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https://www.readbyqxmd.com/read/28933001/redefining-aging-in-hiv-infection-using-phenotypes
#1
REVIEW
David M Stoff, Karl Goodkin, Dilip Jeste, Maria Marquine
PURPOSE OF REVIEW: This article critically reviews the utility of "phenotypes" as behavioral descriptors in aging/HIV research that inform biological underpinnings and treatment development. We adopt a phenotypic redefinition of aging conceptualized within a broader context of HIV infection and of aging. Phenotypes are defined as dimensions of behavior, closely related to fundamental mechanisms, and, thus, may be more informative than chronological age. Primary emphasis in this review is given to comorbid aging and cognitive aging, though other phenotypes (i...
September 20, 2017: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/28931449/frailty-and-depression-in-centenarians
#2
Oscar Ribeiro, Natália Duarte, Laetitia Teixeira, Constança Paúl
BACKGROUND: Physical frailty and depression are common comorbid conditions that have important impact on older adults. Few studies however have examined their co-occurrence in centenarians. This paper explores the relationship between the two conditions and the most characteristic depressive symptoms associated with the frailty syndrome. METHODS: Data come from two Portuguese Centenarian Studies. Frailty was measured using Fried's phenotype, which includes at least three clinical signs: exhaustion, weight loss, weakness, slowness, and low physical activity level; the Geriatric Depression Scale was used to assess depression...
September 21, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28927567/discriminative-ability-of-elixhauser-s-comorbidity-measure-is-superior-to-other-comorbidity-scores-for-inpatient-adverse-outcomes-after-total-hip-arthroplasty
#3
Nathaniel T Ondeck, Daniel D Bohl, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
BACKGROUND: Identifying patients at highest risk for a complex perioperative course following total hip arthroplasty (THA) is more important than ever in order to educate patients, optimize outcomes, and to minimize cost and length of stay. There are no known studies comparing the clinically relevant discriminative ability of 3 commonly used comorbidity indices for adverse outcomes following THA: Elixhauser Comorbidity Measure (ECM), the Charlson Comorbidity Index (CCI), and the modified Frailty Index (mFI)...
September 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28922281/systematic-changes-in-the-national-surgical-quality-improvement-program-database-over-the-years-can-affect-comorbidity-indices-such-as-the-modified-frailty-index-and-modified-charlson-comorbidity-index-for-lumbar-fusion-studies
#4
Blake N Shultz, Taylor D Ottesen, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study of prospectively collected data. OBJECTIVE: To investigate the influence of changes in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database over the years on the calculation of the modified Frailty Index (mFI) and the modified Charlson Comorbidity Index (mCCI) for posterior lumbar fusion studies. SUMMARY OF BACKGROUND DATA: Multiple studies have utilized the mFI and/or mCCI and showed them to be predictors of adverse postoperative outcomes...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28917516/impact-of-frailty-on-outcomes-in-patients%C3%A2-undergoing-percutaneous-mitral%C3%A2-valve-repair
#5
Clemens Metze, Anna-Sophie Matzik, Maximilian Scherner, Maria Isabel Körber, Guido Michels, Stephan Baldus, Volker Rudolph, Roman Pfister
OBJECTIVES: The aim of this study was to describe the impact of frailty in patients undergoing percutaneous mitral valve repair (PMVR). BACKGROUND: Frailty is common in elderly patients and those with comorbidities and is associated with adverse prognosis. METHODS: Frailty according to the Fried criteria was assessed in consecutive patients admitted for PMVR. Associations of frailty with 6-week (device success, changes in 6-minute walking distance and Minnesota Living With Heart Failure Questionnaire and Short Form 36 physical and mental component scores, and improvement ≥1 New York Heart Association functional class) and long-term outcomes during a median follow-up period of 429 days were examined...
September 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#6
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28906482/real-life-experience-with-bortezomib-based-regimens-in-elderly-comorbid-patients-with-newly-diagnosed-multiple-myeloma-polish-retrospective-multicenter-analysis
#7
Iwona Hus, Adam Walter-Croneck, Anna Masternak, Artur Jurczyszyn, Lidia Usnarska-Zubkiewicz, Łukasz Bołkun, Agnieszka Druzd-Sitek, Marcin Rymko, Jadwiga Łętowska, Ewa Lech-Marańda, Marcin Pasiarski, Anna Dmoszyńska
INTRODUCTION    Bortezomib was the first proteasome inhibitor approved in multiple myeloma therapy, initially for resistant/relapsed disease. Currently, VMP (bortezomib, melphalan, prednisone) is one of standard regimens recommended in a first line therapy for patients with multiple myeloma ineligible for high-dose chemotherapy/ autotransplantation (HDT/autoSCT) basing on the results of phase 3 clinical trial by Miguel et al that demonstrated its superiority to MP protocol.  OBJECTIVES    Patients participating in clinical trials are highly selected populations, so observations from clinical practice might provide important information for medical practitioners...
September 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28899661/frailty-polypharmacy-and-health-outcomes-in-older-adults-the%C3%A2-frailty-and-dependence-in-albacete-study
#8
Bonaga Beatriz, Pedro M Sánchez-Jurado, Marta Martínez-Reig, Gabriel Ariza, Leocadio Rodríguez-Mañas, Danijela Gnjidic, Tránsito Salvador, Pedro Abizanda
BACKGROUND/OBJECTIVES: To investigate if polypharmacy modifies the association between frailty and health outcomes in older adults. DESIGN: Ongoing cohort study. SETTING: Albacete City, Spain. PARTICIPANTS: A total for 773 participants, 457 women (59.1%), over age 70 years from the FRADEA Study. MEASUREMENTS: Frailty phenotype, polypharmacy considered as the chronic use of 5 or more drugs, and comorbidity were collected at the baseline visit...
September 9, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28878582/transcatheter-mitral-valve-replacement-with-the-edwards-sapien-3-valve
#9
Biswajit Kar, Angelo Nascimbene, Igor D Gregoric, Manish Patel, Pranav Loyalka
We describe the case of a 57-year-old man who had severe mitral valve stenosis and regurgitation without significant annular calcification. He was not a candidate for surgical valve replacement or repair because of his substantial comorbid conditions, overall frailty, and elevated surgical risk. He underwent successful transcatheter mitral valve replacement of his native mitral valve with compassionate, off-label use of an Edwards Sapien 3 valve. A search of the literature produced no other cases like ours, which represents a further evolution of the transcatheter valve implantation concept...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28874297/patients-with-non-st-segment-elevation-acute-coronary-syndromes-managed-without-coronary-revascularization-a-population-needing-treatment-improvement
#10
Alberto Menozzi, Stefano De Servi, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Zoran Olivari, Leonardo De Luca
NSTE-ACS patients are a heterogeneous population, with different clinical features and prognosis. A large proportion of them is medically managed, without any revascularization. In the EYSHOT and FAST-MI registries such patients were 40% and 35%, respectively. These patients are at higher risk of adverse cardiovascular events and have a worse prognosis compared with those receiving revascularization. Medically managed NSTE-ACS patients consist of different subgroups: those not undergoing coronary angiography, those without significant coronary artery disease, and those with coronary stenoses not referred to revascularization...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28873220/patterns-and-predictors-of-frailty-transitions-in-older-men-the-osteoporotic-fractures-in-men-study
#11
Lauren R Pollack, Stephanie Litwack-Harrison, Peggy M Cawthon, Kristine Ensrud, Nancy E Lane, Elizabeth Barrett-Connor, Thuy-Tien Dam
OBJECTIVES: To describe the natural history of frailty transitions in a large cohort of community-dwelling older men and identify predictors associated with progression to or improvement from states of greater frailty. DESIGN: Prospective cohort study. SETTING: Six U.S. sites. PARTICIPANTS: Community-dwelling men aged 65 and older (N = 5,086). MEASUREMENTS: Frailty was measured at baseline and an average of 4...
September 5, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28868074/update-on-pharmacological-treatment-of-acute-coronary-syndrome-without-persistent-st-segment-elevation-myocardial-infarction-in-the-elderly
#12
REVIEW
Coşkun Usta, Aslı Bedel
The increase in cardiovascular disease prevalence with ageing has been attributed to several age-related changes such as changes in the vascular wall elasticity, the coagulation and haemostatic system and endothelial dysfunction, among other causes. There is a 50% increased mortality risk per 10-year increase in age starting at 65 years old. Here, we aimed to discuss pharmacological treatment in acute coronary syndrome (ACS) without persistent ST segment elevation myocardial infarction in the elderly. The main aim of ACS treatment in elderly people is at preventing ischemia, myocardial damage and complications...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#13
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28863199/hypertension-treatment-strategies-for-older-adults
#14
REVIEW
Maggie W Hansell, Emily M Mann, Julienne K Kirk
This evidence-based review illustrates how to adjust treatment for comorbidities and incorporate frailty and cognitive impairment into the equation.
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28860112/risk-factors-for-falls-in-older-patients-with-cancer
#15
Xiaotao Zhang, Ming Sun, Suyu Liu, Cheuk Hong Leung, Linda Pang, Uday R Popat, Richard Champlin, Holly M Holmes, Vicente Valero, Colin P Dinney, Debu Tripathy, Beatrice J Edwards
OBJECTIVES: A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer. METHODS: This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment...
August 31, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28858118/an-evaluation-of-medication-appropriateness-and-frailty-among-residents-of-aged-care-homes-in-malaysia-a-cross-sectional-study
#16
Syed Shahzad Hasan, Chia Siang Kow, Rohit Kumar Verma, Syed Imran Ahmed, Piyush Mittal, David W K Chong
Aging is significantly associated with the development of comorbid chronic conditions. These conditions indicate the use of multiple medications, and are often warranted by clinical guidelines. The aim of the present study was to evaluate medication appropriateness and frailty among Malaysian aged care home residents with chronic disease. The participants were 202 elderly (≥65 years) individuals, a cross-sectional sample from 17 aged care homes. After ethics approval, each participant was interviewed to collect data on sociodemographics, frailty status (Groningen Frailty Indicator [GFI]), medication appropriateness (Medication Appropriateness Index (MAI), the 2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP])...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28840621/controlling-confounding-by-frailty-when-estimating-influenza-vaccine-effectiveness-using-predictors-of-dependency-in-activities-of-daily-living
#17
Henry T Zhang, Leah J McGrath, Richard Wyss, Alan R Ellis, Til Stürmer
PURPOSE: To improve control of confounding by frailty when estimating the effect of influenza vaccination on all-cause mortality by controlling for a published set of claims-based predictors of dependency in activities of daily living (ADL). METHODS: Using Medicare claims data, a cohort of beneficiaries >65 years of age was followed from September 1, 2007, to April 12, 2008, with covariates assessed in the 6 months before follow-up. We estimated Cox proportional hazards models of all-cause mortality, with influenza vaccination as a time-varying exposure...
August 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28838148/serum-c-reactive-protein-and-congestive-heart-failure-as-significant-predictors-of-herpes-zoster-vaccine-response-in-elderly-nursing-home-residents
#18
Chris P Verschoor, Alina Lelic, Robin Parsons, Carole Evelegh, Jonathan L Bramson, Jennie Johnstone, Mark B Loeb, Dawn M E Bowdish
Background: Elderly long-term care residents often exhibit a myriad of risk factors for immune dysfunction, including chronic inflammation and multiple comorbid conditions, which undoubtedly contribute to their enhanced susceptibility to infection. Hence, understanding the factors required for optimal vaccine responsiveness is critical. Methods: We examined 187 elderly nursing home residents (aged 80-102 years) and 50 community-dwelling seniors (aged 60-75 years) immunized with the live-attenuated varicella-zoster virus (VZV) vaccine...
July 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28835590/association-between-preoperative-frailty-and-mortality-in-patients-with-critical-limb-ischemia-following-infrainguinal-bypass-surgery%C3%A3-usefulness-of-the-barthel-index
#19
Akio Kodama, Akio Koyama, Masayuki Sugimoto, Kiyoaki Niimi, Hiroshi Banno, Kimihiro Komori
BACKGROUND: Most patients with critical limb ischemia (CLI) exhibit severe comorbidities accompanied by frailty. This study assessed and risk-stratified mortality after infrainguinal bypass (IB) in CLI and investigated the effects of frailty.Methods and Results:The study retrospectively reviewed 107 consecutive CLI patients who had undergone de novo IB due to atherosclerotic disease. Data regarding patient age, comorbidities, laboratory data, and functional status were collected; functional status was evaluated using the Barthel index (BI) and nutritional status was evaluated using albumin concentrations and body mass index (BMI)...
August 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28825716/targeting-cellular-senescence-prevents-age-related-bone-loss-in-mice
#20
Joshua N Farr, Ming Xu, Megan M Weivoda, David G Monroe, Daniel G Fraser, Jennifer L Onken, Brittany A Negley, Jad G Sfeir, Mikolaj B Ogrodnik, Christine M Hachfeld, Nathan K LeBrasseur, Matthew T Drake, Robert J Pignolo, Tamar Pirtskhalava, Tamara Tchkonia, Merry Jo Oursler, James L Kirkland, Sundeep Khosla
Aging is associated with increased cellular senescence, which is hypothesized to drive the eventual development of multiple comorbidities. Here we investigate a role for senescent cells in age-related bone loss through multiple approaches. In particular, we used either genetic (i.e., the INK-ATTAC 'suicide' transgene encoding an inducible caspase 8 expressed specifically in senescent cells) or pharmacological (i.e., 'senolytic' compounds) means to eliminate senescent cells. We also inhibited the production of the proinflammatory secretome of senescent cells using a JAK inhibitor (JAKi)...
September 2017: Nature Medicine
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