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frailty and comorbidity

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https://www.readbyqxmd.com/read/29336608/prevalence-of-frailty-and-its-association-with-depressive-symptoms-among-older-adults-in-singapore
#1
Lixia Ge, Chun Wei Yap, Bee Hoon Heng
OBJECTIVES: The aims of the study were to (1) estimate the prevalence of frailty among community-dwelling older adults , and (2) investigate the independent association between level of frailty and depressive symptoms. METHODS: A total of 721 older adults (aged 60 and above ) were included in this study. Severity of frailty was determined using the Clinical Frailty Scale and further classified into four levels (CFS1-3: F1, CFS4: F2, CFS5: F3, and CFS6-7: F4). The depressive symptoms were assessed using the Patient Health Questionnaire-9...
January 16, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29334783/frailty-a-global-measure-of-the-multisystem-impact-of-copd
#2
Nichola S Gale, Ali M Albarrati, Margaret M Munnery, Ruth E Hubbard, Ruth Tal-Singer, John R Cockcroft, Dennis J Shale
Chronic obstructive pulmonary disease (COPD) is a multisystem disease that resembles the accumulation of multiple impairments seen in aging. A comprehensive geriatric assessment (CGA) captures multisystem deficits, from which a frailty index (FI) can be derived. We hypothesized that patients with COPD would be frailer than a comparator group free from respiratory disease. In this cross-sectional analysis, the CGA questionnaire was completed and used to derive an FI in 520 patients diagnosed with COPD and 150 comparators...
January 1, 2018: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/29333024/a-risk-benefit-assessment-approach-to-selection-of-adjuvant-chemotherapy-in-elderly-patients-with-early-breast-cancer-a-mini-review
#3
REVIEW
Vivek Agarwala, Neha Choudhary, Sudeep Gupta
Decision-making regarding the use and selection of adjuvant chemotherapy for breast cancer in elderly patients is challenging due to the presence of age-related comorbidities, frailty, and competing causes of mortality. One area, relatively neglected in most guidelines, is the effect of competing causes of mortality on presumed benefit of adjuvant chemotherapy for breast cancer in these patients. This article utilizes a clinical case to illustrate the principles of risk-benefit assessment of adjuvant chemotherapy in elderly patients...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#4
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29324562/effectiveness-of-interventions-to-prevent-pre-frailty-and-frailty-progression-in-older-adults-a-systematic-review
#5
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Barbara D'Avanzo, Holly Gwyther, Carol Holland
OBJECTIVE: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. INTRODUCTION: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its prevention and treatment, has been presented. INCLUSION CRITERIA: The review considered studies on older adults aged 65 and over, explicitly identified as pre-frail or frail, who had been undergoing interventions focusing on the prevention of frailty progression...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#6
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29315727/considerations-for-optimal-blood-pressure-goals-in-the-elderly-population-a-review-of-emergent-evidence
#7
Diana X Cao, Rebecca J C Tran
Recent hypertension clinical trials and national guideline updates have created a debate on the most appropriate treatment goals in elderly patients with hypertension. In 2014, recommendations by the Eighth Joint National Committee (JNC 8) allowed a more lenient goal for patients 60 years and older compared with previous guidelines. Since then, several large clinical trials and meta-analyses have added more information regarding strict versus lenient treatment goals. Most recently, the American College of Cardiology and American Heart Association Task Force published their highly-anticipated hypertension guideline developed in conjunction with nine additional interdisciplinary organizations...
January 8, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29313883/simple-method-of-screening-for-frailty-in-older-adults-using-a-chronometer-and-tape-measure-in-clinic
#8
Hee-Won Jung, Min-Gu Kang, Jung-Yeon Choi, Sol-Ji Yoon, Sun-Wook Kim, Kwang-Il Kim, Cheol-Ho Kim
OBJECTIVES: Detecting frailty in older adults scheduled for surgery is important to predict the occurrence of adverse outcomes, but because of its complexity, frailty screening is not commonly performed. The objective of the current study was to assess whether frailty can be screened for using automatically measured usual gait speed (UGS) and mid-arm circumference (MAC) in the outpatient clinic. DESIGN: Prospective, cross-sectional study. SETTING: Geriatric center of a tertiary hospital...
January 4, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29298301/mapping-of-global-scientific-research-in-comorbidity-and-multimorbidity-a-cross-sectional-analysis
#9
Ferrán Catalá-López, Adolfo Alonso-Arroyo, Matthew J Page, Brian Hutton, Rafael Tabarés-Seisdedos, Rafael Aleixandre-Benavent
BACKGROUND: The management of comorbidity and multimorbidity poses major challenges to health services around the world. Analysis of scientific research in comorbidity and multimorbidity is limited in the biomedical literature. This study aimed to map global scientific research in comorbidity and multimorbidity to understand the maturity and growth of the area during the past decades. METHODS AND FINDINGS: This was a cross-sectional analysis of the Web of Science...
2018: PloS One
https://www.readbyqxmd.com/read/29290596/management-of-older-adults-with-myelodysplastic-syndromes-mds
#10
REVIEW
Marlise R Luskin, Gregory A Abel
The myelodysplastic syndromes (MDS) are a varied group of hematologic neoplasms that lead to bone marrow failure, and also carry a risk of progression to acute myeloid leukemia. Patients with MDS suffer significant impairments to both their quality of life and survival. Age is the dominant risk factor for the development of MDS, with a median age at diagnosis over 70years. Consequently, patients with MDS frequently have concurrent comorbidities and/or frailty which may be coincident or related to the disease itself...
December 28, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29282013/an-investigation-of-factors-predicting-the-type-of-bladder-antimuscarinics-initiated-in-medicare-nursing-homes-residents
#11
Daniela C Moga, Qishan Wu, Pratik Doshi, Amie J Goodin
BACKGROUND: To examine factors predicting type of bladder antimuscarinics (BAM) initiated in nursing home (NH) residents. METHODS: Incident BAM initiators following NH admission were identified by constructing a retrospective cohort from Medicare files and Minimum Data Set (MDS). Participants included all residents 65 years and older admitted in Medicare-certified NH between January 1, 2007 and December 31, 2008 who were prescribed BAM and had continuous Medicare (Part A, B, and D) enrollment...
December 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29278266/regional-nerve-blockade-for-early-analgesic-management-of-elderly-patients-with-hip-fracture-a-narrative-review
#12
REVIEW
A Scurrah, C T Shiner, J A Stevens, S G Faux
Elderly patients with hip fracture experience high morbidity and mortality, and are often undertreated for pain. Acute pain management in the elderly is challenging, with physiological frailty, medical comorbidities and cognitive impairment commonly compounding pain assessment and treatment. Guidelines outlining current best practice for acute pain management in the elderly now exist, but evidence suggests that practice remains variable and there continues to be scope for improvement. We conducted a narrative review of the literature to examine the challenges of acute pain management in the elderly, and to evaluate evidence for the role of regional nerve blocks for acute pain associated with hip fracture in the elderly...
December 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29276105/grip-strength-measurement-for-frailty-assessment-in-patients-with-vascular-disease-and-associations-with-comorbidity-cardiac-risk-and-sarcopenia
#13
Thomas E Reeve, Rebecca Ur, Timothy E Craven, James H Kaan, Matthew P Goldman, Matthew S Edwards, Justin B Hurie, Gabriela Velazquez-Ramirez, Matthew A Corriere
OBJECTIVE: Frailty is associated with adverse events, length of stay, and nonhome discharge after vascular surgery. Frailty measures based on walking-based tests may be impractical or invalid for patients with walking impairment from symptoms or sequelae of vascular disease. We hypothesized that grip strength is associated with frailty, comorbidity, and cardiac risk among patients with vascular disease. METHODS: Dominant hand grip strength was measured during ambulatory clinic visits among patients with vascular disease (abdominal aortic aneurysm [AAA], carotid stenosis, and peripheral artery disease [PAD])...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29260588/upfront-treatment-of-elderly-myeloma-patients-an-overview-and-update
#14
Hussein G Elsayed, Amal S Alabdulwahab
Multiple myeloma is primarily a disease of older age, with a median age of 70 years at diagnosis. Management of the disease in this diverse population is challenging, in the face comorbidities and frailties. Areas covered: This review discusses the management challenges of elderly myeloma patients in view of the current evidence and propose for performing a formal objective assessment of the functional status to guide choice of treatment. Expert commentary: The approval of many antimyeloma medications with various mechanisms of action in the past two decades had sparked the debate about choosing the best combination, duration of therapy, role of transplant and the possibility to cure myeloma after being changed to a chronic disease...
December 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29249644/current-systemic-therapies-for-metastatic-renal-cell-carcinoma-in-older-adults-a-comprehensive-review
#15
REVIEW
Manuel Caitano Maia, Jacob Adashek, Paulo Bergerot, Lorena Almeida, Simone Fernandes Dos Santos, Sumanta K Pal
Physiological changes that occur during the aging process may impact drug metabolism and availability, consequently affecting treatment efficacy and tolerability. Despite being a disease of older adults, there is little data to guide treatment decisions for older patients with metastatic renal cell carcinoma (mRCC). The recent approval of many new agents for this disease poses a clinical challenge: how to best utilize these drugs in a population (older adults) who has been generally under-represented in clinical studies...
December 14, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29248435/delphi-consensus-of-an-expert-committee-in-oncogeriatrics-regarding-comprehensive-geriatric-assessment-in-seniors-with-cancer-in-spain
#16
Maria-Jose Molina-Garrido, Carmen Guillén-Ponce, Remei Blanco, Juana Saldaña, Jaime Feliú, Maite Antonio, Rosa López-Mongil, Primitivo Ramos Cordero, Regina Gironés
OBJECTIVES: The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. MATERIAL AND METHODS: The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66...
December 13, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29244057/measuring-frailty-in-medicare-data-development-and-validation-of-a-claims-based-frailty-index
#17
Dae Hyun Kim, Sebastian Schneeweiss, Robert J Glynn, Lewis A Lipsitz, Kenneth Rockwood, Jerry Avorn
Background: Frailty is a key determinant of health status and outcomes of health care interventions in older adults that is not readily measured in Medicare data. This study aimed to develop and validate a claims-based frailty index (CFI). Methods: We used data from Medicare Current Beneficiary Survey 2006 (development sample: n = 5,593) and 2011 (validation sample: n = 4,424). A CFI was developed using the 2006 claims data to approximate a survey-based frailty index (SFI) calculated from the 2006 survey data as a reference standard...
December 13, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29230125/older-patients-with-acute-myeloid-leukemia-treatment-challenges-and-future-directions
#18
REVIEW
Laura Finn, Andrew Dalovisio, James Foran
Background: Even though acute myeloid leukemia (AML) occurs most commonly in adults ≥60 years, the treatment of AML in older patients remains a significant challenge. Methods: We reviewed the current literature regarding patient assessment tools, treatment options, and current therapies in clinical trial for patients with AML who are ≥60 years. Results: Our approach to the older patient with AML is evolving with better understanding of the unique disease epidemiology in this population and the development of tools to assess individual patient functional status, including grading systems for comorbidities, geriatric assessment tools, and measurements of frailty...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29225254/observational-study-of-infective-endocarditis-at-a-community-based-hospital-dominance-of-elderly-patients-with-comorbidity
#19
Tomoo Nagai, Yoshiyuki Takase, Akira Hamabe, Hirotsugu Tabata
Objective The purpose of this study was to present the recent clinical profiles and the real-world management of infective endocarditis (IE). Methods All medical records of patients with IE were reviewed retrospectively for their clinical data, including clinical presentation, laboratory results, blood cultures, echocardiographic findings, treatments and complications. Using the clinical data collected, we calculated the EuroSCORE II, the European risk score for adult cardiac surgery, the Charlson Comorbidity Index as a surrogate of comordibity, and the Katz Index as a surrogate of frailty...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29218839/association-between-number-of-teeth-use-of-dentures-and-musculoskeletal-frailty-among-older-adults
#20
Seoyoung Lee, Wael Sabbah
AIM: To assess whether there is a relationship between musculoskeletal frailty and number of teeth/denture use, and whether nutritional intake explains this relationship, in a sample of older Americans. METHODS: Data from the National Health and Nutrition Examination Survey 2011/2012 were used. Handgrip strength was used to show musculoskeletal frailty. Number of teeth and denture use were examined by calibrated dentists. Information on sociodemographic factors, nutrients intake and general health status were collected through interviews...
December 7, 2017: Geriatrics & Gerontology International
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