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This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Frailty is considered a multisystem impairment that makes an individual vulnerable to external or internal stressors. Sarcopenia, the age-dependent loss of muscle mass and function, is proposed as the biological substrate and the pathway whereby the consequences of physical frailty develop. These syndromes are associated with a negative impact in quality of life and can lead to the occurrence of disability, institutionalization, and even mortality. The book focuses upon all the related aspects of frailty and sarcopenia and the new advancements in the related treatments including complex issues and research. It includes high-quality chapters in all related aspects for the syndromes of sarcopenia and frailty, which adversely affect the function and overall effectiveness of the musculoskeletal system and interventions to promote rehabilitation.
Designed to help in the understanding of the causes & course of disability in older women. Offers an excellent overview of diseases & disability & their impact on older women. Covers: adaptation to disability, physical performance measures, the daily lives of disabled older women, utilization of health services, mental health & general well-being, pulmonary diseases & conditions, musculoskeletal disease, neurological conditions, vision & hearing, medication use, instrumental & emotional support, adaptation to disability, & much more.
SARCOPENIA An in-depth examination of sarcopenia’s underexplored yet widespread impact within the field of gerontology Sarcopenia is common in older men and women, and yet awareness of its clinical relevance is still relatively low. Only formally included in the International Classification of Diseases in 2016, the condition may impact societies with serious health-related and financial consequences unless consistent, effective methods of identification and management are adopted. This second edition of Sarcopenia provides geriatricians and other healthcare professionals with a revised and expanded examination of this understudied and underdiagnosed condition. Edited by two leading authorities on the subject, it covers the epidemiology and diagnosis of sarcopenia, as well as treatment options and possible prevention strategies. Eight newly written chapters build upon existing knowledge with fresh data on topics including sarcopenia’s biomarkers and its impact on the healthcare economy. This important text: Defines sarcopenia and explains its clinical relevance Covers all recent scientific evidence Outlines treatment options Considers prevention strategies Discusses sarcopenia as a public health priority Features eight new chapters covering topics such as sarcopenia’s clinical management, its biomarkers, and its financial impact Containing vital information for clinicians and other professionals working in geriatric care, nursing homes, nutrition, cancer, endocrinology, surgery, sports medicine and many other specialties, Sarcopenia, second edition, is a groundbreaking and essential new resource.
This book highlights recent advances in our understanding of sarcopenia and frailty in CKD. The prevalence of sarcopenia and frailty increases substantially as CKD progresses, and experimental studies have demonstrated the pivotal role of accumulated uremic toxin in the development of muscle wasting. Further, sarcopenia and frailty are associated with falls, bone fractures, cognitive impairment, and poor survival prognoses, especially in elderly CKD patients. The syndromes are also related to the risk of end-stage kidney disease. This book provides readers with a deeper understanding of the prevention and management of sarcopenia and frailty in CKD patients to improve their renal and overall health, and suggests directions for future basic and clinical research.
This edited work presents the most current evidence on osteosarcopenia from bench to bedside, which is expected to facilitate the understanding of this syndrome and to develop preventive and therapeutic strategies. With our aging population, chronic diseases such as osteoporosis and sarcopenia are becoming highly prevalent. Fortunately, our understanding of the bone and muscle interactions has increased in recent years. This has allowed to the coining of the term osteosarcopenia to describe a syndrome in which these two diseases overlap. This overlap between osteoporosis and sarcopenia has major negative effects not only on our older adults but also on health systems worldwide. Readers will find a highly translational approach that starts with a summary of recent discoveries on stem cells biology, muscle and bone interactions – including the role of local bone and muscle fat – followed by comprehensive reviews on myokines (i.e. myostatin), osteokines (i.e. osteocalcin) and adipokines (i.e. interleukins) as major players and determinants of bone and muscle loss with aging. In addition, the role of sex steroids (i.e. estrogens, androgens), and calciotropic hormones (i.e. parathyroid hormone, vitamin D) in the pathogenesis of this syndrome is also reviewed. Moreover, using practical diagnostic and therapeutic tips, this book summarizes the clinical characteristics of osteosarcopenic patients thus facilitating the diagnosis and treatment of this syndrome in clinical practice. Finally, the book presents the case for the Falls and Fractures Clinic as the optimal model of care for this syndrome, aimed to avoid fragmentation and optimize osteosarcopenia care, and simultaneously prevent falls and fractures in older persons. This book offers relevant information on the mechanisms of osteosarcopenia, and a practical guide on how to identify and treat this geriatric syndrome and its adverse outcomes, which are dramatically affecting our aging population. The work is written by leaders in the field and is especially suited not only to any researcher in the musculoskeletal arena but also to medical specialists and allied health professionals involved in the care of older persons.
Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.
Vitamin D deficiency is prevalent today not only among the elderly but pervasively throughout all ages of life.This is due, in part, to systemic diseases that affect vitamin D metabolism, to changes in lifestyle, such as insufficient exposure to sunlight, and to increased use of sunscreen. Apart from the obvious effects of vitamin D deficiency on skeletal metabolism, the problem is assuming even greater significance because observational and interventional studies have linked vitamin D deficiency to cardiovascular disease, cancer, and diabetes. This book addresses a variety of important issues that have emerged from this fast-moving area of clinical medicine. The topics include assays of vitamin D and its binding protein, effects on aging and associated complications, primary and secondary states of altered parathyroid hormone secretion, vitamin D in the growing years of children and adolescents, nutritional requirements, and vitamin D as it relates to systemic disorders such as diabetes mellitus. Vitamin D in Clinical Medicine aims to offer new insights, in an evidence-based way, on important issues related to vitamin D. It is written for general practitioners and internists, as well as for endocrinologists, nutritionists, pulmonologists, cardiologists, and oncologists.
Frailty is a clinically recognizable syndrome associated with aging and an increased risk of catastrophic decline in the health of elderly people. Muscles start degenerating with age which results in weakness, decreased energy, slowing, lower activity and severe unintended weight loss. Sarcopenia can be a cause of frailty. It is degenerative loss of skeletal muscle strength, quality and mass with age. The rate of muscle loss depends on several factors such as nutrition, exercise level and co-morbidities. Sarcopenia leads to reduced functional status and can cause significant disability from increased weakness. Muscle loss within this disease occurs due to changes in muscle synthesis signaling pathways. This book provides significant information of this discipline to help develop a good understanding of frailty and sarcopenia. Also included herein is a detailed explanation of the current issues and research on these medical conditions. This book is appropriate for students seeking detailed information in this area as well as for experts.