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Clinics in Geriatric Medicine

journal
https://www.readbyqxmd.com/read/29129221/screening-and-prevention-in-the-modern-era
#1
EDITORIAL
Danelle Cayea, Samuel C Durso
No abstract text is available yet for this article.
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129220/preoperative-screening
#2
REVIEW
Julianna G Marwell, Mitchell T Heflin, Shelley R McDonald
Older adults undergoing elective surgical procedures suffer higher rates of morbidity and mortality than younger patients. A geriatric-focused preoperative evaluation can identify risk factors for complications and opportunities for health optimization and care coordination. Key components of a geriatric preoperative evaluation include (1) assessments of function, mobility, cognition, and mental health; (2) reviews of medical conditions and medications; and (3) discussion of risks, preferences, and goals of care...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129219/cardiovascular-screening-and-primary-prevention-in-older-adults
#3
REVIEW
Ariela R Orkaby, Michael W Rich
Evidence for preventive screening and therapeutic intervention for primary prevention of cardiovascular disease is limited for older adults. In this article, we review screening and prevention strategies, including lifestyle, modifiable risk factors, and medications, that may be considered in older adults, with a focus on those ≥75 years, accounting for age, frailty and functional status, medical conditions, and life expectancy.
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129218/screening-older-adults-for-mental-disorders
#4
REVIEW
Gary J Kennedy, Mirnova E Ceïde
Avoidable disability associated with depression, anxiety, and impaired cognition among older adults is pervasive. Incentives for detection of mental disorders in late life include increased reimbursement, reduced cost, and less burden for patients and families. However, screening not aligned with diagnosis, intervention, and outcome assessment has questionable utility. The link between screening, treatment, and outcomes is well established for depression, less so for anxiety and impaired cognition. This article details the use of common instruments to screen and assess depression, anxiety, and cognitive impairment...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129217/screening-for-geriatric-syndromes-falls-urinary-fecal-incontinence-and-osteoporosis
#5
REVIEW
Erin M Smith, Amit A Shah
The geriatric syndromes of falls, incontinence, and osteoporosis are concerns in older adults because of their potential impact on quality of life. Asking about history of falls or a fear of falling should prompt a multifactorial assessment of fall risk and targeted interventions to reduce falls. Urinary and fecal incontinence should be screened because they are common conditions that are underreported due to embarrassment and general perception that incontinence is a normal part of aging. Women over age 65, men over age 70, and younger patients with high-risk characteristics should be screened with bone mineral density testing with dual-energy x-ray absorptiometry...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129216/screening-for-medication-appropriateness-in-older-adults
#6
REVIEW
Andrew R Zullo, Shelly L Gray, Holly M Holmes, Zachary A Marcum
Older adults are at high risk for inappropriate medication use given their myriad medical conditions and medications. Screening efforts may seem overwhelming, but starting with a focused approach and leveraging a team-based strategy can help practicing clinicians gain initial momentum. Future research is needed to strengthen the evidence base for medication use in older adults and to elucidate effective and scalable interventions to improve medication safety.
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129215/frailty-screening-and-interventions-considerations-for-clinical-practice
#7
REVIEW
Jeremy Walston, Brian Buta, Qian-Li Xue
Frailty is recognized as a cornerstone of geriatric medicine. It increases the risk of geriatric syndromes and adverse health outcomes in older and vulnerable populations. Although multiple screening instruments have been developed and validated to improve feasibility in clinical practice, frequent lack of agreement between frailty instruments has slowed broad implementation of these tools. Despite this, interventions to improve frailty-related health outcomes developed to date include exercise, nutrition, multicomponent interventions, and individually tailored geriatric care models...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129214/exercise-and-older-adults
#8
REVIEW
Jorge Camilo Mora, Willy M Valencia
Regular exercise is essential for healthy aging and offers many health benefits, including reduced risk of all-cause mortality, chronic disease, and premature death. Because physical inactivity is prevalent, greater focus is needed on integrating exercise into care plans and counseling, and developing partnerships that support exercise opportunities. Older adults should be as physically active as their abilities and conditions allow. For substantial health benefits, older adults need to do aerobic, muscle-strengthening, and stretching exercises weekly, and balance activities as needed...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129213/vaccinations-in-older-adults
#9
REVIEW
Megan Burke, Theresa Rowe
Vaccines are important for preventing infections in adults aged ≥65 years. Older adults are at increased risk for complications from vaccine-preventable illnesses due to age-associated changes in immune function and chronic medical comorbidities. Vaccination rates for older adults remain low despite widely accepted practice guidelines. Recommended vaccinations for older adults include (1) influenza; (2) pneumococcal; (3) herpes zoster; (4) tetanus, diphtheria, pertussis; and (5) hepatitis B. Cost influences vaccination rates in older adults...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129212/prevention-and-screening-of-unhealthy-substance-use-by-older-adults
#10
REVIEW
Benjamin H Han, Alison A Moore
The number of older adults who engage in unhealthy substance use is expected to increase substantially to levels never seen before. Older adults, owing to physiologic changes in aging, are at high risk for the adverse effects of alcohol and illegal drug use. Screening and prevention can help older patients to be better informed of the risks of substance use, and reduce high-risk behaviors and its potential negative outcomes. The authors review the prevalence and trends of substance use and their potential impact on health outcomes, and discuss an approach to screening and prevention for older adults...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129211/individualized-approach-to-cancer-screening-in-older-adults
#11
REVIEW
Kimberley T Lee, Russell P Harris, Nancy L Schoenborn
The primary goal of cancer screening is early detection of cancer to reduce cancer-specific mortality and morbidity. The benefits of screening in older adults are uncertain due to paucity of evidence. Extrapolating data from younger populations, evidence suggests that the benefit occurs years later from the time of initial screening and therefore may not be applicable in those older adults with limited life expectancy. Contrast this with the harms of screening, which are more immediate and increase with age and comorbidities...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129210/driving-dilemmas-a-guide-to-driving-assessment-in-primary-care
#12
REVIEW
Emily Morgan
Clinical assessment of fitness to drive can be a challenging part of primary care of older adults. There are no guidelines on screening for driver safety, so it falls to provider judgment on when to assess older drivers. This review offers recommendations on when to assess for driver safety based on red flag conditions, medications, acute events, and patient or family concerns. It reviews how to assess for visual, cognitive, and neuromuscular impairments and what to do as next steps for at-risk drivers once they are identified...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129209/the-medicare-annual-wellness-visit
#13
REVIEW
Jessica L Colburn, Stephanie Nothelle
The Medicare Annual Wellness Visit is an annual preventive health benefit, which was created in 2011 as part of the Patient Protection and Affordable Care Act. The visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes. In this article, the authors review the requirements of the Annual Wellness Visit, discuss ways to use the Annual Wellness Visit to improve the care of geriatric patients, and provide suggestions for how to incorporate this benefit into a busy clinic...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991654/pulmonary-disease-in-the-aging-patient
#14
EDITORIAL
Sidney S Braman, Gwen S Skloot
No abstract text is available yet for this article.
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991653/comorbidities-of-lung-disease-in-the-elderly
#15
REVIEW
Nicola Scichilone
Comorbidities are common in elderly individuals with chronic respiratory diseases. They can affect disease manifestations and severity and can even impact management. Comorbidities can affect the treatment of the lung disease, particularly because of the interaction with the respiratory drugs. Thus, a multidimensional approach with multidisciplinary intervention is suggested for elderly respiratory patients, switching from a disease-oriented scheme to a dysfunction-oriented approach. Unfortunately, older individuals are often excluded from clinical trials because of advanced age and comorbidities...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991652/sleep-in-the-elderly-unanswered-questions
#16
REVIEW
Steven H Feinsilver, Adam B Hernandez
Sleep normally changes with aging, with implications for healthy elderly individuals as well as for those with disease states. Less slow wave sleep (deep sleep) is expected, along with more awakenings, and a tendency toward earlier sleep times. Rapid eye movement sleep behavior disorder is seen primarily in elderly individuals, and it often represents the earliest sign of a chronic and progressive neurologic disease. Complaints of difficulty initiating and maintaining sleep (insomnia) become more common with aging...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991651/lung-cancer-in-the-older-patient
#17
REVIEW
Julie A Barta, Ralph G Zinner, Michael Unger
Cancers of the lung and bronchus are the leading cause of cancer deaths in men and women in the United States, and two-thirds of new lung cancer cases are diagnosed in patients over age 65. There are few dedicated clinical trials in the elderly, leading to both undertreatment and overtreatment biases. Even fit older adults experience age-related decline in physiologic reserve, and additional issues of polypharmacy, geriatric syndromes, and inadequate social support are not uncommon, leading to disparities in treatment and survival...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991650/pulmonary-vascular-diseases-in-the-elderly
#18
REVIEW
Hooman Poor
Pulmonary hypertension is a pathologic hemodynamic condition defined by a mean pulmonary arterial pressure of 25 mm Hg or greater at rest. Because of age-associated stiffening of the heart and the pulmonary vasculature and the higher prevalence in the elderly of comorbidities associated with the development of pulmonary hypertension, it is an increasingly common finding in this patient population. A right heart catheterization is necessary for the diagnosis and characterization of pulmonary hypertension. The general management is to treat the underlying conditions responsible for the development of the disorder...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991649/chronic-obstructive-pulmonary-disease-in-elderly-patients
#19
REVIEW
Felipe Cortopassi, Puncho Gurung, Victor Pinto-Plata
Chronic obstructive pulmonary disease (COPD) is prevalent in the elderly population, with high impact on quality of life, morbidity, and mortality. The diagnosis is usually made based on symptoms and spirometry values that support the presence of airflow obstruction. However, the condition is frequently underdiagnosed. COPD is associated with premature aging and several other medical conditions that can partially explain its underdiagnosis and management. There are several pharmacologic and nonpharmacologic interventions proven to be effective in ameliorating the symptoms of COPD...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991648/asthma-in-the-elderly
#20
REVIEW
Sidney S Braman
The older population has seen the greatest increase in the prevalence of current asthma in recent years. Asthma may begin at any age and when it occurs at an advanced as opposed to a young age, it is often nonatopic, severe, and unremitting. Unfortunately, geriatric-specific guidelines are not available for the diagnosis and treatment of asthma. However, with objective monitoring, avoidance of asthma triggers, appropriate pharmacotherapy, and patient education, the disease can be managed successfully.
November 2017: Clinics in Geriatric Medicine
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