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Clinics in Geriatric Medicine

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https://www.readbyqxmd.com/read/28991654/pulmonary-disease-in-the-aging-patient
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28991647/evaluation-of-dyspnea-in-the-elderly
#8
REVIEW
Donald A Mahler
Dyspnea is due to an imbalance between the demand to breathe and the ability to breathe. The prevalence is ∼30% for those 65 years or older with walking on a level surface or up an incline. Dyspnea is a strong predictor of mortality in elderly individuals. Anemia, cardiovascular disease, deconditioning, psychological disorders, and respiratory diseases are common causes of dyspnea. Initial treatments to relieve breathing discomfort should be directed toward improving the pathophysiology of the underlying disease...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991646/epidemiology-of-lung-disease-in-older-persons
#9
REVIEW
Carlos A Vaz Fragoso
Older persons frequently report respiratory risk factors and symptoms and have a high prevalence of symptomatic lung disease, most commonly obstructive airway disease, interstitial lung disease, and lung cancer. Notably, coexisting nonrespiratory risk factors are also prevalent and may misidentify or modify respiratory diagnoses and their clinical course.
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991645/lung-diseases-of-the-elderly-cellular-mechanisms
#10
REVIEW
Kori Ascher, Sharon J Elliot, Gustavo A Rubio, Marilyn K Glassberg
Natural lung aging is characterized by molecular and cellular changes in multiple lung cell populations. These changes include shorter telomeres, increased expression of cellular senescence markers, increased DNA damage, oxidative stress, apoptosis, and stem cell exhaustion. Aging, combined with the loss of protective repair processes, correlates with the development and incidence of chronic respiratory diseases, including idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease. Ultimately, it is the interplay of age-related changes in biology and the subsequent responses to environmental exposures that largely define the physiology and clinical course of the aging lung...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991644/inflammaging-and-the-lung
#11
REVIEW
Elizabeth J Kovacs, Devin M Boe, Lisbeth A Boule, Brenda J Curtis
With the coming of the "silver tsunami," expanding the knowledge about how various intrinsic and extrinsic factors affect the immune system in the elderly is timely and of immediate clinical need. The global population is increasing in age. By the year 2030, more than 20% of the population of the United States will be older than 65 years of age. This article focuses on how advanced age alters the immune systems and how this, in turn, modulates the ability of the aging lung to deal with infectious challenges from the outside world and from within the host...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28991643/the-effects-of-aging-on-lung-structure-and-function
#12
REVIEW
Gwen S Skloot
Growth of the segment of the population older than 65 years has led to intensified interest in understanding the biology of aging. This article is focused on age-related alterations in lung structure that produce predictable changes in physiologic function, both at rest and during exercise. Increased insight into the physiology of the healthy aging lung should ultimately lead to improved methods of lung function assessment in the elderly (defined as those older than 65 years) as well as better understanding of the manifestations and possibly even the treatment of geriatric lung disease...
November 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689574/the-new-geriatric-giants
#13
EDITORIAL
John E Morley
No abstract text is available yet for this article.
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689573/rapid-geriatric-assessment-secondary-prevention-to-stop-age-associated-disability
#14
REVIEW
John E Morley
The Rapid Geriatric Assessment (RGA) measures frailty, sarcopenia, anorexia, cognition, and advanced directives. The RGA is a screen for primary care physicians to be able to detect geriatric syndromes. Early intervention when geriatric syndromes are recognized can decrease disability, hospitalization, and mortality.
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689572/integrating-quality-palliative-and-end-of-life-care-into-the-geriatric-assessment-opportunities-and-challenges
#15
REVIEW
Daniel Swagerty
This article provides an overview of how integrating quality palliative and end-of-life care into geriatric assessment can be a tremendous benefit to older adult patients and their families. Although the quality of palliative and end-of-life care for older adults has improved greatly, there are still many opportunities to improve the quality of life and function for older adult patients in the last few years of their life. More clinical expertise in comprehensive palliative and end-of-life care must be developed and maintained...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689571/dissecting-delirium-phenotypes-consequences-screening-diagnosis-prevention-treatment-and-program-implementation
#16
REVIEW
Joseph H Flaherty, Jirong Yue, James L Rudolph
Delirium is an acute change in attention and awareness that preferentially occurs in older patients with acute illness. This review provides an overview for clinicians with descriptions of the presentations (phenotypes), consequences, diagnosis, and screening of delirium. In addition, this review provides guidance for the challenges posed by delirium in a health care system, including implementation of delirium programs, tools to address the diagnosis and differential diagnosis of delirium, and a review of preventive and treatment studies with a goal of improving clinical practice...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689570/rapid-depression-assessment-in-geriatric-patients
#17
REVIEW
George T Grossberg, David Beck, Syed Noman Y Zaidi
Depression is common in geriatric patients, especially in those with multiple comorbidities and polypharmacy. Depression in older adults is often underdiagnosed and undertreated. Initial screening for depression can easily be accomplished in the waiting room. Yet the clinical interview still remains the gold standard for diagnosing geriatric depression. Key components of the clinical interview are observant watching of the patient for the subtle signs of depression. Clinical interview should be done with sensitivity to the importance of privacy...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689569/rapid-geriatric-assessment-of-hip-fracture
#18
REVIEW
Jesse Zanker, Gustavo Duque
A comprehensive geriatric assessment, combined with a battery of imaging and blood tests, should be able to identify those hip fracture patients who are at higher risk of short- and long-term complications. This comprehensive assessment should be followed by the implementation of a comprehensive multidimensional care plan aimed to prevent negative outcomes in the postoperative period (short and long term), thus assuring a safe and prompt functional recovery while also preventing future falls and fractures.
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689568/falls-in-the-aging-population
#19
REVIEW
Kareeann S F Khow, Renuka Visvanathan
The number of people living beyond 65 years of age is increasing rapidly, and they are at increased risk of falls. Falls-related injuries and hospitalizations are steadily increasing. Falls can lead to fear of falling, loss of independence, institutionalization, and death, inevitably posing a significant burden to the health care system. Therefore, screening of people at risk of falls and comprehensive assessment of older people at high risk of falls are critical steps toward prevention. This review evaluates the current knowledge relating to falls, with particular focus on rapid screening, assessment, and strategies to prevent falls in the community...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28689567/cognitive-frailty-mechanisms-tools-to-measure-prevention-and-controversy
#20
REVIEW
Bertrand Fougère, Julien Delrieu, Natalia Del Campo, Gaëlle Soriano, Sandrine Sourdet, Bruno Vellas
Physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiologic mechanisms. To stimulate research in this field, the concept cognitive frailty was proposed, emphasizing the important role of brain aging. Cognitive frailty was defined as the presence of cognitive deficits in physically frail older persons without dementia. This subtype of frailty is deemed important, as it may represent a prodromal phase for neurodegenerative diseases and is potentially a suitable target for early intervention...
August 2017: Clinics in Geriatric Medicine
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