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Clinics in Geriatric Medicine

journal
https://www.readbyqxmd.com/read/30390987/nuances-of-surgical-care-for-the-elderly
#1
EDITORIAL
Fred A Luchette, Robert D Barraco
No abstract text is available yet for this article.
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390986/vascular-surgery-and-geriatric-patients
#2
REVIEW
Pegge M Halandras
As the population ages, surgical decision-making in vascular surgery has become more complex. Older patients may not have been offered vascular surgical intervention in the past because of prohibitive physiologic demands and poor health. Patients now have more aggressive management of vascular risk factors with medications, such as statin therapy, and less invasive endovascular or hybrid treatment options. Outcomes in elderly patients may not be comparable with younger patients for entities such as aortic aneurysm repair, carotid endarterectomy, or lower extremity revascularization...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390985/orthopedic-surgery-and-the-geriatric-patient
#3
REVIEW
Alexander S Greenstein, John T Gorczyca
As more patients live longer, it is probable that an increasing number of geriatric patients will require surgery. An organized, systematic, coordinated, multidisciplinary approach to the perioperative management of these patients will result in fewer complications, improved outcomes, and reduced cost of care. Details are herein provided on the preoperative diagnostic evaluation and assessment as well as perioperative care provided to optimize outcomes. The diagnosis, workup, and treatment of osteoporosis and fragility fractures are presented...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390984/surgical-oncology-and-geriatric-patients
#4
REVIEW
Michael E Johnston, Jeffrey J Sussman, Sameer H Patel
Geriatric medicine is a growing field filled with complicated patients who are susceptible to developing cancer. Surgical oncology is expanding while adapting to the increasing elderly population and creating novel treatment regimens for this group of patients. This article reviews surgical oncology in elderly patients and addresses surgical optimization, management of several cancer subtypes, surgical advances in minimally invasive surgery, and ethical considerations.
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390983/transitions-of-care-in-geriatric-medicine
#5
REVIEW
Shailvi Gupta, Justin A Perry, Rosemary Kozar
Elderly patients are at increased risk for morbidity and mortality after injury or surgery in both the inpatient and postdischarge settings. The importance of discharge destination after the index hospitalization is increasingly recognized as a determinant of long-term survival, with discharge to a post-acute care facility portending a worse prognosis. Efforts to minimize discharge to post-acute care facilities should include early discharge planning. Communication among a multidisciplinary care team sets the groundwork for effective discharge planning and transitions of care...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390982/palliative-care-and-geriatric-surgery
#6
REVIEW
Jessica H Ballou, Karen J Brasel
Although many seniors cite maintaining independence and a desire to die at home as health priorities, admission to the ICU and the use of invasive procedures are common near the end of life. Palliative care aims to relieve pain and other symptoms to maintain the highest quality of life for the longest period of time, but surgical patients are less likely to be referred to palliative care than patients with chronic medical conditions. Meeting the palliative care needs of elderly surgical patients requires early recognition, advance care planning, and multidisciplinary interventions that align patient goals with possible outcomes...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390981/utilization-of-geriatric-consultation-and-team-based-care
#7
REVIEW
Joseph F Sucher, Alicia J Mangram, James K Dzandu
Geriatric surgical patients experience higher mortality and morbidity rates than their younger counterparts. Three models of geriatric surgical care are described, with a focus on people, plans, and evaluation. These models include geriatric consultation services, geriatric wards, and geriatric multidisciplinary teams. The optimal care plan should be definitive, aggressive, sustainable, safe, and effective, with consideration for patient treatment preferences and wishes.
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390980/suicide-in-the-elderly-a-multidisciplinary-approach-to-prevention
#8
REVIEW
Steven E Brooks, Sigrid K Burruss, Kaushik Mukherjee
Suicide in the elderly is a growing problem. The elderly population is increasing, and elderly patients have multiple issues that place them at higher risk of suicidality. These issues include physical illnesses, mental illness, loss of functional status, isolation, and family, financial, and social factors. Access to firearms is another significant risk factor, because elderly patients are more likely to use firearms in suicide attempts; interventions to reduce firearms mortality may save lives. Tackling the difficult problem of suicide in the elderly may require a multidisciplinary, community-based series of interventions...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390979/frailty-and-prognostication-in-geriatric-surgery-and-trauma
#9
REVIEW
Cathy A Maxwell, Mayur B Patel, Luis C Suarez-Rodriguez, Richard S Miller
Frailty is a predominant predictor of poor outcomes in older populations. This article presents a review of the concept of frailty and its role for prognostication among geriatric trauma and surgery patients. We discuss models of frailty defined in the scientific literature, emphasizing that frailty is a process of biologic aging. We emphasize the importance of screening, assessment, and inclusion of frailty indices for the development and use of prognostication instruments/tools in the population of interest...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390978/driving-in-the-geriatric-population
#10
REVIEW
Wendy R Greene, Randi Smith
Driving helps older adults stay mobile and independent. The risk of being injured or killed in a motor vehicle crash increases with age. This trend has been attributed more to an increased susceptibility to injury and medical complications among older drivers rather than an increased risk of crash involvement. Older adults tend to take steps to stay safe on the road. They tend to have a high incidence of seat belt use and a lower incidence of impaired driving. Furthermore, older drivers self-select safer driving conditions by avoiding night, bad weather, and high-speed roads compared with younger drivers...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390977/falls-in-the-geriatric-patient
#11
REVIEW
Deborah J Bolding, Ellen Corman
Falls in older adults are multifaceted, and are caused by biologic, behavioral, environmental, and socioeconomic risk factors. An estimated 25% of older adults fall each year. With 10,000 people turning 65 each day, it is essential that those at highest risk receive intervention to decrease the risk and rate of falls. In addition, those older adults at lower risk still need to understand the risk of falls and be educated about maintaining healthy lifestyles. Fall risk assessment and referral to individualized or group-based programming can reduce fall risks and falls...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390976/elder-abuse
#12
REVIEW
Astrid Botty Van Den Bruele, Moustapha Dimachk, Marie Crandall
Elder abuse is generally defined as the maltreatment of individuals over the age of 60, although no precise definition exists in the literature. Types of abuse include, but are not limited to, psychological/emotional, physical, sexual abuse, and financial exploitation. Certain risk factors exist leaving an individual more susceptible to abuse, and many obstacles exist preventing the elimination of abuse. There are also identifiable risk factors that increase the likelihood of perpetration of abuse. This systematic review provides an overview of the scope of the problem, types of abuse, risk factors, characteristics of abusers, and key aspects of elder abuse prevention...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30390975/changing-epidemiology-of-the-american-population
#13
REVIEW
Mohammad Hamidi, Bellal Joseph
The changing epidemiology of the geriatric population in the United States has diverse social, medical, and financial implications that will continue to expand over the next few decades. According to the US Census Bureau, 20% of the US population will be 65 years or older by 2030 and more than 50% will eventually belong to a minority group. These changes are expected to be accompanied by several effects on the geriatric population's demographics, injury characteristics, surgical interventions, and the cost of caring for the geriatric population, which will ultimately broaden the financial burden...
February 2019: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336996/patient-centered-care-and-cognitive-dysfunction
#14
EDITORIAL
John E Morley
No abstract text is available yet for this article.
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336995/nutrition-and-alzheimer-disease
#15
REVIEW
Shirley Steffany Muñoz Fernández, Sandra Maria Lima Ribeiro
We gathered some theoretic and practical concepts related to the importance of nutrition in the prevention and management of Alzheimer disease (AD). Besides the role of nutrients in brain development and functioning, some nutrients exert special control in the development of AD, due to their participation in neurotransmitter synthesis, their modulation in epigenetics mechanisms, and as antioxidants. In addition, some non-nutrient food-derived substances have shown potential in the control of neuroinflammation and consequently in the prevention of AD...
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336994/cognitive-frailty-in-geriatrics
#16
REVIEW
Hidenori Arai, Shosuke Satake, Koichi Kozaki
Since the operational definition of "cognitive frailty" was proposed in 2013 by the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics, several studies have shown the prevalence and outcomes of cognitive frailty. The prevalence of cognitive frailty is quite low in the community settings when the original definition is applied, but higher in clinical settings. In longitudinal studies, cognitive frailty is a risk for disability, poor quality of life, dementia, and death...
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336993/cognitive-stimulation-therapy-for-dementia
#17
REVIEW
Harleen Rai, Lauren Yates, Martin Orrell
Cognitive stimulation therapy has proven to be both an effective and enjoyable psychological treatment for people with dementia. Over the past 20 years, cognitive stimulation therapy has grown from a national, localized treatment in the UK to a more global phenomenon currently being used in more than 25 countries around the world. Much has been accomplished during the cognitive stimulation therapy journey and there is still much to be explored; it is a dynamic field. This article provides an overview of cognitive stimulation therapy by elaborating on its background, evidence, international work, and future directions...
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336992/behavioral-problems-and-dementia
#18
REVIEW
Ladislav Volicer
Behavioral problems decrease quality of life of people with dementia and their care providers. Three main consequences of dementia are functional impairment and in some cases also mood disorders and psychosis. These consequences, alone or in combination, result in 3 main behavioral problems: apathy, agitation, and rejection of care/aggression. Nonpharmacologic management strategies include meaningful activities and individualized comfort care, for example, Namaste Care. If needed, pharmacologic management should concentrate on treatment of main dementia consequences, especially depression, instead of treating secondary symptoms, for example, insomnia...
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336991/traumatic-brain-injury-chronic-traumatic-encephalopathy-and-alzheimer-disease
#19
REVIEW
Roula Al-Dahhak, Rita Khoury, Erum Qazi, George T Grossberg
Traumatic brain injury (TBI) is a major health and economic burden. With increasing aging population, this issue is expected to continue to rise. Neurodegenerative disorders are more common with aging population in general regardless of history of TBI. Recent evidence continues to support a relation between a TBI and neurocognitive decline later in life (such as in athletes and military). This article summarizes the pathologic and clinical effects of TBI (regardless of severity) on the later development of dementia in individuals 65 years or older...
November 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/30336990/lewy-body-dementia
#20
REVIEW
Angela M Sanford
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causing clinically apparent symptoms. Because of its clinical overlap with other forms of dementia, DLB is often underdiagnosed and misdiagnosed. There is currently no cure for DLB and treatments are aimed at ameliorating specific symptoms...
November 2018: Clinics in Geriatric Medicine
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