Letter to the Editor
Emergency department falls interventions improve osteoporosis management in frail older adults
Dear Editor,
Singapore’s population is ageing rapidly and by 2030, around 1 in 4 citizens will be aged 65 and above.1 Older adults represent 21–40%...
Letter to the Editor
Eosinophilic esophagitis and immunoglobulin E-mediated food allergy
Dear Editor,
Food allergy (FA) is an adverse reaction to a specific food antigen—normally harmless to the healthy population—which is mediated by immunological mechanisms and...
Original Article
Transitional care strategies at emergency department for elderly patients: A multicentre study in Singapore
In Singapore, greater efforts are being directed towards developing an integrated health and social ecosystem under the new Healthier SG strategy announced by the...
Review Article
Nutrition therapy in the older critically ill patients: A scoping review
The increasing levels of life expectancy and decreasing fertility are shifting the age structure of the world population towards older ages.1 From year 2020...
Original Article
A Descriptive Study of the Demography, Symptomology, Management and Outcome of the First 300 Patients Admitted to an Independent Hospice in Singapore
Modern society views death as an aberration which has to be postponed and, if possible, prevented at all cost. Death is just unacceptable and...
Original Article
Day Hospital Rehabilitation for the Elderly: A Retrospective Study
Alexandra Hospital is the first hospital in Singapore with a Day Hospital for the elderly. One of the main functions of the Day Hospital...
Original Article
Self-Perception of Health among Elderly Community Dwellers in Singapore
The single most important determinant of the quality of an elderly person’s life is health. In the elderly, health matters affect all other areas...
Others
Musculoskeletal Pain Clinic in Singapore—Sacroiliac Joint Somatic Dysfunction as Cause of Buttock Pain
Patient A, a 33-year-old male administrative coordinator presented with left buttock pain of 4 to 5 years duration which radiated down to the leg...
Others
A Case Report of Adult T-Cell Leukaemia/Lymphoma (ATLL)
Our patient was a 71-year-old Chinese man who presented with a 6-year history of recurrent papular erythematous eruptions to the dermatologist.
This article is available...
Others
Chryseobacterium meningosepticum (Flavobacterium meningosepticum)—A Report of Five Cases in a Local Hospital
Chryseobacterium meningosepticum has been known to be a causative agent of meningitis particularly in the premature and newborn infants. The first case of human...
Others
Disseminated Penicillium marneffei Infection: A Report of Five Cases in Singapore
Penicillium marneffei is a dimorphic fungus that can cause infection in immunocompromised hosts. Reports on infection with this organism were initially uncommon, but after...
Others
Bilateral Caudate Infarct—A Case Report
The head of caudate nucleus forms a prominent bulge in the lateral wall of the anterior horn of the lateral ventricle. Its blood supply...
Review Article
Diagnosing and Managing Faecal Incontinence
Faecal incontinence is the inability to control the passage of gas, liquid or solid through the anus. Its severity varies from infrequent passage of...
Original Article
Perceived Need for Community Geriatric Services: A Survey at a Regional Hospital in Singapore in an Inpatient Setting
Singapore has one of the most rapidly ageing populations in the wor1d. The number of the very aged (>75 years old) has already increased...
Original Article
Swallowing Impairment and Feeding Dependency in the Hospitalised Elderly
Loss of ability to feed independently and swallowing impairment are common problems in the elderly and will be an increasing cause of disability as...
Original Article
Direct Mucosal Targeting of Colonic Receptors by Prokinetic Drugs in an Experimental Model
The direct intraluminal (IL) administration of drugs into the intestine may have an important regional action and therefore clinical implications in the effective management...
Original Article
The Reliability and Validity of the Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the Elderly Chinese in Hong Kong
The Alzheimer’s Disease Assessment Scale (ADAS) is a 21-item scale designed to assess the severity of cognitive and non-cognitive impairment in patients with Alzheimer’s...
Others
Proteinuria and Angiotensin Converting Enzyme (ACE) Gene Polymorphism
Proteinuria is considered a marker of renal disease. Traditionally it has been thought that proteinuria is the result of diseased glomeruli.
This article is available...
Others
The Current State of Multiple Sclerosis Genetic Research
It was Charcot (1868) who first made the formal pathological correlation between lesions in the central nervous system (CNS) and a disorder termed, ‘la...
Others
Cardiovascular Disease: Genes and Public Health
The excitement surrounding the Human Genome Project and its impending completion has raised expectations of the possibilities for genetics in common disease. It is...
Original Article
Screening for Hearing Impairment in Hospitalised Elderly
The prevalence of hearing impairment in the local elderly population is not known. Hearing loss prevalence estimates that 25% to 40% of individuals over...
Original Article
End-of-life Issues—Preferences and Choices of a Group of Elderly Chinese Subjects Attending a Day Care Centre in Singapore
Doctors caring for elderly, dying and terminally ill patients are often faced with the dilemma of having to make difficult decisions especially regarding treatment...
Commentary
Preparing for the silver boom: A falls prevention tool for older adults in the emergency department
Each year, 28–35% of community dwelling adults over 65 years fall.1 This figure increases to about 50% for those above 80 years old.2 Falls...
Original Article
Critical Role of Functional Decline in Delayed Discharge from an Acute Geriatric Unit
In the last decade, many countries have experienced alarming transformation in their demographic patterns, with the elderly population emerging as the fastest growing segment...
Original Article
Urinary Retention in Hospitalised Older Women
Voiding dysfunction is a relatively common problem in hospitalised older patients. Up to one-third of hospitalised elderly were reported to have post-void residual urine...
Original Article
Body Mass Index and Its Related Factors in the Elderly
Cardiovascular disease is one of the leading causes of mortality and morbidity in developed countries, especially among the elderly. In Taiwan, cardiovascular disease is...
Review Article
Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci: Emerging Problems and New Prospects for Management
The prevalence of nosocomial infections due to Gram-positive bacteria has increased dramatically over the last two decades. In North America, Gram-positive cocci now are...
Original Article
The Practice of Foregoing Life Support in the Critically Ill “Old Old”: A Singapore Perspective
Studies on the foregoing of life support (FLS) in North America, Europe and Australia have shown diversity in terms of the incidence, decision-making process...
Original Article
Early Unplanned Readmission of Elderly in Singapore: A Retrospective Study
The number of elderly people in Singapore is expected to increase over the next 2 decades. The proportion of those 60 years and above...
Review Article
Current Understanding of Pre-eclampsia
Pre-eclampsia is a major cause of adverse obstetric outcome. It remains one of the leading causes of maternal mortality1 and continues to contribute significantly...
Original Article
Epidemiology of Beta-haemolytic Group G Streptococcal Bacteraemia in Singapore (1996 to 1998)
Human isolates of group G streptococci (GGS) that form large colonies are similar to group A streptococci (GAS) in terms of virulence and cause...
Original Article
Correlates of Habitual Walking and Sports/Leisure-time Physical Activity in Older Persons in Singapore: Interaction Effects Between Educational Attainment and Gender
Physical inactivity has been identified as a major cause of morbidity and mortality secondary to cardiovascular disease, diabetes mellitus and hypertension. It contributes to...
Original Article
Nursing Home Falls: A Local Perspective
Falls in the elderly has been a well-studied subject and now occupies an important place in geriatric medicine. While many studies have been done...
Original Article
Bedside Clinical Methods Useful as Screening Test for Aspiration in Elderly Patients with Recent and Previous Strokes
Cerebrovascular disease is the fifth commonest cause of hospitalisation in Singapore, and accounts for 2.7% of all hospital discharges. Neurogenic dysphagia is a common...
Review Article
End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy
A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch...
Review Article
Considerations in the Assessment and Management of Older People with Chronic Pain
Persistent pain has been estimated to occur in 50% of community dwelling older people of age 65 years and above. It has been associated...
Review Article
Late-life Depression: Current Issues and New Challenges
Depression in late life (>60 years old) is one of the most common and treatable psychiatric disorders in the elderly. It not only causes...
Review Article
Neurofibrillary and Ethico-legal Tangles: In Search of Surrogates for Dementia Patients Lacking Decision-making Capacity and Relatives
Dementia is an age-prevalent chronic degenerative disease that causes gradual and progressive deterioration of a patient’s cognitive abilities. With Singapore’s rapidly ageing population, the...
Review Article
Assessing Decision-making Capacity in Dementia Patients: A Semi-structured Approach
Given the rapid ageing of Singapore, all practising clinicians can expect to see an exponential rise in the medical and surgical problems of the...
Review Article
An Evidence-based Clinical Approach to the Diagnosis of Dementia
The prevalence of dementia or cognitive impairment in local studies has been shown to range from 2% to 13%. These differences in prevalence rates...
Review Article
Urinary Incontinence in Older Persons: A Simple Approach to a Complex Problem
Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and is a social or hygienic problem. Trivial as it may sound,...
Review Article
The Development of Geriatric Psychiatry Services in Singapore
The population of Singapore is ageing. In 2002, it was estimated that there were 252,700 persons aged >65 years, forming 7.5% of the population....
Review Article
Aged Care Issues and Services in Australia
In Australia, the number of elderly people is increasing rapidly. In 2001, the population of Australia was approximately 19 million people and about 12.6%...
Review Article
Aged Care Services in Singapore – An Overview
The last century has witnessed the establishment of geriatric medicine as a well-recognised medical specialty supported by a respectable body of evidence, which shows...
Editorial
Challenges in Geriatric Medicine: Geriatric Services and Education
Ignatz Nascher first proposed disease and medical care of the aged as a separate specialty and invented the term “geriatrics” in 1909. However, the...
Others
Emergency Department Usage by Community Step-Down Facilities – Patterns and Recommendations
It is projected that elderly persons will make up 18.4% of Singapore’s population by the year 2030. Currently, there are 5189 residents staying in...
Others
Critically Ill Elderly Who Require Mechanical Ventilation: The Effects of Age on Survival Outcomes and Resource Utilisation in the Medical Intensive Care Unit of a General Hospital
Increasing life expectancy and ageing of the “post-war baby boomer” generation have led to the rapidly ageing demographic of many Asian countries. Singapore’s elderly...
Original Article
Thyroid Dysfunction in Elderly Patients
Symptoms and signs of thyroid dysfunction in the elderly tend to be atypical and may be mistakenly attributed to the ageing process. Currently, thyroid...
Original Article
Improving the Diagnosis Related Grouping Model’s Ability to Explain Length of Stay of Elderly Medical Inpatients by Incorporating Function-linked Variables
Casemix refers to the numbers and types of patients within a healthcare setting and Diagnosis Related Groupings (DRGs) represent one mode of classifying casemix....
Original Article
Cyclosporin in the Treatment of Severe Atopic Dermatitis: A Retrospective Study
Cyclosporin is a potent immunosuppressant that inhibits cell-mediated immunity, mainly via inhibition of T helper cells. It has been used successfully in the treatment...
Original Article
Impact of a Pharmacist Consult Clinic on a Hospital-based Geriatric Outpatient Clinic in Singapore
A general philosophy in the care of elderly patients is to use the least drugs possible to achieve the desired clinical outcome. In the...
Original Article
Polypharmacy and Inappropriate Medication Use in Singapore Nursing Homes
The elderly usually have multiple medical problems, requiring prescription drugs to treat diseases and to prevent complications arising from them. Currently, in the United...
Review Article
Neural Progenitor and Stem Cells in the Adult Central Nervous System
Seminal studies in the 1960s, using -thymidine autoradiography, reported that neurogenesis occurs in discrete areas of the adult mammalian brain, in rodents. Studies in...
Original Article
A Study on the Knowledge, Attitudes and Practices of Southeast Asian Dermatologists in the Management of Atopic Dermatitis
Atopic dermatitis (AD) is a chronic and pruritic inflammatory skin disorder that occurs worldwide. Several guidelines on the management of AD have been published...
Others
3rd College of Physicians’ Lecture – Translational Research: From Bench to Bedside and From Bedside to Bench; Incorporating a Clinical Research Journey in IgA Nephritis (1976 to 2006)
In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the...
Original Article
Utility and Validity of the Self-administered SF-36: Findings From an Older Population
The shift towards broader health perspectives and the emphasis on patient preferences have led to the development of many health questionnaires and their inclusion...
Original Article
Evaluation of Dementia: The Case for Neuroimaging All Mild to Moderate Cases
Dementia has been reported to affect 4% to 13% of individuals above the age of 65, with the difference in prevalence rates being dependent...
Original Article
Are Sensory and Cognitive Declines Associated in Older Persons Seeking Aged Care Services? Findings From a Pilot Study
Many cross-sectional and longitudinal studies have reported an association between sensory and cognitive functions in the normal ageing population. Few studies have assessed the...
Original Article
Factors Causing Delay in Discharge of Elderly Patients in an Acute Care Hospital
With the introduction of block budget for acute care hospitals, cost containment is an important issue for all secondary and tertiary hospitals. Though health...
Original Article
Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit
Hospitalisation is a stressful event for the older person. The physiological changes associated with ageing, such as decreased muscle strength and aerobic activity, reduced...
Original Article
Attitudes of First-year Medical Students in Singapore Towards Older People and Willingness to Consider a Career in Geriatric Medicine
With the exponential increase in the elderly population in Singapore, the training of young physicians of tomorrow in the care of elderly patients will...
Review Article
The Emerging Challenge of Age-related Eye Diseases in Singapore
Singapore has one of the fastest ageing populations in the world today. The current elderly population, defined as persons 65 years or older, comprises...
Editorial
Alzheimer’s Disease – Towards More Patient-centred and Meaningful Clinical Outcomes
More than 100 years ago Alois Alzheimer first presented the clinical and pathological features of an unusual brain disease at his seminal lecture in...
Review Article
Health-related Quality of Life in Patients with Systemic Lupus Erythematosus: An Update
Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease associated with significant morbidity and mortality. With improvements in survival in SLE, attention has also...
Original Article
Resource Consumption in Hospitalised, Frail Older Patients
The number of older adults in Singapore has been steadily increasing over the years and will continue to do so. In 2007, older adults...
Original Article
Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden
Dementia is a growing public health issue in the Asia-Pacific region. The number of people with dementia in the Asia-Pacific region will increase from...
Review Article
Potential Endophenotype for Schizophrenia: Neurological Soft Signs
The past decades have witnessed many research endeavours to understand neurological soft signs (NSS) in schizophrenia and its related disorders. These efforts mainly focused...
Original Article
Validity and Reliability of the Expectations Regarding Aging (ERA-12) Instrument among Middle-Aged Singaporeans
With increasing life expectancy and low fertility rates, the proportion of the elderly is rapidly increasing in developed nations, Singapore being no exception. The...
Original Article
Prevalence of Metabolic Syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions and their Association with Coronary Heart Disease in an Elderly Iranian Population
Coronary heart disease (CHD) is one of the most common causes of morbidity and mortality in different communities.1,2 Despite the lack of accurate data,...
Original Article
Junior Doctors’ Attitudes Towards Older Adults and its Correlates in a Tertiary-care Public Hospital
Singapore is a rapidly ageing society. The proportion of older persons above the age of 65 was 6.8% of the population in 1995 and...
Original Article
Presentation and Outcome Amongst Older Singaporeans Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS): Does Age Alone Drive Excess Mortality?
Singapore is a country of high income with a low level human immunodeficiency virus (HIV) epidemic, the yearly incidence of disease currently standing at...
Editorial
Successful Ageing in Singapore—A Viable Goal?
Ageing is a complex process. Achieving it successfully has implications and significance not only for individuals on a personal level but for society at...
Commentary
Projecting the Number of Older Singaporeans with Activity of Daily Living Limitations Requiring Human Assistance Through 2030
Similar to other developed countries in Asia, including Japan, South Korea and Taiwan, the population of Singapore is ageing rapidly. In 2011, 9.3% of...
Original Article
Unipolar versus Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly: Is There a Difference?
Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. The advantages of hemiarthroplasty over internal fixation include earlier mobility, less reoperations and better...
Letter to the Editor
Diagnosing Bacteraemia Early in Older Adults
Sepsis is a prevalent and important cause of morbidity and mortality in the general population. Approximately 750,000 patients in the United States alone develop...
Original Article
Anti-BP180 NC16A IgG Titres as an Indicator of Disease Activity and Outcome in Asian Patients with Bullous Pemphigoid
Bullous pemphigoid (BP) is a subepidermal blistering dermatosis characterised by circulating autoantibodies targeting BP180 and BP230 hemidesmosomal proteins. Anti-BP180 NC16A IgG antibodies have been...
Editorial
A Decade of Progress in the Understanding, Prevention and Treatment of Age-related Macular Degeneration in Singapore
The year 2014 had marked the 10th anniversary of the nationwide Age-related Macular Degeneration (AMD) Awareness Week in Singapore.1 This public health campaign, organised...
Editorial
Evidence-balanced Medicine: “Real” Evidence-based Medicine in the Elderly
Case 1: An 85-year-old male with past history of hypertension is otherwise healthy and enjoys his daily walks and good food. During a health...
Editorial
The Greying Pandemic: Implications of Ageing Human Immunodeficiency Virus-Positive Population in Singapore
Human immunodeficiency virus (HIV) remains a global public health issue. It is estimated that there are 37.9 million people living with HIV (PLHIV) today....