A Simple Screening Test for Hearing Impairment in Elderly Patients

Macphee, G. J. A.; Crowther, John A.; Mcalpine, Christine H.

doi:10.1093/ageing/17.5.347

Cited by 174 publications

(109 citation statements)

References 0 publications

Supporting

Mentioning

101

Contrasting

Unclassified

Order By: Relevance

“…Generally, an assessment of the degree of hearing loss is based on frequency averages at 500, 1000, and 200 Hz (the main speech frequency) in the elderly people. 17,18 When patients had difficulty repeating words spoken in a conversation voice by an observer standing behind the patients, the patients would be diagnosed as hearing impairment likely to benefit from an aid. 17 We thus believe that the simple screening test used in the present study could have, if not precisely, discriminated hearing impairment.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Postoperative Delirium in Cervical Spine Surgery

Ushida¹,

Yokoyama²,

Kishida³

et al. 2009

Spine

View full text Add to dashboard Cite

Study Design. Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries.Objective. To investigate factors contributing to the development of delirium after cervical surgery and see whether amended therapeutic protocols could improve or alter postoperative outcomes.Summary of Background Data. Important consequences of postoperative delirium for the orthopedic patients include impaired recovery and increased morbidity and mortality. Although its risk factors have been reported in orthopedic surgery, there are a very few reports regarding postoperative delirium in spine surgery.Methods. Eighty-one cervical myelopathy patients were retrospectively examined about the incidence of postoperative delirium and the risk factors. Similarly, 41 patients who received postoperative care under modified protocols were prospectively examined.Results. Postoperative delirium occurred more commonly in patients over 70 years and those with hearing impairment. Patients who received high-dose methylprednisolone (Ͼ1000 mg) demonstrated an increased incidence of postoperative delirium. Under modified protocol, we reduced the usage of methylprednisolone and encouraged free body movement with cervical orthosis immediately after surgery. The incidence of postoperative delirium was significantly lower under the modified protocol.Conclusion. Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.Key words: postoperative delirium, cervical spine surgery, hearing impairments, methylprednisolone. Spine 2009;34: 2500-2504Delirium is an acute and relatively sudden decline in attention-focus, perception, and cognition and known to occur usually in the elderly people.1 Its incidence is known to increase during the perioperative period and it can cause major medical management problems. Several previous reviews indicate that delirium may affect a large proportion of orthopedic patients and report prevalence rates of 28% to 61%. 2,3 Although the incidence in hip and knee joint surgery has been widely reported, there are few studies regarding postoperative delirium in spine surgery. 4,5 Increasing age, blood urea levels, cardiothoracic index, hypertension, smoking habits, blood replacement during bypass, atrial fibrillation (AF), pneumonia, and blood fluid balance in the postoperative period were found to be significant risk factors for delirium by logistic regression analysis.6 Previous reports also suggest that prior cognitive impairment and reduced hemoglobin and hematocrit levels are significant risk factors for postoperative delirium. With the development of modern medicine, the percentage of elderly people in the population is increasing and thus the incidence of postoperative delirium would increase. Spinal surgery in general and cervical spinal surgery in particular entail specific management problems and risk factors. During the postoperative phase of cervical spine surgery, it is essential to maintain spina...

show abstract

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Postoperative Delirium in Cervical Spine Surgery

Ushida¹,

Yokoyama²,

Kishida³

et al. 2009

Spine

View full text Add to dashboard Cite

show abstract

“…Psychosocial information included depressive symptoms, assessed with the Center for Epidemiologic Studies-Depression (CES-D) scale 21 ; self-efficacy, assessed with the Falls-Efficacy Scale, an instrument developed to assess one's degree of confidence in performing 10 nonstrenuous activities without falling 22 ; and instrumental and emotional social support, assessed with items adapted from the New Haven EPESE questionnaire. 18 Sensory information included hearing, assessed by the Whisper test, 23 and corrected near visual acuity, assessed with the Rosenbaum card and calculated as the percentage of visual impairment. 24 Functional information included mobility, determined from the number of blocks walked and the flights of stairs climbed on an average day; and cognitive status, assessed with the Folstein Mini-Mental State Examination (MMSE).…”

Section: Candidate Predictorsmentioning

confidence: 99%

Predictors of recovery in activities of daily living among disabled older persons living in the community

1997

View full text Add to dashboard Cite

OBJECTIVE:To identify the factors that predict recovery in activities of daily living (ADLs) among disabled older persons living in the community. DESIGN:Prospective cohort study with 2-year follow-up. SETTING: General community.PARTICIPANTS: 213 men and women 72 years or older, who reported dependence in one or more ADLs. MEASUREMENTS AND MAIN RESULTS:All participants underwent a comprehensive home assessment and were followed for recovery of ADL function, defined as requiring no personal assistance in any of the ADLs within 2 years. Fifty-nine participants (28%) recovered independent ADL function. Compared with those older than 85 years, participants aged 85 years or younger were more than 8 times as likely to recover their ADL function (relative risk [RR] 8.4; 95% confidence interval [CI] 2.7, 26). Several factors besides age were associated with ADL recovery in bivariate analysis, including disability in only one ADL, self-efficacy score greater than 75, Folstein Mini-Mental State Examination (MMSE) score of 28 or better, high mobility, score in the best third of timed physical performance, fewer than five medications, and good nutritional status. In multivariable analysis, four factors were independently associated with ADL recovery-age 85 years or younger (adjusted RR 4.1; 95% CI 1.3, 13), MMSE score of 28 or better (RR 1.7; 95% CI 1.2, 2.3), high mobility (RR 1.7; 95% CI 1.0, 2.9), and good nutritional status (RR 1.6; 95% CI 1.0, 2.5). A mong community-living older persons, the prevalence of disability in one or more activities of daily living (ADLs), such as bathing, dressing, and walking, increases substantially with age, from about 7% in those aged 65 to 74 years, to 14% in those aged 75 to 84 years, to over 24% in those aged 85 years or older. 1 Although useful in estimating the need for health care resources, prevalence estimates of disability do not convey that functional status and disability represent dynamic processes in older persons. Belying the stereotype of the older person as having an inexorable downhill course, from mild impairment to disability, longitudinal studies have found that a substantial minority (24%-30%) of elders, once disabled, recover independence in their ADL function. 1,2 Why some disabled elders recover and others do not is not known. Those who recover can be considered to be resilient. 3 If carefully studied and suitably characterized, these resilient elders might offer investigators valuable insights into the mechanisms of disability and dependence in older persons and facilitate the development of effective and efficient intervention programs to prevent, slow, or reverse ADL dependence. 4 Previous studies of functional recovery have focused almost exclusively on persons hospitalized after an acute event, such as a stroke or hip fracture. [5][6][7][8][9] Conversely, several community-based studies have sought to elucidate the determinants of ADL dependence, 10-12 but none has tried to identify the factors, besides age, that predict recovery of ADL function. CONCLUSIONS:T...

show abstract

“…La agudeza visual fue determinada usando la tarjeta standard de Jaeger (16), la agudeza auditiva establecida a través del test del susurro o Whisper test (17), y finalmente, el estado nutricional fue evaluado utilizando la medición del pliegue cutáneo tricipìtal (PCT), la circunferencia muscular (CM) y la circunferencia del brazo, anotando la medición de la circunferencia a mitad del brazo hacia el 0.1 cm. más cercano y el PCT a los 2 mm.…”

Section: Instrumentos Utilizadosunclassified

Prevalencia y factores de riesgo del estado confusional agudo en el adulto mayor en una sala de emergencias médicas.

Lama-Valdivia¹,

Pinedo²,

Saavedra³

2013

Rev Med Hered

View full text Add to dashboard Cite

Prevalencia y factores de riesgo del estado confusional agudo en el adulto mayor en una sala de emergencias médicas.LAMA VALDIVIA Jaime*, VARELA PINEDO Luis**, ORTIZ SAAVEDRA Pedro José. SUMMARYObjective: To assess the prevalence and risk factors for delirium in elderly patients admitted to the emergency room of a national hospital. Material and methods: We studied all patients older than 60 years of age admitted to the emergency room of the Hospital Nacional Hipólito Unanue of Lima-Perú, between january and april, 2000. The Confusion Assessment Method was used as a test to assess delirium and diagnostic assessment included: several clinical and demographic variables, cognitive status ascertained using the Pfeiffer's test, functional level ascertained using the Katz's scala, depressive symptoms and nutritional status. We compared groups of patients with and without delirium through a stepwise logistic regression analysis. Results: At admission, 47 (42.7%) of 110 consecutive patients were diagnosed as delirious. The risk factors for delirium were: previous cognitive impairment (OR = 5.61; 95% CI, 1.65 -19.03, p < 0.0001), functional dependence (OR = 6.18; 95% CI, 1.25 -30.59, p < 0.001) and grave dehydration (OR = 4.22; 95% CI, 1.12 -9.75, p < 0.05). Conclusions: Delirium is frequent in the elderly admitted to a emergency room. In our study, the risk factors for delirium were: previous cognitive impairment, low functional status and grave dehydration. ( Rev Med Hered 2002; 13: 10-18 ).

show abstract

A Simple Screening Test for Hearing Impairment in Elderly Patients

Cited by 174 publications

References 0 publications

Incidence and Risk Factors of Postoperative Delirium in Cervical Spine Surgery

Incidence and Risk Factors of Postoperative Delirium in Cervical Spine Surgery

Predictors of recovery in activities of daily living among disabled older persons living in the community

Prevalencia y factores de riesgo del estado confusional agudo en el adulto mayor en una sala de emergencias médicas.

Contact Info

Product

Resources

About