Very old persons often have chronic problems, such as physical immobility, unsteady gait, and mental impairments. In such patients, these risks have to be considered and their treatments adapted accordingly.
Deutsches Ärzteblatt International in its current issue introduces two original articles on the subject of geriatric medicine. The study reported by Wolfgang von Renteln-Kruse et al. (Dtsch Arztebl Int 2015; 112: 103) investigated the clinical treatment of geriatric patients with cognitive impairment, who require an appropriate environment and appropriate care. Stefan Grund et al. (Dtsch Arztebl Int 2015; 112: 113) in their study analyzed the concept of a center for geriatric traumatology, to provide care for elderly people who have had accidents resulting in leg fractures, which required inpatient treatment.
Acute older patients who are admitted to the hospital--for example, for infections or cardiocirculatory disorders--often have comorbidities, such as cognitive deficits or dementia. Such comorbidities will have to be considered and treated during inpatient stays. As von Renteln-Kruse et al. showed in their study of a cognitive geriatric ward for, structured and occupational therapy can improve patients' activities with relevance to their everyday lives and--as far as possible--reduce their regular medications.
Fractures resulting from falls are a common disease pattern in geriatric patients. Grund et al. investigated how a center for geriatric traumatology can improve the care provided to such patients. The crucial issue is that such patients receive treatment simultaneously from a trauma surgeon and a geriatrician, from admission to discharge. The study shows that far fewer patients who had received such therapy were admitted to intensive care wards, and that their in-hospital mortality was lower than was the case for patients receiving conventional care. Even though the average duration of hospital stays increased as a result of this treatment concept, the authors emphasize the benefits for the patients.