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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/29351772/effect-of-an-interactive-e-learning-tool-for-delirium-on-patient-and-nursing-outcomes-in-a-geriatric-hospital-setting-findings-of-a-before-after-study
#1
Elke Detroyer, Fabienne Dobbels, Andrew Teodorczuk, Mieke Deschodt, Yves Depaifve, Etienne Joosten, Koen Milisen
BACKGROUND: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29347865/the-influence-of-multimorbidity-on-leading-causes-of-death-in-older-adults-with-cognitive-impairment
#2
Nicholas K Schiltz, David F Warner, Jiayang Sun, Kathleen A Smyth, Stefan Gravenstein, Kurt C Stange, Siran M Koroukian
OBJECTIVE: The aim of this study is to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. METHOD: This is a population-based study using data from the linked 1992-2010 Health and Retirement Study and National Death Index ( n = 9,691). Multimorbidity is defined as a combination of chronic conditions, functional limitations, and geriatric syndromes. Regression trees and Random Forest identified which combinations of multimorbidity associated with causes of death...
January 1, 2018: Journal of Aging and Health
https://www.readbyqxmd.com/read/29337017/management-of-diabetes-in-older-adults
#3
G Sesti, R Antonelli Incalzi, E Bonora, A Consoli, A Giaccari, S Maggi, G Paolisso, F Purrello, G Vendemiale, N Ferrara
Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population...
December 7, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#4
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29260237/-anticoagulation-in-geriatric-patients-with-atrial-fibrillation-with-what-and-for-whom-no-more
#5
REVIEW
P Bahrmann, M Christ
Based on established risk scores, such as the CHA2DS2-VASc score, the indications for oral anticoagulation are given for patients over 65 years old with atrial fibrillation and even more so for patients over 75 years old. Before beginning anticoagulation a geriatric assessment for evaluation of the cognitive ability, the activities of daily living and the risk of falling should be made because of the known complications of anticoagulation. Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with non-vitamin K antagonist oral anticoagulants (NOAC) to prevent ischemic stroke...
December 19, 2017: Herz
https://www.readbyqxmd.com/read/29244786/functional-assessment-as-a-predictor-of-cognitive-impairment-a-retrospective-cohort-study
#6
Gustavo Alberto Sandival Ampuero, Fernando M Runzer-Colmenares, José F Parodi
INTRODUCTION: It is estimated that major neurocognitive disorders will affect 115.4 million people by 2050, representing a significant financial burden for society. Likewise, functional dependence for basic or instrumental activities of daily life is usually a consequence of the greater prevalence of disabling pathologies, and of the progressive decrease of the physiological reserve due to aging. OBJECTIVES: To determine the ratio between the functional test and prediction of deterioration of cognitive function in geriatric patients...
December 12, 2017: Medwave
https://www.readbyqxmd.com/read/29243107/impact-of-geriatric-assessment-for-the-therapeutic-decision-making-of-breast-cancer-results-of-a-french-survey-afsos-and-sofog-collaborative-work
#7
Claire Falandry, Ivan Krakowski, Hervé Curé, Elisabeth Carola, Pierre Soubeyran, Olivier Guérin, Hélène Gaudin, Gilles Freyer
BACKGROUND: Cancer management in the elderly is often considered as suboptimal, highly variable, and rarely evidence-based. Data are needed to understand decision-making processes in this population. MATERIALS AND METHODS: A survey was performed in France to describe decision-making in gynaecologic patients over 70. It followed a three-step method: (1) 101 representative physicians questioned about treatment decision criteria; (2) simplified individual data were collected; (3) as well as detailed data patients receiving chemotherapy...
December 14, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29205846/use-and-clinical-efficacy-of-standard-and-health-information-technology-fall-risk-assessment-tools
#8
Ruth C Teh, Anne Wilson, Damith Ranasinghe, Renuka Visvanathan
OBJECTIVE: To evaluate the health information technology (HIT) compared to Fall Risk for Older Persons (FROP) tool in fall risk screening. METHODS: A HIT tool trial was conducted on the geriatric evaluation and management (GEM, n = 111) and acute medical units (AMU, n = 424). RESULTS: Health information technology and FROP scores were higher on GEM versus AMU, with no differences between people who fell and people who did not fall. Both score completion rates were similar, and their values correlated marginally (Spearman's correlation coefficient 0...
December 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#9
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29188478/-comprehensive-geriatric-care-for-frail-elderly-at-home-a%C3%A2-feasibility-study
#10
Jonneke Kroes, Laura van Buul, Ruth Veenhuizen, Aafke de Groot, Marja Depla, Winfried Vergeer, Cees Hertogh
OBJECTIVE: To evaluate the feasibility of a study on the content and effect of comprehensive geriatric care (CGC) at home for frail elderly. METHOD: Case managers invited new CGC patients of one care organization for participation in the study. At two moments, questionnaires were conducted on (social) functioning, quality of life, perceived problems, perceived informal caregiver burden, and self-management. Information on received care was collected from the patients' medical records, In addition, a questionnaire was administered to the referring physician...
November 29, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/29187666/impact-of-objective-malnutrition-status-on-the-clinical-outcomes-in-patients-with-peripheral-artery-disease-following-endovascular-therapy
#11
Miyuki Yokoyama, Tetsu Watanabe, Yoichiro Otaki, Ken Watanabe, Taku Toshima, Takayuki Sugai, Tetsuya Takahashi, Daisuke Kinoshita, Harutoshi Tamura, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Tetsuro Shishido, Sou Yamauchi, Tamon Yamanaka, Takuya Miyamoto, Isao Kubota
BACKGROUND: Peripheral artery disease (PAD) is an athero-occlusive disease and a known risk factor for cardiovascular events. The controlling nutritional status (CONUT) score and geriatric nutritional risk index (GNRI) are objective tools for evaluating malnutrition and are reportedly associated with poor clinical outcomes in patients with fatal diseases. However, the effect of malnutrition on the clinical outcomes in patients with PAD remains unclear.Methods and Results:We enrolled 357 patients with PAD who underwent endovascular therapy...
November 30, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29187329/impact-of-therapeutic-education-with-a-written-document-on-treatments-knowledge-and-adherence-among-elderly-patients-results-of-a-pilot-study
#12
Claire Vanhaecke Collard, Laetitia Michaut, Florian Caillierez, Daniel Parra, Marc Bonnefoy
Olders patients are exposed to iatrogenic risk as they are often frail, with multiple pathologies and therefore polymedicated. The objective of this study was to evaluate the knowledge of treatment in the elderly before and after a time of oral therapeutic education accompanied by the submission of a written educational support. The impact of that education on the adhesion was also evaluated. METHODS: We've included patients aged at least 75 years old, living at home, and managing themselves their treatment...
December 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29164776/nutritional-screening-and-dietitian-consultation-rates-in-a-geriatric-evaluation-and-management-unit
#13
Elsa Dent, Olivia Wright, Emiel O Hoogendijk, Ruth E Hubbard
AIM: Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition. METHODS: In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA)...
November 22, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#14
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29135667/nationwide-analysis-of-femoral-neck-fractures-in-elderly-patients-a-receding-tide
#15
Derek G Ju, Sean S Rajaee, James Mirocha, Carol A Lin, Charles N Moon
BACKGROUND: Geriatric femoral neck fractures are associated with substantial morbidity and medical cost. We evaluated the incidence and management trends of femoral neck fractures in recent years in the U.S. METHODS: Patient data from 2003 through 2013 were obtained from the Nationwide Inpatient Sample database. Femoral neck fractures in patients ≥65 years old were identified and grouped using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes for internal fixation, hemiarthroplasty, or total hip arthroplasty (THA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#16
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29128297/role-of-geriatric-oncologists-in-optimizing-care-of-urological-oncology-patients
#17
REVIEW
Jean-Pierre Droz, Helen Boyle, Gilles Albrand, Nicolas Mottet, Martine Puts
CONTEXT: Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. OBJECTIVE: To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being...
November 8, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29109936/a-study-of-harmful-drug-drug-interactions-due-to-polypharmacy-in-hospitalized-patients-in-goa-medical-college
#18
Akshay Khandeparkar, Padmanabh V Rataboli
Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy...
October 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/29105507/-factors-affecting-services-offered-to-older-adults-with-psychological-morbidity-an-exploration-of-health-professional-attitudes
#19
Jennifer White, Kath Greer, Grant Russell, Aislinn Lalor, Rene Stolwyk, Cylie Williams, Ted Brown, Terrence Haines
AIM: Poor collaboration between the multiple services involved in hospital discharge planning may contribute to suboptimal patient outcomes post discharge. This study aimed to explore clinician (medical, allied health and nursing) attitudes towards the management of the older patient with psychological morbidity during and following hospitalization. METHODS: Focus groups were held with 54 health professionals comprising of 7 from acute, 20 from subacute (geriatric assessment and rehabilitation), and 27 from community care settings...
November 6, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/29102322/a-systematic-review-and-meta-analysis-of-the-criterion-validity-of-nutrition-assessment-tools-for-diagnosing-protein-energy-malnutrition-in-the-older-community-setting-the-macro-study
#20
Skye Marshall, Dana Craven, Jaimon Kelly, Elizabeth Isenring
BACKGROUND & AIMS: Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community...
October 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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