Skip to main content

Stocking Stuffers for Your Favorite Geriatrician


Don't know what to get your favorite geriatrician for the holidays? Out of ideas as you bought your geriatrician a snuggy last year and this year amazon.com is telling you that the healthcare reform package you ordered is unlikely to be delivered in time for Christmas? Well, good news! The BMJ Christmas edition is here and it is chock-full of articles that you and your Geriatrician will be sure to enjoy. Here are two samples:

  • Perceived age as clinically useful biomarker of ageing. Your geriatrician is probably tired of looking up prognostic indexes to aid in complex decision making around age appropriate cancer screening. It turns out that there may be an easier way. A group from the University of Southern Denmark report that someone’s perceived age, or "how old you think someone looks", correlates with lifespan. The researchers photographed 1,826 Danish twins older than age 70. These photos were then shown to a panel of 20 geriatric nurses, 10 young male student teachers, and 11 older women, who evaluated the perceived age of each twin. Dannish Death records were subsequently used to track the survival of the twins over a seven year period. The results show that the member of each twin set who looked older was more likely to die first, even after adjusting for chronological age, sex, and other biomarkers of aging.
  • Lying obliquely—a clinical sign of cognitive impairmentGeriatricians will jump for joy once they are taught the “oblique sign”. A group of neurologists from Germany decided to determine if patients who fail to “spontaneously orient the body along the longitudinal axis of a hospital bed when asked to lie down” are more likely to have cognitive impairment. They tested 110 inpatients aged 60 or more by asking them to lie down from a sitting position on the side of the examination bed. The researchers then took a photograph of the patient in bed to determine the “obliqueness” of the patient. The results show that an “angular deviation” of at least 7° predicted cognitive impairment according to the three different cognitive tests. Their conclusion – “suspect cognitive impairment in mobile older inpatients with neurological disorders who spontaneously position themselves obliquely when asked to lie on a bed.”
Oh, but there is so much more.  Don't miss the articles on the use of "Nellie the Elephant" as a learning aid during CPR (and why its use should be discontinued), Ageism and the Economist, and how Santa Claus is a public health pariah.

Comments

I have always loved th BMJ Christmas edition. Thanks for posting these I forgot to look for it this year.

Popular posts from this blog

Geroscience and it's Impact on the Human Healthspan: A podcast with John Newman

Ok, I'll admit it. When I hear the phrase "the biology of aging" I'm mentally preparing myself to only understand about 5% of what the presenter is going to talk about (that's on a good day).  While I have words like telomeres, sirtuins, or senolytics memorized for the boards, I've never been able to see how this applies to my clinical practice as it always feels so theoretical.  Well, today that changed for me thanks to our podcast interview with John Newman, a "geroscientist" and geriatrician here at UCSF and at the Buck Institute for Research on Aging.

In this podcast, John breaks down what geroscience is and how it impacts how we think about many age-related conditions and diseases. For example, rather than thinking about multimorbidity as the random collection of multiple different clinical problems, we can see it as an expression of the fundamental mechanisms of aging. This means, that rather than treating individuals diseases, targeting …

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Length of Stay in Nursing Homes at the End of Life

One out of every four of us will die while residing in a nursing home. For most of us, that stay in a nursing home will be brief, although this may depend upon social and demographic variables like our gender, net worth, and marital status. These are the conclusions of an important new study published in JAGS by Kelly and colleagues (many of whom are geripal contributors, including Alex Smith and Ken Covinsky).

The study authors used data from the Health and Retirement Study (HRS) to describe the lengths of stay of older adults who resided in nursing homes at the end of life. What they found was that out of the 8,433 study participants who died between 1992 and 2006, 27.3% of resided in a nursing home prior to their death. Most of these patients (70%) actually died in the nursing home without being transferred to another setting like a hospital.

 The length of stay data were striking:

the median length of stay in a nursing home before death was 5 months the average length of stay was l…