Aging: a subject that must be at the top of world agendas

Greengross, Sally; Murphy, Elaine; Quam, Lois; Rochon, Paula A.; Smith, Richard

doi:10.1136/bmj.315.7115.1029

Cited by 67 publications

(40 citation statements)

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“…Improved longevity has resulted in significant changes in the age profile of many populations (1,2) and a rise in the prevalence of age-related diseases (3)(4)(5). Normal aging leads to decreases in bone mass and muscle strength as well as decreased immune responses to infections.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Testing of Human Cardiac Tissue: Some Implications for MRI Safety

Edwards¹,

Draper²,

Hand³

et al. 2005

Journal of Cardiovascular Magnetic Resonance

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Specific age-related degenerative cardiac diseases stiffen and strengthen tissue resulting in significant forces being required to pull a suture through valve annulus tissue. These forces are significantly greater than magnetically induced < 4.7 T. Therefore, patients with degenerative valvular diseases are unlikely to be at risk of valve dehiscence during exposure to static magnetic field < or = 4.7 T.

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Section: Introductionmentioning

confidence: 99%

Mechanical Testing of Human Cardiac Tissue: Some Implications for MRI Safety

Edwards¹,

Draper²,

Hand³

et al. 2005

Journal of Cardiovascular Magnetic Resonance

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“…With the increasing age and life expectancy of the population in the Western world, and with the elderly (those older than 80 years) accounting for the fastest growing sector of the population, 1 an increase in the incidence of cardiovascular disease is expected. Previous studies have indicated that Ͼ25% of octogenarians are functionally limited by heart disease 2 and that this percentage is expected to be higher in the nonagenarians.…”

mentioning

confidence: 99%

Operative and Middle-Term Results of Cardiac Surgery in Nonagenarians

Saglio¹,

Nasso²,

Barattoni³

et al. 2010

Circulation

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Background-Age Ͼ90 years represents in many centers an absolute contraindication to cardiac surgery. Nonagenarians are a rapidly growing subset of the population posing an expanding clinical problem. To provide helpful information in regard to this complex decision, we analyzed the operative and 5-year results of coronary and valvular surgical procedures in these patients. Methods and Results-We retrospectively reviewed 127 patients aged Ն90 years who underwent cardiac surgery within our hospital group in the period 1998 to 2008. Kaplan-Meier and multiple logistic regression analyses were performed. A longer follow-up than most published studies and the largest series published thus far are presented. Mean age was 92 years (range, 90 to 103 years). Mean logistic EuroSCORE was 21.3Ϯ6.1. Sixty patients had valvular surgery (including 11 valve repairs), 49 patients had coronary artery bypass grafting, and 18 had valvular plus coronary artery bypass grafting surgery (55 left mammary artery grafts implanted). Forty-five patients (35.4%) were operated on nonelectively. Operative mortality was 13.4% (17 cases). Fifty-four patients (42.5%) had a complicated postoperative course. There were no statistically significant differences in the rate and type of complications between patient strata on the basis of type of surgery performed. Nonelective priority predicted a complicated postoperative course. Predictors of operative mortality were nonelective priority and previous myocardial infarction. Kaplan-Meier survival estimates at 5 years were comparable between patient groups on the basis of procedure performed. Conclusions-Although the rate of postoperative complications remains high, cardiac surgery in nonagenarians can achieve functional improvement at the price of considerable operative and follow-up mortality rates. Cardiac operations in these very elderly subjects are supported if appropriate selection is made and if the operation is performed earlier and electively. Our results should contribute to the development of guidelines for cardiac operations in nonagenarians.

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“…Given that the population of the Western world is aging, 44 that we are burdened by more chronic and psychosocial disease, 44,45 and the knowledge that informational continuity of care is particularly important in psychosocial, complex, and palliative care situations, newer clinic arrangements not attentive to the development of such continuity could be problematic. In clinics where patients are seen by different practitioners who do not have access to long-term remembered information, the provision of quality care to these populations, and others, may be challenged.…”

Section: Rogers and Curtismentioning

confidence: 99%