Of 732 consecutive patients admitted to an acute geriatric ward, 178 (24%) were found to be anaemic (haemoglobin of 115 g/l or below). An appropriate cause responsible for anaemia was identified in 83 %. The anaemia of chronic disorders (ACD) (35%) and iron deficiency anaemia (15%) were the commonest causes. The spectrum of disorders associated with ACD is much broader than the classical category of infectious, inflammatory and malignant disorders. The relatively high prevalence of the myelodysplastic syndrome (5%) is striking and this syndrome as a cause of anaemia in geriatric patients deserves more attention than it has so far received. No obvious cause was found in 17 %. The clinical significance of this finding remains unclear.
The seasonal variation of 25-hydroxycholecalciferol and 1,25-dihydroxycholecalciferol was analyzed in 240 elderly subjects (mean age: 78 yr) in Belgium. Serum 25-hydroxycholecalciferol was lowest from February until May (mean levels less than 25 nmol/L). Summer peak levels were, however, not higher than nadir levels in younger control subjects. A seasonal variation in total and free 1,25-dihydroxycholecalciferol concentrations was also observed in the geriatric population with a nadir in February and March (50 +/- 24 pmol/L). The peak values in summer (110 +/- 33 pmol/L) were not different from those of the younger controls. Serum calcium and phosphate were decreased whereas alkaline phosphatase and parathyroid hormone were increased throughout the year in the geriatric patients. Oral 25-hydroxycholecalciferol treatment rapidly normalized serum 1,25-dihydroxycholecalciferol concentrations in vitamin D-deficient subjects. Deficiency of both the vitamin D substrate and hormone is frequent in the elderly population in Belgium.
This study examines possible quantifiable causes of postdeglutition pharyngeal retention in the elderly. Manofluorography and computer processing of video images are performed. Retention in the valleculae and in the piriform sinuses is associated with a markedly reduced pharyngeal shortening, a low tongue driving force (TDF), and a diminished amplitude of the pharyngeal contraction. There is no relationship with the hypopharyngeal suction pump (HSP). Retention limited to the valleculae is associated with a low TDF, and retention restricted to the piriform sinuses is accompanied by a reduced pharyngeal shortening.
The interpretation of the vitamin B-12 and folate status in patients with AD depends largely on the methodology (i.e., serum vitamin vs metabolite levels) and the selection of the control group. Although patients with AD have the highest tHcy and MMA levels, metabolically significant vitamin B-12 and folate deficiency is also a substantial problem in nondemented elderly patients.
Although the STRATIFY satisfactorily predicted the fall risk of patients admitted to general medical and surgical wards and patients younger than 75, it failed to predict the fall risk of patients admitted to geriatric wards and patients aged 75 and older (particularly those aged 75-84).
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