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frailty and comorbidity

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https://www.readbyqxmd.com/read/28091402/geriatric-assessment-to-predict-survival-and-risk-of-serious-adverse-events-in-elderly-newly-diagnosed-multiple-myeloma-patients-a-multicenter-study-in-china
#1
Yu-Ping Zhong, Yi-Zhuo Zhang, Ai-Jun Liao, Su-Xia Li, Chen Tian, Jin Lu
BACKGROUND: Elderly multiple myeloma (MM) patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival (OS) time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. METHODS: We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#2
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28073582/risk-of-inflammatory-bowel-disease-in-patients-with-rosacea-results-from-a-nationwide-cohort-study-in-taiwan
#3
Chun-Ying Wu, Yun-Ting Chang, Chao-Keui Juan, Jeng-Jer Shieh, Yu-Pu Lin, Han-Nan Liu, Jaw-Town Lin, Yi-Ju Chen
BACKGROUND: A link between rosacea and inflammatory bowel disease (IBD) has been proposed with unknown mechanisms. Epidemiologic evidence of this association needs to be examined. METHODS: In this nationwide cohort study, a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 were identified in the Taiwanese National Health Insurance Research Database. Cumulative incidences of IBD were compared between these 2 cohorts...
January 7, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28065454/the-prevalence-association-and-clinical-outcomes-of-frailty-in-maintenance-dialysis-patients
#4
So-Young Lee, Dong Ho Yang, Eunah Hwang, Seock Hui Kang, Sun-Hee Park, Tae Woo Kim, Duk Hyun Lee, Kisoo Park, Jun Chul Kim
OBJECTIVE: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis. DESIGN: In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#5
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28058214/older-candidates-for-kidney-transplantation-who-to-refer-and-what-to-expect
#6
REVIEW
Beatrice P Concepcion, Rachel C Forbes, Heidi M Schaefer
The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28053514/clinical-outcome-and-predictors-of-adverse-events-of-an-enhanced-older-adult-psychiatric-liaison-service-rapid-assessment-interface-and-discharge-newport
#7
Inderpal Singh, Priya Fernando, Jane Griffin, Chris Edwards, Kathryn Williamson, Patrick Chance
BACKGROUND: Hospitals are currently admitting an increasing number of older people, and more than one-third could have an underlying mental health problem. The existing Older Adult Mental Health (OAMH) liaison service was increasingly unable to meet the escalating needs of older and frail patients. Therefore, the service was modernized and enhanced on an "invest-to-save" principle to provide a prompt holistic assessment for older adults with mental health problems. The objective of this study was a service evaluation to appraise clinical outcome, minimize the length of stay, and measure the predictors of adverse outcomes to streamline this enhanced service...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28049443/performance-of-edmonton-frail-scale-on-frailty-assessment-its-association-with-multi-dimensional-geriatric-conditions-assessed-with-specific-screening-tools
#8
Simone Perna, Matthew D'Arcy Francis, Chiara Bologna, Francesca Moncaglieri, Antonella Riva, Paolo Morazzoni, Pietro Allegrini, Antonio Isu, Beatrice Vigo, Fabio Guerriero, Mariangela Rondanelli
BACKGROUND: The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. METHODS: We enrolled 366 hospitalised patients (women\men: 251\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength)...
January 4, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28031949/the-effect-of-frailty-should-be-considered-in-the-management-plan-of-older-people-with-type-2-diabetes
#9
REVIEW
Ahmed H Abdelhafiz, Luan Koay, Alan J Sinclair
The prevalence of diabetes is increasing especially in older age due to increased life expectancy. In old age, diabetes is associated with high comorbidity burden and increased prevalence of geriatric syndromes including frailty in addition to micro- and macro-vascular complications. The emergence of frailty may change the natural history of Type 2 diabetes from a progressive to a regressive course with increased risk of hypoglycemia. This may result in normalization of blood glucose levels and lead to a state of burnt-out diabetes in frail older people with significant weight loss...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28024089/is-polypharmacy-associated-with-frailty-in-older-people-results-from-the-esther-cohort-study
#10
Kai-Uwe Saum, Ben Schöttker, Andreas D Meid, Bernd Holleczek, Walter E Haefeli, Klaus Hauer, Hermann Brenner
OBJECTIVES: To investigate the relationship between polypharmacy and frailty. DESIGN: Longitudinal, observational cohort study. SETTING: Saarland, Germany. PARTICIPANTS: 3,058 community-dwelling adults aged between 57 and 84 years. MEASUREMENTS: Frailty was assessed according to the frailty phenotype, described by Fried et al. Polypharmacy and hyperpolypharmacy were defined as the concomitant use of five or more and 10 or more drugs, respectively...
December 26, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28000144/standing-balance-and-strength-measurements-in-older-adults-living-in-residential-care-communities
#11
Bader A Alqahtani, Mary Ann Ferchak, Theodore J Huppert, Ervin Sejdic, Subashan Perera, Susan L Greenspan, Patrick J Sparto
Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility...
December 20, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#12
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
December 20, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27996360/liver-transplantation-for-hepatocellular-carcinoma-in-young-adults-a-united-network-for-organ-sharing-study
#13
Stefanie M Thomas, Diana Moke, Rocio Lopez, Rabi Hanna, Mohammad Nasser Kabbany, Naim Alkhouri
PURPOSE: Orthotopic liver transplantation (OLT) is curative for hepatocellular carcinoma (HCC). HCC is typically a disease of older adults (OAs); therefore, characteristics and outcomes of OLT for young adults (YAs) (ages 18-40) are not described. The objective of this study was to assess the characteristics and outcomes of YAs with HCC receiving OLT and compare these to OAs (ages >40 years). METHODS: YAs with HCC who had OLT from the United Network for Organ Sharing (UNOS) database were included in this study...
December 20, 2016: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/27994444/the-influence-of-frailty-syndrome-on-medication-adherence-among-elderly-patients-with-hypertension
#14
Beata Jankowska-Polańska, Krzysztof Dudek, Anna Szymanska-Chabowska, Izabella Uchmanowicz
BACKGROUND: Hypertension affects about 80% of people older than 80 years; however, diagnosis and treatment are difficult because about 55% of them do not adhere to treatment recommendations due to low socioeconomic status, comorbidities, age, physical limitations, and frailty syndrome. AIMS: The purposes of this study were to evaluate the influence of frailty on medication adherence among elderly hypertensive patients and to assess whether other factors influence adherence in this group of patients...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27935555/algoplus%C3%A2-scale-in-older-patients-with%C3%A2-dementia-a-reliable-real-world-pain%C3%A2-assessment-tool
#15
Fiammetta Monacelli, Alessio Signori, Laura Roffredo, Katiuscia Pace, Alessio Nencioni, Gisele Pickering, Macian Nicolas, Patrizio Odetti
Pain is still a neglected clinical issue in elderly people with dementia and/or communicative disorders, with an unacceptable higher rate of under diagnosis and under treatment. Cognitive deficit and emotional and psychological disturbances entangle pain symptoms, affecting patient self-report. So far, observational pain tools do not have fully adequate clinimetric properties and quality requirements for easy-to-use daily rating. Older patients with dementia represent a clinical challenge. The assessment of pain is important for improving clinical outcomes, such as functional status, frailty trajectories, comorbidity, and quality of life...
December 5, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#16
Nathan E Brummel, Susan P Bell, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Alessandro Morandi, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, Thomas M Gill, E Wesley Ely
INTRODUCTION The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those ≥18 years old with critical illness is unclear. We hypothesized greater frailty would be associated with subsequent mortality, disability, and cognitive impairment, regardless of age. METHODS At enrollment, we measured frailty using the Clinical Frailty Scale (CFS, range 1 [very fit] to 7 [severely frail]). At 3 and 12 months post-discharge, we assessed vital status, instrumental and basic activities of daily living (IADLs and BADLs), and cognition...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27917433/deaths-among-elderly-patients-in-the-emergency-department-a-needs-assessment-for-end-of-life-care
#17
Rakhee Yash Pal, Win Sen Kuan, Yiwen Koh, Kuhan Venugopal, Irwani Ibrahim
INTRODUCTION: Elderly patients with serious chronic diseases often present to the emergency department (ED) in the last moments of their life, many with identifiable trajectories of dying: organ failure; advanced cancer; and chronic frailty. These patients and their families may benefit more from good end-of-life (EOL) care provision than the standard resuscitative approach. This study aimed to determine the incidence and nature of death among patients aged 65 years and above in an ED, and characterise their trajectories of dying...
December 5, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27914496/computed-tomography-derived-skeletal-muscle-index-a-novel-predictor-of-frailty-and-hospital-length-of-stay-after-transcatheter-aortic-valve-replacement
#18
Vishal Dahya, Jingjie Xiao, Carla M Prado, Penny Burroughs, Dan McGee, Aline C Silva, Julian E Hurt, Shafi G Mohamed, Thomas Noel, Wayne Batchelor
: To determine the prevalence of low skeletal muscle mass in patients undergoing transcatheter aortic valve replacement (TAVR) and whether skeletal muscle mass measured from preoperative computed tomography (CT) images provides value in predicting postoperative length of stay (LOS). BACKGROUND: There are limited data on the use of body composition as a frailty measure in TAVR patients and no studies have determined if this measure predicts LOS. METHODS: We studied 104 consecutive patients who underwent TAVR at Tallahassee Memorial Hospital from 2012 to 2016...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#19
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913517/treatment-of-low-risk-myelodysplastic-syndromes
#20
Valeria Santini
The majority of myelodysplastic syndrome (MDS) patients belong to the International Prognostic Scoring System (IPSS) and IPSS-revised (IPSS-R) lower-risk categories. Their precise diagnostics and prognostic stratification is often a challenge, but may ensure the optimization of therapy. The availability of diverse treatment options has significantly improved the quality of life and survival of this group of patients. Anemia is the most relevant cytopenia in terms of frequency and symptoms in lower-risk MDS, and may be treated successfully with erythropoietic stimulating agents, provided a careful selection is performed on the basis of IPSS-R, endogenous erythropoietin levels, and transfusion independence...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
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