Latest & greatest articles for elderly

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Top results for elderly

4521. An economic appraisal of two strategies in geriatric screening

drawn. Health technology Screening to identify previously unreported needs for geriatric care. Type of intervention Screening. Economic study type Cost-effectiveness analysis. Study population Individuals over 70 years of age, from a coastal community who were not admitted to a hospital or nursing home. Most of the study population werepreviously associated with the fishing industry and educated only to primary school level. Setting Healthcare clinic/community. The economic study was carried out (...) . An economic appraisal of two strategies in geriatric screening. Scandinavian Journal of Social Medicine 1994; 22(4): 293-298 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aged; Cost-Benefit Analysis; Female; Geriatric Assessment; Health Services Needs and Demand /economics; Humans; Male; Mass Screening /economics; Patient Acceptance of Health Care; Primary Health Care /economics; Surveys and Questionnaires /economics; Sweden AccessionNumber 21995000171 Date bibliographic record published

1994 NHS Economic Evaluation Database.

4522. The impact of age on the cost-effectiveness of hypertension treatment: an analysis of randomized drug trials

15,000. For men in 3 trials there were negative effects, 5 trials resulted in cost savings, and the maximum CE ratio was SEK 619,000. In women, 2 trials had negative effects, 2 trials were cost saving and the maximum CE ratio SEK 462,000. Authors' conclusions The cost effectiveness of hypertension treatment improved with age for both men and women. This is primarily due to the greater decline in levels of absolute risk of CHD and stroke that occur amongst older people (despite the relative risk being (...) with age and diastolic blood pressure as the key explanatory variables. Statistical tests were undertaken to ascertain whether any of these variables were significantly related to the CE ratios. The results focused on the effect of age with respect to cost effectiveness. Therefore, the author reported the regression coefficients for different analyses. For men the average cost per life year gained decreased by SEK 16,000 every year of older age at treatment, whilst for women the equivalent was SEK

1994 NHS Economic Evaluation Database.

4523. Comprehensive discharge planning for the hospitalized elderly: a randomized clinical trial

of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Comprehensive hospital discharge plan protocol for the elderly. Type of intervention Disease management; early discharge. Economic study type Cost-effectiveness analysis. Study population Patients aged 70 years and older, hospitalised in selected medical and surgical cardiac diagnostic related groups. Setting Hospital. The economic study (...) patients there was more than one re-hospitalisation) so it may underestimate the costs. Source of funding National Institute of Nursing Research Bibliographic details Naylor M, Brooten N, Jones R, Lavizzomourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly: a randomized clinical trial. Annals of Internal Medicine 1994; 120(12): 999-1006 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Aged; Aged, 80 and over; Caregivers; Clinical Protocols; Fees

1994 NHS Economic Evaluation Database.

4524. The impact on infant birth weight and gestational age of cotinine-validated smoking reduction during pregnancy. (Abstract)

The impact on infant birth weight and gestational age of cotinine-validated smoking reduction during pregnancy. To evaluate the impact of cotinine-confirmed smoking reduction during pregnancy on infant birth weight and gestational age at birth.Group analyses from a prospective, randomized smoking-cessation intervention trial using cotinine levels to assess smoking cessation and reduction.Four maternity clinics of Jefferson County Health Department in Birmingham, Ala.A total of 803 pregnant (...) smokers and 474 never smokers with a fetal gestational age of 32 weeks or less at the first prenatal visit to a clinic.Infant birth weight and gestational age at birth.Infants who were born to women who quit smoking (quitters) had the highest mean birth weight (3371 +/- 581 g), followed by infants who were born to women who did not change smoking behavior (no changers) (3043 +/- 587 g). The mean infant birth weight of infants born to the quitters, adjusted by mother's age, race, height, weight

1993 JAMA Controlled trial quality: uncertain

4525. Effects of preventive home visits to elderly people. Full Text available with Trip Pro

Effects of preventive home visits to elderly people. To assess the effect of preventive home visits by public health nurses on the state of health of and use of services by elderly people living at home.Randomised controlled trial.General population of elderly people in one of the southern regions of the Netherlands.580 subjects aged between 75 and 84 years randomly allocated to intervention (292) or control (288) group.Four visits a year over three years in intervention group. Control group (...) % increased risk of admission (incidence rate ratio 1.4; 90% confidence interval 1.2 to 1.6). No differences were found in long term institutional care, and overall expenditure per person in the intervention group exceeded that in the control group by 4%. Additional analyses showed that visits were effective for subjects who initially rated their health as poor.Preventive home visits are not beneficial for the general population of elderly people living at home but might be effective when restricted

1993 BMJ Controlled trial quality: uncertain

4526. Adverse reactions to influenza vaccine in elderly people: randomised double blind placebo controlled trial. Full Text available with Trip Pro

Adverse reactions to influenza vaccine in elderly people: randomised double blind placebo controlled trial. To assess the frequency and type of side effects after influenza vaccination in elderly people.Randomised double blind placebo controlled study.15 general practices in the southern Netherlands.1806 patients aged 60 or older, of whom 904 received influenza vaccine and 902 placebo.Adverse reactions reported on postal questionnaire completed four weeks after vaccination.210 (23%) patients

1993 BMJ Controlled trial quality: predicted high

4527. Is dilution of cows' milk formula necessary for dietary management of acute diarrhoea in infants aged less than 6 months? (Abstract)

Is dilution of cows' milk formula necessary for dietary management of acute diarrhoea in infants aged less than 6 months? There is concern that feeding full-strength animal milk to infants aged less than 6 months with diarrhoea may have adverse consequences. We assessed the effects on clinical course of two feeding regimens in 159 Guatemalan and Brazilian infants aged 2 weeks to 6 months who had had acute diarrhoea for 120 h or less, showed signs of mild to moderate dehydration, and had (...) between presence of reducing substances in stools and treatment failure (OR 4.3, 95% CI 1.1 to 16.8), but reducing substances in stools were common both in treatment successes (61%) and in failures (87%). Our study supports the conclusion that, for infants under 6 months of age with diarrhoea whose only food is animal milk or formula, the milk or formula normally given should be provided in full strength as soon as dehydration has been corrected.

1993 Lancet Controlled trial quality: uncertain

4528. Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. Full Text available with Trip Pro

Chronic constipation in long stay elderly patients: a comparison of lactulose and a senna-fibre combination. To compare the efficacy and cost effectiveness of a senna-fibre combination and lactulose in treating constipation in long stay elderly patients.Randomised, double blind, cross over study.Four hospitals in Northern Ireland, one hospital in England, and two nursing homes in England.77 elderly patients with a history of chronic constipation in long term hospital or nursing home care.A (...) effective and well tolerated for chronic constipation in long stay elderly patients. The senna-fibre combination was significantly more effective than lactulose at a lower cost.

1993 BMJ Controlled trial quality: predicted high

4529. Screening for breast cancer in women aged 40-49 years

and targeting activities on women 50 to 69 years old. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Aged; Breast Neoplasms; Cost-Benefit Analysis; Mammography; Mass Screening; Middle Aged Language Published English, French Country of organisation Canada Province or state Quebec Address for correspondence Conseil d'Evaluation des Technologies de la Sante du Quebec, 2021, avenue Union, #1040, Montreal, Quebec H3A S29, Canada. Tel: 514-873-2563; FAX: 514-873-1369 Email: aetmis (...) Screening for breast cancer in women aged 40-49 years Screening for breast cancer in women aged 40-49 years Screening for breast cancer in women aged 40-49 years Caro J J, O'Brien J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Caro J J, O'Brien J. Screening for breast cancer in women aged 40-49 years. Montreal: Conseil d'Evaluation des

1993 Health Technology Assessment (HTA) Database.

4530. Hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment

Hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment Hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment Hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment Office of Technology Assessment Record Status This is a bibliographic record of a published health technology assessment (...) . The agency responsible for the publication, formerly a member of INAHTA, has subsequently been disbanded. No evaluation of the quality of this assessment has been made for the HTA database. Citation Office of Technology Assessment. Hip fracture outcomes in people age 50 and over: mortality, service use, expenditures, and long-term functional impairment. U. S. Congress. Office of Technology Assessment (OTA). Background paper; BP-H-120. 1993 Authors' objectives To develop information about the outcomes

1993 Health Technology Assessment (HTA) Database.

4531. Screening for abdominal aortic aneurysm in men aged 60 to 80 years: a cost-effectiveness analysis

Screening for abdominal aortic aneurysm in men aged 60 to 80 years: a cost-effectiveness analysis Screening for abdominal aortic aneurysm in men aged 60 to 80 years: a cost-effectiveness analysis Screening for abdominal aortic aneurysm in men aged 60 to 80 years: a cost-effectiveness analysis Frame P S, Fryback D G, Patterson C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Ultrasonography and palpation of the abdomen by physical examination for the detection of abdominal aortic aneurysm (AAA). Type of intervention Secondary prevention Economic study type Cost-effectiveness analysis. Study population Hypothetical cohort of men aged 60 to 80 years. Setting Primary care/ hospital. The economic study was carried out

1993 NHS Economic Evaluation Database.

4532. Should the elderly receive chemotherapy for node-negative breast cancer? A cost-effectiveness analysis examining total and active life-expectancy outcomes

/effectiveness ratios were calculated. Using conventional survival as the outcome measure the costs per life year were $14,910 for a 60 year old woman and $24,400 for a 75 year old. The costs per QALY were $28,200 (aged 60), $31,300 (aged 65), $36,300 (aged 70), $44,400 (aged 75) and $57,100 (aged 80). Using active life expectancy the costs per QALY of adjuvant chemotherapy in elderly women with breast cancer increased to $59,300 (aged 65), $75,000 (aged 70), $96,000 (aged 75) and $212,500 (aged 80). Both (...) in the economic analysis The average survival benefit for a 60 year old was 5.5 months and for an 80 year old woman was 2.5 months. The quality-adjusted benefit of adjuvant chemotherapy for women with breast cancer at various ages was calculated to be 2.8 months (aged 60), 2.8 months (aged 65), 2.2 months (aged 70 years), 1.8 months (aged 75 years) and 1.4 months (aged 80 years). When active life expectancy was the outcome measure the average gain fell to 1.3 months for a 65 year old and 0.4 months for an 80

1993 NHS Economic Evaluation Database.

4533. Routine ultrasonography in utero and school performance at age 8-9 years. (Abstract)

Routine ultrasonography in utero and school performance at age 8-9 years. Most fetuses in developed countries are exposed in utero to diagnostic ultrasound examination. Many pregnant women express concern about whether the procedure harms the fetus. Since most routine ultrasound examinations are done at weeks 16-22, when the fetal brain is developing rapidly, effects on neuronal migration are possible. We have sought an association between routine ultrasonography in utero and reading (...) and writing skills among children in primary school. At the age of 8 or 9 years, children of women who had taken part in two randomised, controlled trials of routine ultrasonography during pregnancy were followed-up. The women had attended the clinics of 60 general practitioners in central Norway during 1979-81. The analysis of outcome was by intention to treat: 92% of the "screened" group had been exposed to ultrasound screening at weeks 16-22, and 95% of controls had not been so exposed

1992 Lancet Controlled trial quality: uncertain

4534. Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. Full Text available with Trip Pro

Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. To establish whether treatment with diuretic or beta blocker in hypertensive older adults reduces risk of stroke, coronary heart disease, and death.Randomised, placebo controlled, single blind trial.226 general practices in the MRC general practice research framework.4396 patients aged 65-74 randomised to receive diuretic, beta blocker, or placebo. Patients had mean systolic (...) cardiovascular events (35% (17% to 49%), p = 0.0005) compared with the placebo group. The beta blocker group showed no significant reductions in these end points. The reduction in strokes was mainly in non-smokers taking the diuretic.Hydrochlorothiazide and amiloride reduce the risk of stroke, coronary events, and all cardiovascular events in older hypertensive adults.

1992 BMJ Controlled trial quality: predicted high

4535. Safety and immunogenicity of single-dose live oral cholera vaccine CVD 103-HgR in 5-9-year-old Indonesian children. (Abstract)

Safety and immunogenicity of single-dose live oral cholera vaccine CVD 103-HgR in 5-9-year-old Indonesian children. Oral vaccines offer great promise as public-health measures to prevent disease in less-developed countries. CVD 103-HgR, a genetically engineered, attenuated, Vibrio cholerae O1 strain has proved effective in industrialised countries. We have assessed the safety, immunogenicity, and excretion of this live cholera vaccine in children in north Jakarta, Indonesia. 412 children aged 5

1992 Lancet Controlled trial quality: uncertain

4536. Randomised trial of case finding and surveillance of elderly people at home. (Abstract)

Randomised trial of case finding and surveillance of elderly people at home. Health screening for old people who live at home has been the subject of debate for 30 years or so. It has come to the fore again in the UK with the new emphasis on annual assessments by general practitioners (GPs) of those aged 75 or more. Screening in the elderly has implications for manpower. How can it best be done? We describe here a randomised, controlled study of case finding and surveillance in patients aged 65 (...) visits by a GP. Quality-of-life measures revealed no between-group differences, but self-rated health status was superior in the intervention group. We conclude that the use of a postal screening questionnaire with selective follow-up and intervention can favourably influence outcome and use of health care resources by elderly people living at home.

1992 Lancet Controlled trial quality: uncertain

4537. Comparison of umbilical-artery velocimetry and cardiotocography for surveillance of small-for-gestational-age fetuses. (Abstract)

Comparison of umbilical-artery velocimetry and cardiotocography for surveillance of small-for-gestational-age fetuses. Intrauterine growth retardation is associated with an increased risk of fetal asphyxia as well as greater perinatal morbidity and mortality. Ultrasound fetometry enables detection of fetuses that are small for gestational age. Doppler velocimetry of the umbilical artery has good predictive ability for fetal distress, but it is not yet clear whether it could replace (...) cardiotocography in antenatal surveillance of small-for-gestational-age fetuses. We have done a randomised comparison of the two methods. At four obstetric departments in Sweden, women with fetuses found to be small on ultrasound examination at 31 completed weeks of pregnancy or later were randomly assigned to antenatal surveillance with either doppler velocimetry (doppler; 214) or cardiotocography (CTG; 212). Pregnancies in the doppler group were managed according to a protocol based on blood-flow classes

1992 Lancet Controlled trial quality: uncertain

4538. Can health visitors prevent fractures in elderly people? Full Text available with Trip Pro

Can health visitors prevent fractures in elderly people? To assess whether intervention by a health visitor could reduce the number of fractures, over a four year period, in those aged 70 and over.Randomised, controlled trial; randomisation by household.General practice in a market town.Of 863 patients aged 70 and over on the practice records, 674 were traced and successfully interviewed; 350 were assigned to the intervention group, 324 as controls.The people in the intervention group were (...) over four years.The incidence of fractures was 5% (16/350) in the intervention group and 4% (14/324) in the control group (difference not significant).A health visitor visiting a group of people aged 70 and over and using simple preventive measures had no effect on the incidence of fractures.

1992 BMJ Controlled trial quality: uncertain

4539. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. (Abstract)

Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Ageing is associated with impaired immune responses and increased infection-related morbidity. This study assessed the effect of physiological amounts of vitamins and trace elements on immunocompetence and occurrence of infection-related illness. 96 independently living, healthy elderly individuals were randomly assigned to receive nutrient supplementation or placebo. Nutrient status (...) year, p = 0.002). Supplementation with a modest physiological amount of micronutrients improves immunity and decreases the risk of infection in old age.

1992 Lancet Controlled trial quality: uncertain

4540. Effect of regular exercise on 24-hour arterial pressure in older hypertensive humans. (Abstract)

Effect of regular exercise on 24-hour arterial pressure in older hypertensive humans. The experimental goals were to determine if regular low-intensity aerobic exercise reduces 24-hour arterial blood pressure in middle-aged and older (aged 50 years or older) humans with mild diastolic (90-105 mm Hg) essential hypertension and, if so, whether this is accurately reflected by changes in casual recordings made at rest. Fourteen subjects walked 3-4 days/wk for 6 months, with 10 exercising (...) -aged and older humans with mild (diastolic) essential hypertension and 2) training-associated changes in casually determined blood pressure at rest are dependent on the measurement conditions and, most importantly, do not necessarily reflect the magnitude or even the direction of changes in arterial pressure throughout an entire day.

1991 Hypertension (Dallas, Tex. : 1979)