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Canadian Geriatrics Journal: CGJ

Mathilde Labbé, Katerina Nikolitch, Romeo Penheiro, Marilyn Segal, Karl J Looper, Nathan Herrmann, Steven Selchen, Soham Rej
No abstract text is available yet for this article.
September 2016: Canadian Geriatrics Journal: CGJ
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
Katherine McKenzie, Lynn Martin, Hélène Ouellette-Kuntz
BACKGROUND: Individuals with intellectual and developmental disabilities (IDD) are both living longer than in previous generations and experiencing premature aging. Improved understanding of frailty in this aging population may inform community supports and avoid negative outcomes. METHODS: The objective of this study was to review the literature on frailty and IDD and determine areas for future research and application. The methodological framework for a scoping review as developed by H...
September 2016: Canadian Geriatrics Journal: CGJ
Carolyn Wong, David B Hogan
BACKGROUND: A common scenario that may pose challenges to primary care providers is when an older patient has been discharged from hospital. The aim of this pilot project is to examine the experiences of patients' admission to hospital through to discharge back home, using analysis of patient narratives to inform the strengths and weaknesses of the process. METHODS: For this qualitative study, we interviewed eight subjects from the Sheldon M. Chumir Central Teaching Clinic (CTC)...
September 2016: Canadian Geriatrics Journal: CGJ
Suzette C Brémault-Phillips, Jasneet Parmar, Steven Friesen, Laura G Rogers, Ashley Pike, Bryan Sluggett
BACKGROUND: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS: A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. RESULTS: Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes...
September 2016: Canadian Geriatrics Journal: CGJ
Pierre Molin, Kenneth Rockwood
No abstract text is available yet for this article.
June 2016: Canadian Geriatrics Journal: CGJ
Pierre Molin, Kenneth Rockwood
Two new sets of criteria for Alzheimer's disease (AD) are now in play, including one set released in 2014, and a proposal for a "new lexicon" for how to describe the disease spectrum. A 2012 Canadian consensus conference said that to then, none of the new criteria or terminology would change primary care practice; that is still likely to be so. For dementia consultants, however, the new criteria pose challenges and offer opportunities. In general, the new criteria see an expanded role for bio-markers. Even so, the evidence base for this remains incomplete...
June 2016: Canadian Geriatrics Journal: CGJ
Lesley Charles, Jean Triscott, Bonnie Dobbs, Peter George Tian, Oksana Babenko
BACKGROUND: The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives...
June 2016: Canadian Geriatrics Journal: CGJ
Randall Sargent, Cynthia Brocklebank, Helen Tam-Tham, Tyler Williamson, Patrick Quail, Diana Turner, Neil Drummond
BACKGROUND: Warfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care. METHODS: This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio (INR) tests in the range 2...
June 2016: Canadian Geriatrics Journal: CGJ
Salina Juma, Mary-Margaret Taabazuing, Manuel Montero-Odasso
BACKGROUND: Frailty is characterized by increased vulnerability to external stressors. When frail older adults are admitted to hospital, they are at increased risk of adverse events including falls, delirium, and disability. The Clinical Frailty Scale (CFS) is a practical and efficient tool for assessing frailty; however, its ability to predict outcomes has not been well studied within the acute medical service. OBJECTIVE: To examine the CFS in elderly patients admitted to the acute medical ward and its association with length of stay...
June 2016: Canadian Geriatrics Journal: CGJ
Kenneth Madden
No abstract text is available yet for this article.
June 2016: Canadian Geriatrics Journal: CGJ
Afeez Abiola Hazzan, Janis Humphrey, Laurie Kilgour-Walsh, Katherine L Moros, Carmen Murray, Shannon Stanners, Maureen Montemuro, Aidan Giangregorio, Alexandra Papaioannou
BACKGROUND: Engaging with art can be valuable for persons living with dementia. 'Artful Moments' was a collaborative project undertaken by the Art Gallery of Hamilton and the Behavioural Health Program at Hamilton Health Sciences that sought to develop and implement a program of arts-based activities for persons in the middle-to-late stages of dementia who exhibit behavioural symptoms and for their accompanying care partners. METHODS: This pilot study employed a qualitative descriptive design...
June 2016: Canadian Geriatrics Journal: CGJ
Elena Lebedeva, Mei Huang, Lisa Koski
BACKGROUND: The Montreal Cognitive Assessment (MoCA) is a screening tool for mild cognitive impairment (MCI) in elderly individuals. We hypothesized that measurement error when using the new alternate MoCA versions to monitor change over time could be related to the use of items that are not of comparable difficulty to their corresponding originals of similar content. The objective of this study was to compare the difficulty of the alternate MoCA items to the original ones. METHODS: Five selected items from alternate versions of the MoCA were included with items from the original MoCA administered adaptively to geriatric outpatients (N = 78)...
March 2016: Canadian Geriatrics Journal: CGJ
Kathryn Hominick, Victoria McLeod, Kenneth Rockwood
BACKGROUND: Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge...
March 2016: Canadian Geriatrics Journal: CGJ
Kasim Abdulaziz, Jeffrey J Perry, Monica Taljaard, Marcel Émond, Jacques S Lee, Laura Wilding, Marie-Josée Sirois, Jamie Brehaut
BACKGROUND: This study was designed to determine a clinically significant point drop in function to define functional decline and the required sensitivity for a clinical decision tool to identify elderly patients at high risk of functional decline following a minor injury. METHODS: After a rigorous development process, a survey questionnaire was administered to a random sample of 178 geriatricians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique...
March 2016: Canadian Geriatrics Journal: CGJ
Kenneth M Madden
No abstract text is available yet for this article.
March 2016: Canadian Geriatrics Journal: CGJ
Scott C Forbes, Jayna M Holroyd-Leduc, Marc J Poulin, David B Hogan
BACKGROUND: Observational studies have suggested that various nutrients, dietary supplements, and vitamins may delay the onset of age-associated cognitive decline and dementia. We systematically reviewed recent randomized controlled trials investigating the effect of nutritional interventions on cognitive performance in older non-demented adults. METHODS: We searched MEDLINE, CINAHL, Embase, and the Cochrane Library for articles published between 2003 and 2013. We included randomized trials of ≥ 3 months' duration that examined the cognitive effects of a nutritional intervention in non-demented adults > 40 years of age...
December 2015: Canadian Geriatrics Journal: CGJ
Peng You, Marie Leung, Victoria Y Y Xu, Alexander Astell, Sudeep S Gill, Michelle Gibson, Christopher Frank
BACKGROUND AND PURPOSE: To foster interest in geriatric care, the Queen's Geriatrics Interest Group (QGIG) collaborated with the Division of Geriatric Medicine to arrange a Geriatrics Pre-Clerkship Observership Program. METHODS: Forty-two pre-clerkship medical students participated in the program between October 2013 and May 2014. Participants were paired with a resident and/or attending physician for a four-hour weekend observership on an inpatient geriatric rehabilitation unit...
December 2015: Canadian Geriatrics Journal: CGJ
Vanessa Thoo, Janya Freer, Keri-Leigh Cassidy
BACKGROUND: The Fountain of Health (FoH) initiative offers valuable evidence-based mental health knowledge and provides clinicians with evaluated tools for translating knowledge into practice, in order to reduce seniors' risks of mental disorders, including dementia. METHODS: A presentation on mental health promotion and educational materials were disseminated to mental health clinicians including physicians and other allied health professionals either in-person or via tele-education through a provincial seniors' mental health network...
December 2015: Canadian Geriatrics Journal: CGJ
Susan Freter, Michael Dunbar, Katalin Koller, Chris MacKnight, Kenneth Rockwood
BACKGROUND AND PURPOSE: Delirium is common after hip fracture. Previous work has shown that a simple delirium risk factor tool, the Delirium Elderly At Risk instrument (DEAR), has a high inter-rater reliability in this population. Little research has looked at the ability of risk factor screening tools to identify patients at high risk of pre-operative delirium. This study investigates the ability of the DEAR to identify patients at high risk of pre-operative delirium, as well as reporting its performance in a post-operative validation sample...
December 2015: Canadian Geriatrics Journal: CGJ
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