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multidimensional geriatric assessment

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https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#1
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
#2
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/significant-health-impact-of-accelerated-aging-in-young-hiv-infected-individuals-on-antiretroviral-therapy-in-malaysia
#3
Reena Rajasuriar, Meng Li Chong, Nor Syuhada Ahmad Bashah, Siti Azdiah Abdul Aziz, Megan Mcstea, Erica Chai Yong Lee, Pui Li Wong, Iskandar Azwa, Sharifah Faridah Syed Omar, Pauline Siew Mei Lai, Sasheela Ponampalavanar, Suzanne M Crowe, Sharon R Lewin, Shahrul Bahyah 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 characterised ten geriatric conditions (GCs) 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 out-patient clinic in University Malaya Medical Centre, Malaysia and controls from the community...
March 29, 2017: AIDS
https://www.readbyqxmd.com/read/28279606/frailty-and-multimorbidity-different-ways-of-thinking-about-geriatrics
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27908282/role-of-geriatric-intervention-in-the-treatment-of-older-patients-with-cancer-rationale-and-design-of-a-phase-iii-multicenter-trial
#12
Pierre Soubeyran, Catherine Terret, Carine Bellera, Franck Bonnetain, Olivier Saint Jean, Angéline Galvin, Camille Chakiba, Marie-Dominique Zwolakowski, Simone Mathoulin-Pélissier, Muriel Rainfray
BACKGROUND: In the general geriatric population, programs linking geriatric evaluation with interventions are effective for improving functional status and survival of the patients. Whether or not these interventions improve health related quality of life (HRQoL) or overall survival (OS) in older patients with cancer is not yet clear. Indeed, randomized data on the effect of such interventions on survival and HRQoL are rare and conflicting. We describe the rationale and design of a phase III multicenter trial aimed at assessing the efficacy of geriatric intervention in the management of elderly patients with cancer...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27896228/the-european-innovation-partnership-on-active-and-healthy-ageing-synergies-protocol-for-a-prospective-observational-study-to-measure-the-impact-of-a-community-based-program-on-prevention-and-mitigation-of-frailty-icp-pmf-in-community-dwelling-older-adults
#13
G Liotta, F Orfila, M Vollenbroek-Hutten, R Roller-Winsberger, M Illario, D Musian, S Alvino, R O'Caoimh, A Cano, W Molloy, G Iaccarino, M C Marazzi, M C Inzerilli, O Madaro, C Paul, P Csonka, A C Vince, E Menditto, M Maggio, P Scarcella, F Gilardi, F Lucaroni, P Abete, V Girardi, R Barra, L Palombi
Aim of this paper is to describe the protocol of the study "Impact of a Community-based Program on Prevention and Mitigation of Frailty in community-dwelling older adults" developed in the framework of the European Innovation Partnership on Active and Healthy Ageing. This proposal has been developed by the Partnership Action groups on frailty, fall prevention and polypharmacy in older. The proposal wants to assess the impact of community-based programs aimed to counteract three main outcomes related to frailty: hospitalization, institutionalization and death...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27871235/development-of-the-interrai-home-care-frailty-scale
#14
John N Morris, Elizabeth P Howard, Knight R Steel
BACKGROUND: The concept of frailty, a relative state of weakness reflecting multiple functional and health domains, continues to receive attention within the geriatrics field. It offers a summary of key personal characteristics, providing perspective on an individual's life course. There have been multiple attempts to measure frailty, some focusing on physiologic losses, others on specific diseases, disabilities or health deficits. Recently, multidimensional approaches to measuring frailty have included cognition, mood and social components...
November 21, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27869890/-anmco-sic-sici-gise-sicch-consensus-document-risk-stratification-in-elderly-patients-undergoing-cardiac-surgery-and-transcatheter-aortic-valve-implantation
#15
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 the most frequent valvular diseases in developed countries, and its impact on public healthcare resources and assistance is increasing. A substantial proportion of elderly patients with severe aortic stenosis is frequently not eligible for surgery because of advanced age, frailty and multiple comorbidities. 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...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27803007/management-of-chronic-lymphocytic-leukemia-cll-in-the-elderly-a-position-paper-from-an-international-society-of-geriatric-oncology-siog-task-force
#16
R Stauder, B Eichhorst, M E Hamaker, K Kaplanov, V A Morrison, A Österborg, I Poddubnaya, J A Woyach, T Shanafelt, L Smolej, L Ysebaert, V Goede
Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is > 70 years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living and social support...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27726223/performance-of-the-multidimensional-geriatric-assessment-and-multidimensional-prognostic-index-in-predicting-negative-outcomes-in-older-adults-with-cancer
#17
V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27678211/frailty-and-resilience-in-an-older-population-the-role-of-resilience-during-rehabilitation-after-orthopedic-surgery-in-geriatric-patients-with-multiple-comorbidities
#18
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
https://www.readbyqxmd.com/read/27567441/assessment-of-frailty-in-community-dwelling-older-adults-residents-in-the-lazio-region-italy-a-model-to-plan-regional-community-based-services
#19
Giuseppe Liotta, Rónán O'Caoimh, Francesco Gilardi, Maria Grazia Proietti, Gennaro Rocco, Rosaria Alvaro, Paola Scarcella, D William Molloy, Stefano Orlando, Sandro Mancinelli, Leonardo Palombi, Alessandro Stievano, Maria Cristina Marazzi
PURPOSE OF THE STUDY: The prevalence of frailty is expected to increase worldwide in parallel with demographic ageing. Despite this, little is known about the prevalence in different populations particularly community-based samples. This cross-sectional study evaluates the prevalence of frailty in a community-dwelling older adult population and describes a methodology to plan community-based interventions. METHODOLOGY: A random sample of 1331 older adults, resident in the Lazio-Region of Italy, were screened by trained public health nurses (PHNs) by administering a validated questionnaire (the Functional Geriatric Evaluation questionnaire)...
January 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27534904/detained-and-distressed-persistent-distressing-symptoms-in-a-population-of-older-jail-inmates
#20
Marielle Bolano, Cyrus Ahalt, Christine Ritchie, Irena Stijacic-Cenzer, Brie Williams
Distressing symptoms are associated with poor function, acute care use, and mortality in older adults. The number of older jail inmates is increasing rapidly, prompting calls to develop systems of care to meet their healthcare needs, yet little is known about multidimensional symptom burden in this population. This cross-sectional study describes the prevalence and factors associated with distressing symptoms and the overlap between different forms of symptom distress in 125 older jail inmates in an urban county jail...
November 2016: Journal of the American Geriatrics Society
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