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multidimensional geriatric assessment

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
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
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)...
August 12, 2016: Archives of Gerontology and Geriatrics
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...
August 18, 2016: Journal of the American Geriatrics Society
Lorenzo M Donini, Eleonora Poggiogalle, Alessio Molfino, Aldo Rosano, Andrea Lenzi, Filippo Rossi Fanelli, Maurizio Muscaritoli
INTRODUCTION: Malnutrition plays a major role in clinical and functional impairment in older adults. The use of validated, user-friendly and rapid screening tools for malnutrition in the elderly may improve the diagnosis and, possibly, the prognosis. The aim of this study was to assess the agreement between Mini-Nutritional Assessment (MNA), considered as a reference tool, MNA short form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and Nutrition Risk Screening (NRS-2002) in elderly institutionalized participants...
October 1, 2016: Journal of the American Medical Directors Association
Naheed Rajabali, Darryl Rolfson, Sean M Bagshaw
Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement...
September 2016: Canadian Journal of Cardiology
E Damier, E Chidlovskii, B Bertrand, V M Dang, G Vanzetto, P Couturier
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a treatment for high-risk patients with symptomatic severe aortic stenosis. The aim of the study is to assess results of comprehensive geriatric assessment before TAVI and geriatrician advices about TAVI procedure feasibility. We report one-year outcomes after TAVI procedure. METHODS: All patients who underwent comprehensive geriatric assessment in geriatric day hospital before TAVI were prospectively included in Grenoble...
September 2016: Annales de Cardiologie et D'angéiologie
H Talasz, M Gosch, M Kofler, M Lechleitner
INTRODUCTION: Voiding disorders are a common problem in elderly people. The highest incidence and prevalence occurs in female patients with a high level of dependency and cognitive impairments. AIM: The aim of the study was to define the correlation between the presence of voiding disorders and age-related functional deficits in hospitalized elderly patients within the framework of a comprehensive geriatric assessment. This is of utmost importance for planning adequate further diagnostic and therapeutic measures...
July 6, 2016: Zeitschrift Für Gerontologie und Geriatrie
Maurizio Gallucci, Manuela Mazzetto, Pierpaolo Spagnolo, Maria Aricò, Cristina Bergamelli, Maria Grazia Oddo, Giovanni Gallo, Paola Astolfo, Enrico Di Giorgi, Nicola Vanacore
Dementia is one of the most disabling health conditions in older people. Increasing attention is paid to the preclinical phase of dementia and to the prevention programs to reduce the number of patients in the future. Aims of the current study are: a) to present Mild Cognitive Impairment (MCI) as a heterogeneous risk factor and to expose the relationship between cognitive impairment and lifestyles such as physical activity, Mediterranean diet, reading and socialization; b) to present a model, called "Camminando e leggendo… ricordo" (CLR), as a practical experience of secondary prevention aimed at MCI older people...
April 2016: Annali Dell'Istituto Superiore di Sanità
Müzeyyen Çiyiltepe, Özgül Akın Şenkal
BACKGROUND: Although voice therapy is commonly used as an initial treatment for geriatric dysphonia, its role in the treatment for different organic voice disorder is less defined. AIMS: The goal of this study was to investigate dysphonia and therapy modalities in this cohort. METHODS: This study analyzes the demographics, Voice Handicap Index questionnaires, and acoustic voice measures including fundamental frequency, jitter and shimmer by using Kay Elemetrics Computerized Speech Lab Multidimensional voice program which were obtained in all patients before and after treatment...
June 20, 2016: Aging Clinical and Experimental Research
L M Gutiérrez-Robledo, J A Avila-Funes
Traditionally, frailty has been understood as a biological syndrome associated with bad health-related outcomes. However, nowadays there are no universally accepted diagnostic criteria for this syndrome, much less studies approaching it from a non-biological framework. Some previous work has been able to highlight social factors as important features implicated in the development of this entity, and are now recognized as relevant to understand frailty. However, research in this field is still limited. It seems clear that social factors, often ignored in the medical context, might represent risk factors for the development of this geriatric syndrome...
2012: Journal of Frailty & Aging
Salvatore Battaglia, Alida Benfante, Mario Spatafora, Nicola Scichilone
KEY POINTS: Asthma in the elderly can be difficult to identify due to modifications of its clinical features and functional characteristics.Several comorbidities are associated with asthma in the elderly, and this association differs from that observed in younger patients.In clinical practice, physicians should treat comorbidities that are correlated with asthma (i.e. rhinitis or gastro-oesophageal reflux), assess comorbidities that may influence asthma outcomes (i.e. depression or cognitive impairment) and try to prevent comorbidities related to -'drug-associated side-effects (i...
March 2016: Breathe
Anna Maria Mello, Giulia Paroni, Julia Daragjati, Alberto Pilotto
Studies on populations at different ages have shown that after birth, the gastrointestinal (GI) microbiota composition keeps evolving, and this seems to occur especially in old age. Significant changes in GI microbiota composition in older subjects have been reported in relation to diet, drug use and the settings where the older subjects are living, that is, in community nursing homes or in a hospital. Moreover, changes in microbiota composition in the old age have been related to immunosenescence and inflammatory processes that are pathophysiological mechanisms involved in the pathways of frailty...
2016: Digestive Diseases
E Liuu, P Caillet, H Curé, N Anfasi, L De Decker, F Pamoukdjian, F Canouï-Poitrine, P Soubeyran, E Paillaud
Scientific societies recommend the implementation of a comprehensive geriatric assessment (CGA) in cancer patients aged 70 and older. The EGA is an interdisciplinary multidimensional diagnostic process seeking to assess the frail older person in order to develop a coordinated plan of treatment and long-term follow-up. Identification of comorbidities and age-induced physiological changes that may increase the risk of anticancer treatment toxicities is essential to better assess the risk-benefit ratio in elderly cancer patients...
July 2016: La Revue de Médecine Interne
Fabio Agusta, Salvatore Battaglia, Alida Benfante, Mario Spatafora, Nicola Scichilone
Asthma in older populations is characterized by frequent comorbid conditions, which increase the risk of side effects and of detrimental interactions between respiratory and non-respiratory drugs. These observations lead to the need to manage asthma in older populations by applying a multidimensional assessment and a multidisciplinary treatment; therefore, we favor the use of the 'geriatric' term to define asthma in the elderly. Geriatric asthma is a complex disease, which may not necessarily imply that it is also complicated, although the two conditions may often coexist...
July 2016: Expert Review of Clinical Pharmacology
D R Gustafson, Q Shi, M Thurn, S Holman, H Minkoff, M Cohen, M W Plankey, R Havlik, A Sharma, S Gange, M Gandhi, J Milam, D Hoover
BACKGROUND: Biological similarities are noted between aging and HIV infection. Middle-aged adults with HIV infection may present as elderly due to accelerated aging or having more severe aging phenotypes occurring at younger ages. OBJECTIVES: We explored age-adjusted prevalence of frailty, a geriatric condition, among HIV+ and at risk HIV- women. DESIGN: Cross-sectional. SETTING: The Women's Interagency HIV Study (WIHS)...
2016: Journal of Frailty & Aging
Mariana Murea, Scott Satko
Vascular access preparation, a pervasive challenge in hemodialysis (HD), is emerging as a multidimensional subject in geriatric nephrology. Previously published guidelines declared arteriovenous fistulas (AVF) as the preferred vascular access for all patients on HD. In this article, the benefit-risk evidence for using AVF versus an alternative access (arteriovenous graft [AVG] or tunneled central venous catheter [TCVC]) in the elderly is pondered. Compared to their younger counterparts, the elderly have significantly lower survival rates independent of the vascular access used for HD...
September 2016: Seminars in Dialysis
Zeljka Popović, Ivanka Gajić, Kosovka Obradović-Djuricić, Dragoslav P Milosević
BACKGROUND/AIM: Quality of life related to health should be seen as a multidimensional concept that, in addition to the physical symptoms associated with a disease and treatment, should include physical, psychological and social functioning of a person. The primary objective of this study was to use the Serbian preliminary version of the Geriatric Oral Health Assessment Index (GOHAI) questionnaire in oder to examine the consistency, reliability and stability, as well as an introduction to the verification tool...
December 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Grazia D'Onofrio, Francesco Panza, Daniele Sancarlo, Francesco F Paris, Leandro Cascavilla, Antonio Mangiacotti, Michele Lauriola, Giulia H Paroni, Davide Seripa, Antonio Greco
In Alzheimer's disease (AD) patients with delusions, clinical outcomes and mortality result from a combination of psychological, biological, functional, and environmental factors. We determined the effect of delusions on mortality risk, clinical outcomes linked to comprehensive geriatric assessment (CGA), cognitive, depressive, and neuropsychiatric symptoms (NPS) in 380 consecutive AD patients with Mini-Mental State Examination, Clinical Dementia Rating scale, 15-item Geriatric Depression Scale, and Neuropsychiatric Inventory (NPI), assessing one-year mortality risk using the Multidimensional Prognostic Index (MPI)...
2016: Journal of Alzheimer's Disease: JAD
Henk Verloo, Céline Goulet, Diane Morin, Armin von Gunten
BACKGROUND: Delirium and frailty - both potentially reversible geriatric syndromes - are seldom studied together, although they often occur jointly in older patients discharged from hospitals. This study aimed to explore the relationship between delirium and frailty in older adults discharged from hospitals. METHODS: Of the 221 patients aged >65 years, who were invited to participate, only 114 gave their consent to participate in this study. Delirium was assessed using the confusion assessment method, in which patients were classified dichotomously as delirious or nondelirious according to its algorithm...
2016: Clinical Interventions in Aging
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