Geriatrics

Updated: January 2021

Vitamin D, Omega-3 Fatty Acids and Exercise for Disease Prevention in Older Adults

  • A 2020 double-blind, placebo-controlled randomized controlled trial investigated the benefits of vitamin D, omega-3 fatty acids, and exercise in disease prevention in older adults (aged 70+). The 6 primary outcomes were change in systolic and diastolic blood pressure (BP), Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and incidence rates (IRs) of nonvertebral fractures and infections over 3 years. 1900 randomized participants (mean age, 74.9 years; 61.7% women), completed the study (88%). Conclusions: Among adults without major comorbidities aged 70+, treatment with vitamin D3, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function. These findings do not support the effectiveness of these 3 interventions for these clinical outcomes. ABSTRACT

Balance and Fall Prevention

  • A 2020 Cochrane systematic review found that exercise reduces the rate of falls in older adults by 23% overall. Different forms of exercise had different impacts on falls. Compared with control, balance and functional exercises reduce the rate of falls by 24%. Multiple types of exercise (commonly balance and functional exercises plus resistance exercises) probably reduce the rate of falls by 34%. Tai Chi may reduce the rate of falls by 19%. The effects of programs that primarily involve resistance training, dance or walking are uncertain.FREE FULL TEXT
  • A 2020 systematic review assessed physical therapeutic interventions regarding mobility and participation in older patients with vertigo, dizziness, and balance disorders. Interventions included vestibular rehabilitation, computer-assisted training, Tai Chi, canal repositioning maneuvers, and manual therapies, among others. In conclusion, vestibular rehabilitation in any variation (including in addition to canal repositioning maneuvers) appeared to be effective in treating older adults with vertigo, dizziness, and balance disorders. FREE FULL TEXT
  • A 2020 randomized controlled trial evaluated the effects of plantar myofascial mobilization (PMM) on the plantar area, balance, and functional mobility in 45 elderly women. They found that PMM promoted changes in foot structure, as well as improvement in functional mobility and body balance. ABSTRACT

 

Extremities

  • A 2020 randomized controlled trial of 36 participants over the age of 60, with limited ankle mobility, found that six sessions of a talus mobilization-based was superior compared to sham treatment with greatest mobility gain in terms of the weight-bearing ankle dorsiflexion range of motion after the first session. Importantly, the restoration of joint mobility is enhanced over time after the end of the intervention (from 8 degree to 11 degrees). ABSTRACT

Lumbar Spinal Stenosis

  • A 2020 systematic review and meta-analysis of 41 papers estimated prevalence of lumbar spinals stenosis (LSS) with clinical criteria was 11% in the general population and ranged from 25 to 39% in clinical populations. Whereas the prevalence of radiological signs of LSS was 11% in asymptomatic populations, 38% in the general populations and ranged from 15 to 32% in clinical populations. Notable, there was an increase in LSS prevalence by age for both clinical diagnosis and radiological diagnosis with indication that prevalence happens earlier using a radiological diagnosis (around 40 years) compared to a clinical diagnosis (around 50 years). ABSTRACT

Postoperative exercise

  • A 2020 prospective, randomized trial compared the effects of chronic resistance (CR) exercise, chronic aerobic (CA) exercises, and a combination of the two exercise types (CR + CA), and the effects they may have on postoperative function and proinflammatory muscular Toll-like receptor-associated signaling in postoperative elderly patients. All three exercise groups were effective in improving VO2max. The CR and CR + CA groups both improved quadriceps cross sectional area, and maximum knee-extensor force, and lowered muscular proinflammatory signaling markers in this population. ABSTRACT[/restrict]

A literature synthesis of Chiropractic Care in Geriatrics — an academically rigorous analysis of all the available scientific literature using internationally accepted tools to rate each article according to specific criteria indicating only what we can conclude with supportable, scientific evidence.