Original Article
Anti-osteoporosis drugs reduce mortality in cancer patients: A national cohort study of elderly with vertebral fractures
Osteoporotic vertebral fractures (OVFs) are the most prevalent type of fragility fractures, affecting 25% of adults in their early 70s and 43% of those over the age of 80.1,2 Following an OVF, persistence of the vertebral deformity may lead to spinal kyphosis, which is associated with chronic lower back...
Editorial
Anti-osteoporosis drugs and reduction of mortality in cancer patients
Osteoporosis and cancer share a complex relationship, with each condition influencing the progression and outcomes of the other.1 Multiple factors, such as chemo- and hormonal therapies, and the direct invasion of bone tissue by malignant cells contribute to the accelerated bone loss seen in cancer patients.1 Various anti-osteoporosis drugs,...
Letter to the Editor
Impact of an ageing population on the intensive care unit
Dear Editor,
Intensive care unit (ICU) resources are scarce and expensive, and deciding if intensive care is suitable for older patients involves complex clinical reasoning, ethical challenges and cost considerations. Although some studies show that ICU mortality increases with age, others suggest that age alone is not predictive of poor...
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% of emergency department (ED) users and proportionally are the highest users of ED services.2
One-third of community dwellers over 65 years of age fall each year,...
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 Ministry of Health. This life-course approach aims to promote overall healthier living in collaboration with key community partners (e.g. intermediate and long-term care service providers)...
Letter to the Editor
A strategy to make COVID-19 vaccination more accessible to the elderly
Dear Editor,
Singapore embarked on the COVID-19 National Vaccination Programme in early 2021. The main modality employed to achieve the mass vaccinations has been the Vaccination Centres (VCs). These are dedicated facilities created with the sole purpose of providing the public with safe and convenient access to vaccination services.
While the...
Editorial
ICU nutrition: Bracing for the silver tsunami
The global population’s life expectancy is growing with a steady increase in the proportion of older patients admitted to the intensive care unit (ICU).1 Up to 13% of the ICU patients are above the age of 80.2 Older critically ill patients have lower physiological reserves of the various organ...
Original Article
Cost analysis of a Patient-Centred Medical Home for community-dwelling older adults with complex needs in Singapore
The Patient-Centred Medical Home (PCMH) is a model of chronic care that replaces episodic primary care, with the delivery of primary care to patients, families and communities. It is guided by the principles of first-contact accessibility, comprehensiveness and whole-person orientation, integration and care coordination, sustained clinician-patient relationships, and quality...
Letter to the Editor
Knowledge and perception of fall prevention in hospital: A survey of nursing staff
Dear Editor,
Hospital falls are a common debilitating problem worldwide and are associated with negative patient outcomes and increased financial costs to organisations.1,2 While current research has demonstrated the positive impact of a multifaceted fall prevention programme in hospitals, results have been mixed in showing a statistically significant decline...
Review Article
Determinants of emergency department utilisation by older adults in Singapore: A systematic review
Older adults in Singapore contribute to a disproportionately higher number of visits to the emergency department (ED), mirroring trends around the world.1,2 For instance, hospital admissions among those aged ≥65 years have been on the rise from 2018 to 2020, contributing a growing burden to ED services over the...
Original Article
The Profile of Hospitalised Patients with Parkinson’s Disease
Prevalence studies in various parts of the world have shown that Parkinson’s disease (PD) is relatively common among the aged in all countries. Crude prevalence rates range from 10 to 450 per 100 000 population.
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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 from 42,700 in 1985 to 75,500 in 1995.
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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 disease (AD).
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Editorial
Delirium in patients following general anaesthesia
Delirium is a disturbance of consciousness characterised by an acute onset and fluctuating course of inattention, accompanied by either a change in cognition or a disorganised thinking, resulting in an impaired ability of the patient to receive, process, store and recall information. Delirium develops over a short period of...
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 of the population. Owing to their generally poorer health status in terms of chronic illnesses and long-term disability, the elderly consume a disproportionate amount of...
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 and outcome. However, they have not specifically looked into such practice in the elderly.
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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 is estimated to increase from the present 11% to 27% by the year 2030.
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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 a range of serious infections. These included infective endocarditis which had been emphasised in older reports1 but was found to be uncommon in later studies.
This...
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 on falls in community-dwelling elderly, relatively few studies have focused on the problem in institutionalised elderly.
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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. By 2030, there will be 794,000, forming 18.4% of the population.
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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 nursing homes.
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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 population above the age of 65 will rise from 7.5% in 2002 to 18.9% by the year 2030.
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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 States, those who are 65 years and older (geriatric age group) make up 13% of the total population but consume 33% of all prescription drugs.
This...
Original Article
Hip Fractures in the Elderly: The Impact of Comorbid Illnesses on Hospitalisation Costs
Management of hip fractures is costly and continues to generate significant costs throughout the one-year period after discharge.1 They demand considerable resources from a country’s health care system.2,3 Hip fractures are the commonest cause for admission in the acute orthopaedics setting in the elderly.4 As a result of an...
Commentary
A Review of Geriatric Education in Singapore
The United Nations International Plan of Action on Ageing (IPA), formulated during the First World Assembly on Ageing in Vienna in 1982, listed gerontological education at all levels as a priority in order to meet the challenges of global population ageing.1 The Second World Assembly on Ageing held in...
Original Article
Profiling Acute Presenting Symptoms of Geriatric Patients Attending an Urban Hospital Emergency Department
Singapore’s population is ageing rapidly. Today 1 out of every 12 Singaporeans is aged 65 or above. In 2030, it is expected to be 1 out of 5.1 This poses a challenge to our healthcare system especially our emergency departments.
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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 is projected to increase to 20% by the year 2030. The medical community is also faced with a similar problem in caring for an ageing...
Original Article
Clinical Outcome Following Treatment of Stable and Unstable Intertrochanteric Fractures with Dynamic Hip Screw
Intertrochanteric (IT) fracture is among the most common orthopedic injuries in the elderly population, and is associated with osteoporosis. It usually occurs as a result of low energy trauma e.g. trivial falls. It carries considerable morbidity and mortality. In Singapore, there has been an increase in the incidence of...
Original Article
Older Age at Initial Presentation to Human Immunodeficiency Virus (HIV) Care and Treatment at the Communicable Disease Centre (CDC) in Singapore, 2006 to 2011
Since the first case of human immunodeficiency virus (HIV) in Singapore was identified in 1985, the incidence of HIV/acquired immunodeficiency syndrome (AIDS) has steadily increased, reaching a peak rate of 125.2 cases per million population in 2008. From 2006 to 2011, 28.3% of newly diagnosed HIV/AIDS cases in Singapore...
Original Article
Can Preoperative Scoring Systems be Applied to Asian Hip Fracture Populations? Validation of the Nottingham Hip Fracture Score (NHFS) and Identification of Preoperative Risk Factors in Hip Fractures
Osteoporotic hip fractures are common and have significant consequences on mortality and functional capability which indirectly has familial, social and economic repercussions. The inpatient mortality rates approach 4% to 12%, while 1-year mortality is between 12% to 37%.2, Studies from Denmark, Italy, the United Kingdom (UK), and the United...
Review Article
Changing Landscape of Nursing Homes in Singapore: Challenges in the 21st Century
Nursing homes trace their evolution to American alms-houses in the 1930s where retired nurses welcomed the elderly and ill into their homes. In Singapore, community-based charitable organisations pioneered the earliest sheltered accommodations for homeless and destitute elderly immigrants. For instance, the local chapter of the Little Sisters of the...
Original Article
Determinants of Health-Related Quality of Life Among Community Dwelling Elderly
Singapore is experiencing an unprecedented age shift as the post-war baby boomers turn 65 years in 2012. Currently there are 378,700 people aged 65 and above, and these numbers are estimated to go up to 600,000 by 2020. These growing elderly population have multiple coexisting medical conditions which are...
Commentary
Prehabilitation and Its Role in Geriatric Surgery
The population in Singapore is ageing rapidly. According to statistics, by 2030, 1 in 2 adults in Singapore will be >65 years old. As the life expectancy of the population has improved significantly in the past few decades, a substantial portion of this rapidly ageing population will place a...
Letter to the Editor
Congenital adhesion band causing recurrent subacute intestinal obstruction in a virgin abdomen
Intestinal obstruction (IO) caused by malignancy and adhesion bands from previous surgery is common among adults. However, IO caused by congenital adhesion bands (CAB) in the elderly is rare. We report a case of a 63-year-old man who presented with acute-on-chronic intestinal obstruction due to CAB, which caused pseudointestinal...
Editorial
Tackling osteoporosis and fragility fractures in Singapore
A shift in worldwide population ageing demographics has occurred in the 21st century. The longevity miracle is most keenly felt in Singapore, a young nation which gained its independence only in 1965, but has one of the fastest growing ageing populations in the world. It is estimated that by...