Subject(s)
Body Height , History, Ancient , History, Early Modern 1451-1600 , History, Medieval , History, Modern 1601- , ScotlandABSTRACT
The prevalence of fractures in medieval Scotland is assessed, particular attention being given to excavations of cemeteries beside three Carmelite cemeteries, at Aberdeen, Perth and Linlithgow, and another one at Whithorn Abbey. In the friaries the prevalence of fractures was 7.6% and in Whithorn it was 5.0%. These figures are comparable with an estimated prevalence of 7.2% for individuals between 0 and 65 years in present day Scotland. Males were more at risk of fractures than females, but a small group from both genders had been struck on the head by weapons. A study from a rural cemetery in England indicates that both male and female peasants had a much higher risk of fractures than their urban counterparts.
Subject(s)
Fractures, Bone/history , Female , Fractures, Bone/epidemiology , History, 15th Century , History, Ancient , History, Medieval , Humans , Male , Prevalence , Rural Health/history , Scotland/epidemiology , Urban Health/historySubject(s)
Famous Persons , Leprosy/history , History, Medieval , Humans , Paleopathology/history , ScotlandABSTRACT
Review of medical and archaeological papers reveals that osteoarthritis has been common in humans and hominids since Paleolithic times. In the British Isles, there was a particularly high prevalence in remains from Romano-British and Saxon burials suggesting that, whatever genetic factors there may have been, there was an extremely high level of physical activity. The prevalence of the condition was lower in late Medieval times; and, in at least one study of subjects from the 18th and 19th centuries, lower than in the current population. In early times, there was a reduction in bone density when there was a change from hunter gathering to agriculture which may have resulted from a change physical activity. Severe cases of osteoporosis have been identified from individual skeletons dated to the Bronze Age. In the Early Medieval period of Nubia there was progressive bone loss in women. Multiple pregnancy, prolonged lactation and dietary deficiency may have been factors. Though women from the 18th and 19th centuries experienced post-menopausal bone loss, this was not as severe as in the present day.
Subject(s)
Osteoarthritis/history , Ancient Lands/epidemiology , Bone Density , Dental Caries/epidemiology , Dental Caries/history , Female , History, 15th Century , History, 18th Century , History, 19th Century , History, Ancient , History, Medieval , Humans , Male , Osteoarthritis/epidemiology , Paleopathology , United Kingdom/epidemiologySubject(s)
Aging/physiology , Blood Pressure/physiology , Aged , Aged, 80 and over , Cohort Studies , Female , Follow-Up Studies , Humans , Longitudinal Studies , MaleABSTRACT
OBJECTIVES: To evaluate the appropriateness of two sets of commonly used anthropometric reference data for nutritional assessment of elderly people. DESIGN: Cross sectional study. SETTING: Two general practices in Edinburgh. SUBJECTS: 200 independently living men and women aged 75 or over randomly recruited from the age and sex register of the practices. MAIN OUTCOME MEASURES: Weight (kg), knee height (cm), demispan (cm), mid-upper arm circumference (cm), triceps skinfold thickness (mm), arm muscle circumference (cm) body mass index (kg/m2), and demiquet (kg/m2) in men and mindex (kg/m) in women. RESULTS: Men and women in Edinburgh were significantly shorter than those in measured for the Nottingham reference data (demispan 0.79 v 0.80 (P < 0.05) for men and 0.72 v 0.73 (P < 0.01) for women). Comparison with data from South Wales showed that men and women from Edinburgh had significantly greater mid-upper arm circumference, triceps skinfold thickness, and arm muscle circumference. No one fell below the 10th centile of the South Wales data (the commonly used out off point for determining malnutrition) for these measures. CONCLUSIONS: Both sets of reference data commonly used in Britain may be inappropriate for nutritional screening of elderly people in Edinburgh. Contemporary reference data appropriate for the whole of Britain need to be developed, and in the longer term biologically or clinically defined criteria for undernutrition should be established.
Subject(s)
Aged/statistics & numerical data , Anthropometry , Nutritional Status , Body Height , Body Weight , Cross-Sectional Studies , Female , Humans , Male , Reference Values , Reproducibility of Results , Scotland/epidemiologyABSTRACT
BACKGROUND: disease often confounds the identification of risk factors for age-associated cognitive decline in elderly subjects. If the cognitive effects of ageing are to be distinguished from those of disease, healthy people need to be studied. METHODS: we examined the effects of incident disease and drug prescription on cognitive change in a sample of initially healthy old people in a longitudinal study and related these to age, education, social class and blood pressure. We screened general practice case notes of 10,000 patients aged 70 years and over resident in Edinburgh to identify potentially healthy subjects. We visited 1467 potential subjects at home and enquired directly about health problems and medications, administered the Mini-Mental State Examination (MMSE) and National Adult Reading Test and recorded educational attainment, occupation and blood pressure. RESULTS: 603 subjects (237 male, 366 female), mean age 75.7 years (range 70-88 years), reported no health problems and were taking no regular medications. Four years after the initial visit we determined the outcome of all 603 subjects and retested available survivors. Psychometric tests were then administered to the 429 (71.1%) available survivors after a median period of 4.2 years (69 subjects were dead, 15 were too unwell, 12 had moved away and 78 either refused or failed to reply). Forty-two subjects had significant sensory impairment or interrupted testing, 195 remained in good health, 29 reported or had documented disease but were on no regular medication and 163 were on regular medication for diseases diagnosed during the follow-up period. MMSE score declined by 0.3 points in the healthy group (P < 0.048). However, once a single outlier whose MMSE score fell from 29 to 22 was excluded, the mean decline for the remainder was non-significant at 0.2 points (P = 0.079). There was no significant difference in cognitive decline between those who had and those who had not started medication (P = 0.59). CONCLUSIONS: the study fails to support the hypothesis that cognitive decline can be attributed to age alone in healthy old people. If such a decline exists, we consider that it is unlikely to account for loss of more than 0.1 MMSE point per year.
Subject(s)
Cognition Disorders/diagnosis , Dementia/diagnosis , Geriatric Assessment , Neuropsychological Tests , Aged , Aged, 80 and over , Cognition Disorders/etiology , Cognition Disorders/psychology , Dementia/etiology , Dementia/psychology , Female , Geriatric Assessment/statistics & numerical data , Humans , Intelligence Tests/statistics & numerical data , Male , Mental Status Schedule/statistics & numerical data , Neuropsychological Tests/statistics & numerical data , Psychometrics , Reference Values , Scotland/epidemiologyABSTRACT
Both hypertension and cognitive decline are common in old age. We sought to examine the effects of blood pressure (BP) on rates of cognitive decline in a longitudinal study of community-resident healthy old people. A total of 603 initially healthy old people aged over 69 years were visited at home. Subject's age, years of full-time education, Social Occupational Classification, health status and medication use were recorded. Sitting systolic and diastolic BP was measured, and the Mini-Mental State Examination (MMSE) and National Adult Reading Test (NART) administered. Follow-up was planned after 4 years: 69 subjects were dead, 15 were too unwell and 12 had moved away; 78 subjects either refused or failed to reply. Psychometric tests were administered to the remaining 429 (71.1%) after a median period of 4.20 years. Forty-two subjects had significant sensory impairment or interrupted testing. No significant differences in cognitive decline were found between those who had started medication (n = 163) and those remaining untreated (n = 224). Mean MMSE score change was 0.44 points (s.d. 2.07, P < 0.001). Entering all baseline variables into a stepwise regression analysis significant positive effects were found for initial MMSE score (beta = 0.50, P < 0.001), age (beta = 0.17, P < 0.001), systolic BP (beta = 0.16, P < 0.001) and period between testing (beta = 0.14, P = 0.004), and negative effect for NART-predicted IQ (beta = -0.16, P = 0.003).). We conclude that (1) older people exhibit faster age-associated cognitive decline as measured by MMSE; (2) people with higher NART-predicted IQs are relatively protected; (3) people with high systolic BPs are at greater risk of cognitive decline.
Subject(s)
Aging/physiology , Aging/psychology , Blood Pressure , Cognition , Aged , Aged, 80 and over , Analysis of Variance , Female , Follow-Up Studies , Humans , Male , Sex FactorsSubject(s)
Aged , Ethics, Medical , Geriatrics , Patient Advocacy , Health Services for the Aged/economics , Humans , PrejudiceSubject(s)
Aged/physiology , Blood Pressure/physiology , Aged, 80 and over , Female , Humans , Male , Mortality , Survival RateABSTRACT
Patients over the age of 65 years with clear catch specimens of urine containing organisms sensitive to norfloxacin were blindly randomised to receive either norfloxacin in a dose of 400 mg twice daily for 7 days or a placebo for the same period. Urine cultures were repeated immediately prior to treatment, at the end of treatment and at 7 days, 1 month and 3 months after treatment. Physical and mental function were assessed by performing a Crighton Behavioural Rating Scale at the same time intervals. Observations were made on 29 each of subjects on norfloxacin and placebo. The proportions of patients abacteriuric at the end of treatment, 7 days and 3 months post- treatment were 16/24 (66%), 12/24 (50%) and 5/24 (21%) in the norfloxacin group and 10/26 (38%), 8/26 (31%) and 8/25 (32%) in the placebo group. Percentage calculations (and denominators) exclude those patients withdrawn or for whom there were no specimens available at the sampling interval in question. Means and 95% intervals for the Crighton Behaviour Rating Scales initially and at 3 months in subjects on norfloxacin were 18.1 (15.1-20.7) and 19.1 (16.2-21.9) respectively. The same figures for the placebo group were 15.7 (12.6-18.8) and 16.6 (13.7-19.5). It is concluded that a 7 day course of norfloxacin for the treatment of asymptomatic bacteriuria had no effect on the physical and mental function of elderly continuing care patients, and that one explanation for this is that there was a high rate of urinary re-infection.
ABSTRACT
We report the case of an 86-year-old man who was admitted with congestive cardiac failure and chronic renal failure. He was previously known to have a thoracic aortic aneurysm and chronic bronchitis. There was no history of myocardial infarction but his heart failure was assumed to be due to ischaemic heart disease. Despite treatment of the heart failure the patient died. At post-mortem he was found to have Toxoplasma gondii myocarditis.