Neurogeriatrics—a vision for improved care and research for geriatric patients with predominating neurological disabilities

Abstract

Geriatric medicine is a rapidly evolving field that addresses diagnostic, therapeutic and care aspects of older adults. Some disabilities and disorders affecting cognition (e.g. dementia), motor function (e.g. stroke, Parkinson’s disease, neuropathies), mood (e.g. depression), behavior (e.g. delirium) and chronic pain disorders are particularly frequent in old subjects. As knowledge about these age-associated conditions and disabilities is steadily increasing, the integral implementation of neurogeriatric knowledge in geriatric medicine and specific neurogeriatric research is essential to develop the field. This article discusses how neurological know-how could be integrated in academic geriatric medicine to improve care of neurogeriatric patients, to foster neurogeriatric research and training concepts and to provide innovative care concepts for geriatric patients with predominant neurological conditions and disabilities.

Static Balance and Chair-Rise Performance in Neurogeriatric Patients: Promising Short Physical Performance Battery-Derived Predictors of Fear of Falling

“…First, due to the cross-sectional study design, we cannot draw conclusions regarding the causality of relationships. Second, this is a heterogeneous study cohort representing geriatric patients with predominating neurological disabilities with acute onsets and chronic disease courses ( 13 ), thus we cannot draw definite conclusions for patients with specific diseases and also cannot adjust the analyses for disease-related confounders (e.g., freezing in patients with PD). Third, we did not include measures of physical activity and anxiety, and we had to rely on self-reported retrospective falls assessment.…”

“…This may lead to a deconditioning effect on muscle strength and balance, aggravating a downward spiral towards functional decline (2,5,9,10). Neurological diseases such as stroke/small vessel disease, vertigo, Parkinson's disease (PD) and polyneuropathy (PNP) have been identified as risk factors for falls (2,(11)(12)(13) with the prevalence of falls among neurological in-patients being almost twice as high as in an age-matched population (14). FOF was identified as a risk factor for future falls in neurological patients (14,15) and is negatively correlated with health-related quality of life in patients with PD (16,17) and stroke (18).…”

Electroencephalography Findings in Older Adults Undergoing Geriatric Treatment: A Surrogate for the Outcome?

“…Many investigations have indicated that patients might benefit from this approach [ 4 , 5 ]. However, there are a number of factors that may influence a patient’s functional abilities as well as their ability to recover [ 6 , 7 ]. In particular, disorders of the central nervous system such as ischemic or hemorrhagic stroke, tumors, epilepsy, encephalopathy, delirium, or dementia may cause deficits and affect rehabilitation [ 6 , 7 ].…”

“…However, there are a number of factors that may influence a patient’s functional abilities as well as their ability to recover [ 6 , 7 ]. In particular, disorders of the central nervous system such as ischemic or hemorrhagic stroke, tumors, epilepsy, encephalopathy, delirium, or dementia may cause deficits and affect rehabilitation [ 6 , 7 ]. Electroencephalography (EEG) is an established neurological procedure that provides valuable information for estimating and monitoring cerebral function and determines cognitive performances [ 8 ].…”

Multiprofessionelle Therapieoptionen bei psychischen Erkrankungen im Alter – aktuelle Aspekte eines bekannten Themas

“…B. [5,8]). Ebenso ist psychiatrische Versorgung im Allgemeinen und gerontopsychiatrische Tätigkeit im Speziellen ohne eine solche Perspektive nicht denkbar.…”