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https://www.readbyqxmd.com/read/29349584/-percutaneous-endoscopic-gastrostomy-in-geriatrics-indications-technique-and-complications
#1
Rainer Wirth
The technique of percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a semi-invasive approach for children with the need for a gastric fistula in order to avoid an operative intervention. The suture pull-through method was rapidly established and is now omnipresent. Because scientific evidence is broadly missing, there is some uncertainty about the indications in geriatric medicine. Guidelines do not recommend the insertion of a PEG in patients with severe dementia and malnutrition. Tube feeding is mainly recommended as a temporary method for patients who cannot take oral nutrition for more than 3 days or for whom the energy intake for more than 10 days presumably covers less than 50% of their needs, assuming that the overall prognosis is reasonable...
January 18, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29343976/epidemiology-associated-burden-and-current-clinical-practice-for-the-diagnosis-and-management-of-alzheimer-s-disease-in-japan
#2
REVIEW
William Montgomery, Kaname Ueda, Margaret Jorgensen, Shari Stathis, Yuanyuan Cheng, Tomomi Nakamura
The burden of dementia in Japan is large and growing. With the world's fastest aging population, it is estimated that one in five elderly people will be living with dementia in Japan by 2025. The most common form of dementia is Alzheimer's disease (AD), accounting for around two-thirds of dementia cases. A systematic review was conducted to examine the epidemiology and associated burden of AD in Japan and to identify how AD is diagnosed and managed in Japan. English and Japanese language databases were searched for articles published between January 2000 and November 2015...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#3
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29318004/poly-de-prescribing-to-treat-polypharmacy-efficacy-and-safety
#4
Doron Garfinkel
Background: The aim of this study was to evaluate efficacy and safety of poly-de-prescribing (PDP) based on the Garfinkel method in older people with polypharmacy. Methods: A longitudinal, prospective, nonrandomized study in Israel was carried out between 2009 and 2016. Comprehensive geriatric assessments were performed at home in people age ⩾66 years consuming ⩾6 prescription drugs. Exclusion criteria were life expectancy <6 months and a seeming unwillingness to cooperate (poor compliance)...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29317807/pain-assessment-in-impaired-cognition-paic-content-validity-of-the-dutch-version-of-a-new-and-universal-tool-to-measure-pain-in-dementia
#5
Annelore H van Dalen-Kok, Wilco P Achterberg, Wieke E Rijkmans, Sara A Tukker-van Vuuren, Suzanne Delwel, Henrica Cw de Vet, Frank Lobbezoo, Margot Wm de Waal
Objectives: Detection and measurement of pain in persons with dementia by using observational pain measurement tools is essential. However, the evidence for the psychometric properties of existing observational tools remains limited. Therefore, a new meta-tool has been developed: Pain Assessment in Impaired Cognition (PAIC), as a collaborative EU action. The aim is to describe the translation procedure and content validity of the Dutch version of the PAIC. Methods: Translation of the PAIC into Dutch followed the forward-backward approach of the Guidelines for Establishing Cultural Equivalence of Instruments...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29315276/identifying-dietary-patterns-associated-with-mild-cognitive-impairment-in-older-korean-adults-using-reduced-rank-regression
#6
Dayeon Shin, Kyung Won Lee, Mi-Hye Kim, Hung Ju Kim, Yun Sook An, Hae-Kyung Chung
Diet plays a crucial role in cognitive function. Few studies have examined the relationship between dietary patterns and cognitive functions of older adults in the Korean population. This study aimed to identify the effect of dietary patterns on the risk of mild cognitive impairment. A total of 239 participants, including 88 men and 151 women, aged 65 years and older were selected from health centers in the district of Seoul, Gyeonggi province, and Incheon, in Korea. Dietary patterns were determined using Reduced Rank Regression (RRR) methods with responses regarding vitamin B6, vitamin C, and iron intakes, based on both a one-day 24-h recall and a food frequency questionnaire...
January 9, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29285784/staff-s-reactions-toward-partnered-sexual-expressions-involving-people-with-dementia-living-in-long-term-care-facilities
#7
Feliciano Villar, Montserrat Celdrán, Rodrigo Serrat, Josep Fabà, Teresa Martínez
AIMS (OF THE PAPER): This study explores staff responses, in terms of common practices, toward partnered sexual relationships in long-term care facilities where one or both people involved have dementia. It also tries to determine personal and institutional factors influencing these responses. BACKGROUND: Although some studies, mostly qualitative, have focused on reactions to residents' sexual expressions so far the issue has not been assessed in a study using large and diverse samples...
December 28, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29282327/practice-guideline-update-summary-mild-cognitive-impairment-report-of-the-guideline-development-dissemination-and-implementation-subcommittee-of-the-american-academy-of-neurology
#8
Ronald C Petersen, Oscar Lopez, Melissa J Armstrong, Thomas S D Getchius, Mary Ganguli, David Gloss, Gary S Gronseth, Daniel Marson, Tamara Pringsheim, Gregory S Day, Mark Sager, James Stevens, Alexander Rae-Grant
OBJECTIVE: To update the 2001 American Academy of Neurology (AAN) guideline on mild cognitive impairment (MCI). METHODS: The guideline panel systematically reviewed MCI prevalence, prognosis, and treatment articles according to AAN evidence classification criteria, and based recommendations on evidence and modified Delphi consensus. RESULTS: MCI prevalence was 6.7% for ages 60-64, 8.4% for 65-69, 10.1% for 70-74, 14.8% for 75-79, and 25.2% for 80-84...
December 27, 2017: Neurology
https://www.readbyqxmd.com/read/29281895/underreporting-of-gender-and-race-ethnicity-differences-in-nih-funded-dementia-caregiver-support-interventions
#9
Andrea Gilmore-Bykovskyi, Rachel Johnson, Lily Walljasper, Laura Block, Nicole Werner
Women and racial/ethnic minority dementia caregivers have unique caregiving experiences and support needs. To ensure the identification of potentially important differences in outcomes within these groups, the amended National Institutes of Health (NIH) Policy on Inclusion of Women and Minorities mandates reporting by gender and race/ethnicity. The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. A focused systematic literature review of studies published from 1994 to 2015 located 48 articles meeting inclusion criteria...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/29281086/characteristics-of-patients-with-atrial-fibrillation-prescribed-antiplatelet-monotherapy-compared-with-those-on-anticoagulants-insights-from-the-garfield-af-registry
#10
Freek W A Verheugt, Haiyan Gao, Wael Al Mahmeed, Giuseppe Ambrosio, Pantep Angchaisuksiri, Dan Atar, Jean-Pierre Bassand, A John Camm, Frank Cools, John Eikelboom, Gloria Kayani, Toon Wei Lim, Frank Misselwitz, Karen S Pieper, Martin van Eickels, Ajay K Kakkar
Aims: Current atrial fibrillation (AF) guidelines discourage antiplatelet (AP) monotherapy as alternative to anticoagulants (ACs). Why AP only is still used is largely unknown. Methods and results: Factors associated with AP monotherapy prescription were analysed in GARFIELD-AF, a registry of patients with newly diagnosed (≤6 weeks) AF and ≥1 investigator-determined stroke risk factor. We analysed 51 270 patients from 35 countries enrolled into five sequential cohorts between 2010 and 2016...
December 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29274807/deintensification-of-hypoglycaemic-medications-use-of-a-systematic-review-approach-to-highlight-safety-concerns-in-older-people-with-type-2-diabetes
#11
REVIEW
A H Abdelhafiz, A J Sinclair
IMPORTANCE: Intensive treatment of older people with diabetes is common placing them at increased risk of adverse events such as hypoglycaemia and hospitalisation for drug errors. Little is known about when, how or for whom to deintensify hypoglycaemic medications. OBJECTIVE: To explore the characteristics of patients for whom deintensification is appropriate and to determine the outcome of deintensification. EVIDENCE REVIEW: Medline, Google scholar and EmBase search from 1997 to present was performed using keywords relating to diabetes mellitus, polypharmacy, hypoglycaemia, hospitalisation, deintensification, deprescribing and reduction, simplification or withdrawal of hypoglycaemic medications...
November 29, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29273521/the-pathology-and-pathophysiology-of-vascular-dementia
#12
REVIEW
Raj N Kalaria
Vascular dementia (VaD) is widely recognised as the second most common type of dementia. Consensus and accurate diagnosis of clinically suspected VaD relies on wide-ranging clinical, neuropsychological and neuroimaging measures in life but more importantly pathological confirmation. Factors defining subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes as well as time after the initial vascular event...
December 19, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29258633/dementia-friendly-dentistry-why-dementia-guidelines
#13
Paul Batchelor
FGDP(UK) recently launched its dementia-friendly dentistry: good practice guidelines publication, which members will have received free-of-charge. Vice Dean and editor of the guidelines, Paul Batchelor, explains why the publication is necessary and why all practitioners should make the effort to incorporate these recommendations into their practice.
December 1, 2017: Primary Dental Journal
https://www.readbyqxmd.com/read/29240340/update-on-current-care-guideline-memory-disorders
#14
(no author information available yet)
Any complaint about memory should be examined. Diagnosis is based on international criteria. Basic evaluation consists of medical history, clinical evaluation, cognitive tests and brain imaging. When a diagnosis of Alzheimer's disease (AD), AD with cerebrovascular disease or with Lewy Body disease (LBD), or Dementia associated with Parkinson's disease or LBD is made, evidence-based medical therapy (acetylcholine esterase inhibitor or memantine) is indicated as a part of comprehensive care. In frontotemporal degenerations, these drugs are ineffective...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29227157/systematic-review-of-the-diagnostic-accuracy-of-the-non-english-versions-of-addenbrooke-s-cognitive-examination%C3%A2-%C3%A2-revised-and-iii
#15
Noor Habib, Joshua Stott
OBJECTIVE: This systematic review aims to review the evidence for the diagnostic accuracy of the non-English updated versions of Addenbrooke's Cognitive Examination (ACE) - the ACE-Revised (ACE-R) and the ACE-III - in the diagnosis of dementia. METHODS: A systematic search resulted in 16 eligible studies evaluating the diagnostic accuracy of ACE-R and ACE-III in ten different languages. Most studies were assessed as of medium to low quality using Standards for Reporting of Diagnostic Accuracy (STARD) guidance...
December 11, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/29220386/does-cognitive-impairment-impact-adherence-a-systematic-review-and-meta-analysis-of-the-association-between-cognitive-impairment-and-medication-non-adherence-in-stroke
#16
Daniela Rohde, Niamh A Merriman, Frank Doyle, Kathleen Bennett, David Williams, Anne Hickey
BACKGROUND: While medication adherence is essential for the secondary prevention of stroke, it is often sub-optimal, and can be compromised by cognitive impairment. This study aimed to systematically review and meta-analyse the association between cognitive impairment and medication non-adherence in stroke. METHODS: A systematic literature search of longitudinal and cross-sectional studies of adults with any stroke type, which reported on the association between any measure of non-adherence and cognitive impairment, was carried out according to PRISMA guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/29216836/key-stakeholders-experiences-of-respite-services-for-people-with-dementia-and-their-perspectives-on-respite-service-development-a-qualitative-systematic-review
#17
Emma O' Shea, Suzanne Timmons, Eamon O' Shea, Siobhan Fox, Kate Irving
BACKGROUND: Respite services provide a break in the caregiving relationship for people with dementia and their carers, however they are often under-used and service acceptability can be low. This study aims to understand key stakeholders' experiences of respite services for people with dementia, with a view to informing respite service development. METHODS: A systematic search was conducted of the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science, and Cochrane databases (1980-2016, English) with fixed search terms relating to 'respite' and 'dementia', following PRISMA guidelines...
December 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29214153/alzheimer-s-disease-diagnosis-discrepancy-between-clinical-neuroimaging-and-cerebrospinal-fluid-biomarkers-criteria-in-an-italian-cohort-of-geriatric-outpatients-a-retrospective-cross-sectional-study
#18
Giulia A M Dolci, Sarah Damanti, Valeria Scortichini, Alessandro Galli, Paolo D Rossi, Carlo Abbate, Beatrice Arosio, Daniela Mari, Andrea Arighi, Giorgio G Fumagalli, Elio Scarpini, Silvia Inglese, Maura Marcucci
Background: The role of cerebrospinal fluid (CSF) biomarkers, and neuroimaging in the diagnostic process of Alzheimer's disease (AD) is not clear, in particular in the older patients. Objective: The aim of this study was to compare the clinical diagnosis of AD with CSF biomarkers and with cerebrovascular damage at neuroimaging in a cohort of geriatric patients. Methods: Retrospective analysis of medical records of ≥65-year-old patients with cognitive impairment referred to an Italian geriatric outpatient clinic, for whom the CSF concentration of amyloid-β (Aβ), total Tau (Tau), and phosphorylated Tau (p-Tau) was available...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29202645/influence-of-specific-comorbidities-on-survival-after-early-stage-breast-cancer
#19
Marianne Ewertz, Lotte Holm Land, Susanne Oksbjerg Dalton, Deirdre Cronin-Fenton, Maj-Britt Jensen
BACKGROUND: While comorbidity indices are useful for describing trends in survival, information on specific comorbidities is needed for the clinician advising the individual breast cancer patient on her treatment. Here we present an analysis of overall survival, breast cancer-specific mortality, and effect of medical adjuvant treatment among breast cancer patients suffering from 12 major comorbidities compared with breast cancer patients without comorbidities. MATERIAL AND METHODS: The study population was identified from the Danish Breast Cancer Cooperative Group and included 59,673 women without prior cancer diagnosed with early-stage breast cancer in Denmark from 1990 to 2008 with an estimated median potential follow-up of 14 years and 10 months...
January 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29198287/a-cross-sectional-examination-of-the-prevalence-of-psychotropic-medications-for-people-living-with-dementia-in-australian-long-term-care-facilities-issues-of-concern
#20
Mitchell McMaster, Elaine Fielding, David Lim, Wendy Moyle, Elizabeth Beattie
BACKGROUND: Behavioral and psychological symptoms of dementia (BPSD) are a common problem in long-term care facilities (LTC). Clinical guidelines dictate that first-line treatments for BPSD are psychosocial and behavioral interventions; if these are unsuccessful, psychotropic medications may be trialed at low doses and their effects can be monitored. METHODS: There have previously been no studies with nationally representative samples to investigate psychotropic administration in LTCs in Australia...
December 4, 2017: International Psychogeriatrics
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