[Parkinson's disease]. / Parkinson-Krankheit.

Parkinson's disease (PD) is an unparalleled example of a neurodegenerative disorder that can be effectively managed leading to sustained symptom control and quality of life. The cooperation of neurologists with general practitioners, gastroenterologists, and geriatricians is of increasing importance for an optimized management of PD. New diagnostic criteria for PD and for atypical Parkinsonism, which should be considered in the differential diagnostics, include non-motor symptoms and aim to diagnose these disorders as early as possible. Recent research has shown that there are highly complex and clinically relevant interactions with PD at all levels of the gastrointestinal tract, which have been increasingly better understood and have direct clinical relevance. Novel dopaminergic treatment approaches focus on circumvention of the impaired gastrointestinal tract of PD patients. The management of geriatric PD patients and PD dementia requires specific clinical knowledge. Worldwide, PD has emerged as a model disease for the development of network structures for the treatment of chronic neurological diseases.

European postgraduate curriculum in geriatric medicine developed using an international modified Delphi technique.

BACKGROUND: the European Union of Medical Specialists (UEMS-GMS) recommendations for training in Geriatric Medicine were published in 1993. The practice of Geriatric Medicine has developed considerably since then and it has therefore become necessary to update these recommendations. METHODS: under the auspices of the UEMS-GMS, the European Geriatric Medicine Society (EuGMS) and the European Academy of Medicine of Ageing (EAMA), a group of experts, representing all member states of the respective bodies developed a new framework for education and training of specialists in Geriatric Medicine using a modified Delphi technique. Thirty-two expert panel members from 30 different countries participated in the process comprising three Delphi rounds for consensus. The process was led by five facilitators. RESULTS: the final recommendations include four different domains: 'General Considerations' on the structure and aim of the syllabus as well as quality indicators for training (6 sub-items), 'Knowledge in patient care' (36 sub-items), 'Additional Skills and Attitude required for a Geriatrician' (9 sub-items) and a domain on 'Assessment of postgraduate education: which items are important for the transnational comparison process' (1 item). CONCLUSION: the current publication describes the development of the new recommendations endorsed by UEMS-GMS, EuGMS and EAMA as minimum training requirements to become a geriatrician at specialist level in EU member states.

Development and validation of the Patient Benefit Index for the dermatocosmetic treatment of aged skin.

This study aimed to develop and validate an instrument for the assessment of patient-relevant benefit in dermatocosmetic treatment, i.e., skin care, of aged skin. Based on an open item collection with 33 elderly persons, items on patient-relevant treatment goals were collected. An expert panel selected 20 items to be most relevant and feasible for the questionnaire named Patient Benefit Index for Aged Skin (PBI-AS). The instrument, which assesses goal importance and achievement, was tested in a cognitive debriefing and validated in a longitudinal study (n = 80) along with the Dry Skin Area and Severity Index (DASI) and the Dermatology Quality of Life Index (DLQI) as convergent validation criteria. The cognitive debriefing showed the good practicability and feasibility of the instrument. Significant correlation with change in DASI (r = -0.527; p < 0.001) supports convergent validity of the PBI-AS. By contrast, correlation with DLQI was poor, indicating the different constructs. The PBI-AS is a valid and feasible tool for the patient-centered assessment of dermatocosmetic treatment benefit in aged skin.

A Long-Term Study to Evaluate Acidic Skin Care Treatment in Nursing Home Residents: Impact on Epidermal Barrier Function and Microflora in Aged Skin.

BACKGROUND: The pH of the stratum corneum (SC) in the elderly is elevated and linked to impaired SC function. Therefore, this paper addresses the question of whether acidic skin care generates positive clinical, biophysical, and microbiological effects in aged skin. METHODS: This study was performed to assess skin care effects in nursing home residents (aged 80-97 years). Visual, biophysical, and microbiological methods were used. Subjects were randomly assigned to 1 of 2 groups and treated over 7 weeks with skin care products adjusted to a pH of 4.0 (group A) or a pH of 6.0 (group B). RESULTS: Compared to baseline, SC integrity improved significantly in group A (p = 0.007), whereas there was no change in group B (p = 0.672). SC recovery 24 h after perturbation increased significantly in group A (p = 0.004) compared to baseline. The SC recovery in group B was not significant compared to baseline (p = 0.327). CONCLUSION: Long-term treatment with pH 4.0 skin care results in a significant improvement in epidermal barrier function compared to identical products with a pH of 6.0. In addition, effects on skin dryness and resident flora were demonstrated, but without significant differences, between the 2 groups. Based on these results, we recommend adjustment of skin care products for the elderly to a pH of 4.0 to maintain the health of aged skin. © 2015 S. Karger AG, Basel.

[The situation of elderly patients]. / Situation des alteren Patienten.

Elderly and old tumour patients differ very much individually and a broad range of variation is even to be observed in patients of the same age group. But these patients differ from younger patients in many respects: This concerns the process of treatment decision and the expectations of the therapy on the one hand. Relevant differences with regard to younger patients exist also because of the age-related physiological changes and frequent age-typical comorbidities which may increase the toxicity of a therapy and the surgery-associated morbidity and lethality because of a decreased functional reserve capacity.