Blood pressure in the very old.

Seven hundred and twenty-four people (541 female, 183 male), aged 84-88 years and living at home in the city of Tampere, Finland, accepted our invitation to be examined in the outpatient department of the local geriatric hospital. These subjects were re-examined annually, and their fate was followed for 3 years. The blood pressure level was a prognostic sign for mortality during the first year after its measurement. The lowest mortality rate was found among those subjects with systolic blood pressure between 140 and 169 mmHg and diastolic blood pressure between 70 and 99 mmHg. Blood pressures outside of these ranges were associated with increased mortality rates, particularly cardiac and coronary mortality. The mortality rate was especially high among those whose systolic blood pressure had decreased to low levels in the year before, but was lower in those whose systolic blood pressure had decreased from high to middle levels (140-169 mmHg) than in those with consistently high systolic blood pressure. Eventual institutionalization was more common in those with low systolic blood pressure.

Screening of thyroid function in the hospitalized aged.

When a thyroid test was made on all the patients coming to a geriatric department of a hospital, markedly more new cases of hypothyroidism (17 as against 2), and also somewhat more new cases of hyperthyroidism (34 as against 21) were found than when the thyroid test was used only on clinical suspicion of thyroid dysfunction. The authors consider a thyroid test (T4?) worth taking systematically in all aged patients admitted to hospital.

Body weight and the three-year prognosis in very old people.

We studied prospectively the three-year prognosis of persons aged 84-88 years living in their own homes in the city of Tampere, Finland in 1981-84. Out of the target population 722 persons (64 per cent), 181 of them male (25 per cent), participated in the initial survey. A re-examination was carried out annually for the next three years. Increased mortality was observed for subjects with body mass index less than or equal to 22.0 kg/m2, statistically significantly in women but not in men. Mortality was not increased in those with body mass index greater than or equal to 30.0 kg/m2 in either sex. Low body mass index was associated with mortality due to stroke. Low body mass index was related to permanent hospitalization and also to failure to cope with living at home. On average, body weight was somewhat reduced during the follow-up period. Both a loss and a gain in weight by two kilograms or more during the first follow-up year were associated with increased mortality but not with institutionalization during the next two years.

Serum vitamin D level after an annual intramuscular injection of ergocalciferol.

An annual intramuscular injection of ergocalciferol (150,000 IU) normalized low serum (25(OH)D concentrations in elderly people for 1 year. The treatment had a slight effect on serum 24,25(OH)2D levels but no effect on 1,25(OH)2D levels.

Annual injection of vitamin D and fractures of aged bones.

In order to investigate the effect of a supplementation of vitamin D in the prophylaxis of fractures of the bones of aged people, an annual intramuscular injection of ergocalciferol (150,000-300,000 IU) was given to two series of aged subjects: first to 199 (45 male) of 479 subjects (110 male) aged more than 85 years who were living in their own home, and second to 142 (29 male) of 320 (58 male) subjects aged 75-84 and living in a home for aged people. This prospective series was divided into treatment groups according to month of birth. These injections were given annually from September to December in the years 1985-1989, two to five times to each participant. The fracture rates, laboratory values, vitamin D levels, possible side effects, and mortality were followed until October 1990. A total of 56 fractures occurred in the 341 vitamin D recipients (16.4%) and 100 in 458 controls (21.8%) (P = 0.034). The fracture rate was about the same in both outpatient and municipal home series. Fractures of the upper limb were fewer in the vitamin D recipients, 10/341 = 2.9% (P = 0.025), than in the controls, 28/458 = 6.1%, during the follow-up. A similar result was obtained in fractures of ribs, 3/341 = 0.9% and 12/458 = 2.6%, respectively. Fractures of the lower limbs occurred almost as frequently, 31/341 = 9.1%, among the vitamin D recipients as among the controls, 49/458 = 10.7%. The fracture rate was higher in females (22.2%) than in males (9.5%). The fractures were fewer in the vitamin D recipients only in females.(ABSTRACT TRUNCATED AT 250 WORDS)