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frailty and comorbidity

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https://www.readbyqxmd.com/read/28819091/review-of-current-evidence-regarding-surgery-in-elderly-patients-with-meningioma
#1
Fusao Ikawa, Yasuyuki Kinoshita, Masaaki Takeda, Taiichi Saito, Satoshi Yamaguchi, Fumiyuki Yamasaki, Koji Iida, Kazuhiko Sugiyama, Kazunori Arita, Kaoru Kurisu
The Japanese population features the highest rate of elderly individuals worldwide. Moreover, Japan has the highest number of computed tomography/magnetic resonance imaging devices in the world, which has led to an increase in the incidental detection of meningioma in healthy elderly patients. Many previous papers have discussed the risks and indications for surgery in this patient population, but available information remains insufficient, and the definition of "elderly" has not been standardized. This review tried to clarify the published evidence and challenges associated with elderly meningioma based on a search of the PubMed database using the terms "meningioma," "elderly," and "surgery" for English-language clinical studies and collected related papers published from 2000 to 2016...
August 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28818571/timing-of-palliative-care-team-referrals-for-inpatients-receiving-rapid-response-services-a-retrospective-pilot-study-in-a-us-hospital
#2
M Williams, M Cardona-Morrell, P Stevens, J Bey, M E Smith Glasgow
BACKGROUND/OBJECTIVES: Research indicates up to one-third of rapid response team calls relate to end-of-life symptoms. The CriSTAL criteria were developed as a screening tool to identify high risk of death within three months. The primary purpose of this pilot study was to investigate the timing of palliative care referrals in patients receiving rapid response team services, and patients' CriSTAL criteria score on admission. The potential feasibility of using the CriSTAL tool to stimulate earlier Palliative Care Team (PCT) referral served as an underlying goal, and investigation of a relationship between specific CriSTAL criteria and the prediction of in-hospital death was a secondary objective...
August 8, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28808093/are-disagreements-in-caregiver-and-patient-assessment-of-patient-health-associated-with-increased-caregiver-burden-in-caregivers-of-older-adults-with-cancer
#3
Tina Hsu, Matthew Loscalzo, Rupal Ramani, Stephen Forman, Leslie Popplewell, Karen Clark, Vani Katheria, Rex Strowbridge, Redmond Rinehart, Dan Smith, Keith Matthews, Jeff Dillehunt, Tao Feng, David Smith, Canlan Sun, Arti Hurria
BACKGROUND: As patients age, caregivers increasingly provide essential support and patient information. We sought to determine if patient-caregiver assessments of patient health differ and if differences contribute to burden in caregivers of older adults with cancer. MATERIALS AND METHODS: One hundred patients, aged ≥65, and their caregivers independently assessed patient function, comorbidity, nutrition, social activity, social support, and mental health. Caregivers completed the Caregiver Strain Index (CSI)...
August 14, 2017: Oncologist
https://www.readbyqxmd.com/read/28801236/frailty-status-in-older-adults-is-related-to-alterations-in-indoleamine-2-3-dioxygenase-1-and-guanosine-triphosphate-cyclohydrolase-i%C3%A2-enzymatic-pathways
#4
Diego Marcos-Pérez, María Sánchez-Flores, Ana Maseda, Laura Lorenzo-López, José C Millán-Calenti, Barbara Strasser, Johanna M Gostner, Dietmar Fuchs, Eduardo Pásaro, Vanessa Valdiglesias, Blanca Laffon
BACKGROUND: Frailty is a multidimensional syndrome correlated to the loss of homeostasis and increased vulnerability to stressors, which is associated with increase in the risk of disability, comorbidity, hospitalization, and death in the elderly. It is based on the interplay of physiological, psychological, social, and environmental factors. OBJECTIVES: Because aging involves a detrimental immune response, this work aimed to assess the possible role of chronic low-grade immune stimulation on frailty status in the elderly...
August 8, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28794619/grip-strength-as-a-frailty-diagnostic-component-in-geriatric-inpatients
#5
Joanna Dudzińska-Griszek, Karolina Szuster, Jan Szewieczek
BACKGROUND: Frailty has emerged as a key medical syndrome predictive of comorbidity, disability, institutionalization and death. As a component of the five frailty phenotype diagnostic criteria, patient grip strength deserves attention as a simple and objective measure of the frailty syndrome. The aim of this study was to assess conditions that influence grip strength in geriatric inpatients. PATIENTS AND METHODS: The study group consisted of 80 patients aged 78...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28777289/sarcopenia-increases-risk-of-long-term-mortality-in-elderly-patients-undergoing-emergency-abdominal-surgery
#6
Erika L Rangel, Arturo J Rios-Diaz, Jennifer W Uyeda, Manuel Castillo-Angeles, Zara Cooper, Olubode A Olufajo, Ali Salim, Aaron D Sodickson
BACKGROUND: Frailty is associated with poor surgical outcomes in elderly patients but is difficult to measure in the emergency setting. Sarcopenia, or the loss of lean muscle mass, is a surrogate for frailty and can be measured using cross-sectional imaging. We sought to determine the impact of sarcopenia on one-year mortality after emergency abdominal surgery in elderly patients. METHODS: Sarcopenia was assessed in patients ≥70 years old who underwent emergency abdominal surgery at a single hospital from 2006-2011...
August 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28776149/how-do-oncologists-make-decisions-about-chemotherapy-for-their-older-patients-with-cancer-a-survey-of-australian-oncologists
#7
E B Moth, B E Kiely, V Naganathan, A Martin, P Blinman
PURPOSE: Oncologists are making treatment decisions on increasing numbers of older patients with cancer. Due to comorbidities and frailty that increase with age, such decisions are often complex. We determined factors influencing oncologists' decisions to prescribe chemotherapy for older adults. METHODS: Members of the Medical Oncology Group of Australia (MOGA) were invited to complete an online survey in February to April 2016. RESULTS: Ninety-three oncologists completed the survey of which 69 (74%) were consultants and 24 (26%) were trainees, with most (72, 77%) working predominantly in a public hospital-associated practice...
August 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28771952/prevalence-and-determinants-of-frailty-and-associated-comorbidities-among-older-gurkha-welfare-pensioners-in-nepal
#8
Sirjana Devkota, Bruce Anderson, Roy L Soiza, Phyo K Myint
AIM: Population aging is increasing in low-income countries. Despite this, there is distinct lack of knowledge about the prevalence of comorbidities and determinants of frailty among older people in these countries. METHODS: We examined data from "Health and Social Care Needs Assessment Survey of the Gurkha Welfare Pensioners" carried out in 2014. Participants were aged ≥60 years from the Gorakha, Lamjung and Tanahu districts of Nepal. Face-to-face interviews were carried out using validated questionnaires...
August 2, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#9
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28764647/relationship-between-oral-health-and-fried-s-frailty-criteria-in-community-dwelling-older-persons
#10
Benedikta Kamdem, Laurence Seematter-Bagnoud, Fabiana Botrugno, Brigitte Santos-Eggimann
BACKGROUND: Oral health and frailty might be linked through several pathways, but previous studies are scarce. This study examined the association between oral health and components of Fried's frailty phenotype. METHODS: This cross-sectional analysis was based on a sample of 992 community-dwelling persons aged 73 to 77 years observed in the 2011 follow-up of the Lausanne 65+ cohort (Lc65+) study. Data were collected through annual mailed questionnaires, interview and physical examination...
August 1, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28763363/ovarian-cancer-in-elderly-patients-patterns-of-care-and-treatment-outcomes-according-to-age-and-modified-frailty-index
#11
Annamaria Ferrero, Luca Fuso, Elisa Tripodi, Roberta Tana, Alberto Daniele, Valentina Zanfagnin, Stefania Perotto, Angiolo Gadducci
OBJECTIVE: The present study assessed the predictive value of age and Modified Frailty Index (mFI) on the management of primary epithelial ovarian cancer (EOC) patients aged 70 years or older (elderly). METHODS: A retrospective multicenter study selected elderly EOC patients treated between 2006 and 2014. Treatments were analyzed according to the following age group categories: (1) 70 to 75 years versus (2) older than 75 years, and mFI of less than 4 (low frailty) versus greater than or equal to 4 (high frailty)...
August 1, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28763310/elderly-patients-with-multiple-myeloma-towards-a-frailty-approach
#12
Sonja Zweegman, Monika Engelhardt, Alessandra Larocca
PURPOSE OF REVIEW: To describe how to better identify frail multiple myeloma patients and to treat them appropriately. RECENT FINDINGS: Proteasome inhibitors, such as bortezomib, carfilzomib, and ixazomib, and immunomodulatory agents (IMiDs), such as thalidomide, lenalidomide, and pomalidomide, have significantly improved the outcome of multiple myeloma patients in the last decade. However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit...
September 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28762628/prognostic-value-of-physical-function-tests-and-muscle-mass-in-elderly-hospitalized-patients-a-prospective-observational-study
#13
Rubén Hernández-Luis, Esther Martín-Ponce, María Monereo-Muñoz, Geraldine Quintero-Platt, Silvia Odeh-Santana, Emilio González-Reimers, Francisco Santolaria
AIM: To determine the prognostic value for mortality of physical function tests, muscle mass loss, disability and frailty in elderly hospitalized patients. METHODS: We prospectively included 298 hospitalized patients aged >60 years (152 men and 146 women). We assessed comorbidity using the Charlson Comorbidity Index; nutrition by body mass index, midarm muscle area and subjective nutritional score; physical muscle function by handgrip strength, gait speed, standing balance and stand up test; disability using the Barthel test and activities of daily living; frailty by the clinical frailty scale and Fried frailty index; and cognitive impairment by the Pfeiffer test...
August 1, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28760787/bridging-the-age-gap-in-breast-cancer-evaluation-of-decision-support-interventions-for-older-women-with-operable-breast-cancer-protocol-for-a-cluster-randomised-controlled-trial
#14
Karen Collins, Malcolm Reed, Kate Lifford, Maria Burton, Adrian Edwards, Alistair Ring, Katherine Brain, Helena Harder, Thompson Robinson, Kwok Leung Cheung, Jenna Morgan, Riccardo Audisio, Susan Ward, Paul Richards, Charlene Martin, Tim Chater, Kirsty Pemberton, Anthony Nettleship, Christopher Murray, Stephen Walters, Oscar Bortolami, Fiona Armitage, Robert Leonard, Jacqui Gath, Deirdre Revell, Tracy Green, Lynda Wyld
INTRODUCTION: While breast cancer outcomes are improving steadily in younger women due to advances in screening and improved therapies, there has been little change in outcomes among the older age group. It is inevitable that comorbidities/frailty rates are higher, which may increase the risks of some breast cancer treatments such as surgery and chemotherapy, many older women are healthy and may benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty is variable and largely non-evidence based, specifically with regard to rates of surgery for operable oestrogen receptor-positive disease and rates of chemotherapy for high-risk disease...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28747535/palliative-care-in-end-stage-valvular-heart-disease
#15
REVIEW
Jill M Steiner, Stephanie Cooper, James N Kirkpatrick
Valvular heart disease (VHD), particularly aortic valve disease, is prevalent with increasing incidence. When surgery is not possible, or when risks outweigh benefits, percutaneous treatment options may offer effective alternatives. However, procedures may not always go as planned, and frail patients or those whose symptoms are caused by other comorbidities may not benefit from valve intervention at all. Significant effort should be made to assess frailty, comorbidities and patient goals prior to intervention...
August 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28739453/modified-frailty-index-can-be-used-to-predict-adverse-outcomes-and-mortality-after-lower-extremity-bypass-surgery
#16
Tarik Ali, Erik Lehman, Faisal Aziz
OBJECTIVES: Frailty has been increasingly used as a prognostic indicator for various surgical operations. Patients with peripheral arterial disease represent a cohort of population with advanced medical comorbidities. The aim of this study is to correlate the postoperative outcomes after lower extremity bypass surgery with pre operative modified frailty index. METHODS: Using 2010 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, patients undergoing infrainguinal arterial bypass surgery were identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739158/assessment-and-management-of-radiotherapy-induced-toxicity-in-older-patients
#17
Anita O'Donovan, Michelle Leech, Charles Gillham
Radiotherapy is an attractive treatment option for older adults, especially where surgery and chemotherapy pose too great a risk. Radiotherapy toxicity may be divided into acute/early and late effects of treatment. The latter may have limited relevance to an older patient with competing causes of mortality due to significant comorbidity. Altered fractionation regimes have been employed in numerous sites, with no significant toxicity impact. These offer greater convenience in the elderly, especially those with limited social support or in active caregiving roles...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28737297/correlates-of-frailty-phenotype-and-frailty-index-and-their-associations-with-clinical-outcomes
#18
G Guaraldi, A Malagoli, O Theou, T D Brothers, Lmk Wallace, R Torelli, C Mussini, S Sartini, S A Kirkland, K Rockwood
OBJECTIVES: Frailty is a predictor of adverse health outcomes and can be measured across the life course, including among people living with HIV. The purpose of this study was to examine two commonly used measures of frailty - the frailty index (FI) and frailty phenotype - to assess common characteristics and to describe associations with multimorbidity, falls, and disability in people aging with HIV. METHODS: This was a cross-sectional observational study including 482 consecutive HIV-infected patients (mean age 53...
July 24, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28732817/severity-and-features-of-frailty-in-systemic-sclerosis-associated-interstitial-lung-disease
#19
Sabina A Guler, Joanne M Kwan, Tiffany A Winstone, Kathryn M Milne, James V Dunne, Pearce G Wilcox, Christopher J Ryerson
BACKGROUND: Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterized by multiple symptoms and comorbidities. The cumulative impact of these deficits can be summarized using the concept of frailty; however, frailty has not been characterized in patients with SSc-ILD. METHODS: Patients with SSc-ILD and non-CTD fibrotic ILD were recruited from specialized clinics. Frailty was assessed using a 42-item patient-reported Frailty Index, calculated as the proportion of reported deficits divided by the total number of surveyed items...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#20
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
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