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multidimensional geriatric assessment

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https://www.readbyqxmd.com/read/28797368/geriatric-assessment-for-primary-care-providers
#1
REVIEW
Hong-Phuc T Tran, Susan D Leonard
Because of a growing, aging population and a shortage of geriatricians in the United States, the care of geriatric patients will mostly devolve to primary care providers. This article reviews the different aspects of a multidimensional, multidisciplinary geriatric assessment. Assessment tools and training of office staff to take on larger roles can help primary care providers reduce the burden of work associated with performing a comprehensive geriatric assessment.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28759970/a-novel-assessment-and-profiling-of-multidimensional-apathy-in-alzheimer-s-disease
#2
Ratko Radakovic, John M Starr, Sharon Abrahams
BACKGROUND: Apathy is a complex multidimensional syndrome frequently reported in Alzheimer's disease (AD) and is associated with impaired awareness. Here we present a psychometrically robust method to profile apathy in AD. OBJECTIVES: To determine the validity and reliability of a multidimensional apathy measure, the Dimensional Apathy Scale (DAS), and explore the apathy subtype profile and its associations in AD. METHODS: 102 people with AD and 55 healthy controls were recruited...
July 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28751850/anmco-sic-sici-gise-sicch-executive-summary-of-consensus-document-on-risk-stratification-in-elderly-patients-with-aortic-stenosis-before-surgery-or-transcatheter-aortic-valve-replacement
#3
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one of the most frequent valvular diseases in developed countries, and its impact on public health resources and assistance is increasing. A substantial proportion of elderly people with severe aortic stenosis is not eligible to surgery because of the advanced age, frailty, and multiple co-morbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750273/prognostic-value-of-the-g8-and-modified-g8-screening-tools-for-multidimensional-health-problems-in-older-patients-with-cancer
#4
Claudia Martinez-Tapia, Elena Paillaud, Evelyne Liuu, Christophe Tournigand, Rima Ibrahim, Virginie Fossey-Diaz, Stéphane Culine, Florence Canoui-Poitrine, Etienne Audureau
BACKGROUND: The G8 screening tool has been developed to identify older cancer patients requiring a geriatric assessment for tailoring therapy. Little is known about its prognostic value, particularly by tumour site. An optimised version has been recently developed, but no prognostic information is available. We compared the prognostic value of both instruments overall and by tumour site. METHODS: Data were from a prospective cohort of cancer patients ≥70 years old referred to 1 of 6 French geriatric oncology clinics between 2007 and 2014 (n = 1333)...
July 24, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28739160/using-heat-maps-to-assess-the-multidimensional-association-of-comorbidities-with-survival-in-older-cancer-patients-treated-with-chemotherapy
#5
Jae Jin Lee, Jongphil Kim, Marina Sehovic, Lu Chen, Martine Extermann
OBJECTIVE: To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We assessed how heat maps can unveil specific patterns of comorbidities associated with overall survival (OS) in older cancer patients treated with chemotherapy. MATERIAL AND METHODS: We reviewed four trials that prospectively evaluated comorbidities using CIRS-G...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28727796/effects-of-health-risk-assessment-and-counselling-on-physical-activity-in-older-people-a-pragmatic-randomised-trial
#6
Anna Marie Herghelegiu, André Moser, Gabriel Ioan Prada, Stephan Born, Matthias Wilhelm, Andreas E Stuck
BACKGROUND: Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling. METHODS: The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA...
2017: PloS One
https://www.readbyqxmd.com/read/28689569/rapid-geriatric-assessment-of-hip-fracture
#7
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/28689565/anorexia-of-aging-assessment-and-management
#8
REVIEW
Francesco Landi, Anna Picca, Riccardo Calvani, Emanuele Marzetti
Older people often experience loss of appetite and/or decreased food intake that, unavoidably, impact energy metabolism and overall health status. The association of age-related nutritional deficits with several adverse outcomes has led to the recognition of a geriatric condition referred to as "anorexia of aging." Anorexia is an independent predictor of morbidity and mortality both in the community and across clinical settings. Multidimensional interventions within personalized care plans currently represent the most effective option to ensure the provision of adequate amounts of food, limit weight loss, and prevent adverse health outcomes in older adults...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#9
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#10
Giovanni Guaraldi, Frank J Palella
: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28417242/combined-use-of-the-multidimensional-prognostic-index-mpi-and-procalcitonin-serum-levels-in-predicting-1-month-mortality-risk-in-older-patients-hospitalized-with-community-acquired-pneumonia-cap-a-prospective-study
#11
Alberto Pilotto, Simone Dini, Julia Daragjati, Manuela Miolo, Monica Maria Mion, Andrea Fontana, Mario Lo Storto, Martina Zaninotto, Alberto Cella, Paolo Carraro, Filomena Addante, Massimiliano Copetti, Mario Plebani
BACKGROUND: Several scores and biomarkers, i.e., procalcitonin (PCT), were proposed to stratify the mortality risk in community-acquired pneumonia (CAP). AIM: Evaluating prognostic accuracy of PCT and Multidimensional Prognostic Index (MPI) for 1-month mortality risk in older patients with CAP. METHODS: At hospital admission and at discharge, patients were evaluated by a Comprehensive Geriatric Assessment to calculate MPI. Serum PCT was measured at admission and 1, 3, and 5 days after hospital admission...
April 17, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28358731/major-health-impact-of-accelerated-aging-in-young-hiv-infected-individuals-on-antiretroviral-therapy
#12
Reena Rajasuriar, Meng L Chong, Nor S Ahmad Bashah, Siti A Abdul Aziz, Megan Mcstea, Erica C Y Lee, Pui L Wong, Iskandar Azwa, Sharifah F Syed Omar, Pauline S M Lai, Sasheela Ponampalavanar, Suzanne M Crowe, Sharon R Lewin, Shahrul B Kamaruzzaman, Adeeba Kamarulzaman
BACKGROUND: Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls. METHODS: HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community...
June 19, 2017: AIDS
https://www.readbyqxmd.com/read/28279606/frailty-and-multimorbidity-different-ways-of-thinking-about-geriatrics
#13
Matteo Cesari, Mario Ulises Pérez-Zepeda, Emanuele Marzetti
The terms multimorbidity and frailty are increasingly used in the medical literature to measure the risk profile of an older individual in order to support clinical decisions and design ad hoc interventions. The construct of multimorbidity was initially developed and used in nongeriatric settings. It generates a monodimensional nosological risk profile, grounding its roots in the somewhat inadequate framework of disease. On the other hand, frailty is a geriatric concept that implies a more exhaustive and comprehensive assessment of the individual and his/her environment, facilitating the implementation of multidimensional and tailored interventions...
April 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28244024/-geriatric-inpatients-with-iron-deficiency-associated-restless-legs-syndrome-a-retrospective-analysis
#14
Benjamin Lieske, Gabriele Röhrig, Ingrid Becker, Ralf-Joachim Schulz, Maria Cristina Polidori, Jan Kassubek
OBJECTIVE: The Restless Legs Syndrome (RLS) is a clinically relevant condition in geriatric patients. An association between iron deficiency and RLS is largely acknowledged. The clinical and therapeutic management of iron deficiency-associated RLS has been, however, poorly evaluated in geriatric patients. METHODS: Data from all RLS inpatients admitted to a geriatric unit between 2009 and 2011 were retrospectively collected on demographics and clinical characteristics, iron status, drug treatment including iron substitution, as well as comprehensive geriatric assessment (CGA) scores...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28238508/using-a-multidimensional-prognostic-index-mpi-based-on-comprehensive-geriatric-assessment-cga-to-predict-mortality-in-elderly-undergoing-transcatheter-aortic-valve-implantation
#15
Marie-Laure Bureau, Evelyne Liuu, Luc Christiaens, Alberto Pilotto, Jean Mergy, Fabienne Bellarbre, Pierre Ingrand, Marc Paccalin
BACKGROUND: Selection of appropriate elderly who can benefit from transcatheter aortic valve implantation (TAVI) is challenging. We evaluated the prognosis of this procedure according to the comprehensive geriatric assessment (CGA) based on the multidimensional prognostic index (MPI). METHODS: Prospective observational monocentric study from January 2013 to December 2015. Consecutive patients aged ≥75 who underwent TAVI and a complete CGA were included. Baseline demographic, geriatric and cardiologic data were collected...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28228654/low-ft3-a-possible-marker-of-frailty-in-the-elderly
#16
Aldo Bertoli, Alessia Valentini, Maria Assunta Cianfarani, Elena Gasbarra, Umberto Tarantino, Massimo Federici
INTRODUCTION: Frailty is associated with a functional decline of multiple physiological systems, of which they may be a cause or consequence. The objective of the study was to evaluate the prevalence of thyroid hormone modifications in elderly frail subjects and its relationship with frailty. STUDY POPULATION AND METHODS: An observational study was carried out at the University Hospital "Tor Vergata" in Rome among ambulatory and hospitalized patients. The study population consisted of 112 elderly subjects: 62 were hospitalized following hip fracture and 50 control subjects were outpatients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#17
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
February 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28049285/evidence-based-guidelines-for-fall-prevention-in-korea
#18
REVIEW
Kwang-Il Kim, Hye-Kyung Jung, Chang Oh Kim, Soo-Kyung Kim, Hyun-Ho Cho, Dae Yul Kim, Yong-Chan Ha, Sung-Hee Hwang, Chang Won Won, Jae-Young Lim, Hyun Jung Kim, Jae Gyu Kim
Falls and fall-related injuries are common in older populations and have negative effects on quality of life and independence. Falling is also associated with increased morbidity, mortality, nursing home admission, and medical costs. Korea has experienced an extreme demographic shift with its population aging at the fastest pace among developed countries, so it is important to assess fall risks and develop interventions for high-risk populations. Guidelines for the prevention of falls were first developed by the Korean Association of Internal Medicine and the Korean Geriatrics Society...
January 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28029467/-frail-vig-index-design-and-evaluation-of-a-new-frailty-index-based-on-the-comprehensive-geriatric-assessment
#19
Jordi Amblàs-Novellas, Joan Carles Martori, Núria Molist Brunet, Ramon Oller, Xavier Gómez-Batiste, Joan Espaulella Panicot
INTRODUCTION: Frailty is closely linked to health results. Frailty indexes (FI) and the Comprehensive Geriatric Assessment (CGA) are multidimensional tools. FI serve to quantitatively measure frailty levels. They have shown to have an excellent correlation with mortality. However, they are infrequently used in clinical practice. Given the need for new, more concise, and pragmatic FI, a new FI is proposed based on a CGA (Frail-VIG Index). MATERIAL AND METHODS: A prospective, observational, longitudinal study was conducted, with cohort follow up at 12 months or death...
May 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/27923981/sarcopenia-and-frailty-in-chronic-respiratory-disease
#20
Anna E Bone, Nilay Hepgul, Samantha Kon, Matthew Maddocks
Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field...
February 2017: Chronic Respiratory Disease
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