Public Release: 

Annals of Internal Medicine, tip sheet, November 4, 2003

American College of Physicians

Vulnerable Older Adults Need Special Geriatric Care to Remain Independent

Vulnerable older adults - estimated at one-third of all adults over 65 - are getting generally good treatment for medical conditions, such as heart disease, stroke and diabetes, a new study finds (Article, p. 740). But care for important geriatric conditions (e.g., bedsores, falls, incontinence) and end-of-life care need improvement. Vigilance and treatment for such conditions help the elderly continue to remain independent. Researchers studied 420 vulnerable elderly patients, living in the community (not in nursing homes or hospitals), enrolled in one of two health organizations. Vulnerable adults were those whose lives were compromised by advanced age, impaired mobility, frailty and disease. (NOTE: This article is the subject of a video news release. Call for coordinates.) An editorial writer notes that many older adults prefer to minimize disability and maximize mobility and quality of life, rather than postpone death (Editorial, p. 696).

Leeches Relieved Pain in Arthritic Knees, But More Research Is Needed

A week after receiving one treatment of leech therapy, 24 patients reported less pain than 27 patients receiving a topical treatment for pain from knee osteoarthritis, a new randomized study found (Article, p. 724). Both groups reported similar pain after the first week, but patients who received leech therapy reported fewer overall arthritis symptoms throughout the 13-week study period. The researchers say that leech therapy holds promise to treat osteoarthritis, a condition that currently has limited options for long-term therapy. Larger randomized studies are needed to determine the effectiveness and safety of the therapy, especially when applied repeatedly, and to understand the pharmacologic properties of leech therapy and/or saliva.

Study Looks at 3 Ways to Measure Blood Pressure for Insight Into Mortality

Researchers studied the joint effect on risk for death of three measures of blood pressure - systolic blood pressure, diastolic blood pressure and pulse pressure (the difference between the first two) (Article, p. 731). Using data from the 15-year mortality follow-up of participants in a large national survey, they found that as systolic blood pressure increased, the risk of death increased steadily. The relationship between diastolic blood pressure and death was more complex, with very low blood pressure being associated with an increased rate of death in people over 65. The relationship between pulse pressure and death rates was complex. The authors recommend against using pulse pressure to estimate the risk of death.

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Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

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