental ageing mechanisms, it may be possible to delay, prevent, or alleviate chronic diseases as a group, rather than individually, and enhance healthspan. Such a compression of morbidity would have profound clinical and economic benefits, with reductions in life-years spent with chronic disease and age-related dysfunction. However, barriers remain, including lack of clinical and regulatory paradigms for translating agents that target fundamental ageing processes into clinical interventions, and a shortage of personnel trained to do so. Here we consider research findings that support the potential value of translational ageing research and strategies to move these findings from bench to bedside.
Gerontechnology
Authors: Dutta Tilak , Taati Babak , Holliday Pamela , Li Yue , Pong Steven , Mihailidis Alex , Fernie Geoff 
Published: December 2017

Abstract
As we age, we become more likely to encounter disabilities. Most are health-related conditions that can make it difficult to maintain our quality of life and make us more susceptible to further illness and injury. These conditions also make the lives of our caregivers (paid and informal) more difficult and place them at risk of burnout, illness, or injury of their own. The vast majority of us want to continue living in our own homes as we age but the challenge of living with disability can make this difficult. This chapter describes how the right tools can limit the negative effects of disability and support successful ageing whether in our homes or in an institution to help us be happier and healthier, for longer.
Personalized medicine for older adults
Authors: Akner Gunnar 
Published: December 2017

Abstract
Each older person presents with a unique clinical phenotype. This clinical heterogeneity in older adults calls for a high degree of personalized/individualized approach to geriatric medicine and to the care of older adults. Individualized clinical health analysis and management could be performed according to the DTF-model (i.e. Diagnostics-Treatment-Follow-up), which has implications for education/training, medical records, organization, and financing of care for older people. A four-step clinical analysis process based on the DTF-model is presented, aiming to operationalize how a comprehensive geriatric assessment could be visualized, thereby serving as a much longed for ‘geroscope’. A main challenge for the future is to restructure healthcare to suit the most common long-term health problem (i.e. multimorbidity). Future medical developments should be based on geriatric principles and preferably be organized to allow clinical research in clinical routine care to stimulate relevance and development of new methods for clinical treatment trials.
Dematiaceous fungi
Authors: Kidd Sarah E. , Halliday Catriona L. 
Published: December 2017

Abstract
The dematiaceous fungal pathogens, classified by their darkly pigmented hyphae, cause infection in both immunosuppressed and immunocompetent individuals. Infections may present as chromoblastomycosis, mycetoma, and a spectrum of phaeohyphomycoses varying in severity. The route of infection may be through traumatic inoculation, or inhalation with or without dissemination. A number of species are considered neurotropic and can cause cerebral abscesses in immunocompetent persons. Infections can occur worldwide, but are most common in the tropics, and some species appear to have specific geographic ranges. Diagnosis requires sampling at the site of infection; direct microscopy using KOH (potassium hydroxide), haematoxylin and eosin, and/or Fontana-Masson stains; and culturing. Accurate species identification is essential. Treatment includes antifungal therapy with or without surgery, and antifungal susceptibility testing is recommended for all cultures.
Mucoraceous moulds
Authors: Rogers Thomas R. , Johnson Elizabeth M. 
Published: December 2017

Abstract
The mucoraceous moulds are members of the order Mucorales and comprise a number of genera within which are species that typically cause life-threatening infections in immunocompromised hosts, but are also pathogens of patients with diabetes mellitus or burns, or following traumatic injuries or near-drowning incidents, and in iron overload. Clinical presentations may be of rhinocerebral, pulmonary, cutaneous, or disseminated disease. Once established at its initial focus, the infection can progress rapidly. Diagnosis is challenging because this is a relatively rare disease, cultures from sites of infection may be negative, and few biomarkers exist to aid laboratory diagnosis. Histopathological examination of infected tissue is useful in diagnosis. Clinicians should have a high level of suspicion when immunocompromised patients present with sinus infection, facial swelling, orbital bone erosion, nodular lung infiltration, or necrotic skin eschars. The only currently available antifungal agents with evidence of clinical utility in mucormycosis are amphotericin B, posaconazole, and isavuconazole.