These results suggest that prolonged moderate to high intensity resistance training may be carried out by healthy older adults with reasonable compliance, and that such training leads to sustained increases in muscle strength. These improvements are rapidly achieved and are accompanied by hypertrophy of both type 1 and type 2 muscle fibers.

Men exhibit age-related adaptive changes in long bone geometry, namely, endosteal resorption and periosteal apposition of bone, that help to preserve bone strength. It is not clear whether women undergo similar adaptive responses. To address this question, we assessed the bone mineral density and cross-sectional geometry of the radius and ulna at the one-third distal site by single photon absorptiometry and computed tomography (CT) in healthy young (n = 21, age 20-30 years) and older (n = 22, age 63-84 years) women. We used the CT data to compute the total subperiosteal, medullary, and cortical areas, as well as the maximum, minimum, and polar moments of inertia. We normalized the geometric parameters for bone length and performed comparisons using both the original and size-corrected data. Radial and ulnar bone mineral content and density were 20-30% lower in the older women (P < 0.0001). Ulnar width, total area, medullary area, and maximum and polar moment of inertia were greater in the older than in the younger women. Although we observed similar trends when we examined the radius data that were corrected for bone size, age-related differences in radial geometry were less pronounced and were not significant. We conclude that women undergo endosteal resorption and periosteal apposition of the ulna with age, thereby exhibiting an adaptive pattern that helps to preserve bone strength. The different behavior of these two bones suggests that local, rather than systemic, factors underlie this adaptation.

Our results suggest opportunities to improve hospitalists' ability to lead serious illness communication by increasing the time hospitalists have for discussions, improving documentation systems and communication between inpatient and outpatient clinicians, and targeted training on challenging communication scenarios.

Background Communication skills are critical in Geriatrics and Palliative Medicine because these patients confront complex clinical scenarios. We evaluated effectiveness of the Geritalk communication skills course by comparing pre- and post-course real-time assessment of participants leading family meetings. We also evaluated the participants’ sustained skills practice. Measures We compare participants’ skill acquisition before and after Geritalk using a direct observation Family Meeting Communication Assessment Tool, and assessed their deliberate practice at follow-up. Intervention First-year Geriatrics or Palliative Medicine fellows at Mount Sinai Medical Center and the James J. Peters Bronx VA Medical Center participated in Geritalk. Outcomes Pre- and post-course family meeting assessments were compared. An average net gain of 6.8 skills represented a greater than 20% improvement in use of applicable skills. At two-month follow-up, most participants reported deliberate practice of fundamental and advanced skills. Conclusions This intensive training and family meeting assessment offers evidence-based communication skills training.

A simple question about steadiness identified patients at increased risk for in-hospital ADL decline and, in patients who lost ADL function immediately before admission, failure to recover.