Anemia in older individuals is associated with reduced survival, and increased risk of functional dependence and therapeutic complications from drugs, congestive heart failure, and possibly dementia. Chronic anemia in older individuals is mostly due to iron deficiency, nutritional or metabolic deficiencies, and anemia of chronic inflammation. In about one-third of cases, the cause of anemia is not evident. It is hypothesized that it might be related to early myelodysplasia or to relative erythropoietin insufficiency. In older cancer patients, anemia may increase the risk of chemotherapy-related complications and of functional deterioration. Hemoglobin levels of individuals age 65 years and older receiving cytotoxic chemotherapy should be maintained at 12 gm/dL or higher. This may be accomplished with erythropoietic growth factors. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[7]:18-23)

Although it is not practical to consider eliminating falls, an interdisciplinary team–focused approach that concentrates on reducing fall risk is an achievable goal when caring for frail, elderly residents in long-term care facilities. There are multiple comorbid conditions, as well as comfort and environmental issues, that contribute to fall risk, and whenapproached in a coordinated manner, these conditions can be identified and interventions designed. Each member of the interdisciplinary team has a specific expertise that should be utilized when creating therapeutic approaches. Realistic care plans, staff in-services, and flow of information from the nursing care plans to the certified nursing assistants help to coordinate approaches to reduce fall risk. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[7]:24-33)

Prior to and since the development of prescription pharmacologic therapies for Alzheimer’s disease and dementia, there has been significant interest in and use of alternative therapies by the lay public. To some extent, this is related to the lack of a variety of available classes of therapies and “cures,” and to some extent, it is related to expense, limited efficacy, and side effects of these prescription agents. Since patients and caregivers often confront the treating physician about efficacy of alternative agents, the practitioner should be knowledgeable and up-to-date on this issue. Part I of this article covers the latest research on alternative therapies such as non-steroidal anti-inflammatory drugs, aspirin, cyclooxygenase-2 inhibitors, vitamins and selegiline, and homocysteine in the management of Alzheimer’s disease and dementia. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[7]:34-41)