© Borgis - Postępy Nauk Medycznych 4/2010, s. 322-323
Dramatic increases of life expectancy in the developed countries have resulted in unprecedented numbers and proportions of older adults in the population. In Poland problem of growing population of people over 65 is still not known as a real danger for economic and health service. The need for existence of special geriatric wards (or even neurogeriatric) as a place to treat very old people with their illnesses is not fully understood in our country. Even so, we prove as I hope, in our journal that clinical picture of many so called typical neurological diseases in old age are different, and we also need to emphasize that as neurologists we do have manage neurological diseases in our old patients in different, peculiar way. For example even sclerosis multiplex could be different in old population. However the term late-onset multiple sclerosis is defined as appearing of the first symptoms suggesting MS in the age over 50. This type of diagnosis is made in 4-9,6% cases. The progression of disease and disability progression in the late-onset MS is usually quicker, and the prognosis is worse. The Late onset MS usually is the big diagnostic problem, and in process of establishing the proper diagnosis detailed differential diagnosis in necessary, which take into account vascular pathology of the brain and spinal core, compressive myelopathies, pathologies connected with arterial hypertension, and the metabolic diseases, vasculitis, degenerative and deficiency syndromes. SM in old population is rather rare for the other hand stroke is very typical in that period of life.Most of strokes will occur in the elderly population. Apart from age, the most important stroke risk factor, substantial impact on stroke incidence have widespread of hypertension, diabetes and obesity. Increase stroke incidence in elderly is also caused by increase frequency of cardiovascular changes. Different course of stroke in the elderly is determined by poorer cardiovascular response, multiple organ dysfunction, multiple medications consumption and presence of other neurological conditions. In the end the course of stroke is more severe, there are more complications and more adverse events connected to pharmacotherapy. Moreover there are more complications due to bedridden state. Early mortality in the stroke patients over 85 years old is twofold bigger as in younger patients. Additionally functional state is significantly worse in the elderly patients after stroke and institutional care is more often needed.
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