Nongeriatric Groups Research Articles

Comparison of chronic kidney disease progression and associated complications between geriatric and non-geriatric groups.

There is no consensus on the physiologic decline in estimated glomerular filtration rate (GFR) due to geriatric conditions related with the aging or chronic kidney disease (CKD) itself. In this study, we aimed to compare the CKD progression and associated complications in a large sample of geriatric and non-geriatric patients. The data of in 506 patients at age between 30 to 90 years and diagnosed with CKD at stage 2 and above (15 mL/min/1.73 m2 ≤ eGFR < 90 mL/min/1.73 m2) were collected retrospectively and compared among geriatric (>65 years old) and non-geriatric individuals. The rate of hypertension was higher in geriatrics compared to non-geriatrics (96.6% vs 91.9%, P = .04). Among laboratory findings, only PTH level was significantly lower and HCO3 concentration was higher in geriatrics compared to non-geriatrics (P = .02, P < .001, respectively). There was no significant difference in last measured eGFR (P = .99) while that measured 4 years ago was lower in geriatrics compared to that of non-geriatrics (P < .001). eGFR change was smaller in geriatrics compared to non-geriatrics (P < .001), and rate of progressive renal disease among non-geriatric group (39%) was found to be significantly higher than in the geriatrics (17.2%) (P < .001). The prevalence of hyperkalemia was lower in geriatrics at stage 3a (P = .02); prevalence of hyperparathyroidism was lower in those at stage 3b (P = .02) and lastly the acidosis was observed significantly lower in geriatric patients at stage 3a, 3b, and 4 compared to the non-geriatrics at corresponding stages (P < .001, P = .03, and P = .04, respectively). The eGFR change was significantly smaller in geriatrics at stage 3b and 4 (P < .001 and P = .04, respectively) while the rate of progressed renal disease was lower in geriatrics at stage 3a and 3b (21.1% vs 9.9%, P = .03 and 41.2% vs 11.1%, P < .001, respectively). eGFR change in 4-year period and the rates of progressive renal disease are higher in the non-geriatrics and also the prevalence of secondary complications of CKD, such as hyperparathyroidism, acidosis, and hyperkalemia, are higher in non-geriatrics. This may reflect that decline of GFR in geriatric individuals is at least partially related to physiological aging rather than kidney disease. Therefore, devising age related CKD definitions might be appropriate.

Sleep disorders among elderly in Saudi Arabia: A cross-sectional study.

Aging has been shown to have an impact on sleep patterns, necessitating a deep dive into understanding the complex relationship between aging and sleep disorders. This study aimed to assess the prevalence of sleep disorders among elderly people and identify the associations between different factors and sleep disorders in this age group. This study was conducted at nursing homes in Jeddah. The target populations were those aged 65 years and older (geriatric group) and those aged younger than 65 years (nongeriatric group). Validated questionnaires, including the Athens Insomnia Scale, Berlin Questionnaire, Epworth Sleepiness Scale, International restless legs syndrome (RLS) Study Group, and Pittsburgh Sleep Quality Index, were used to assess different sleep disorders. A total of 313 participants were recruited in the geriatric (n = 153) and nongeriatric (n = 160) groups. Compared with the nongeriatric group, the geriatric group had greater risks of obstructive sleep apnea (OSA) (70.6%) and RLS (40.5%) (P < 0.001). Both groups had a notable prevalence of poor sleep quality (86.6%). Although insomnia was found to be common, there was no significant difference in the prevalence of insomnia between the two groups. In addition, insomnia (odds ratio [OR] = 3.04, confidence interval [CI]: 1.06-8.86, P = 0.037), OSA (OR = 3.17, CI: 1.06-9.41, P = 0.038), and high body mass index (OR = 1.76, CI: 1.63-2.9, P = 0.003) were significantly associated with poor sleep quality. This study revealed that sleep disorders, particularly OSA and RLS, are common in the elderly population in Saudi Arabia.

Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients.

Worldwide, the incidence of chronic fungal rhinosinusitis (CFRS) has increased. Although ageing leads to weakening of the immune system, which increases susceptibility to CFRS, the CFRS characteristics in geriatric patients are unclear. Therefore, we comparatively analysed the clinical characteristics of CFRS in geriatric and non-geriatric patients. This retrospective analysis compared the demographics, rhinologic symptoms, multiple allergen simultaneous tests, olfactory function tests, paranasal sinus computed tomography findings, and outcomes of 131 patients with CFRS who underwent functional endoscopic sinus surgery and 131 enrolled patients were divided in geriatric (> 65years) and non-geriatric (≤ 65years) groups. Among the geriatric and non-geriatric participants (n = 65, 49.6% and n = 66, 50.4%, respectively), hypertension and diabetes mellitus were more common in the geriatric group. Demographics, including symptoms, showed no significant intergroup differences. Normosmia and hyposmia were significantly less prevalent, whereas phantosmia and parosmia were more prevalent in the geriatric group than in the non-geriatric group (p = 0.03 and p = 0.01, respectively). Sphenoidal sinus involvement was significantly higher in geriatric patients than in non-geriatric patients (p = 0.02). Based on greater sphenoidal sinus involvement, a deeper anatomical area is more vulnerable to fungal infection in the geriatric group than in the non-geriatric group. Increasing clinicians' awareness of CFRS in geriatric patients with olfactory dysfunction, including phantosmia and parosmia, is important for early intervention.

Microvascular reconstruction for oral cancer in older adult patients: the impact of age on surgical outcomes

Flap complications continue to be a challenge in microsurgical reconstruction for older adults. We aimed to evaluate the impact of age on surgical outcomes after microvascular reconstruction. We retrospectively investigated 103 patients with oral squamous cell carcinoma who had undergone microvascular reconstruction surgery to compare microsurgical reconstruction, common postoperative complications, and flap success rates in geriatric (>75 years) and non-geriatric (<75 years) patients. We also evaluated differences based on the American Society of Anesthesiologists Physical Status score. We found no significant differences between the geriatric and non-geriatric groups in peri-operative, postoperative, or general complications. Conversely, we found that delirium and aspiration pneumonia were significantly more likely to occur in geriatric patients and that multiple medical complications were significantly more likely to occur in geriatric patients with a high American Society of Anesthesiologists score. Microvascular reconstruction can be performed effectively and without excessive complications in geriatric patients, and age should not be considered a contraindication for this procedure. Comorbidities play a stronger role in the prediction of adverse events.

Comparing GIST outcomes between geriatric and non-geriatric patients: A population-based analysis.

e23513 Background: Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the GI tract, typically presenting as subepithelial neoplasms in the stomach with rarer occurrences in the small bowel, colorectum, &amp; esophagus. Standard-of-care treatment includes surgical resection followed by Imatinib. It is unclear whether differences in patient outcomes exist across age groups. The Surveillance, Epidemiology, &amp; End Results (SEER) program is an extensive cancer database which proves useful in analyzing cancer trends. This SEER analysis aims to investigate differences in GIST outcomes for patients aged &gt; 70 versus ≤70 years. Methods: SEER*STAT version 8.4.0.1 was used to extract relevant gastrointestinal stromal sarcoma (ICD-O-3 8936/3) data for the years 2000-2019. Geriatric age was defined as &gt; 70 years. Variables assessed include age, surgery, gender, cause-specific death, &amp; overall survival. Statistical methods included univariate analysis using the KM survival estimate (95% confidence interval) for five-year survival and Log-Rank tests to observe statistical significance of the survival distribution. Multivariate Cox’s PH regression model was also used to estimate hazard ratio of death for geriatric patients adjusted for gender, stage, and surgery. Results: The number of patients included in this analysis within the study period was 13579, with an overall 5-year survival of 68.6% (95% CI: 67.7–69.5). Non-geriatric and geriatric patient data yielded 5-year survival rates of 77.4% (76.4%–78.3%) and 53.3% (51.7%–54.8%) respectively ( p&lt; .0001). Cancer-specific death was 39.11% in 2000 and 3.33% in 2019. Male and female patients yielded 5-year survival rates of 73.0% (71.5%–74.4%) and 82.6% (81.2%–83.9%) in the younger group respectively ( p&lt; .0001), while geriatric data yielded rates of 49.1% (46.8%–51.3%) and 57.3% (55.1%–59.4%) respectively ( p&lt; .0001). With respect to no surgery and surgery, younger patient data yielded 5-year survival rates of 48.7% (45.8%–51.4%) and 83.7% (82.7%–84.7%) respectively ( p&lt; .0001), while geriatric data yielded rates of 29.3% (26.5%–32.1%) and 62.8% (60.8%–64.6%) respectively ( p&lt; .0001). Multivariate Cox PH regression model yielded an estimated hazard ratio of 2.56 (2.42–2.70) for geriatric patients ( p&lt; .0001). Conclusions: Cancer-specific death has decreased since 2000, indicating an overall improvement in survival &amp; treatment methods. Younger female patients had the highest 5-year survival rates, while older male patients yielded the lowest rates. We observed lower survival rates overall in the older group &amp; a hazard ratio of 2.56 for geriatric patients. Surgery appeared to enhance survival rates in both the geriatric &amp; non-geriatric groups, suggesting that surgery is an important factor in overall GIST survival regardless of age group. Large prospective studies will help define the appropriate management in geriatric patients.

Density Spectral Array Enables Precise Sedation Control for Supermicrosurgical Lymphaticovenous Anastomosis: A Retrospective Observational Cohort Study.

Supermicrosurgical lymphaticovenous anastomosis (LVA) is a minimally invasive surgical technique that creates bypasses between lymphatic vessels and veins, thereby improving lymphatic drainage and reducing lymphedema. This retrospective single-center study included 137 patients who underwent non-intubated LVA in southern Taiwan. A total of 119 patients were enrolled and assigned to two study groups: the geriatric (age ≥ 75 years, n = 23) and non-geriatric groups (age < 75 years, n = 96). The primary outcome was to investigate and compare the arousal and maintenance of the propofol effect-site concentration (Ce) using an electroencephalographic density spectral array (EEG DSA) in both groups. The results showed that the geriatric group required less propofol (4.05 [3.73-4.77] mg/kg/h vs. 5.01 [4.34-5.92] mg/kg/h, p = 0.001) and alfentanil (4.67 [2.53-5.82] μg/kg/h vs. 6.68 [3.85-8.77] μg/kg/h, p = 0.047). The median arousal Ce of propofol among the geriatric group (0.6 [0.5-0.7] μg/mL) was significantly lower than that in patients aged ≤ 54 years (1.3 [1.2-1.4] μg/mL, p < 0.001), 55-64 years (0.9 [0.8-1.0] μg/mL, p < 0.001), and <75 years (0.9 [0.8-1.2] μg/mL, p < 0.001). In summary, the combined use of EEG DSA provides the objective and depth of adequate sedation for extensive non-intubated anesthesia in late-elderly patients who undergo LVA without perioperative complications.

Locomotion as a Measure of Well-Being in Captive Chimpanzees (Pan troglodytes).

Locomotion in non-human primates, including walking, climbing, and brachiating among other types of movement (but not pacing), is a species-typical behavior that varies with age, social housing conditions, and environmental factors (e.g., season, food availability, physical housing conditions). Given that captive primates are typically observed to engage in lower levels of locomotor behaviors than their wild counterparts, increases in locomotion are generally considered to be indicative of improved welfare in captivity. However, increases in locomotion do not always occur with improvements in welfare, and sometimes occur under conditions of negative arousal. The use of time spent in locomotion as a welfare indicator in studies of well-being is relatively limited. We conducted focal animal observations on 120 captive chimpanzees across a series of studies and found higher percentages of time spent in locomotion (1) upon transfer to a new enclosure type, (2) in larger groups with wider within-group age ranges, and fewer males, and (3) with participation in an experimental medication choice paradigm. We also found that, among geriatric chimpanzees, those housed in nongeriatric groups exhibited more locomotion than those living in geriatric groups. Lastly, locomotion was significantly negatively correlated with several indicators of poor welfare and significantly positively correlated with behavioral diversity, one indicator of positive welfare. Overall, the increases in time spent in locomotion observed in these studies were part of an overall behavioral pattern indicative of enhanced welfare, suggesting that an increase in time spent in locomotion itself may be an indicator of enhanced welfare. As such, we suggest that levels of locomotion, which are typically assessed in most behavioral experiments, may be used more explicitly as indicators of welfare in chimpanzees.

Effects of age, gender and modifiable risk factors on low back pain

Low back pain increases with age and causes a burden of serious socio-economic adverse outcomes. Gender, age, vitamin D insufficiency, and obesity are some of the factors that are considered accountable for the etiology of low back pain, however, conflicting results are present in the literature regarding their effects on low back pain. In this study, we aimed to evaluate the effect of pain duration, pain intensity, gender, and preventable risk factors including vitamin D and body mass index (BMI), on low back pain. File registration data of 274 patients (211 females, 63 males) were included in this retrospective study. Age, gender, pain intensity, BMI, and vitamin D levels were recorded. Patients aged 60 and over were considered as the geriatric group. We observed that higher Visual Analogue Scale (VAS) scores were significantly associated with increased BMI (p=0.007) and advanced age (p=0.049). Duration of pain was positively correlated with, age (p&lt;0.001) and BMI (p=0.02). There was no significant relation between VAS scores and vitamin D levels. The duration of the disease was longer in women than men (p=0.038), but no significant difference was observed for VAS scores between genders. When the study group was divided into geriatric and non-geriatric groups, disease duration was higher in the geriatric group (p&lt;0.001), but no significant difference was observed between VAS scores. BMI, which is among the modifiable risk factors, is closely related to low back pain. The increase in both BMI and VAS scores, especially with advancing age, indicates that overweight older individuals are at high risk for low back pain.

Patterns of biopsy-proven renal diseases in geriatric patients: A single medical center experience.

The elderly population is expanding rapidly, and that has become a major healthcare burden in terms of chronic kidney disease. The distribution patterns of kidney diseases in these elderly patients remain largely unclear. Here, we compared biopsy-based renal disease patterns between elderly and nonelderly patients. We performed a single-center, retrospective study (1992-2008) on biopsy-proven renal diseases to compare results between geriatric patients (age ≥ 65 years; n = 254) and nongeriatric patients (18 ≤ age < 65 years; n = 2592). Renal pathology was interpreted by pathologists based on light microscopy, immunofluorescence, and electron microscopy. The ages of the geriatric and nongeriatric groups were 71.8 ± 4.5 (65.1-87.3) and 39.7 ± 17.6 (18-64.9) years, respectively, and 74% and 41% of them, respectively, were men. In the geriatric group, the most frequent diagnosis was membranous nephropathy (46.1%), followed by minimal change disease/focal segmental glomerulosclerosis (16.9%), diabetic nephropathy (8.3%), hypertensive nephrosclerosis (7.5%), and IgA nephropathy (5.9%). The geriatric group had more membranous nephropathy and less lupus nephritis and IgA nephropathy than the nongeriatric group. Furthermore, the 5-year survival rate of the geriatric group was significantly low. Our results demonstrated the different distributions of renal biopsy patterns in geriatric patients diagnosed with acute or chronic progressive kidney injury and proteinuria through renal biopsy.

Association between the plasma-to-red blood cell ratio and survival in geriatric and non-geriatric trauma patients undergoing massive transfusion: a retrospective cohort study

BackgroundThe benefits of a high plasma-to-red blood cell (RBC) ratio on the survival of injured patients who receive massive transfusions remain unclear, especially in older patients. We aimed to investigate the interaction of age with the plasma-to-RBC ratio and clinical outcomes of trauma patients.MethodsIn this retrospective study conducted from 2013 to 2016, trauma patients who received massive transfusions were included. Using a generalized additive model (GAM),we assessed how the plasma-to-RBC ratio and age affected the in-hospital mortality rates. The association of the plasma-to-RBC ratio [low (< 0.5), medium (0.5–1.0), and high (≥ 1.0)] with in-hospital mortality and the incidence of adverse events were assessed for the overall cohort and for patients stratified into non-geriatric (16–64 years) and geriatric (≥ 65 years) groups using logistic regression analyses.ResultsIn total, 13,894 patients were included. The GAM plot of the plasma-to-RBC ratio for in-hospital mortality demonstrated a downward convex unimodal curve for the entire cohort. The low-transfusion ratio group was associated with increased odds of in-hospital mortality in the non-geriatric cohort [odds ratio 1.38, 95% confidence interval (CI) 1.22–1.56]; no association was observed in the geriatric group (odds ratio 0.84, 95% CI 0.62–1.12). An increase in the transfusion ratio was associated with a higher incidence of adverse events in the non-geriatric and geriatric groups.ConclusionThe association of the non-geriatric age category and plasma-to-RBC ratio for in-hospital mortality was clearly demonstrated. However, the relationship between the plasma-to-RBC ratio with mortality among geriatric patients remains inconclusive.

Correlation of Neutrophil to Lymphocyte Ratio with Interleukin-10 in Diagnosis and Monitoring of Coronavirus Disease-19 Patients

BACKGROUND: The enforcement of diagnosis and monitoring of therapy success in SARS-Cov-2 infection, which causes COVID-19 disease, necessitates laboratory tests that may assess and identify patients prior to developing critical circumstances requiring additional treatment. The Neutrophil to Lymphocyte Ratio (NLR) and Interleukin-10 (IL-10) testing are two laboratory procedures used. AIM: This study aims to determine the correlation between NLR and Interleukin-10 (IL-10) in diagnosing and monitoring COVID-19 patients. METHODS: An observational analytic cross-sectional design enrolled about 73 COVID-19 patients who met the inclusion criteria and were willing to participate in the study. The levels of NLR and IL-10 were assessed by Sysmex XS-800i Automated Hematology Analyzer and sandwich ELISA methods. Data were analyzed using SPSS version 17 for Windows. RESULTS: A median of NLR values was 4.02 (1.24-47.89), following IL-10 concentration was 1.870 (0.110–33.368) pg/mL. There was a significant difference in NLR values between critical and non-critical categories (p = 0.000), geriatric and non-geriatric groups (p = 0.006), as well as in groups with comorbid and without comorbidities (p = 0.006). Meanwhile, a significant difference in IL-10 levels was only found between critical and non-critical categories (p = 0.000). There was a moderately significant positive correlation between NLR and IL-10 in COVID-19 patients (r = 0.411; p = 0.000). CONCLUSION: There is a significant positive correlation between NLR values and IL-10 levels in COVID-19 patients.

Geriatric patients with esophageal motility disorders benefit more from minimally invasive peroral endoscopic myotomy: a multicenter study in Japan.

Geriatric patients with existing studies on the safety and efficacy of peroral endoscopic myotomy (POEM) for achalasia involve small sample sizes and single institutions. However, multi-center, large-scale data analyses are lacking. The study aimed to clarify the characteristics of geriatric patients with esophageal motility disorders (EMDs) and determine the procedure-related outcomes and clinical course following POEM. This cohort study included 2,735 patients with EMDs who were treated at seven Japanese facilities between 2010 and 2019. The patients' characteristics and post-POEM clinical courses were compared between the geriatric (age ≥ 75years; n = 321) and non-geriatric (age < 75years; n = 2,414) groups. Compared with the non-geriatric group, the geriatric group had higher American Society of Anesthesiologists physical status scores; more recurrent cases; lower incidence of chest pain; and higher incidence of type III achalasia, distal esophageal spasm, and Jackhammer esophagus. Furthermore, the incidence of sigmoid esophagus was higher, although esophageal dilation was not severe in this group. POEM was safe and effective for geriatric patients with treatment-naïve and recurrent EMDs. Furthermore, compared with the non-geriatric group, the geriatric group had lower post-POEM Eckardt scores, fewer complaints of refractory chest pain, and a lower incidence rate of post-POEM reflux esophagitis. Geriatric patients are characterized by worse clinical conditions, more spastic disorders, and greater disease progression of EMDs, which are also the indications for minimally invasive POEM. POEM is more beneficial in geriatric patients as it has lowering symptom scores and incidence rates of reflux esophagitis.

Evaluation of diabetes self-management education in geriatrics with type 2 diabetes in Turkey.

This study was conducted to evaluate the diabetes education efficiency of individuals over 65 years old in Turkey, which has the highest prevalence of diabetes in Europe. We retrospectively evaluated 320 patients who attended Turkey diabetes self-management group education program (TDSMEP) between 2016 and 2020 in a secondary hospital. Participants who have been followed up for a maximum of 9 months are grouped as over 65 years old and under. Of the 320 patients, 114 formed the geriatric group and 206 the non-geriatric group. After the training, the number of patients who had HbA1c≤7% increased significantly in both the geriatric (28.1-45.6%) and non-geriatric (19.9-42.2%) (P=0.001) groups. After the training, similar HbA1c goals were achieved in the geriatric and non-geriatric groups. The most significant HbA1c decrease was observed at the 3rd month of follow-up and remained stable until the 9th month. In logistic regression analysis, the factors affecting HbA1c failure (HbA1c>7%) after training in the geriatric group were long diabetes duration (OR=1.07, 95% CI: 1.02-1.13, P=0.01), high basal HbA1c levels (OR=1.31, 95% CI: 1.03-1.67, P=0.03), and low education level (OR=3.88, 95% CI: 1.54-9.76, P=0.001). This is the first study to evaluate the effectiveness of TDSMEP for geriatric individuals whose HbA1c≤7% increased from 28% to 45.6% during follow-up after the training. TDSMEP is recommended for all adult age groups, regardless of age range.

Epidemiology and outcomes of geriatric and non-geriatric patients with drug allergy labels in Hong Kong.

Adverse drug reactions are more common in geriatric patients than in younger patients, but there have been insufficient studies concerning the epidemiology or burden of drug allergy labels in geriatric patients. We prospectively investigated the prevalence and outcomes of geriatric patients with drug allergy labels in a cohort of hospitalised patients. Patients admitted to a regional hospital over a 6-month period were recruited for this study. All patients with drug allergy labels were prospectively followed until discharge; clinical data were anonymously extracted for analyses. Patients were categorised into either geriatric (aged ≥65 years) or non-geriatric (aged <65 years) groups. Demographic characteristics, clinical outcomes, and prevalences of drug allergy labels were compared between groups. There were 4361 admissions involving 3641 patients during the 6-month study period. Overall, 492 patients (13.5%) had drug allergy labels, consisting of 151 non-geriatric patients (30.7%) and 341 geriatric patients (69.3%). The prevalence of drug allergy labels did not significantly differ between geriatric and non-geriatric patients (13.5% vs 13.5%, P=0.976). Significantly more patients in the geriatric group had drug allergy labels to cardiovascular system drugs (15.5% vs 4.6%, P=0.001). Geriatric patients had a significantly lower rate of direct discharge from the hospital (73.0% vs 88.1%, P<0.001) and required transfers to convalescent or rehabilitation care for further management. More than 13% of hospitalised geriatric patients had drug allergy labels. The leading causes of drug allergy labels were similar between geriatric and non-geriatric patients. Geriatric patients with drug allergy labels had significantly more labelled allergies to cardiovascular system drugs and adverse clinical outcomes.

Assessment of morbidity and mortality factors affecting geriatric trauma: A comprehensive cross-sectional study in Central India

India is the second-most populous country in the world has about 76.6 million people at or over the age of 60, constituting above 7.7% of total population. A cross-sectional study of 300 cases of geriatric and non-geriatric population groups was conducted at well-established Trauma, Orthopaedic and Neurosurgical services centre in Central India. Mechanisms of injury sustained by the participants showed that Falls which include both Ground level falls (GLF) and Fall from height (&gt;2 metres) contributed to 55.4% cases in the geriatric population. The next most common cause of trauma in the geriatric population was road traffic accidents amounting to 34.3% of the cases. Data on the injuries sustained by both the study cohorts in terms of the different body regions based on Abbreviated Injury Scale (AIS) and Injury severity score (ISS) showed the head region was most consistently and maximally injured in both the study populations. Comorbidity profiles of geriatric and non-geriatric trauma populations showed significantly high hypertension, cerebrovascular disease, diabetes, diminished hearing and vision among the geriatric group. The maximum number of geriatric patients underwent Orthopaedic and spine surgeries (44.9%), Intercostal drain placements (34.6%), while the non-geriatric population had a higher number of Craniotomies (40%) and Intercostal drain placement (33.5%) surgeries respectively. The geriatric population had a significantly higher crude mortality rate of 39.3% compared to the non-geriatric population ( 26.3% ). With reference to intervention procedures, the geriatric population had a lower percentage of operative intervention and a higher rate of conservative management as compared to the non-geriatric population.

Salivary pH and Taste Sensitivity among Geriatric and Non-Geriatric Patients in a Tertiary Hospital: A Cross Sectional Study

Objective: To evaluate the association of salivary pH and taste sensitivity among geriatric and non-geriatric patients in an otorhinolaryngology - head and neck surgery out-patient clinic.&#x0D; Methods:&#x0D; Design: Cross-Sectional Study&#x0D; Setting: Tertiary Government Training Hospital&#x0D; Participants: 40 otorhinolaryngology out-patients&#x0D; &#x0D; Results: Of the 40 patients aged 24 to 92-years-old (mean age 59.8 years), 21 were geriatric and 19 were non-geriatric. The mean salivary pH was 6.66 (range 5 to 8) and 6.63 (range 5 to 7) for geriatric and non-geriatric groups; the difference in mean salivary pH was not statistically significant (p = .87). The salivary pH in the geriatric group showed a negative correlation with age (r=0.06), while the salivary pH in the non-geriatric group had a positive correlation with age (r=0.14). Overall, increases in age among the non-geriatric group were correlated with increase in salivary pH which were not observed in the geriatric patients. In the geriatric group, among the 4 tastants, the strongest correlation between taste sensitivity and salivary pH was observed for quinine followed by sucrose and NaCl, but no correlation for citric acid. In the non-geriatric group, the strongest correlation between taste sensitivity and salivary pH was observed for NaCl, followed by quinine, citric acid and sucrose.&#x0D; Conclusion: There was no significant difference between the mean salivary pH of geriatric and non-geriatric patients, and both means were within normal. There was a negative correlation between age and salivary pH in the geriatric group, and a positive correlation in the non-geriatric group. Salivary pH had the strongest correlation with taste sensitivity for quinine and NaCl among geriatric and non-geriatric participants, respectively, but the reasons for, and significance of this cannot be inferred from the present study.&#x0D; Keywords: salivary pH; taste sensitivity; gustatory function; geriatric

Differences in Behavior Between Elderly and Nonelderly Captive Chimpanzees and the Effects of the Social Environment.

The population of NIH-owned or NIH-supported captive research chimpanzees is quickly becoming aged, and the 1998 NIH breeding moratorium has resulted in a skewed age distribution. As such, behavioral management programs aimed at refining the care of an aging captive chimpanzee population have become increasingly important. However, little research exists that addresses the ways in which captive chimpanzee behavior differs as a function of the interaction of age and aspects of the captive environment. We examined overall differences in behavior between elderly (35 y and older) and nonelderly (younger than 35 y) captive chimpanzees. Elderly chimpanzees exhibited significantly more rough scratching (a behavioral indicator of anxiety) and inactivity, less behavioral diversity, and less affiliation than their nonelderly counterparts. We also assessed whether elderly chimpanzee behavior and wounding rates differed as a function of housing in geriatric (group average age, 35 y or older) or nongeriatric (group average age, younger than 35 y) groups. In our program, geriatric social groups were characterized by smaller group size, more females within the group, and higher levels of individual mobility impairment compared with nongeriatric groups. Furthermore, elderly chimpanzees housed in geriatric groups displayed significantly increased rough scratching, decreased locomotion and submission than nongeriatric animals but no difference in wounding. These findings suggest that housing elderly chimpanzees in nongeriatric groups may be beneficial, given that doing so may stimulate locomotion. However, the establishment and maintenance of geriatric groups may be unavoidable as the demographics of the population of captive former research chimpanzees continues to age. Therefore, refinements to captive geriatric care strategies for chimpanzees should focus on methods of evaluating and enhancing functionally appropriate captive environments within geriatric groups.

Thyroid cancer surgery in the elderly: a comparative study of 1176 patients

Background: The aim of this study is to compare the results of patients who were treated with two groups (under 65 years and over 65 years) of thyroid cancer.Methods: A retrospective review of 1176 patients undergoing thyroid cancer surgery between January 2007 and December 2016 was performed. Patients were grouped as ≥65 (geriatric group) and &lt;65 years (non-geriatric group).Results: A total of 139 patients (11.8%) were over 65 years of age and 1037 patients (88.2%) were under 65 years of age. There were 104 female (74.8%) and 35 (25.2%) male patients in the geriatric group. In the non-geriatric group, 917 (78%) patients were female and 259 (22%) were male (p = 0.39). FNAB showed a significant increase in malignant potential in the elderly (p = 0.005). In our series, malignant differences between geriatric and non-geriatric groups are less pronounced among thyroid carcinomas other than capsular invasion. Although there was no significant difference in histopathologic examination, malignant cytology was higher in the elderly patients. There was no significant difference between the young and elderly patients in terms of complication.Conclusions: In this study, papillary Thyroid Ca (PTC) was found to be the most common type of cancer and we could not find any difference in cancer type distribution in geriatric and non-geriatric patients. Total/near total thyroidectomy in experienced hands is safe for elderly patients. There is no difference in terms of complication.

Update on the effect of age on acute pancreatitis morbidity: a retrospective, single-center study.

IntroductionAcute pancreatitis (AP) is one of the urgent diseases of gastroenterology. Due to the growth of the elderly population, the frequency of the disease in the elderly population is also increasing.AimTo evaluate the contributing factors of mortality in geriatric patients (age ≥ 65 years) and non-geriatric (age < 65 years) patients.Material and methodsWe retrospectively analyzed data of consecutive patients with AP, in the Adana Numune Education and Research Hospital between March 2013 and September 2015.ResultsOf the 602 patients studied, 405 were female and 197 were male and their mean age was 55.2 ±19.5 years. The most common etiological factors were biliary stone, hyperlipidemia and alcohol, respectively. Two hundred and four patients were in the geriatric group and 394 patients were in the non-geriatric group. 84.4% of patients had mild AP, and 15.6% of patients had moderate to severe AP according to the revised Atlanta classification. 91.7% of non-geriatric patients had mild AP while 70.7% of geriatric patients had mild AP (p < 0.001). 29.4% of geriatric patients had moderate-to-severe AP while 8.4% of non-geriatric patients had moderate-severe AP. Duration of hospital stay was 6.2 ±3 days and 5.3 ±2.3 days in geriatric and non-geriatric groups respectively (p < 0.001). Mortality was higher in the geriatric group than the non-geriatric group (9.6% vs. 0.5%, respectively) (p < 0.001).ConclusionsAcute pancreatitis in the geriatric population shows a more severe course than the non-geriatric population. Geriatric patients have longer duration of hospital stay and higher mortality than non-geriatric patients.

The geriatric polytrauma: Risk profile and prognostic factors.

In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS). Age, hemoglobin (Hb) level, systolic blood pressure (BP), Glasgow Coma Scale (GCS) score, timing of and necessity for intubation were analyzed in relation to mortality and in comparison with younger patients. Geriatric polytrauma patients (n=140) had overall mortality rate of 65%, whereas younger patients (n=1468) had mortality rate of 15.9%. Despite equivalent severity of injury (HPTS less age points) in geriatric and non-geriatric groups, mortality rate was 4 times higher in geriatric group. Major blood loss with Hb <8 g/dL was revealed to be 3 times more fatal than moderate or minor blood loss (Hb ≥8 g/dL). GCS score <12 corresponded to double mortality rate (39% vs 83%). Age by itself is significant risk factor and predictor of increased mortality in polytrauma patients. Additional risk factors include very low GCS score and systolic BP <80 mm Hg, for instance, as potential clinical indicators of massive bleeding and traumatic brain injury. Such parameters demand early and rapid treatment at prehospital stage and on admission.