Resuscitation in the elderly: a blessing or a curse?

Article Abstract:

Each year in the United States, sudden cardiac death or heart attack causes 400,000 to 600,000 deaths. Most of these deaths occur outside of a hospital with few patients surviving to be admitted. However, survival from a cardiac arrest is improved if a bystander or witness begins resuscitation early. The benefits of cardiopulmonary resuscitation in the elderly are not clear. Long-term illnesses in the elderly increase their risk of cardiac arrest and may also affect survival from cardiac arrest. Death of resuscitated patients is most often related to brain damage resulting from anoxia, or lack of oxygen. Elderly patients are at increased risk of anoxia because of the prevalence of central nervous system disease in that population. One study reported that among 22 percent of elderly patients successfully resuscitated, only 8 percent survived and half were placed in chronic care facilities because of neurological defects. Elderly patients who suffer cardiac arrest have a poor outcome despite rapid resuscitation and satisfactory vital signs because of underlying disease and poor tolerance of their central nervous system to decreased oxygen supply. In addition, their quality of life is often diminished, despite successful resuscitation. Resuscitation may only benefit elderly patients who sustain a witnessed cardiac arrest, have evidence of a heart rhythm, do not have severe underlying disease, and whose normal heart rhythm is restored within five minutes of the cardiac arrest. Guidelines are needed to determine the benefits of resuscitating elderly patients with sudden cardiac arrest. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Patient outcomes, Mortality, Demographic aspects, Cardiac arrest, Cardiac resuscitation, editorial

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Restricted activity among older people living in the community

Article Abstract:

Many older people restrict their activity for health reasons and many never seek medical care for the problem. This was the conclusion of a 15-month study of 754 people 70 years old and older who belonged to a large health plan in Connecticut. The most common problems that restricted activity included fatigue, joint stiffness, dizziness, cold or flu symptoms, difficulty breathing, and fear of falling.

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Restricted activity: key indiator of decline or "just having a bad day"?

Article Abstract:

Restricted activity among elderly patients may be a sign of a developing functional disability. In a study of 754 elderly patients, 77% reported at least one day of restricted activity caused by a health problem during the study and about one-third did not seek medical care for the problem.

Editorial

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