Kevin C. Fleming

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OBJECTIVE To describe the causes, evaluation, and management of urinary incontinence in the elderly population. DESIGN We reviewed pertinent articles in the medical literature and summarized the types of incontinence and contributing factors. RESULTS Urinary incontinence is common in elderly patients and often has a major role in determining whether a(More)
OBJECTIVE To review the evaluation and management of delirium in elderly patients for primary-care providers. DESIGN We summarize the clinical features, course, pathophysiologic aspects, predisposing factors, causes, and differential diagnosis of delirium and discuss approaches to affected patients and various management strategies. RESULTS Delirium, an(More)
OBJECTIVE The epidemiology of chronic constipation in the elderly remains poorly defined. We aimed to study the prevalence of, and potential risk factors for, constipation in a representative elderly community, using symptom-based diagnostic criteria. METHODS An age and gender-stratified random sample of 1833 eligible residents of Olmsted County,(More)
Despite a burgeoning elderly population, the number of nurses and other providers of direct care has declined to critical levels at many health care facilities. There are also insufficient medical clinicians to meet the demand for health services. A shrinking workforce, an aging population, financial pressures, and increased consumer demand will translate(More)
This study examined patterns and associates of excessive eating (hyperphagia) in a community-based registry of patients with dementia. From patients enrolled in the Mayo Clinic Alzheimer's Disease Patient Registry (n = 439), 39 were identified with excessive eating reported on the Behavior Symptom Checklist at some time during their illness. They were(More)
Upper gastrointestinal tract symptoms are common in the elderly and, despite a paucity of data, nonsteroidal antiinflammatory drugs (NSAIDs) are believed to be important risk factors. We aimed to evaluate the association of NSAIDs with dyspepsia and heartburn in a population-based study. An age- and gender-stratified random sample of Olmsted County,(More)
OBJECTIVE To describe the pharmacokinetic and pharmacodynamic changes that occur with aging and to discuss common problems noted with the use of medications often prescribed for elderly patients. DESIGN We searched the medical literature, reviewed pertinent articles, and summarized drug-related information applicable to geriatric patients. RESULTS Use(More)
OBJECTIVE To describe the assessment and management of constipation and fecal incontinence in elderly patients. DESIGN We reviewed pertinent publications in the recent medical literature and outlined effective management strategies for constipation and fecal incontinence in the geriatric population. RESULTS Constipation can be classified into two(More)
OBJECTIVE To describe important aspects of pressure ulcer prevention and management, especially in elderly patients. DESIGN We reviewed pertinent published material in the medical literature and summarized effective strategies in the overall management of the elderly population with pressure ulcers. RESULTS Pressure ulcers are commonly encountered in(More)
OBJECTIVE To describe simple, practical measures of physical and psychosocial function to detect problems and enhance the care of elderly patients. DESIGN We reviewed pertinent articles and current standard textbooks of geriatrics; the most useful findings are summarized, and tools that can be used for functional assessment of the geriatric population are(More)