White Matter Hyperintensities Are an Independent Predictor of Physical Decline in Community-Dwelling Older People

Gerontology ◽  
2012 ◽  
Vol 58 (5) ◽  
pp. 398-406 ◽  
Author(s):  
Jacqueline J.J. Zheng ◽  
Kim Delbaere ◽  
Jacqueline C.T. Close ◽  
Perminder Sachdev ◽  
Wei Wen ◽  
...  
Keyword(s):  
White Matter ◽  
Older People ◽  
White Matter Hyperintensities ◽  
Independent Predictor ◽  
Community Dwelling ◽  
Physical Decline ◽  
Community Dwelling Older People

scholarly journals Birth Parameters Are Associated With Late-Life White Matter Integrity in Community-Dwelling Older People

Stroke ◽  
2009 ◽  
Vol 40 (4) ◽  
pp. 1225-1228 ◽  
Author(s):  
Susan D. Shenkin ◽  
Mark E. Bastin ◽  
Tom J. MacGillivray ◽  
Ian J. Deary ◽  
John M. Starr ◽  
...  
Keyword(s):  
White Matter ◽  
Older People ◽  
Late Life ◽  
Community Dwelling ◽  
White Matter Integrity ◽  
Community Dwelling Older People

scholarly journals Is there an association between orthostatic hypotension and cerebral white matter hyperintensities in older people? The Irish longitudinal study on ageing

2020 ◽  
Vol 9 ◽  
pp. 204800402095462
Author(s):  
Anne Buckley ◽  
Daniel Carey ◽  
James M Meaney ◽  
RoseAnne Kenny ◽  
Joseph Harbison
Keyword(s):  
Longitudinal Study ◽  
White Matter ◽  
Older People ◽  
Orthostatic Hypotension ◽  
White Matter Hyperintensities ◽  
Community Dwelling ◽  
Prior History ◽  
Multiple Time ◽  
Increased Risk ◽  
Mr Brain

Introduction Orthostatic Hypotension (OH) is an abnormal drop in blood pressure (BP) that occurs following orthostatic challenge. OH is associated with increased risk of falls, cognitive impairment and death. White Matter Hyperintensities (WMH) on MR Brain are associated with vascular risk factors such as hypertension, diabetes and age. We examined whether extent White matter intensities were associated with presence of OH detected in a community dwelling population of older people. Methods Individuals from the MR sub-study of the Irish Longitudinal Study of Ageing underwent a 3 Tesla MR Brain scan to assess WMH severity (Schelten’s Score). The scans were performed during the Wave 3 TILDA health assessment phase when the subjects also underwent assessment for OH with an active stand protocol. Data was analysed for association between WMH and vascular risks and orthostatic change in BP 10 second intervals during the OH evaluation. Results 440 subjects were investigated; median age 72 years (65–92 years) and 228 (51.5%) female. Range of Scheltens’ Scores was 0–32. Mean score was 9.72 (SD 5.87). OH was detected in 68.4% (301). On linear regression, positive associations were found between Scheltens’ Score and age, hypertension, prior history of stroke and TIA, and with OH at 30, 70, 90 and 100 seconds following standing (p < 0.05, O.R. 1.9–2.5). Conclusion WMD is associated with OH detected at multiple time points using active stand in community dwelling older subjects. Further research is necessary to evaluate the direction of this association.

scholarly journals Brain white matter tract integrity and cognitive abilities in community-dwelling older people: The Lothian Birth Cohort, 1936.

2013 ◽  
Vol 27 (5) ◽  
pp. 595-607 ◽  
Author(s):  
Tom Booth ◽  
Mark E. Bastin ◽  
Lars Penke ◽  
Susana Muñoz Maniega ◽  
Catherine Murray ◽  
...  
Keyword(s):  
White Matter ◽  
Older People ◽  
Birth Cohort ◽  
Cognitive Abilities ◽  
Community Dwelling ◽  
White Matter Tract ◽  
Brain White Matter ◽  
Lothian Birth Cohort ◽  
Community Dwelling Older People

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

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