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Clinics in Geriatric Medicine

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https://www.readbyqxmd.com/read/29661340/geriatric-otolaryngology-why-it-matters
#1
EDITORIAL
Karen M Kost
No abstract text is available yet for this article.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661339/frailty-and-polypharmacy-in-older-patients-with-otolaryngologic-diseases
#2
REVIEW
David Eibling
Frailty and Polypharmacy commonly impact disease processes and treatment of patients with otolaryngologic disorders. Although well known to geriatricians, the 2 concepts often elude other physicians, including otolaryngologists. This article reviews the common manifestations likely to be encountered in otolaryngology patients, reviews frailty measures in surgical patients, and makes recommendations regarding education of nongeriatricians.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661338/anesthesia-in-the-elderly-patient-undergoing-otolaryngology-head-and-neck-surgery
#3
REVIEW
Takumi Codère-Maruyama, Albert Moore
Geriatric patients undergoing surgery have a whole set of specific physiologic changes, perioperative needs, and postoperative complications. This review presents an overview of the basic concepts and the evolving challenges pertaining to the care of geriatric patients undergoing otolaryngologic procedures from the perspective of the anesthesiologist.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661337/thyroid-disorders-in-the-elderly-an-overall-summary
#4
REVIEW
Kevin Higgins
Medical care for elderly patients is often distinctly different from that of younger counterparts. This is no truer than in a thyroid disorder context, where patients are often asymptomatic and polypharmacy is a potential consideration. Understanding how treatment of these patients can deviate from common practices is an essential asset to any health care provider. The purpose of this article is to shed light on those deviations and address inherent complexities in caring for elderly patients in an effort to improve quality of care...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661336/cutaneous-head-and-neck-malignancies-in-the-elderly
#5
REVIEW
Brian B Hughley, Cecelia E Schmalbach
Cutaneous malignancy of the head and neck affects a large proportion of elderly patients. The severity ranges from small, easily treatable lesions to large, invasive, potentially metastatic tumors. Surgical treatment is the primary treatment of most skin cancers; however, geriatric patients are more likely to have multiple comorbidities that increase the risk of surgery. Multiple treatment modalities exist, including surgical, radiation, and medical therapy. Recommendations and treatment options for basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and melanoma are outlined and reviewed...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661335/head-and-neck-cancer-in-the-elderly-frailty-shared-decisions-and-avoidance-of-low-value-care
#6
REVIEW
Leila J Mady, Marci L Nilsen, Jonas T Johnson
Head and neck cancer (HNC) is a disease of older adults. Recurrent and metastatic head and neck squamous cell carcinoma portends a poor prognosis, with median overall survival of less than 12 months. Within this vulnerable population, significant treatment-related toxicities and physical and psychosocial sequelae can be devastating to quality of life at the end of life. Shared decision making and early comprehensive palliative and support services are at the crux of the approach to older adults with HNC. In doing so, low-value care that fails to meet the goals of patients and their caregivers at the end-of-life may be avoided...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661334/rhinosinusitis-and-allergies-in-elderly-patients
#7
REVIEW
Constanza J Valdés, Marc A Tewfik
The sinonasal tract plays important roles in respiration, olfaction, and defense against external pathogens. Like many organ systems, the nose and sinuses undergo several changes with advancing age that can play a role in the development of disease. This article discusses the physiology of the aging sinonasal tract and reviews the common diseases affecting older patients, such as rhinitis and rhinosinusitis.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661333/sleep-disorders-in-the-elderly
#8
REVIEW
Kathleen Yaremchuk
Although some physiologic changes in sleep are a normal part of the aging process, other sleep complaints made by elderly patients can indicate a primary or secondary sleep disorder. It is important to recognize the difference between normal age-related changes and what may require further testing to make an accurate diagnosis. Proper diagnosis and treatment of sleep disorders can improve the quality of life and safety for the elderly and their families.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661332/voice-disorders-in-the-elderly
#9
REVIEW
Karen M Kost, Robert T Sataloff
Presbyphonia is more common than appreciated by most physicians, and it is associated with undesirable vocal characteristics such as hoarseness, weakness, breathiness, instability, and tremulousness. Hearing impairment in the patient or his or her friends, family, and associates exacerbates the problem, resulting in depression and social withdrawal, further reducing quality of life. Moreover, voice weakness and instability are all too often misinterpreted as reflecting intellectual instability. Expert diagnosis, medical treatment, voice therapy and training, and occasionally surgery usually can maintain or restore vocal stability and "youth...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661331/geriatric-dysphagia
#10
REVIEW
Ozlem E Tulunay-Ugur, David Eibling
Geriatric dysphagia is an unrecognized and underdiagnosed problem with significant morbidity and potential mortality. It requires diligence by the clinician and a team approach for successful management. Careful history-taking is the key in the treatment of these patients and determines further workup, as well as treatment.
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661330/balance-disorders-in-older-adults
#11
REVIEW
David Eibling
Balance disorders are common in the elderly and can lead to falls, with resultant severe morbidity and even mortality. Progressive loss of vestibular function begins in middle age and is affected by multiple disease processes. Polypharmacy impacts many disease processes in the elderly, with balance function being one of the most susceptible. Evaluation of the older patient with a balance disorder is critical for the well-being of these patients, as it may drive intervention. This article reviews balance disorders often encountered in older patients and makes recommendations regarding education of nonotolaryngologists...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29661329/hearing-loss-in-the-elderly
#12
REVIEW
Rohan Patel, Brian J McKinnon
Presbycusis, or age-related hearing loss (ARHL), is the result of physiologic and pathologic changes associated with advancing age. ARHL presents typically with a high-frequency hearing loss, which contributes to greater trouble hearing consonants within words. Consonants convey the bulk of meaning within a word, and this loss of linguistic information results in complaints associated with ARHL. Hearing aids and cochlear implants significantly improve the lives of older adults with hearing loss, in particular, those with depression and dementia...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29129221/screening-and-prevention-in-the-modern-era
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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