© Geriatric Times. All rights reserved.

Innovations

by Geriatric Times Staff

Geriatric Times

November/December 2001

Vol. II

Issue 6

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New Medication Guide Available for Healthy Aging

As part of their Healthy Aging Program, Merck-Medco recently published Medication Guidebook for Healthy Aging. Geared for those aged 55 years and older, this guidebook can help patients make sense of the growing number of pharmaceuticals that might be prescribed for them.

The 800-page guidebook is divided into three sections: facts common to many medications; medical problems and the medications (including over-the-counter) often used to treat them; and the reference guides and index, which offer medication listings, definitions of medical terms and other useful references. To address the growing concern of adverse drug reactions, each chapter explicitly outlines potential effects associated with the medications. Readers are reminded throughout the book to consult a physician or health care professional regarding side effects that bother them, do not go away or cause them to discontinue their medication.

"Today, we have a greater number of people taking a greater number of newer medications over longer periods of time," Lester Paul, M.D., M.S., co-editor of the guidebook, said in a statement to the press. "This taken together with an aging population makes it important to educate people on the safe use of medication and advise them of the real dangers that an adverse drug event could pose" -- AV

Tracking Systems To Help Find Patients With AD

Over half of people with Alzheimer's Disease (AD) are likely to wander, according to Brian Hance, director of Safe Return. Two programs have been initiated that will help in locating these individuals.

Safe Return, initiated by the national Alzheimer's Association, is a registry program that files information and pictures of its participants. As soon as Safe Return is notified of the missing person, their information and photograph are faxed to local law enforcement agencies. Safe Return also offers family support until the person is found. Patients registered with Safe Return wear or carry Safe Return's toll-free number, which allows anyone who finds the missing person to help return them home.

The Digital Angel Senior System is a tracking device in the form of a wristwatch and pager that uses global positioning system technology to detect a person's whereabouts. The biosensors in the wristwatch can transmit the wearer's vital signs as well, and the watch can be equipped to detect whether the person is upright, in the process of standing or has fallen. The watch also has an emergency button that can be used to contact the call center and emergency medical services.

An Alzheimer's Association representative said studies have shown that almost half of patients with AD who were not found within 24 hours died of dehydration and/or hypothermia. These new programs and devices can help eliminate these possibilities -- RR

Meal Kit Makes Preparing for Colonoscopy Easier

Patients preparing for a colon examination are restricted to a liquid diet two to three days prior to the procedure in order to clear the colon so it may be accurately evaluated. Patients may also need to take laxatives or recieve an enema before the procedure. Many patients find it hard to comply with this advice and eat food that leaves too much residue in the bowel.

The NutraPrep meal kit, designed by E-Z-EM Inc., contains low-residue foods that replace the liquid diet. The meal kit is intended to provide essential nutrition while significantly reducing the amount of residue remaining in the bowel after digestion, in addition to providing patients a tolerable, easy-to-comply-with regimen.

The meal kit contains a full day's worth of an assortment of foods. The kit also includes a patient instruction booklet, and each food item is labeled for use at either breakfast, lunch or dinner.

In a pilot study to assess the efficacy of NutraPrep, 36 patients were randomized to one of three bowel preparations one day before colonoscopy: the first group received the NutraPrep meal kit and a laxative preparation; the second received a modified version of NutraPrep, including only liquid foods, and a laxative; and the third group received treatment as usual, which consisted of a clear liquid diet in addition to a double dose of sodium phosphate solution.

Evaluators found that 50% of patients on the clear liquid diet had significant amounts of retained residue, while only 25% of patients using the NutraPrep kit had residue. Overall quality of bowel preparation was rated at 66.7% for those taking the NutraPrep, compared to 33.3% for those on the clear diet.

The American Cancer Society estimates that 98,200 new cases of colon cancer will be diagnosed in the United States this year. An accurate colonoscopy can detect cancer, precancerous lesions and other abnormal growths -- JH

Portable Walkway System Objectively Measures Gait

Gait deviation may predict an increased risk of falls and may be due to muscle weakness, joint instability, acute or chronic injuries, or other problems. Proper diagnosis and treatment rely on accurate gait measurement, which is often based on subjective visual assessment. The GAITRite portable electronic walkway system provides objective reliable measurements of spatial and temporal gait parameters.

After several gait cycles, compensatory mechanisms, inconsistencies and asymmetries are recorded with GAITRite, capturing the relative arrangement, geometry and applied pressure of each footfall. The data are processed into footfall patterns and to produce individual, comparison to norms and outcome reports. The system measures cadence, step length, velocity and Functional Ambulation Performance (FAP) score.

An electronic walkway that connects to a Windows PC port, GAITRite contains sensor pads in a roll-up carpet. It can be utilized by patients with or without shoes; by those using assistive devices such as canes, crutches and walkers; and without placing any devices on patients themselves. Immediate pre- and post-treatment feedback is provided, allowing an objective measure of walking function and fall risk -- EAD