CG CLASSIFIEDS
We are looking for a second fellowship-trained Geriatrician to join our amazing rural Upstate New York community.
Supplements & Special Projects
Physician Perspectives
A Common, Yet Often Undiagnosed Problem
I first met Mr. M, a 79-year-old man, after he fell and fractured his femur. He reported to me that for the past two years he has noted reduced sensation from his knees down and has not felt steady ambulating. This has progressed to the point where he currently spends most of his day in a wheelchair. He uses a walker or cane when transferring from his bed, chair, or car. He has continued to drive, though admitted he recognizes that it is not safe since he cannot feel the bottom of his feet, and at times is not sure whether he is applying the brakes correctly. Mr. M stated that he tries to driv
Appropriate Use of Clopidogrel in the Older Adult
To the Editor,
I generally agreed with the analysis and conclusions of the article in the January 2010 edition of Clinical Geriatrics entitled “Appropriate Use of Clopidogrel in the Older Adult” by Dr. Ackermann.1 I have two comments:
1. I think the potential for drug-drug interactions at the cytochrome P450 2C19 enzyme should be emphasized more. Dr. Ackermann mentions the potential interaction of proton pump inhibitors (PPIs) with clopidogrel. These drugs are common in the elderly, and I doubt many primary care physicians or specialists who prescribe clopidogrel
AoA Programs Offer Seniors and Their Caregivers More Essential Services, Right in their Communities
It didn’t make the front page or lead the nightly news, but there was some very good news for older adults—and their caregivers—in the fiscal year 2011 budget that President Obama proposed last month: In keeping with Mr. Obama’s spending plan, funding for the Department of Health & Human Services’ Administration on Aging (AoA) would increase $108.4 million next year, reaching $1.624 billion.
This is indeed good news because the AoA is responsible for administering the Older Americans Act. Its mission is to provide a comprehensive, coordinated, cost-effective network of home- and
A Patient’s Illness, A Patient’s Life
I’ve been practicing geriatric psychiatry since the early 1980s. Over this period, patients have come and gone; some left because they got better, some because they did not. But there is also a group of patients who neither get better nor leave. With time, they have become an increasing proportion of my clientele. A typical patient would be a 70ish, divorced/separated/widowed, African-American female, who along with her hypertension, obesity, arthritis, and diabetes has also been diagnosed with depression. The depression is relatively long-standing, and despite modest benefits from various a
Opioid Analgesics for Persistent Pain in the Older Patient: Part I
Introduction
The opioid analgesics are among the oldest of drugs in use today, with evidence of use dating back thousands of years. These agents mimic the endogenous opioid peptides and act by reducing neuronal excitability (by hyperpolarizing the neuron via enhancement of potassium ion influx) and inhibiting neurotransmitter release (by reducing calcium ion influx). Their effects are mediated by binding to specific receptors in the central and peripheral nervous systems (Table I).1
In this two-part article, some general concepts underlying the use of opioid analgesics
Clinical Geriatrics Blogs
Coming in Future Issues of Clinical Geriatrics
Series: Diabetes in the Elderly
Series: Cancer in Older Adults
First Report® Conference Coverage: American Academy of Neurology, American Diabetes Association, 2010 Digestive Disease Week
Assessment and Classification of Pain in the Elderly Patient
Pharmacologic Management of Pain in Older Patients
Miscellaneous Pain Syndromes in Older Adults
Nonhernia Causes of Inguinal Pain in the Elderly
