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Most Cited Archives of Gerontology and Geriatrics Articles
The most cited articles published since 2011, extracted from Scopus.
Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fractureMarco Di Monaco | Fulvia Vallero | Roberto Di Monaco | Rosa Tappero
Volume 52, Issue 1, January 2011, Pages 71-74
Changes in body composition, including a decrease in muscle and bone mass, accompany aging. Our aim was to assess the prevalence of sarcopenia and its association with osteoporosis in hip-fracture women. We performed a Dual-Energy X-Ray Absorptiometry (DXA) scan in 313 of 340 women, 20.9 ± 6.5 (mean ± S.D.) days after hip-fracture occurrence. To adjust appendicular lean mass for body size we divided it by height squared in each woman. A total of 180 of the 313 women (58%) were sarcopenic, whereas 230 (74%) were osteoporotic. After adjustment for age and interval between fracture and DXA scan we found a significant association between sarcopenia and osteoporosis (p= 0.026). For a sarcopenic woman the adjusted odds ratio (OR) for osteoporosis was 1.80 (95%CI. = 1.07-3.02). Our data shows the high prevalence of sarcopenia and its significant association with osteoporosis in a large sample of hip-fracture women. Data supports a research approach on preventive and treatment strategies for osteoporosis and sarcopenia targeting both bone and muscle tissue. Furthermore, data should be considered when the economic burden of sarcopenia is estimated, given the high proportion of sarcopenic women with bone fragility. © 2010 Elsevier Ireland Ltd.
Physical exercise modulates peripheral levels of brain-derived neurotrophic factor (BDNF): A systematic review of experimental studies in the elderlyFlávia Gomes de Melo Coelho | Sebastião Gobbi | Carla Andreza Almeida Andreatto | Danilla Icassati Corazza | Renata Valle Pedroso | Ruth Ferreira Santos-Galduróz
Volume 56, Issue 1, January 2013, Pages 10-15
The objective of this study was to conduct a systematic review of studies that analyzed the effect of physical exercise on the peripheral levels of BDNF in elderly individuals. Method: We conducted a search in PsycINFO, Biological Abstracts, Pubmed, Web of Science, and Science Direct from 1990 to 2011, using the following keywords: " physical exercise" , " physical activity" , " physical therapy" , " training" , " BDNF" , " neuroplasticity" , " neurotrophins" , " neuroplasticity proteins" , " aged" , " older" , " elderly" The articles were considered for inclusion in the review if they were studies with elderly, assessed peripheral (serum and/or plasma) BDNF and evaluated an acute exercise or chronic exercise (training). Results: Five randomized controlled trial and one randomized non-controlled trial studies were analyzed. Five out of six studies reported a significantly higher BDNF response to aerobic acute exercise and to aerobic or strength training program in healthy elderly and elderly with different pathologies. Conclusion: It was not possible to establish a recommendation protocol for the type and intensity of physical exercise required to produce an increase in levels BDNF. However, physical exercise, particularly, moderate-intensity exercises seem to be more effective to promote increase the peripheral levels of BDNF in the elderly. © 2012 Elsevier Ireland Ltd.
Body composition and its association with cardiometabolic risk factors in the elderly: A focus on sarcopenic obesityJi Youn Chung | Hee Taik Kang | Duk Chul Lee | Hye Ree Lee | Yong Jae Lee
Volume 56, Issue 1, January 2013, Pages 270-278
Important changes in body composition with aging are a progressive loss of muscle mass and increase of fat mass. Despite their enormous clinical importance, body composition changes such as sarcopenic obesity in the elderly are under-recognized. This study aimed to examine the relationship of body composition with a wide variety of cardiometabolic risk factors among 2943 subjects (1250 men and 1693 women) aged 60 years or older from Korean National Health Examination and Nutrition Survey (KNHANES). Sarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by weight (%) of <1 SD below the sex-specific mean for young adults. Obesity was defined as a body mass index (BMI) ≥25kg/m2. Body composition was categorized into four non-overlapping groups: the sarcopenic obese, sarcopenic nonobese, nonsarcopenic obese, and nonsarcopenic nonobese groups. A wide variety of cardiometabolic risk factors, including blood pressure (BP), glucose tolerance indices, lipid profiles, inflammatory markers, and vitamin D level, were compared according to body composition group. The prevalence of sarcopenic obesity was 18.4% in men and 25.8% in women. In both sexes, the prevalence of vitamin D deficiency and metabolic syndrome was highly prevalent in the sarcopenic obese group. Serum insulin level, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride levels, and ferritin levels were the highest in the sarcopenic obese group in both men and women, whereas HDL-cholesterol and 25-hydroxyvitamin D (25(OH)D) levels were the lowest in the sarcopenic obese group. The sarcopenic obese group was more closely associated with insulin resistance, metabolic syndrome, and cardiovascular disease (CVD) risk factors than any other group in this elderly population. © 2012 Elsevier Ireland Ltd.
Association between inflammatory-related disease burden and frailty: Results from the Women's Health and Aging Studies (WHAS) I and IISandy S. Chang | Carlos O. Weiss | Qian Li Xue | Linda P. Fried
Volume 54, Issue 1, January 2012, Pages 9-15
Frailty is associated with a pro-inflammatory state, which has been characterized by elevated levels of systemic inflammatory biomarkers, but has not been related to the number of co-existing chronic diseases associated with inflammation. We sought to determine the extent to which a higher number of inflammatory-related diseases is associated with frailty and to identify the most common disease patterns associated with being frail in older adults. We performed binomial regression analyses to assess whether a higher count of inflammatory-related diseases increases the probability of frailty using data from the WHAS I and II, companion cohorts composed of 70-79-year-old community-dwelling older women in Baltimore, Maryland (n= 620). An increase of one inflammatory-related disease was associated log-linearly with frailty (Prevalence Ratio (PR) = 2.28, 95% Confidence Interval (CI) = 1.81-2.87). After adjusting for age, race, education, and smoking status, the probability of frailty remained significant (PR = 1.97, 95%CI = 1.52-2.55). In the frail population, chronic kidney disease (CKD) and depressive symptoms (Prevalence = 22.9%, 95%CI = 14.2-34.8%); CVD and depressive symptoms (21.7%, 95%CI = 13.2-33.5%); CKD and anemia (18.7%, 95%CI = 11.1-29.7%); cardiovascular disease (CVD), CKD, and pulmonary disease (10.7%, 95%CI = 5.2-21.0%); CKD, anemia, and depressive symptoms (8.7%, 95%CI = 3.9-18.2%); and CVD, anemia, pulmonary disease, and depressive symptoms (5.0%, 95%CI = 1.6-14.4%) were among the most frequent disease combinations. Their prevalence percentages were significantly higher in the frail versus non-frail women. A higher inflammatory-related disease count, perhaps reflecting a greater pro-inflammatory burden, increases the likelihood of frailty. Shared mechanisms among specific disease combinations may further contribute to this risk. © 2011 Elsevier Ireland Ltd.
Designing robots for the elderly: Appearance issue and beyondYa Huei Wu | Christine Fassert | Anne Sophie Rigaud
Volume 54, Issue 1, January 2012, Pages 121-126
This paper provides the results of three focus groups organized in the framework of the ROBADOM project, aiming at designing a service type assistive robot for the elderly with mild cognitive impairment living at home. The main objective of these focus groups was to give some recommendations to engineers in charge of the design of the robot's appearance. Results showed that although many humanoid robots were criticized by most participants, some small creative humanoid robots were appreciated. However, beyond the issue of the robot appearance, many ethical and social issues were raised. These focus groups offered an opportunity for participants to discuss the very idea of an assistive robot and to challenge some implicit preconceptions of the roboticists. Finally, we discuss how assistive robots could be designed considering the social context of the elderly and how to implicate the elderly as future end-users in the design process. © 2011 Elsevier Ireland Ltd.
Evaluation and management of oropharyngeal dysphagia in different types of dementia: A systematic reviewKannayiram Alagiakrishnan | Rahima A. Bhanji | Mini Kurian
Volume 56, Issue 1, January 2013, Pages 1-9
Introduction: Dysphagia, or swallowing impairment, is a growing concern in dementia and can lead to malnutrition, dehydration, weight loss, functional decline, and fear of eating and drinking as well as a decrease in quality of life (QOL). Objective: The aim of this article is to do a systematic review of the literature to determine the patterns of swallowing deficits in different types of dementia and to look at the usefulness of different diagnostic and management strategies. Methods: An electronic literature search was done using five electronic databases from 1990 to 2011. One thousand and ten records were identified and 19 research articles met the inclusion criteria. These studies were heterogeneous in design and methodology, type of assessment and outcomes, so only descriptive analysis (narrative reporting) was possible. Results: Prevalence of swallowing difficulties in patients with dementia ranged from 13 to 57%. Dysphagia developed during the late stages of frontotemporal dementia (FTD), but it was seen during the early stage of Alzheimer's dementia (AD). Limited evidence was available on the usefulness of diagnostic tests, effect of postural changes, modification of fluid and diet consistency, behavioral management and the possible use of medications. Use of Percutaneous Endoscopic Gastrostomy (PEG) tubes in advanced dementia, did not show benefit with regards to survival, improvement in QOL, or reduction in aspiration pneumonia. Significant gaps exist regarding the evidence for the evaluation and management of dysphagia in dementia. © 2012 Elsevier Ireland Ltd.
Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adultsAlfonso Salguero | Raquel Martínez-García | Olga Molinero | Sara Márquez
Volume 53, Issue 2, September 2011, Pages 152-157
This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults. © 2010 Elsevier Ireland Ltd.
Risk factors for falls and fall-related injuries in adults 85 years of age and olderAnna C. Grundstrom | Clare E. Guse | Peter M. Layde
Volume 54, Issue 3, May 2012, Pages 421-428
Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65-84 years of age. Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. © 2011 Elsevier Ireland Ltd.
The ability of three different models of frailty to predict all-cause mortality: Results from the European Male Aging Study (EMAS)Rathi Ravindrarajah | David M. Lee | Stephen R. Pye | Evelien Gielen | Steven Boonen | Dirk Vanderschueren | Neil Pendleton | Joseph D. Finn | Abdelouahid Tajar | Matthew D L O'Connell | Kenneth Rockwood | György Bartfai | Felipe F. Casanueva | Gianni Forti | Aleksander Giwercman | Thang S. Han | Ilpo T. Huhtaniemi | Krzysztof Kula | Michael E J Lean | Margus Punab | Frederick C W Wu | Terence W. O'Neill | Luisa Petrone | Giovanni Corona | Herman Borghs | Jolanta Slowikowska-Hilczer | Renata Walczak-Jedrzejowska | Ilpo Huhtaniemi | Frederick Wu | Terence O'Neill | Joseph Finn | Philip Steer | David Lee | Stephen Pye | Felipe Casanueva | Ana I. Castro | Imre Földesi | Imre Fejes | Paul Korrovitz | Min Jiang
Volume 57, Issue 3, November 2013, Pages 360-368
Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n=2929) at baseline and 6.6% (n=193) died over a median 4.3 years of follow-up. The FI was generated from 39 deficits, including self-reported health, morbidities, functional performance and psychological assessments. The FP and FS consisted of five phenotypic criteria and both categorized individuals as robust when they had 0 criteria, prefrail as 1-2 criteria and frail as 3+ criteria. The mean FI increased linearly with age (r2=0.21) and in Cox regression models adjusted for age, center, smoking and partner status the hazard ratio (HR) for death for each unit increase of the FI was 1.49. Men who were prefrail or frail by either the FP or FS definitions, had a significantly increased risk of death compared to their robust counterparts. Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used. © 2013 Elsevier Ireland Ltd.
Impairments in mobility and balance in relation to frailtyDaniel H J Davis | Michael R H Rockwood | Arnold B. Mitnitski | Kenneth Rockwood
Volume 53, Issue 1, July 2011, Pages 79-83
We set out to describe the relationship between impaired balance, mobility and frailty, and relate these to risk of death. We examined a subsample of 1295 community-dwelling non-demented adults from the second wave of the Canadian Study of Health and Aging (CSHA), a prospective population-based cohort study. Frailty index (FI) scores were constructed from a standardized comprehensive geriatric assessment (FI-CGA). History of mobility impairments and falls were assessed. Timed-up-and-go (TUG) and functional reach (FR) performance were measured. The CSHA clinical frailty scale (CFS) was judged by a physician. Adverse outcomes were determined at CSHA-3, conducted 5 years later. The FI-CGA varied in association with impaired mobility and balance. A history of mobility problems was demonstrable at FI-CGA scores >0.12. This level of frailty also represented the most marked deterioration in performance measures (TUG and FR). FI-CGA scores best predicted mortality (HR 1.04 ± 0.02), proving to be a dominating factor in multivariate regression models that included mobility and balance markers. Only at the upper range of FI-CGA reported (>0.45) did all participants demonstrate mobility impairment. Impaired balance and mobility contribute to frailty, but neither is sufficient to define a participant as frail. © 2010 Elsevier Ireland Ltd.
Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: The FRALLE surveyPilar Jürschik | Carmen Nunin | Teresa Botigué | Miguel Angel Escobar | Ana Lavedán | Maria Viladrosa
Volume 55, Issue 3, November 2012, Pages 625-631
The aim of this study was to assess the prevalence of frailty and to identify factors associated with frailty in older people living in the community through a cross-sectional study of community-dwelling persons age 75 and older. A total of 640 individuals were interviewed using the FRALLE survey between 2009 and 2010. This survey measures frailty through the five Fried criteria, and through questions on sociodemographics, health habits, health status, social relations and data on health-related quality of life. The mean age of the participants was 81.3 ± 5.0; 39.7% were men. The prevalence of frailty was 9.6% (95% confidence interval (CI): 7.6-11.5) and that of pre-frailty was 47% (95% CI: 42.7-51.2). After the logistic regression, age (over 85 years) (odds ratio (OR): 3.61; 95% CI: 1.65-7.91; p< 0.001), depressive symptoms (OR: 3.13; 95% CI: 1.37-7.13; p= 0.0006), comorbidity (OR: 5.20; 95% CI: 1.78-15.16; p= 0.0002), cognitive impairment (OR: 3.22; 95% CI: 1.48-7.02; p= 0.0003), poor social ties (OR: 0.57; 95% CI: 0.43-0.77; p< 0.001) and poor physical health (OR: 0.98; 95% CI: 0.97-0.98; p< 0.001) were significantly associated with frailty. There is great variability in the prevalence of frailty depending on the study considered. The lack of homogeneity in the measurement of the five criteria, the age of participants and the degree of dependence could explain the differences observed. Here, the factors associated with frailty were age, comorbidity, cognitive impairment and depressive symptoms, while the diversity of social interaction and health-related physical function were protective factors. © 2012 Elsevier Ireland Ltd.
Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI)Camila Vieira Ligo Teixeira | Lilian Teresa Bucken Gobbi | Danilla Icassatti Corazza | Florindo Stella | José Luiz Riani Costa | Sebastião Gobbi
Volume 54, Issue 1, January 2012, Pages 175-180
Mild cognitive impairment (MCI) can be a stage of pre-dementia. There is no consensus about pharmacological treatment for this population, so it is important to structure non-pharmacological interventions for increasing their cognitive reserve. We intended to analyze the effects of non-pharmacological interventions in the cognitive functions in older people with MC, in form of a systemic review. Data sources were the Web of Science, Biological Abstracts, Medline, Pub Med, EBSCHost, Scirus and Google Scholar. All studies were longitudinal trials, with MCI sample, aged > 60 years, community-dwelling, and having cognitive functions as dependent variable. Seven studies, from 91 previously selected ones, were identified according to the inclusion criteria. Six studies used cognitive intervention, improving memory and one study used physical activity as intervention, improving executive functions. The results show evidence that physical activity and cognitive exercise may improve memory and executive functions in older people with MCI. But yet, more controlled studies are needed to establish a protocol of recommendations regarding the systemization of exercise, necessary to produce benefits in the cognitive functioning in older people with MCI. © 2011 Elsevier Ireland Ltd.
Sarcopenia is more prevalent in men than in women after hip fracture: A cross-sectional study of 591 inpatientsMarco Di Monaco | Carlotta Castiglioni | Fulvia Vallero | Roberto Di Monaco | Rosa Tappero
Volume 55, Issue 2, September 2012, Page
Our aim was to compare the prevalence of sarcopenia in men and women with hip fracture. We studied 591 of 630 hip fracture inpatients consecutively admitted to our Rehabilitation ward. All the patients underwent a Dual-Energy X-Ray Absorptiometry (DXA) scan 18.4 ± 8.7 (mean ± SD) days after hip fracture occurrence. Sarcopenia was defined when appendicular lean mass divided by height squared was less than two standard deviations below the mean of the young reference group obtained from population based studies. Using normative data from the New Mexico Elder Health Study, 340 of the 531 women (64.0%), and 57 of the 60 men (95.0%) had sarcopenia. Using normative data from the survey performed in Rochester, Minnesota, 116 of the 531 women (21.8%), and 52 of the 60 men (86.7%) had sarcopenia. After adjustment for age, time between fracture occurrence and DXA scan, number of medications in use, and number of concomitant diseases, men had a significantly higher prevalence of sarcopenia than women (p< 0.001). The adjusted odds ratio was either 10.54 (95% CI from 3.25 to 34.16) or 23.64 (from 10.8 to 51.6) depending on the reference population adopted. Our data shows a high proportion of sarcopenic subjects after hip-fracture. Sarcopenia was significantly more prevalent in men than in women. Relevancy of prevention and treatment of muscle loss is emphasized, particularly in men. © 2012 Elsevier Ireland Ltd.
Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderlySi Sheng Huang | Meng Chih Lee | Yi Cheng Liao | Wen Fu Wang | Te Jen Lai
Volume 55, Issue 1, July 2012, Pages 55-59
The purpose of this study was to investigate caregiver burden associated with BPSD in Taiwanese people. The study had a cross-sectional design. Eighty-eight patients with dementia and 88 caregivers who visited the memory clinic of a medical center from January 2007 to December 2007 were recruited. The BPSD were assessed using the neuropsychiatric inventory (NPI); caregiver burden was evaluated using the NPI caregiver distress scale (NPI-D). Demographic data on the patients and caregivers along with patients' cognitive functions and clinical dementia ratings were collected. In addition to descriptive statistics, we analyzed the relationship between each parameter and caregiver burden using binary correlation. The results showed a statistically significant positive correlation between the total NPI-D score and the total NPI score (r=. 0.898, p< 0.001). For individual BPSD, delusions had the highest mean NPI-D score, followed by agitation/aggression, anxiety, irritability/lability, and dysphoria/depression. The symptom frequency of anxiety, delusions, and agitation/aggression showed a statistically significant positive correlation with caregiver's NPI-D score. These findings suggest that improvement of treatments for delusions, agitation/aggression, anxiety, irritability/lability, and dysphoria/depression among dementia patients may reduce caregiver burden. © 2011 Elsevier Ireland Ltd.
Leisure activity, mobility limitation and stress as modifiable risk factors for depressive symptoms in the elderly: Results of a national longitudinal studyChun Te Lee | Chih Jung Yeh | Meng Chih Lee | Hui Sheng Lin | Vincent Chin Hung Chen | Ming Hong Hsieh | Chi Hua Yen | Te Jen Lai
Volume 54, Issue 2, March 2012, Page
Few national longitudinal studies have investigated the modifiable risk factors for depression in the elderly. This study investigated the risk factors and health-related behaviors associated with depressive symptoms using a national survey of Taiwanese elderly with a 4-year follow-up period. In this prospective cohort study, 1481 non-demented population-based elderly were interviewed at baseline in 2003 and at follow-up in 2007. The independent variables included demographics, chronic medical diseases and health-related behaviors assessed at baseline. The dependent variable was depressive symptoms assessed at follow-up. Reduced rank regression was applied to characterize independent factors related to depressive symptoms. The prevalence of depressive symptoms at follow-up was 21.1%. The results of multivariate analyses revealed three independent risk factors for depressive symptoms: fewer leisure activities (odds ratio, OR = 0.56, 95% confidence interval, CI = 0.38-0.83, p= 0.0034), more mobility limitations (OR = 1.93, 95% CI = 1.30-2.86, p= 0.0011) and higher stress levels (OR = 2.43, 95% CI = 1.68-3.50, p< 0.0001). The leisure activities least associated with depression were reading newspapers/books and doing outdoor building projects; the two mobility limitations most associated with depression were difficulty in lifting things and in climbing stairs. The two stresses most associated with depression were perceived health stress and financial stress. These results indicated that interventions to prevent or reduce depression in older adults should include practical strategies aimed at these modifiable risk factors. © 2011 Elsevier Ireland Ltd.
Potentially inappropriate prescribing (IP) for elderly medical inpatients in Taiwan: A hospital-based studyChien Liang Liu | Li Ning Peng | Yi Tsun Chen | Ming Hsien Lin | Li Kuo Liu | Liang Kung Chen
Volume 55, Issue 1, July 2012, Pages 148-151
Older people tend to have multiple comorbid conditions and subsequent polypharmacy, which place them at higher risk of adverse drug events, drug-drug and drug-disease interactions and IP. IP includes several patterns, such as inappropriate dose or duration, prescribing drugs having significant drug-disease or drug-drug interactions, and the omission of potentially beneficial medications. The main purpose was to evaluate the prevalence of IP among medical inpatients in a medical center, so to evaluate the associative factors of IP in Taiwan. From January to December of 2009, all patients aged 65 years and older who were discharged from the medical wards of Taipei Veterans General Hospital were randomly sampled for study (the sampling rate around 1.0%). The IP was evaluated by the STOPP and START criteria. Each medical record was carefully reviewed by physicians who had been trained. Overall, 520 records of elderly medical ward inpatients (mean age = 79.2 ± 6.7 years, 73.8% males) were included for study. In total, 3455 items of medication were prescribed for these 520 patients (mean = 6.6 ± 3.2 items). According to STOPP criteria, 36.2% of the study subjects had at least one potentially inappropriate medication (PIM). The most common PIMs were: (1) medications that may adversely affect those who are prone to falls, e.g., benzodiazepines, neuroleptics and first generation antihistamines (14.2%). (2) Ca-channel blockers with chronic constipation (12.3%). (3) Use of neuroleptic agents (5.6%). (4) Long-term, long-acting benzodiazepines (2.5%). (5) Prolonged use of first generation antihistamines (2.1%). Besides, 218 patients (41.9%) had at least one potentially prescribing omission (PPO). Common PPOs included: (1) statin therapy in diabetes mellitus if coexisting major cardiovascular risk factors present (19.0%). (2) Antiplatelet therapy in diabetes mellitus with co-existing major cardiovascular risk factors (12.5%). (3) Metformin with type 2 diabetes with or without metabolic syndrome (in the absence of renal impairment) (8.7%). (4) Angiotensin converting enzyme inhibitor or angiotensin II receptor blockers with chronic heart failure (7.3%). (5) Aspirin or clopidogrel with a documented history of atherosclerotic coronary, cerebral or peripheral vascular disease in patients with sinus rhythm (7.1%). Logistic regression showed that older age and number of medications were significant risk factors for PIMs. In conclusion, the prevalence of PIMs among elderly medical inpatients in a medical center in Taiwan was 36.2% and PPOs was 41.9%. Further study is needed to clarify the underlying causes of potentially IP to promote better quality of prescribing for older patients. © 2011 Elsevier Ireland Ltd.
What factors affect life satisfaction (LS) among the oldest-old?Åsa Enkvist | Henrik Ekström | Sölve Elmståhl
Volume 54, Issue 1, January 2012, Pages 140-145
Few studies have examined the association between LS in the oldest-old and not only health-related, but also psychological and socio-economical factors. The aim of this study was to examine LS in relation to functional capacity, locus of control (LoC) health status and other factors previously known to influence LS in the oldest-old. The study population consisted of 681 individuals aged 78-98 years, drawn from the longitudinal population study "Good Aging in Skåne" (GÅS), part of a national survey (SNAC) who fulfilled a questionnaire. In a regression model was shown that the number of symptoms, marital status, LoC, especially internal and powerful others, depressive mood and age significantly could predict life satisfaction three years later. Specific diagnoses like stroke, dementia and cardiac disease were not related to LS. Independence in physical functioning was related to unchanged LS, stratified for age and gender during a 3-year follow-up. The clinical implications of this study are that attention should be paid to recognizing and treating factors that affect LS and are reachable for medical intervention. Relieving symptoms and paying attention to personality factors that modify LS seem to be key-factors in the care of elderly. © 2011.
A multidisciplinary intervention program improved the outcome after hip fracture for people with dementia-Subgroup analyses of a randomized controlled trialMichael Stenvall | Monica Berggren | Maria Lundström | Yngve Gustafson | Birgitta Olofsson
Volume 54, Issue 3, May 2012, Page
Background: People with cognitive impairment and dementia have a poor outcome after a hip fracture surgery, about 30-50% of all those who sustain a hip fracture have dementia. Therefore the aim was to investigate whether a multidisciplinary postoperative intervention program could reduce postoperative complications and improve functional recovery among people with dementia. Methods: A randomized controlled trial with subgroup analyses among patients with dementia. Sixty-four patients with femoral neck fracture, aged ≥70 years at Umeå University Hospital, Sweden. The intervention consisted of staff education, individualized care planning and rehabilitation, active prevention, detection and treatment of postoperative complications, especially delirium. The staff worked in teams to apply comprehensive geriatric assessment, management and rehabilitation, including a follow-up at 4 months postoperatively. The control group followed conventional postoperative routines. Results: There were fewer postoperative complications in the intervention group such as urinary tract infections, p= 0.001; nutritional problems, p= 0.025; postoperative delirium, p= 0.002; falls, p= 0.006. At 4 months a larger proportion in the intervention group had regained their previous independent indoor walking ability performance, p= 0.005. At 12 months a larger proportion in the intervention group had regained the activities of daily living (ADL) performance level they had before the fracture, p= 0.027. Conclusion: This study demonstrates that patients with dementia who suffer a hip fracture can benefit from multidisciplinary geriatric assessment and rehabilitation and should not be excluded from rehabilitation programs. © 2011 Elsevier Ireland Ltd.
Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgeryKwang il Kim | Kay Hyun Park | Kyung Hoi Koo | Ho Seong Han | Cheol Ho Kim
Volume 56, Issue 3, May 2013, Pages 507-512
The proportion of elderly patients who undergo surgery has rapidly increased; however, clinical indicators predicting outcomes are limited. Our aim was to evaluate the significance of comprehensive geriatric assessment (CGA) in elderly patients undergoing elective surgery. We studied 141 consecutive elderly patients (age: 78.0 ± 6.5 years old, male: 41.1%) who were referred to our geriatric department for surgical risk evaluation. CGA was performed to evaluate physical health, functional status, psychological health, and social support. The primary composite outcome of this study was in-hospital death or post-discharge institutionalization. In-hospital adverse events, such as delirium, pressure ulcers, pneumonia, and urinary tract infections, were also evaluated. The associations between CGA and in-hospital adverse events, in-hospital death, and post-discharge institutionalization were investigated. There were 32 adverse outcomes (6 in-hospital deaths and 26 post-discharge institutionalizations). Compared with the patients who were discharged to their homes, patients with adverse outcomes were characterized by poor nutritional status and prior strokes. However, there was no significant difference in surgical risk or anesthesia type. The CGA results showed that patients with adverse outcomes were associated with functional dependency and poor nutrition. The cumulative number of impairments in the CGA domain was significantly associated with adverse outcomes, in-hospital events, and prolonged hospital stays. In multiple logistic regression analysis, cumulative impairment in CGA was independently associated with surgical outcomes in elderly patients undergoing elective surgery. Preoperative CGA can identify elderly patients at greater risk for mortality, post-discharge institutionalization, adverse in-hospital events, and prolonged length of hospital stay. © 2012 Elsevier Ireland Ltd.
Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in JapanYoshimi Tanimoto | Misuzu Watanabe | Wei Sun | Yumiko Sugiura | Yuko Tsuda | Motoshi Kimura | Itsushi Hayashida | Toshiyuki Kusabiraki | Koichi Kono
Volume 55, Issue 2, September 2012, Page
This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as " normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. © 2012 Elsevier Ireland Ltd.
Differences in muscle coactivation during postural control between healthy older and young adultsKoutatsu Nagai | Minoru Yamada | Kazuki Uemura | Yosuke Yamada | Noriaki Ichihashi | Tadao Tsuboyama
Volume 53, Issue 3, November 2011, Pages 338-343
The purpose of this study was to clarify the difference in muscle coactivation during postural control between older and young adults and to identify the characteristics of postural control strategies in older adults by investigating the relationship between muscle coactivation and postural control ability. Forty-six healthy older adults (82.0 ± 7.5 years) and 34 healthy young adults (22.1 ± 2.3 years) participated. The postural tasks selected consisted of static standing, functional reach, functional stability boundary and gait. Coactivation of the ankle joint was recorded during each task via electromyography (EMG). The older adults showed significantly higher coactivation than the young adults during the tasks of standing, functional reach, functional stability boundary (forward), and gait (p< 0.01). Postural sway area (ρ= 0.42, p< 0.05) and functional reach distance (ρ= -0.52, p< 0.05) significantly correlated with coactivation during the corresponding task in older adults, i.e., muscle coactivation was significantly higher in the elderly with low postural control ability than in the elderly with high balance ability. Increased muscle coactivation could be a necessary change to compensate for a deterioration in postural control accompanying healthy aging. Further research is needed to clarify in greater detail positive and negative effects of muscle coactivation on postural control. © 2011 Elsevier Ireland Ltd.
Muscle strength, muscle balance, physical function and plasma interleukin-6 (IL-6) levels in elderly women with knee osteoarthritis (OA)M. L A S Santos | W. F. Gomes | D. S. Pereira | D. M G Oliveira | J. M D Dias | E. Ferrioli | L. S M Pereira
Volume 52, Issue 3, May 2011, Pages 322-326
An increased circulating level of inflammatory cytokines has been associated with sarcopenia, functional disability, chronic diseases, and mortality in the elderly. Osteoarthritis (OA) is a disease common to this population, the seriousness of articular degeneration has been associated to the increase in some cytokines, IL-6 among them. The aim of the present study was to correlate IL-6 plasma levels with muscle strength, endurance, muscle balance hamstring/quadriceps (H/Q) and physical function in 80 elderly women (71.2±5.3) with knee OA. IL-6 was measured using enzyme-linked immunosorbent assay (ELISA). Quadriceps and hamstring muscle strength, endurance and hamstring-quadriceps muscle balance were assessed using a Biodex system 3 pro® isokinetic dynamometer. Physical function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Spearman's correlation coefficient was used to explore the relationship between the outcomes at the significance level of α=0.05. IL-6 was inversely correlated to the endurance of the hamstring muscles (r=-0.232; p=0.03) and muscle balance (H/Q) on the lower right side at 180°/s (r=-0.254; p=0.023). No significant correlation between IL-6, muscle strength and physical function was found. Our results show that elevated levels of IL-6 may possibly contribute to the reduction of the endurance of hamstring muscles and H/Q muscle balance in the elderly studied. © 2010 Elsevier Ireland Ltd.
Disability and co-morbidity in relation to frailty: How much do they overlap?Olga Theou | Michael R H Rockwood | Arnold Mitnitski | Kenneth Rockwood
Volume 55, Issue 2, September 2012, Page
The purpose of this study was to examine the association of disability and co-morbidity with frailty in older adults. 2305 participants aged 65+ from the second wave of the Canadian Study of Health and Aging (CSHA), a prospective population-based cohort study, comprised the study sample. Following a standard procedure, two different frailty index (FI) measures were constructed from 37 deficits by dividing the recorded deficits by the total number of measures. One version excluded disability and co-morbidity items, the other included them. Time to death was measured for up to five years. Frailty was defined using either the frailty phenotype or a cut-point applied to each FI. Of people defined as frail using the frailty phenotype, 15/416 (3.6%) experienced neither disability nor co-morbidity. Using 0.25 as the cut-point score for the FI (without disability/co-morbidity) resulted in 101/1176 (8.6%) frail participants that had neither disability nor co-morbidity. Activities of daily living (ADL) limitations and co-morbidities occurred more often among people with the highest levels of frailty. The first ADLs to become impaired with increasing frailty were bathing, managing medication, and cooking with more than 25% of older adults with a FI score (without disability/co-morbidity) >0.22 experiencing dependency on them. The hazard ratio (HR) per 0.1 increase in FI score was 1.25 (95% CI: 1.20-1.30) when disability and co-morbidity were included in the index and 1.21 (1.16-1.25) when they were not included. In conclusion, disability and co-morbidity greatly overlap with other deficits that might be used to define frailty and add to their ability to predict mortality. © 2012 Elsevier Ireland Ltd.
Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one yearJ. Winchester | M. B. Dick | D. Gillen | B. Reed | B. Miller | J. Tinklenberg | D. Mungas | H. Chui | D. Galasko | L. Hewett | C. W. Cotman
Volume 56, Issue 1, January 2013, Pages 96-103
AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N=104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian. =69.8%; Latino/Hispanic Americans. =20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2. h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted. © 2012 .
Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysisSilvia Deandrea | Francesca Bravi | Federica Turati | Ersilia Lucenteforte | Carlo La Vecchia | Eva Negri
Volume 56, Issue 3, May 2013, Pages 407-415
This is a systematic review and meta-analysis aimed at providing a comprehensive and quantitative review of risk factors for falls in older people in nursing homes and hospitals. Using MEDLINE, we searched for prospective studies investigating risk factors for falls in nursing home residents (NHR) and older hospital inpatients (HI). When there were at least 3 studies investigating a factor in a comparable way in a specific setting, we computed the pooled odds ratio (OR) using random effect models. Twenty-four studies met the inclusion criteria. Eighteen risk factors for NHR and six for HI were considered, including socio-demographic, mobility, sensory, medical factors, and medication use. For NHR, the strongest associations were with history of falls (OR = 3.06), walking aid use (OR = 2.08) and moderate disability (OR = 2.08). For HI, the strongest association was found for history of falls (OR = 2.85). No association emerged with age in NHR (OR = 1.00), while the OR for a 5. years increase in age of HI was 1.04. Female sex was, if anything, associated with a decreased risk. A few other medical conditions and medications were also associated with a moderately increased risk. For some important factors (e.g. balance and muscle weakness), a summary estimate was not computed because the measures used in various studies were not comparable. Falls in older people in nursing homes and hospitals have multifactorial etiology. History of falls, use of walking aids and disability are strong predictors of future falls. © 2012 Elsevier Ireland Ltd.


text:
Valorie Curry On American Pastoral And Why Some Men Are Still So Scared Of Vaginas
An unapologetically female conversation with one of the year's breakout stars
An unapologetically female conversation with one of the year's breakout stars
Director Park Chan-wook's masterpiece is a smutty yet cerebral look at an unlikely romance
Actor Daniel Kountz tells MTV News the hilarious backstory of Kal's portal spell
Where do you start when you want to help? Gianfranco Rosi provides an empathetic window to the path of action.
Though he'll never win an Oscar, Jumpy the dog is as good an actor as his human costars, and they know it
900 costumes and props are up for sale: Here's how you can snag one
'She is as powerful a character as we've ever put in a movie'
Who knew
Director Barry Jenkins crafts a stunning, sensitive portrayal of a boy's fraught journey to manhood
Raviv Ullman's 'Standing Ground' Will Focus On How Some Pipelines Could Affect The Environment
A look back at director Barry Jenkins's first remarkable feature film
Which is bad and which is worse?
Pixar OG Andrew Stanton on the scene he was sad to let go and his secret weapon: Baby Dory
The controversy over casting of the live-action 'Mulan' raises some tricky issues — including the complicating power of the Chinese box office
'Of Dogs and Men' will premiere at the Savannah Film Festival
Phillip Van Dyke welcomes a new baby girl. Maybe she'll be a pumpkin for Halloween?
Wolverine is officially too old for this shit
'Oldboy' director Park Chan-wook transplants the Victorian erotic thriller to 1930s Korea — adding just a dash of tentacle porn
'There are two types of beings in the universe — those who dance and those who do not'
'High School Musical' is creating families before our very eyes
Troypay is still going strong
The first episode of Season 2 welcomes author Rosalind Wiseman, Holland Roden and Shelly Hennig of 'Teen Wolf,' and costume designer Mark Bridges
C'mon, guys, it wasn't that bad

subset: commoncrawl


text: "It's Movie Time" January 6, 2006 ShareTwitter Facebook Google+ Email Click on MP3 above to hear the 5 minute "It's Movie Time" radio show anytime "on demand."By hosts John DeSando and Clay Lowe with film critic Johnny DiLoretto substituting for Lowe "It's Movie Time" has won 8 national awards including Silver Microphone and Communicator national honors. Drs. Lowe and DeSando were moderator and panelist respectively on TV 25's "World Film Classics." Both have been professors, Lowe at The Ohio State University and DeSando at Franklin University in Columbus, Ohio. Johnny DiLoretto is from NewsCenter on ABC 6-Fox 28 View the discussion thread.


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Evernote for iPhone, iPad, and Apple Watch is the modern workspace that syncs between all of your devices. Work everywhere and stay productive: • Write notes, checklists, and research • Organize web articles, docs, and photos • Discuss your work with others, right within the app • Present ideas without creating a slide deck --- "When it comes to taking all manner of notes and getting work done, Evernote is an indispensable tool." – PC Mag --- 100 million people use it to move projects forward: WRITE & ORGANIZE • Stay focused: write in an uncluttered workspace • Get things done: make to-do's and checklists • Attach files: keep Office docs, PDFs, and photos • Get organized: notebooks and tags keep work tidy • Find anything: searchable text in notes and photos DISCUSS & COLLABORATE • Work chat: discuss notes without leaving the app • Work together: share notebooks for team projects • Meeting prep: create agendas and action items YOUR DIGITAL ASSISTANT • Make connections: turn biz cards into contacts • Track expenses: organize receipts, bills & invoices • Plan travel: save research and reservations EVERNOTE FOR APPLE WATCH • Dictate notes: audio will be transcribed in Evernote • Recent notes: view newly created & updated notes • Dictate searches: get results on your Apple Watch • Never forget: set reminders and get notifications ACCOMPLISH EVEN MORE WITH EVERNOTE PREMIUM Evernote is free to download and use. Evernote Premium unlocks even more productivity: • Offline access - work anywhere, even without a connection • Unlimited uploads - keep all the files you need to get work done • Better search - search inside Office docs and attachments • Greater privacy - add a Touch ID or passcode lock • PDF annotation - use shapes and comments to give visual feedback • Presentation mode - turn notes into beautiful presentations, no slides required Two subscription levels: 1) Evernote Premium: $5.99 monthly, $49.99 annually 2) Evernote Plus: $2.99 monthly, $24.99 annually --- "Use Evernote as the place you put everything...don't ask yourself which device it's on—it's in Evernote" – The New York Times --- Price may vary by location. Subscriptions will be charged to your credit card through your iTunes account. Your subscription will automatically renew unless canceled at least 24 hours before the end of the current period. You will not be able to cancel the subscription once activated. Manage your subscriptions in Account Settings after purchase.Read more +
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You cannot afford to take chances with the "what ifs" when you depend on your job for your livelihood. You can recognize the changing economic or social undercurrent at your job if you know the signs that your boss wants to fire you. Your proactive outlook can help you land on your feet or walk away from a potentially traumatic event with a plan for the future and your dignity still intact.
Keeping You Out of the Loop
Your boss may be considering your termination if you experience the sudden social withdrawal of others. Not only are you excluded from the water cooler chit-chat, you also seem to be left out when it comes to strategy meetings or important company updates. If employees in subordinate positions are keeping you up to date, your pink slip could be on its way. In the same way, your co-workers or your boss may avoid opportunities to work with you or frequently complain that you are unpleasant. No one enjoys working with someone who is constantly disagreeable.
Changing up the Lineup
If the boss who hired you or the mentor who trained you has recently been laid off, you can reasonably expect a change in your position as well. Some companies will completely restructure when a new CEO takes charge or when another company has bought or merged with your company. Whether the company is downsizing your department or eliminating the old regime, a change in the traditional lineup is not a good sign. Likewise, a change in the lineup also occurs when you find yourself training new personnel that will take over some of your responsibilities at a lower salary. You could be training your more cost-effective replacement.
Missing the Mark
The quickest way to get promoted is to make the boss look good; inversely, the quickest way to get fired is to make the boss look bad. Job termination may be knocking at your door after only a few poor performance reviews marking your lack of productivity. Your company may be particularly sensitive to poor performance if your industry has recently experienced a downturn. A nonchalant attitude also gives the impression of inefficiency. If you are the last one to arrive, your boss may conclude that you should be the first to get the boot.
Receiving Busy Work
Even if you are productive with your assignments, the problem may lie in what those assignments entail. If your boss gradually begins giving you seemingly insignificant or menial tasks, he may be phasing you out. This sign may be particularly telling if you once received fresh and innovative projects. Similarly, a boss contemplating your termination may give you never-ending assignments or assignments in which you cannot succeed. These types of assignments buy the boss time while she plans your termination or finds your replacement.
- Photo Credit Jupiterimages/Photos.com/Getty Images
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Must Watch
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So, this brand new, weekly, half-hour series is all about animated comedy shorts. Not the sort of shorts that you wear, but the sort of shorts that you watch. Well, okay, we guess that the shorts that you wear could be featured in a short that you watch and then, consequently, that episode would be about the shorts that you wear. But, really, if you think about it, then it would just be that short that was about shorts, not the show that was about shorts (plus as they'd be animated you wouldn't be wearing them). Did we mention that some of the shorts featured herein aren't always standalone but rather sometimes weave a larger story?
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TV Network - Comedy Central
TV Network - Comedy Central


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Cyclones try to find answers for poor shootingUPDATED 9:06 PM CST Jan 14, 2014
4-25 from 3-point land spelled disaster for Iowa State on Monday night.Video Transcript
newscast. Iowa State's teams love the 3-point shot. Fred Hoiberg's squad this year has averaged 25 3-point attempts a game. On average, they hit about 35% of them ... Which is good enough to lead ISU to a 14-1 record and the #8 national ranking. Fortunately ... They had yet to have a bad showing ... Until last night's date with Kansas. Iowa State's crew couldn't hit anything ... 4-25 for the game ... Just 16% from deep. Especially frustrating considering they only got beat by 7... Iowa State at Texas Saturday at 3
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Doctor insights on:
Excessive Carrying Angle Of The Elbow
My elbow carrying angle is around 20.How can I reduce it?I have a medical examination in a month.
Elbow carrying angle: is the angle made by the arm and forearm where they meet with the elbow. An angle of 20 degrees is more common in women, and typically is a values angle meaning the hand is out from the body with the hands down at the side and the palms facing forward and this is normal for some. If you are referring to an angle where the elbow sticks out, then that is often from an old fracture and correction OK ...Read moreGet help now ›
What causes your elbow to lock up when carrying something an you have to pop it ?
This can be caused : by a loose fragment from an old injury. It gets caught in the joint, & your moving it about causes it to get out of the way. See an orthopedic surgeon & have it evaluated. Sometimes a loose fragment is made up of only cartilage, & will not be seen on x-rays, & a CT scan with some contrast needs to be done. Also an MRI can visualize them. ...Read moreGet help now ›
Managing Tennis Elbow (Checklist)
My elbows lock up when im carrying stuf is their a way to prevent my elbows from locking up?
See below: I would see an orthopedist to determine why this is occurring first. ...Read moreGet help now ›
Feels like something loose in my elbow joint when carrying a heavy load and it is painful too?
Loose cartilage?: You may have loose cartilage in elbow. See an orthopedist for evaluation. ...Read moreGet help now ›
Left Shoulder, elbow, wrist pain/discomfort after carrying heavy bags or walking dog ?
Hurts starting in shoulder blade. Uncomfortable.
Myofascial : This sounds like you may be experiencing a myofascial trigger point; this irritation of muscle groups can even mimic nerve root type pain. The shoulder girdle area is a common site for these types of regional muscle fiber strains. If your dog takes you for the walk (with lots of tugging) then a few trips to dog training school may help to change unruly tugging. A lighter, fashionista bag ? ...Read moreGet help now ›
I have elbow tendonitus, if I try to lift something it bothers me. Can it be certain angles irritates it more?
Tennis elbow: Usually lifting up a suitcase or twisting a screwdriver and other such activities cause pain. You can go to a drug store or Walmart and get a tennis elbow strap to put pressure on the outside of the elbow where the pain is and take motrin 800 mg 3x/'day for the pain. It is called lateral epicondylitis. it will take several weeks to calm down ...Read moreGet help now ›
Fell off bike. Elbow scraped and arm has an angle to it?
See your doctor: You describe symptoms that can only be honestly assessed by your doctor in his or her office. Only after a thorough evauation will he/she be able to come up with what's wrong and what to do to get you better. ...Read moreGet help now ›
Fell three weeks ago landed on my arm, it was swollen a couple days and a little black and blue, arm still hurt arm does not hurt if at 90 degree angle but when i extend arm or bring in less than 90 degree angle arm hurt at front crease part of elbow
You : You could try simple measures such as over-the-counter medication, like Ibuprofen or aleve; however, it seems to me that it might be worth your while to seek additional input from your primary care physician. Three weeks is a rather lengthy time to have persistent loss of motion of the elbow. ...Read moreGet help now ›
I have arm pain in both arms almost every day. I get sharp pains depending on the angle/weight I put on them.The pain shoots from my shoulder to elbow?
Over use: either the way you sleep, you are putting some pressure on the muscle. or it could be the way you are placing your arm over a keyboard or a computer board if you use a computer for work. watch out to any repetitive motion that you might be doing at work,and how is that affecting your muscle,or your joint. it is some kind of over use of the muscle. take ibuprofen,or aleve,message your arms often. ...Read moreGet help now ›
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- Itchy red rash on inside of the elbow
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- Causes of rash inside the elbow
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- Elbow carrying angle excessive


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The Big Broadway Sing-Along: Belt Out Show Tunes and More
* Additional fees apply. No coupon or promo codes necessary to enjoy the displayed discount price.
The last date listed for The Big Broadway Sing-Along was Monday May 11, 2015 / 7:30pm.
Currently at Edlavitch DCJCC
Master Guitarist Steven Hancoff Shares Bach's Life Story Through Images & Songs
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Using music, video and hundreds of historic images and contemporary art stills, master guitarist and… More
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Reviews & Ratings
Featured review from Florence HarveyRed Velvet
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Wonderful treat-- for an non-singer to belt out all my Broadway favorites with no "critics" to tell me I wasn't Ethel Merman…
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This was a wonderful evening. We sang song after song -- what a joy. I noticed that some of the reviews are posted here from last year. Last year's presentation did not run very smooth due to a pianist/master of ceremonies who was obviously...continued
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Really fun! The lyrics for the songs were clearly displayed; the entertainers were lively; the audience was energetic; and I was blessed to have a man who could really sing sit very near to me. So, I got to indulge my passion for singing and...continued
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This could have been a perfect evening. Singers Will Gartshore and Bayla Whitten were beyond wonderful. Gartshore, whom I had seen in several plays, sang like an angel. Joshua Morgan is clearly an extremely talented pianist, but unfortunately...continued
This event is part of the Washington Jewish Music Festival.


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I Want To Know What You Wear When You Sleep
A group where you say what you wear when you go to bed. Please ADD STORIES to do this and not leave comments on other people's stories! 1,683 People
I slept naked last night.I don't do that too often so it was quite exciting. Normally I sleep in a long shirt (and panties of course), or when it is cold in pajama's
AmandaRunner 26-30, F 7 Responses 17 Jul 15, 2015
Schumy 31-35, M 7 Responses 3 Dec 21, 2015
iv bought nawty outfits .the one is a small white dress with pink hearts evrywher . i think it has decided its going to become my nighty ^_^ <3 :) :D ^_^ <3
cdwishimatgurlCalandraBelle 36-40, T 2 Responses 2 Jan 29
even tho im alone an noone sees i like to dresssexy for bed even stockings an suspenders aometimes as makes me feel good xx
angelfallen80 36-40, F 15 Responses 29 Jan 29
Nothing like sleeping in your birthday suit!Mmmmm...all nakey feeling the sheets caressing my body and even better with a naked hottie next to me!
ChelseaLDM 41-45, F 22 Responses 19 Nov 11, 2015
Lingerie usually. Sometimeswhen I'm really tired and just crash it's panties and a t-shirt, but I prefer a nightgown.
AlbertSAT 66-70, M 12 Responses 16 Aug 15, 2015
djniceguy 41-45, M 3 Responses 3 Feb 28
I just like to wear a smile Feels good toslide 8 bed and not have any restrictions :D
konradpet 51-55, M 11 Responses 3 Jan 11
hi am a A B hi where my happy & my plasticpants in my cot
kittybaby1968age3 46-50, M 1 Response 0 Jan 28
An old shirt, a pair of pantiesand any comfortable pants
NudistJen 46-50, F 34 Responses 30 Feb 28
sally2089 26-30, F 18 Responses 43 Feb 18
Hi I'm Wolfie :) I sleep in my drawws Howmany you girls sleeps naked ?
I sleep nude. Always have.Feels so much better being naked.
salstar04 36-40, F 13 Responses 20 Sep 11, 2015
I sleep nude and havefor the last 25 yrs
djniceguy 41-45, M 1 Jan 29
Nothing, i like to be free,love the feeling of the covers lightly rubbing over my naked body Love a warm body pressed against mine and the hope that his hands wander over me
Sweetmepea 36-40, F 8 Responses 21 Nov 26, 2015
Jennixx 31-35, F 2 Responses 9 Oct 5, 2015
love sleeping in a tank top n undies.soo comfty.
shrit and pajama pantswhich are most of the time Fluffy
It depends on my mood.Sometimes of I'm feeling risqué,I'll sleep nude.If I am indifferent,I'll just sleep in a tank top and shorts.Other times,I will just sleep in a huge shirt
Imamess0324 16-17, F 8 Responses 15 Sep 12, 2015
I don't like this.. its a lil psychothat they made a group like this.. especially for pervy men and women on here .. why would someone say what they are wearing? .. Maybe I'm a Lil paranoid but this is a disgusting group .. I only joined to say this! *walks away*
mergirl123 18-21, F 2 Responses 10 Apr 6, 2015
ComfortableMost of the time I wear shorts and a tank top but lately I have been wearing Bermudas bra and yoga shorts. It's really comfortable to wear
XxTeresaaBoooxx 18-21, F 5 Responses 8 Sep 8, 2013
creativeuername 18-21, F 6 Responses 11 Oct 5, 2015
hi am a A B hi where my happy & my plasticpants in my cot
kittybaby1968age3 46-50, M 1 Response 1 Jan 28
I sleep with pantiesand t-shirt or naked depends on how hot it is.
DemiFrsr 18-21, F 3 Responses 9 Jan 29
Nothing,underwear and bra/shirt ,underwear, or shirt
Whatever underwear I happen to be wearing,so anything from a full slip to just panties. 98% of the time it's bra and undies, though.
msjenny42 36-40, F 4 Responses 1 Mar 18
I like to sleep in an extra large man's T Shirt.And nothing on the bottom. Most of my sleeping T Shirts have Doctor Who themes.
RubyRed36 36-40, F 3 Responses 7 Jan 31
I always wear an adult diaper to bed now.In the warmer weather with just a T-shirt. When it is cold I put on nice flannel pajamas with footies on over my diaper.
kellycares 41-45, F 15 Responses 14 Apr 16, 2014
shirtless97 18-21, M 3 Responses 2 Feb 19
SethTheKid 13-15, M 3 Responses 1 Jan 28
Quokka61 51-55, M 17 Responses 16 Jun 24, 2015
To be honest I sleep nudeunless I have to share sleeping quarters with someone. In which case I usually opt for tank top and undies.
Elexxa 26-30, T 1 Response 2 Jan 29
SethTheKid 13-15, M 2 Responses 1 Jan 11
I sleep naked almost all the time,but if I wear anything at all, it's just a thong.
modelnude4u 51-55, M 2 Responses 1 Jan 29
TheNudeBot 16-17, M 2 Responses 0 Jan 29
jpeck1 41-45 1 Response 0 Jan 13
I used to wear whatever I worefor the day, but recently I started wearing nothing at all to bed and I sleep much better this way.
jroyal32 16-17, M 2 Responses 2 Jan 28
I ware a onsies or footed PJsso comfy
QueenLesbiansnowbunny 31-35, F 1 Response 2 Mar 28
Yadirarubi 18-21, F 4 Responses 12 Jun 2, 2015
I always sleep naked no matter whereor what.
NurZuGast 46-50, F 15 Responses 24 Jan 2, 2015
That's a no brainer, I sleep in a nightgown ofcourse! The problem is deciding on which nightgown to wear that night. I love having a closet full of so many beautiful, sexy, silky choices. Yum! Yum!
silkydrawers 46-50 12 Responses 17 Oct 8, 2015
EbolaKing911 18-21, M 1 Response 1 Jan 27
I usually wear thongor g-string panties and a t-shirt to bed.
thongbum82 31-35, M 3 Responses 2 Feb 24
I wear nothing. ..........lol
Hisham98 18-21, M 1 Response 0 Jan 29
kencity 18-21, F 8 Responses 11 Nov 9, 2014
Boyshorts and a croptop., on cold nights boyshorts and a loose long shirt.
armpitcourtney 13-15, F 8 Responses 12 Feb 21, 2015
I sleep with nothing onbut a smile :)
Cupcakestoy 41-45, F 8 Responses 11 Jan 29
Absolutely nothing.... Usually.
So I'm always cold. Which is kind of perfectregarding the bedroom, because my boyfriend is always hot. As long as I sleep cuddled next to him, his beautiful body keeps me warm. We both sleep naked most nights, it's perfect.
yourtheocean 22-25, F 6 Responses 13 Nov 8, 2014
RM629 26-30, M 13 Responses 23 Nov 28, 2015
Usually in my onesieor just in my diaper and a t-shirt.
I love wearing an oversized top.So comfortable! But let's be honest, sleeping naked is the best! Only in summer though! Hahaha
lc543 18-21, F 2 Responses 11 Nov 8, 2014


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Not usually a good sign. Maybe the Europeans selling to buy bullets for the Bazooka.
What do you mean so much?It's not even$800 yet.That would be a 50% drop.Still too high for me.A 80% drop I might consider.You are funny.
If you look at the 6month chart and you put any credence in charts, it was in a rising triangle, a bearish sign, and could be beginning a deeper selloff...a breakdown out of this could take it quickly to 1420....If so, i would imagine a huge bounce off that number. This is the base from which the meteoric rise to 1900+ started...Very common in 'parabolic bursts', such as the move gold made, to retrace back to its mean and even further...Look at Dell '00, Kkd-Cien-Jdsu '11, lots of examples...Silver most likely the same move with time, thus the $19 target that many have for it..
why is it up so much? there could be a lot of gold dumped into this market