Clinical Geriatrics

Introduction

Many adults with intellectual and other developmental disabilities (IDD) are achieving life expectancies commensurate with the general population. Although they are survivors, they often have complex physical and mental health needs that have not been previously identified or treated. Geriatrics healthcare professionals may have received little formal training in their care, and may experience difficulty in distinguishing normal from atypical aging trajectories in this population.1 The following is an overview of healthcare issues related to the aging adult with IDD.

Herpes zoster (HZ) affects millions of older adults annually worldwide and lowers quality of life in a substantial number of older individuals via acute and chronic pain or postherpetic neuralgia (PHN). Herpes zoster is caused by the reactivation of varicella-zoster virus (VZV) in sensory ganglia and is spread in afferent peripheral nerves in the setting of age, disease, and drug-related decline in cellular immunity to VZV. This article reviews treatment strategies and recent research for the prevention and treatment of HZ and PHN. Pharmacotherapeutic strategies to reduce HZ pain include antiv

The patient’s chief complaint directs the musculoskeletal exam. Identical complaints often have different etiologies and require the exam to progress in different directions. Weakness, balance, changes in the appearance and functional ability of the muscles, and sensation are common complaints that may be primarily muscular or neurological in origin. Deciding which direction to pursue in terms of an evaluation depends first on a thorough exam and a logical approach.

Abnormal postures and bodily asymmetries can be muscular or neurological in origin. Muscle weakness of the hand can indicat

An estimated 22% of adults 65 years of age or older have Alzheimer’s disease (AD).1 Because the incidence of AD doubles every 5 years after age 65, its prevalence is expected to increase as the United States population ages.2 The impact of this neurodegenerative disease encompasses a range of symptoms affecting cognition, function, and behavior.

Like many other diseases, there is a spectrum of continuum for AD, and there are different features at each stage. Artificially, the spectrum has been divided into mild, moderate, and severe stages. In the mild stage (Mini-Mental State Examinatio

Methicillin-resistant S. aureus infection is a particularly serious problem in hospitals, where MRSA often exceeds 25% of S. aureus isolates. Because MRSA strains are not susceptible to cephalosporin or semi-synthetic penicillin antibiotics, intravenous vancomycin is usually employed when MRSA infections occur. For reasons of cost, toxicity, and to avoid driving the emergence of vancomycin-resistant Enterococcus (VRE) or the more fearsome vancomycin-resistant S. aureus (VRSA), vancomycin is not routinely ordered at the outset of most infections. Rather, empiric antibiotics are selected that wo