Module232025

07/05/2025

The elderly – comprehension, cognition and retention Reduced comprehension, particularly in understanding complex language, is a common experience with normal aging 5 declines in performance of cognitive tasks that require quick processing or information transformation 6 Cumulative knowledge and experiential skills are well maintained into advanced age but short-term and episodic memories and are less efficient 7 including measures of speed of processing, working memory, and executive cognitive function. Older people do not consider invitations due to problems in literacy, visual or auditory impairments How do you deal with a patient who is completely blind or deaf? They may become tired during long assessment sessions or refuse to take part in some assessments (e.g. cognitive tests) Hawthorn effect: people tend to improve when they receive attention – so the baseline may “move”

A 75 year old triallist, says, at Visit 3: “Am in in a clinical trial? I didn’t know. Have I agreed to something?“ Her son, a lawyer, is present.

37

The elderly – what is “normal”

Let’s think about the baseline readings we normally take in trials, and look at the effects of age on these ECGs – in one study, only 7% of patients had a “normal” ECG atrial fibrillation, conduction defects, indications of ischaemia in over 25% of patients Labs reduced creatinine clearance (but normal creatinine due to reduced muscle mass) reduced RBC, due to decreased renal function neutrophil and platelet counts changes reflecting background inflammation changes in lymphocytes are due to immunosenescence Higher ESR values may be normal in the elderly ConMeds The elderly are most likely to be taking multiple conmeds MedHx The elderly are more likely to have a long list of previous and concurrent conditions

France stops Valneva's chikungunya vaccine rollout in over 65s after safety issue EndPoints News, April 28, 2025 07:00 AM EDT

38