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Efficacy of hip protector pads to prevent hip fracture is controversial. This study was done to evaluate two comparable groups for fracture risk. Two matched cohorts of long-term care residents in Canada, assessing the efficacy of hip protector pads. Evaluation included demographics, medications/diagnoses, cognition (Mini Mental Status Examination (MMSE)), balance (Berg), bone mineral density (calcaneal ultrasound), falls/injuries at baseline and completion. Of the 58 participants, there were two confirmed hip fractures (8%) in the hip pad (one while wearing the pad) and eight (24%) in the control groups. But baseline demographics showed significant differences between hip pad (25) and control groups (33) in MMSE, Berg and osteoporosis treatment, all being less in the hip pad group. This persisted at completion, with a higher mortality in the hip pad group. Baseline differences predisposed the hip pad group to a higher fracture risk, but there were fewer hip fractures in this group. Small numbers, multifactorial nature of hip fractures and the inability to control for many of these variables in the real world make efficacy of hip protector pads difficult to confirm. Hip protector pads should be offered as part of the osteoporosis management of frail elderly, especially in those unable/unwilling to take pharmacotherapy. [ABSTRACT FROM AUTHOR]

Canadian Consensus guidelines regarding appropriate use of nonsteroidal anti-inflammatory drugs (NSAID) were recently published. This study was done to evaluate the application of these guidelines on NSAID practice patterns in frail elderly patients referred to a specialist Geriatric Assessment Clinic. A retrospective chart review was undertaken of referrals who were currently prescribed NSAIDs. Data were captured on age, sex, weight, diagnoses, medications and dosages, indication for NSAID treatment, lying BP (as assessed in the clinic) and recent serum creatinine result. Creatinine clearance was subsequently calculated use the Cockcroft–Gault equation. Complete data were available on 107 patients (68% women, average age 80.6 years). Thirty percent were on a traditional NSAID, the remainder were on a Coxib. Concomitant aspirin was prescribed in 37%. Cytoprotection was being used in 38% and did not increase appreciably in patients with additional risk factors for GI toxicity, i.e., concomitant aspirin usage(35%), and history of GI toxicity (48%). Sixty-seven were taking anti-hypertensive medications, although more than two thirds of these patients were uncontrolled. Newly diagnosed hypertension was present in 19.6%. Calculated creatinine clearance revealed moderate to severe renal impairment in 79% of subjects, although serum creatinine was only elevated in 18%. In total, 70% of subjects were found to have relative or absolute risk factors for NSAID therapy. Given the high prevalence of potential contraindications to anti-inflammatory drug usage in this study, we advocate the dissemination and application of these guidelines in geriatric patients in an attempt to reduce potential morbidity and mortality. [ABSTRACT FROM AUTHOR]

Dysphagia is a common problem in the elderly patient. Palato-pharyngo-laryngeal myoclonus, however, is a rare cause of this. We report a case of a 78-year-old man with dysphagia due to palato-pharngo-laryngeal myoclonus that was ultimately managed conservatively with a good functional outcome. [ABSTRACT FROM AUTHOR]

Dysphagia is a common problem in the elderly patient. Palato-pharyngo-laryngeal myoclonus, however, is a rare cause of this. We report a case of a 78-year-old man with dysphagia due to palato-pharngo-laryngeal myoclonus that was ultimately managed conservatively with a good functional outcome. [ABSTRACT FROM AUTHOR]

Presents a study which determines the prevalence and disease associations of certain autoantibodies among elderly patients. View that many autoanibodies became generally elevated in elderly people as a result of immunosenescene; Reference to the SENIEUR Protocol; Methodology used to conduct the study; Discussion of the study; Results and conclusions reached.

Introduction: Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. Less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying osteoporosis. Objective: A multidisciplinary Canadian hip fracture working group has developed practical recommendations to meet Canadian quality indicators in post hip fracture care. Methods: A comprehensive narrative review was conducted to identify and synthesize key articles on post hip fracture orthogeriatric care for each of the individual sections and develop recommendations. These recommendations are based on the best evidence available today. Conclusion: Recommendations are anticipated to reduce recurrent fractures, improve mobility and healthcare outcomes post hip fracture, and reduce healthcare costs. Key messages to enhance postoperative care are also provided. [ABSTRACT FROM AUTHOR]

The article discusses a study which demonstrated that a hospital-based case manager could increase rates of appropriate osteoporosis treatment to 51 percent compared with 22 percent for usual care. Compared with usual care, it found that using a case manager for patients with hip fractures increased rates of appropriate osteoporosis treatment. The intervention dominated usual care and it suggests that systems implementing an intervention similar to ours should expect to see a reduction in fractures, gains in life expectancy and substantial cost savings.

This article presents a study regarding the use of case manager to enhance osteoporosis treatment after hip fracture. Patients who endure hip fracture are at high risk of recurrent fractures, but osteoporosis treatment rates 1 year after sustaining a fracture are less than 10 percent to 20 percent. An osteoporosis case manager intervention was developed. For a low cost, a case manager was able to considerably increase rates of osteoporosis treatment in a vulnerable elderly population at high risk of future fractures.