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Biomedical subjects

H C Hanger

Publications and source records attributed to H C Hanger.

33 records · Page 2Linked to original sources
PubMed1993

The costs of returning home.

AIMS: To measure the use, and the financial cost to the patient, of medical and domiciliary services, in an elderly population following discharge from hospital. To estimate the effect of recent changes in Accident Compensation Corporation (ACC), Disabled Persons Community Welfare Act (DPCW) interpretation and user part charges on those costs. METHODS: Elderly patients discharged home from hospital were visited 3 months following their discharge. The use of medical services and pharmaceuticals, receipt of formal domiciliary support services and adaptive equipment was recorded, together with the cost to the patient of each. RESULTS: Ninety-four (88%) of 106 eligible patients were visited. Fifty percent lived alone and 77% were solely reliant on state benefits for income. Forty (42%) received meals on wheels, 64 (68%) domestic help and 42 (45%) district nursing. Most (86%) required the use of a walking aid and 77 (82%) needed further adaptive equipment to return home. The mean cost to the patient was $541.40 for the first 3 months. Changes in the funding of community supports would add an average of $60.38 (11.2%) to this cost. CONCLUSION: Elderly patients recently discharged from hospital are high users of domiciliary support services. Any changes to their funding need monitoring to determine the effects on utilisation, costs and health status for the patient.

Aftercare↗
PubMed1993

Lipid, lipoprotein and apolipoprotein distributions in an elderly New Zealand population.

The aim of this study was to determine the lipid, lipoprotein and apolipoprotein distribution in an ambulant elderly New Zealand population, and to consider the association between these and other variables (including body mass index, diabetes mellitus, and smoking history) with the prevalence of manifest macrovascular disease in a cross-section analysis. The population sample was randomly selected from the age/sex register of a large urban medical centre in Christchurch, New Zealand. A total of 369 subjects (participation rate 69%) aged 65 years and older were screened for manifest macrovascular disease, diabetes mellitus, smoking status, height and body weight. Levels of plasma total cholesterol, triglycerides, HDL cholesterol, apolipoproteins AI and B, glucose, glycated haemoglobin and fibrinogen were measured. Three way analysis of variance (ANOVA) was used to compare continuous variables across age/sex/macrovascular disease groups. Females had significantly higher levels of total and HDL cholesterol, apolipoproteins AI and B than males. Body mass index showed a significant decrease with increasing age. Macrovascular disease was manifest in 24% of males, and in 26% of females. No direct correlation was seen between any of the measured continuous variables and the presence of macrovascular disease, except for fibrinogen (P < 0.05). No significant association was seen between macrovascular disease and smoking status, nor with a diagnosis of diabetes. In females, the frequency of macrovascular disease was significantly higher amongst those with low (< 1.00 mmol/L) levels of HDL.

Age Factors↗
PubMed1993

Questions people ask about stroke.

BACKGROUND AND PURPOSE: We sought to identify the type and frequency of questions asked about stroke by patients, relatives, and caregivers. METHODS: All stroke-related inquiries made to Stroke Association Advice Centers in the United Kingdom during a 4-month period were recorded. RESULTS: During the study period, 1,397 people asked 1,908 questions. Nearly one quarter needed more information about the nature of stroke. The other most common inquiries concerned help at home (with many expressing concern about their current level of community support), requests for information about stroke clubs, speech difficulties, rehabilitation, personality changes, and depression. CONCLUSIONS: Knowledge of the questions asked should enable health professionals to provide better information to stroke victims and allow modification of stroke information pamphlets.

Age Factors↗
PubMed1992

A comparison of elderly patients with proximal femoral fractures and a normal elderly population: a case control study.

AIM: To assess the importance of bone density and other risk factors in elderly subjects with hip fractures. METHOD: Thirty-six subjects with femoral neck fracture were compared with 72 community controls in this case control study. Variables compared included: history of falls, previous fracture, body mass index, hand grip strength, blood pressure, medication use, cigarette smoking, alcohol intake, visual acuity, age at menopause, mental status quotient, mobility index and mid thigh circumference. Bone mineral density was measured at the hip (DPA absorptiometer) in the 36 subjects with hip fracture and 36 community controls. RESULTS: Fracture patients had significantly (p < 0.01) reduced bone mineral density at femoral neck (0.64 vs 0.74 g/cm2) and trochanteric regions (0.55 vs 0.66 g/cm2). They also had significantly (p < 0.05) lower body mass index, weaker hand grip strength, smaller mid thigh circumference, reduced mobility and more previous fractures. After controlling for age and sex stepwise logistic regression identified handgrip strength, mobility status and falls in that ranking as risk factors for fracture. Bone mineral density was correlated with mobility status and grip strength. CONCLUSION: Patients with hip fracture have lower bone mineral density than controls. Mobility, grip strength and muscle bulk appear to be important in fracture aetiology and could operate either through bone density or risk of falling.

Accidental Falls↗
PubMed1992

Prevalence of diabetes mellitus in an ambulant elderly New Zealand population.

The prevalence of diabetes mellitus (both known and previously undiagnosed) was studied in a population sample, predominantly Caucasoid and resident in the community with an age/sex distribution representative of the New Zealand population aged 65 + years, using WHO criteria. The population sample was randomly selected from the age/sex register of a large urban medical centre in Christchurch, New Zealand. Three hundred and sixty-nine subjects (participation rate 69.4%) were screened by casual glucose and glycated haemoglobin measurement, followed by oral glucose tolerance testing (OGTT) if one or both were elevated. The minimum prevalence rate of diabetes in the study sample was 17.2 +/- 3.3% in men and 12.5 +/- 2.2% in women (since not all patients underwent OGTT). The rate was only significantly higher in men than women in the 70-74 year age group (P less than 0.01). The combined age-adjusted prevalence rates for the New Zealand elderly are estimated to be 9.9% known diabetes, 5.0% previously undiagnosed, with the total prevalence rate 14.9%. Newly diagnosed subjects had a significantly higher body mass index than known diabetic or non-diabetic subjects (P less than 0.01). Eighty-two percent of newly diagnosed subjects had visited their general practitioner at least once during the previous 6 months. Measurement of glycated haemoglobin had a greater positive predictive value than casual blood glucose in the detection of new cases. There was no difference in frequency of attendance with general practitioners or in hospital admission rates between non-diabetic patients, or those with known or newly diagnosed diabetes. This study suggests that diabetes mellitus may be a prevalent disorder amongst the New Zealand elderly.

Age Factors↗
PubMed1991

Erythrocyte sedimentation rates in the elderly: a community study.

One hundred and ninety-four elderly subjects living in the community were randomly selected in order to define a reference range for erythrocyte sedimentation rate (ESR) for this age group. Mean (S.D) values were 4.1 (2.9) mm in one hour and 7.2 (2.6) mm in one hour for men and women respectively. Values ranged from 0-44 mm in one hour. The ESR showed significant independent correlations with fibrinogen, haemoglobin (male and female) and albumin levels (male only). A new algorithm for determination of the upper limit of normal for age is proposed: Females ESR = Age/3 + 10 Male ESR = Age/3.

Age Factors↗
PubMed1991

A community study of vitamin B12 and folate levels in the elderly.

OBJECTIVE: To measure the prevalence of low serum vitamin B12, folate, and red cell folate levels and their relationship with other nutritional indices. DESIGN: Prospective survey of elderly subjects using radioisotope dilution assays. SETTING: Primary care medical center, Christchurch, New Zealand. PATIENTS: 257 elderly subjects (age 65 years and over), residing in their own homes or in residential homes, were randomly selected. Of these, 204 (79%) participated. The study population was comparable to the elderly population of New Zealand. MAIN OUTCOME MEASURES: Vitamin B12, serum, and red cell folate levels. RESULTS: The prevalence rates for low levels of serum vitamin B12, folate, and red cell folate were 7.3%, 1%, and 3.3%, respectively. The elderly cohort had lower vitamin B12 (P less than 0.001) but higher serum and red cell folate levels (P less than 0.001) than our normal reference range (age 18-65 years). Red blood cell folate levels showed positive correlations with nutritional indices and mental test scores. No correlations were found between vitamin B12 levels and diet or other nutritional indices. CONCLUSIONS: Low folate levels in older people living at home are infrequent findings. In contrast low vitamin B12 levels are more common. Poor diet and undernutrition may contribute to low folate levels, but these factors are less important for the low B12 levels found.

Aged↗
PubMed1990

Screening the elderly: a Christchurch study.

Two hundred and four people aged 65 year or older participated in a study to assess the merits of screening the elderly in a general practice. An average of 4.6 (SD 2.2) problems per patient were found. There was a mean of 1.1 (1.0) previously unrecognised problems per patient. Visual and hearing impairment, prostatism, incontinence and some neurological conditions were the main unrecognised problems. Those with unrecognised problems were older, less mobile and received more community supports. There was also a trend towards lower mental status questionnaire and functional scores and to greater medication usage. The results of this study support the principle of screening or case finding in the elderly. Targeting those at risk is required in order to reduce the workload involved. However, the current at risk indicators identified only a proportion of those in need of screening. Further research is required as to how to correctly identify these patients.

Activities of Daily Living↗