Several medical conditions seem to predispose to polypharmacy in very old patients. To attain old age seems to be associated with few comorbidities, which reduces the need for a high number of pharmaceuticals. Physicians should pay attention to the identified predictors in very old patients, as polypharmacy may lead to adverse events and unnecessary hospitalization.
There is a high incidence of Diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
Aim of this study was investigate the prevalence and incidence of atrial fibrillation (AF) and to describe the clinical characteristics, risk profiles, and types of anticoagulant therapy for stroke prevention and the clinical outcomes in persons admitted to a long-term care hospital. We conducted a retrospective cohort study using data from the electronic medical records of patients aged 65 years or older living in two long-term care hospitals between January 1, 2014 and October 31, 2017. Overall data from 1148 patients (mean age 84.1 ± 7.9 years, 74.2% women) were analyzed. At baseline, the median CHA2DS2-VASc score was 4 (IQR 3–5) and the HAS-BLED score 2 (IQR 2–3). We observed patients over a median period of 3.7 years. The point prevalence of AF was 29.6% (95% CI 25.8–33.7) on January 1, 2014. The 1-year cumulative incidence of de novo AF was 4.0% (2.8–5.6). Oral anticoagulants were prescribed in 48% of patients with AF. The cumulative incidence at 1 year for a composite outcome of TIA, stroke, or systemic arterial embolism was 0.6% (0.1–3.1) and 1.7% (0.5–4.6) and for bleeding 2.6% (0.9–6.2) and 1.8% (0.5–4.8) in patients with AF and oral anticoagulants or no oral anticoagulants, respectively. In long-term care hospital patients, we observed a high burden of AF. However, only about half of patients with AF received oral anticoagulation for stroke prevention.
There is a high prevalence of diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
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