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frailty and comorbidity

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https://www.readbyqxmd.com/read/28632933/patient-characteristics-associated-with-a-successful-response-to-nurse-led-care-programs-targeting-the-oldest-old-a-comparison-of-two-rcts
#1
Nienke Bleijenberg, Lorenz Imhof, Romy Mahrer-Imhof, Margaret I Wallhagen, Niek J de Wit, Marieke J Schuurmans
BACKGROUND: To improve the effectiveness of community-based care programs, especially those targeting the oldest-old population (80+), data are needed that elucidate those factors associated with a successful response to the intervention. Two comparable nurse-led care programs have been evaluated in two large randomized controlled trials (RCTs), one in Switzerland and one in the Netherlands. AIMS: To identify common patient characteristics that are related to a successful response to proactive nurse-led care, we explored if and to what extent, identical factors were present in both study populations...
June 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#2
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28612635/wearable-sensors-can-they-benefit-patients-with-chronic-kidney-disease
#3
Fokko Pieter Wieringa, Natascha Broers, J P Kooman, Frank M van der Sande, Chris van Hoof
Introduction This article ponders upon wearable medical measurement devices in relation to Chronic Kidney Disease (CKD) and its' associated comorbidities - and whether these might benefit CKD-patients. We aimed to map the intersection(s) of nephrology and wearable sensor technology to help technologists understand medical aspects, and clinicians to understand technological possibilities that are available (or soon will become so). Areas covered A structured literature search on main comorbidities and complications CKD patients suffer from, was used to steer mini-reviews on wearable sensor technologies clustered around 3 themes being: Cardiovascular-related, diabetes-related and physical fitness/frailty...
June 14, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28601217/-hiv-infection-as-a-cause-of-accelerated-aging-and-frailty
#4
Zaida Jiménez, Matilde Sánchez-Conde, Fátima Brañas
The HIV-infected population is aging due to the success of combination antiretroviral therapy, which prolongs survival, as well as the growing number of newly diagnosed cases in adults 50 years old and over. HIV-infected individuals suffer from an accelerated aging due to the persistent and chronic activation of the immune system that leads to immune exhaustion and accelerated immunosenescence, even when on optimal immuno-virological control treatment. The clinical expression of the immunosenescence state is an increased prevalence of aging-related non-HIV associated comorbidities and a rising prevalence of frailty occurring earlier than in the general population...
June 7, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28595883/prognostic-impact-of-revascularization-in%C3%A2-poor-risk-patients-with-critical%C3%A2-limb%C3%A2-ischemia-the-priority-registry-poor-risk-patients-with-and-without-revascularization-therapy-for-critical-limb-ischemia
#5
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Nobuyoshi Azuma, Shinsuke Nanto, Masaaki Uematsu
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28594992/association-of-modified-frailty-index-score-with-perioperative-risk-for-patients-undergoing-total-laryngectomy
#6
Brandon Wachal, Matthew Johnson, Alissa Burchell, Harlan Sayles, Katherine Rieke, Robert Lindau, William Lydiatt, Aru Panwar
Importance: Objective preoperative risk assessment tools, such as the Modified Frailty Index (mFI), may inform patient and physician decision making when considering total laryngectomy. Estimation of outcomes may help to set realistic expectations about recovery and outcomes and facilitate optimal resource management. Objective: To evaluate the association between the mFI score as a measure of frailty and outcomes following total laryngectomy. Design, Setting, and Participants: Retrospective evaluation using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a risk- and case-mix-adjusted national quality assessment program...
June 8, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28588078/walking-as-a-window-to-risk-and-resiliency
#7
Karen P Alexander
Walking is fundamental to preserving health and independence. An individual's usual pace of walking is also recognized as an indicator of health, risk for dependency, and a predictor of long-term survival. Reducing gait speed by just 0.1m/sec provides important information about outcomes in older adults that goes beyond chronologic age, sex, comorbidity, and self-reported function combined. This small reduction in gate speed is significant because each individual sets the pace necessary to accommodate a host of integrated functions that allow him or her to walk...
June 6, 2017: Circulation
https://www.readbyqxmd.com/read/28587892/the-modified-frailty-index-to-predict-morbidity-and-mortality-for-retroperitoneal-sarcoma-resections
#8
Jiwon Sarah Park, Sarah B Bateni, Richard J Bold, Amanda R Kirane, Daniel J Canter, Robert J Canter
BACKGROUND: The modified frailty index (mFI) is an important method to risk-stratify surgical patients and has been validated for general surgery and selected surgical subspecialties. However, there are currently no data assessing the efficacy of the mFI to predict acute morbidity and mortality in patients undergoing surgery for retroperitoneal sarcoma. METHODS: Using the American College of Surgeons' National Surgical Quality Improvement Program from 2007 to 2012, we performed a retrospective analysis of patients with a diagnosis of primary malignant retroperitoneal neoplasm who underwent surgical resection...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28587850/frailty-and-risk-of-adverse-outcomes-in-hospitalized-older-adults-a%C3%A2-comparison-of-different-frailty-measures
#9
Edward Chong, Esther Ho, Jewel Baldevarona-Llego, Mark Chan, Lynn Wu, Laura Tay
OBJECTIVES: There is a paucity of data for the assessment of frailty in acutely ill hospitalized older adults. We aim to (1) compare the performance of frailty measures [5-item scale of fatigue, resistance, ambulation, illnesses, and loss of weight) (FRAIL), Tilburg Frailty Indicator (TFI), and Clinical Frailty Scale (CFS)] in identifying frailty, using the widely adopted Frailty Index (FI) as "gold standard," and (2) compare their ability to predict negative outcomes among hospitalized older adults...
June 3, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28583470/insights-into-the-current-management-of-older-adults-with-type-2-diabetes-in-the-ontario-primary-care-setting
#10
Graydon S Meneilly, Lori D Berard, Alice Y Y Cheng, Peter J Lin, Lori MacCallum, Ross T Tsuyuki, Jean-François Yale, Nahal Nasseri, Jean-François Richard, Lianne Goldin, Anatoly Langer, Mary K Tan, Lawrence A Leiter
OBJECTIVE: The Goal Oriented controL of Diabetes in the Elderly populatioN (GOLDEN) Program assessed the management of older persons with type 2 diabetes in Canadian primary care. METHODS: Data were extracted from the records of 833 consecutively identified persons 65 years of age or older who had type 2 diabetes and were taking 1 antihyperglycemic agent or more; they were managed by 64 physicians from 36 Ontario clinics. RESULTS: More than half (53%) had glycated hemoglobin (A1C) levels of 7...
June 2, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28583408/discrimination-ability-of-comorbidity-frailty-and-subjective-health-to-predict-mortality-in-community-dwelling-older-people-population-based-prospective-cohort-study
#11
Sasmita Kusumastuti, Thomas Alexander Gerds, Rikke Lund, Erik Lykke Mortensen, Rudi G J Westendorp
OBJECTIVE: To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age. PARTICIPANTS: 36,751 community-dwelling subjects aged 50-100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe. METHODS: Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression...
June 2, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28581675/concurrent-chemotherapy-is-associated-with-improved-survival-in-elderly-patients-with-bladder-cancer-undergoing-radiotherapy
#12
Mark C Korpics, Alec M Block, Brendan Martin, Courtney Hentz, Ellen R Gaynor, Elizabeth Henry, Matthew M Harkenrider, Abhishek A Solanki
BACKGROUND: The current study was conducted to compare the overall survival (OS) of concurrent chemoradiotherapy (CCRT) versus radiotherapy (RT) alone in elderly patients (those aged ≥80 years) with muscle-invasive bladder cancer (MIBC). METHODS: Patients aged ≥80 years with cT2-4, N0-3, M0 transitional cell MIBC who were treated with curative RT (60-70 Gray) or CCRT were identified in the National Cancer Data Base. Univariable and multivariable frailty survival analyses, as well as 1-to-1 propensity score matching, were used to isolate the association between CCRT and OS...
June 5, 2017: Cancer
https://www.readbyqxmd.com/read/28579772/delayed-but-successful-response-to-noninvasive-ventilation-in-copd-patients-with-acute-hypercapnic-respiratory-failure
#13
Malcolm Lemyze, Quentin Bury, Aurélie Guiot, Marie Jonard, Usman Mohammad, Nicolas Van Grunderbeeck, Gaelle Gasan, Didier Thevenin, Jihad Mallat
BACKGROUND: We evaluated a new noninvasive ventilation (NIV) protocol that allows the pursuit of NIV in the case of persistent severe respiratory acidosis despite a first NIV challenge in COPD patients with acute hypercapnic respiratory failure (AHRF). PATIENTS AND METHODS: A prospective observational multicentric pilot study was conducted in three tertiary hospitals over a 12-month study period. A total of 155 consecutive COPD patients who were admitted for AHRF and treated by NIV were enrolled...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28578164/discriminative-ability-of-commonly-used-indices-to-predict-adverse-outcomes-after-poster-lumbar-fusion-a-comparison-of-demographics-asa-the-modified-charlson-comorbidity-index-and-the-modified-frailty-index
#14
Nathaniel T Ondeck, Daniel D Bohl, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Blake N Shultz, Adam M Lukasiewicz, Jonathan N Grauer
BACKGROUND CONTEXT: As research tools, the American Society of Anesthesiologist physical classification system (ASA), the modified Charlson Comorbidity Index (mCCI), and the modified Frailty Index (mFI) have been associated with complications following spine procedures. However, with respect to clinical utility for various adverse outcomes, no known study has compared the predictive performance of these indices specifically following posterior lumbar fusion (PLF). PURPOSE: To compare the discriminative ability of ASA, mCCI, and mFI as well as demographic factors including age, body mass index (BMI) and gender for perioperative adverse outcomes following PLF...
May 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28566447/management-of-endocrine-disease-l-thyroxine-replacement-therapy-in-the-frail-elderly-a-challenge-in-clinical-practice
#15
Rosaria Maddalena Ruggeri, Francesco Trimarchi, Bernadette Biondi
The number of elderly people, mostly over 85 years (the "oldest old"), is increasing worldwide. As a consequence, accompanying morbidity and disability have been increasing, and frailty, defined as an age-related condition of decline of physiological reserves and vulnerability, represents an emerging problem. Caring for older frail people may represent a challenge, since the elderly differ significantly from younger adults in terms of comorbidity, polypharmacy, pharmacokinetics and greater vulnerability to adverse drug reactions...
May 31, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28555712/frailty-in-end-stage-renal-disease-patients-under-dialysis-and-its-association-with-clinical-and-biochemical-markers
#16
V Poveda, M Filgueiras, V Miranda, A Santos-Silva, C Paúl, E Costa
Frailty is a common complication in elderly patients with end-stage renal disease (ESRD) under dialysis, which is a strong risk factor for low quality of life, morbidity, and mortality. In this work, we aimed to evaluate the prevalence of frailty in a group of Portuguese ESRD patients, and its association with socio-demographic, clinical and biochemical markers. We performed a cross-sectional study with 83 ESRD patients (44 males and 39 females, 64.3 [±14.6] years old) on regular dialysis. The classification of the ESRD patients as robust, pre-frail and frail was performed using the FRAIL questionnaire...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28549718/sarcopenia-is-associated-with-physical-and-mental-components-of-health-related-quality-of-life-in-older-adults
#17
Betty Manrique-Espinoza, Aarón Salinas-Rodríguez, Oscar Rosas-Carrasco, Luis Miguel Gutiérrez-Robledo, José Alberto Avila-Funes
OBJECTIVES: To estimate the association between sarcopenia and the health-related quality of life (HRQoL) among community-dwelling older adults. DESIGN: Cross-sectional analysis of a prospective cohort. SETTING: The Rural Frailty Study, a prospective study on the prevalence of frailty in rural settings in Mexico, with baseline and follow-up measurements conducted in 2009 and 2013, respectively. PARTICIPANTS: Five hundred forty-three men and women older than 70 years...
May 23, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28544527/biomarkers-associated-with-mortality-in-patients-undergoing-dialysis
#18
Ana Rebollo Rubio, Jose Miguel Morales Asencio, Mª Eugenia Pons Raventos
BACKGROUND: Survival for patients commencing renal replacement therapy is around 90% in the first year and 83% at two years after starting dialysis. The factors that appear to predict mortality are comorbidity and frailty associated with kidney disease, glomerular filtration rate, age and biochemical factors. OBJECTIVES: To analyse the condition of patients starting renal replacement therapy, based on biomarkers commonly used in clinical practice and their association with mortality, measured 6 and 12 months after initiating replacement therapy...
May 23, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28544338/alcohol-consumption-and-risk-of-unemployment-sickness-absence-and-disability-pension-in-denmark-a-prospective-cohort-study
#19
Maja Baeksgaard Jørgensen, Lau Caspar Thygesen, Ulrik Becker, Janne S Tolstrup
AIMS: We investigated the association between weekly alcohol consumption and binge drinking and the risk of unemployment, sickness absence and disability pension. DESIGN: Prospective register-based cohort study SETTING: Denmark PARTICIPANTS: A sample of 17,690 men and women, aged 18 to 60 years, from the Danish Health and Morbidity Survey in 2000, 2005 and 2010 participated in the study. Participants worked the entire year prior to baseline. MEASUREMENTS: Administrative registers were used to obtain information on unemployment, sickness absence and disability pension during a 5-year follow-up period...
May 21, 2017: Addiction
https://www.readbyqxmd.com/read/28539134/does-metformin-protect-against-osteoarthritis-an-electronic-health-record-cohort-study
#20
Lauren A Barnett, Kelvin P Jordan, John J Edwards, Danielle A van der Windt
BACKGROUND: Obesity is a major risk factor for osteoarthritis (OA) whilst there is some evidence that diabetes also increases risk. Metformin is a common oral treatment for those with diabetes. OBJECTIVE: The aim is to investigate whether metformin reduces the risk of OA. METHODS: This was a cohort study set within the Consultations in Primary Care Archive, with 3217 patients with type 2 diabetes. Patients at 13 general practices with recorded type 2 diabetes in the baseline period (2002-2003) and no prior record of OA were identified...
May 25, 2017: Primary Health Care Research & Development
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