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https://www.readbyqxmd.com/read/29792992/frailty-status-as-a-predictor-of-three-month-cognitive-and-functional-recovery-following-spinal-surgery-a-prospective-pilot-study
#1
Robert J Rothrock, Jeremy M Steinberger, Henry Badgery, Andrew C Hecht, Samuel K Cho, John M Caridi, Stacie Deiner
Background Context As increasing numbers of elderly Americans undergo spinal surgery, it is important to identify which patients are at highest risk for poor cognitive and functional recovery. Frailty is a geriatric syndrome which has been closely linked to poor outcomes, and short form screening may be a helpful tool for preoperative identification of at risk patients. Purpose To conduct a pilot study on the usefulness of a short-form screening tool to identify elderly patients at increased risk for prolonged cognitive and functional recovery following elective spine surgery...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792577/serious-consequences-of-malnutrition-and-delirium-in-frail-older-patients
#2
Elizabeth Rosted, Tatiana Prokofieva, Suzanne Sanders, Martin Schultz
Malnutrition is highly prevalent in geriatric patients and is associated with an increased risk of death. In addition, delirium is a common condition of the older hospitalized patients. As brain has a high nutritional requirement, malnutrition may play an important role in cognitive dysfunction including the development of delirium. This study investigated the association between delirium and malnutrition in frail older patients and the effects on adverse outcomes. It was found that 75% of the patients with delirium suffered from malnutrition indicating that malnutrition contributes to the development of delirium in older hospitalized patients...
May 24, 2018: Journal of Nutrition in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29792220/frailty-measurement-and-its-contribution-to-clinical-care-and-health-services-a-commentary
#3
Shannon Wu, Bruce Leff
Frailty is associated with poorer quality of life and higher healthcare utilization and spending. Despite its importance, no clear consensus exists on the definition of frailty. The recent IJHPR article by Buch et al. significantly contributes to the advancement of Israel's understanding of frailty by estimating for the first time the prevalence of frailty in the country. This commentary discusses the context of past and current advancements in measuring frailty and discusses how frailty measurement can contribute to both clinical care and the organization of health services to care for frail older adults in Israel and other developed countries...
May 23, 2018: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29791891/transanal-endoscopic-microsurgery-with-or-without-completion-total-mesorectal-excision-for-t2-and-t3-rectal-carcinoma
#4
Jeroen W A Leijtens, Thomas W A Koedam, Wernard A A Borstlap, Monique Maas, Pascal G Doornebosch, Tom M Karsten, Eric J Derksen, Laurents P S Stassen, Camiel Rosman, Eelco J R de Graaf, André J A Bremers, Jeroen Heemskerk, Geerard L Beets, Jurriaan B Tuynman, Kevin L J Rademakers
AIM: Transanal endoscopic microsurgery (TEM) is used for the resection of large rectal adenomas and well or moderately differentiated T1 carcinomas. Due to difficulty in preoperative staging, final pathology may reveal a carcinoma not suitable for TEM. Although completion total mesorectal excision is considered standard of care in T2 or more invasive carcinomas, this completion surgery is not always performed. The purpose of this article is to evaluate the outcome of patients after TEM-only, when completion surgery would be indicated...
May 23, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29791711/percutaneous-edge-to-edge-transcatheter-mitral-valve-repair-current-indications-and-future-perspectives
#5
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29789758/advantages-of-intraoperative-implant-for-interstitial-brachytherapy-for-accelerated-partial-breast-irradiation-either-frail-patients-with-early-stage-disease-or-in-locally-recurrent-breast-cancer
#6
Salvatore Cozzi, Maria Laplana, Dina Najjari, Andrea Slocker, Xavier Encinas, Joan Pera, Ferran Guedea, Cristina Gutierrez
Purpose: To describe the intraoperative multicatheter implantation technique for accelerated partial breast irradiation (APBI) delivered with high-dose-rate brachytherapy (HDR-BT). Secondarily, to evaluate outcomes and toxicity in a series of 83 patients treated with this technique at our institution. Material and methods: Retrospective analysis of a series of patients treated with HDR-BT APBI after intraoperative multicatheter interstitial implant between November 2006 and June 2017 at our institution...
April 2018: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29788097/hypertension-treatment-for-older-people-navigating-between-scylla-and-charybdis
#7
Simon Paul Conroy, Rudi Gerardus Johannes Westendorp, Miles D Witham
Hypertension is a common condition in older people, but is often one of many conditions, particularly in frail older people, and so is rarely managed in isolation in the real world-which belies the bulk of the evidence upon which is treatment decisions are often based. In this article, we discuss the issues of ageing, including frailty and dementia, and their impact upon blood pressure management. We examine the evidence base for managing hypertension in older people, and explore some therapeutic ideas that might influence treatment decisions and strategies, including shared decision making...
May 21, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29785281/impact-of-the-applied-simulated-and-integrated-learning-approach-on-nursing-assistants-knowledge-and-confidence-caring-for-frail-seniors-in-nursing-homes
#8
Veronique M Boscart, George Heckman, Meaghan Davey, Michelle Heyer, John P Hirdes
Background: Increasing importance is being placed on optimizing the role of Nursing Aides (NAs) in improving quality of care for nursing home (NH) residents. One approach to do so is to have NAs participate in assessments embedded within the Minimum Data Set (MDS). This pilot study aimed to design and evaluate the Applied Simulated and Integrated Learning Approach (ASILA) program, a novel innovative training program for NAs employed in NHs to enhance their ability to assess residents within an inter-professional framework...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29784592/short-term-resource-utilization-and-cost-effectiveness-of-comprehensive-geriatric-assessment-in-acute-hospital-care-for-severely-frail-elderly-patients
#9
Niklas Ekerstad, Björn W Karlson, David Andersson, Magnus Husberg, Per Carlsson, Emelie Heintz, Jenny Alwin
OBJECTIVE: The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. DESIGN: Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. INTERVENTION: Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit...
May 18, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29781713/caregiving-burden-and-psychological-distress-in-chinese-spousal-caregivers-gender-difference-in-the-moderating-role-of-positive-aspects-of-caregiving
#10
Daniel Fu Keung Wong, Ting Kin Ng, Xiao Yu Zhuang
OBJECTIVES: This study endeavors to advance the current literature by examining the gender differences in the caregiving experiences and the stress-buffering role of positive aspects of caregiving (PAC) among Chinese spousal caregivers of frail elders in Hong Kong. METHOD: Forty-nine husband caregivers and 121 wife caregivers of frail elders in Hong Kong (N = 170) responded to the Positive Aspects of Caregiving (PAC) scale, the Zarit Burden Interview (ZBI), the 21-item Depression, Anxiety, and Stress Scales (DASS-21), and demographic questions...
May 21, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29781555/dependence-on-others-for-oral-hygiene-and-its-association-with-hand-deformities-and-functional-impairment-in-elders-with-a-history-of-leprosy
#11
Raquel Conceição Ferreira, Talita Xavier Gonçalves, Anna Rachel Dos Santos Soares, Luísa Rodrigues de Abreu Carvalho, Fernanda Lamounier Campos, Marco Túlio de Freitas Ribeiro, Andrea Maria Eleutério de Barros Lima Martins, Efigênia Ferreira E Ferreira
OBJECTIVE: To analyse the frequency of dependence on others for oral hygiene and its association with hand deformities, frailty and dependence on others for basic activities of daily living (BADL) among elders with a history of leprosy. BACKGROUND: Dependence on others for oral hygiene has not been considered in multifunctional geriatric assessments. MATERIAL AND METHODS: Edentulous elders with a history of leprosy who used complete dentures and resided in a former leprosy colony were classified as independent or partially/completely dependent on others for brushing their dentures or rinsing and for BADL, and as frail or robust...
May 21, 2018: Gerodontology
https://www.readbyqxmd.com/read/29779319/-comprehensive-geriatric-assessment-can-predict-the-clinical-outcomes-of-elderly-patients-with-diffuse-large-b-cell-lymphoma-in-china
#12
C L Zhang, R Feng, J T Li, Y Tian, T Wang, H Liu
Objective: To validate comprehensive geriatric assessment (CGA) system in Chinese elderly diffuse large B cell lymphoma (DLBCL) patients. Methods: Patients ≥ 65 years of age who had been diagnosed with de novo DLBCL were screened for eligibility ( n =99). CGA was performed during staging procedures through application of the following instruments: age, comorbidity score according to the Cumulative Illness Rating Score for Geriatrics(CIRS-G), activities of daily living (ADL), and instrumental activities of daily living (IADL)...
April 14, 2018: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29778652/frailty-and-diabetes-among-mexican-american-older-adults
#13
Bret T Howrey, Soham Al Snih, Kyriakos S Markides, Kenneth J Ottenbacher
PURPOSE: Progressive physical frailty in older adults is associated with increased risk of falls, disability, institutionalization, and mortality. Although associations between diabetes and frailty have been observed, the impact of diabetes on frailty in older Hispanics is largely unexplored. We examine the association of diabetes on the odds of frailty among older Mexican Americans. METHODS: Using data from the Hispanic Established Population for the Epidemiological Study of the Elderly from 1995 until 2012, frailty was assessed by slow gait, weak hand grip strength, exhaustion, and unexplained weight loss (n = 1327)...
April 26, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/29777549/frailty-risk-in-hospitalized-older-adults-with-and-without-diabetes-mellitus
#14
Deborah A Lekan, Thomas P McCoy
BACKGROUND: Research indicates that diabetes mellitus (DM) may be a risk factor for frailty and individuals with DM are more likely to be frail than individuals without DM, however, there is limited research in hospitalized older adults. OBJECTIVES: To determine the extent of frailty in hospitalized older adults with and without DM using a 16-item Frailty Risk Score (FRS) and assess the role of frailty in predicting 30-day rehospitalization, discharge to an institution, and in-hospital mortality...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775746/anthropometric-measurements-and-mortality-in-frail-older-adults
#15
Jonathan F Easton, Christopher R Stephens, Heriberto Román-Sicilia, Matteo Cesari, Mario Ulises Pérez-Zepeda
BACKGROUND: As the number of older adults increases, so does the number of frail older adults. Although anthropometry has been widely used as a way to stratify the overall mortality risk of a person, the significance of these measurements becomes blurred in the case of frail older adults who have changes in body composition. Therefore, the aim of this study is to determine the association of anthropometric measurements (body mass index, knee-adjusted height body mass index, waist-to-hip ratio and calf circumference) with mortality risk in a group of older Mexican adults...
May 15, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29774388/withholding-or-withdrawing-of-life-sustaining-therapy-in-older-adults-%C3%A2-80-years-admitted-to-the-intensive-care-unit
#16
Bertrand Guidet, Hans Flaatten, Ariane Boumendil, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zafeiridis, Dylan W De Lange
PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision)...
May 17, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#17
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29772961/contrasts-in-older-persons-experiences-and-significant-others-perceptions-of-existential-loneliness
#18
Helena Larsson, Anna-Karin Edberg, Ingrid Bolmsjö, Margareta Rämgård
BACKGROUND: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the views of frail older persons and their significant others concerning existential loneliness are in concordance...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29770839/are-multidose-drug-dispensing-systems-initiated-for-the-appropriate-patients
#19
Bram J Mertens, H F Kwint, Rob J van Marum, Marcel L Bouvy
PURPOSE: It is unknown if multidose drug dispensing (MDD) systems are initiated for the appropriate patients. Therefore, the objective of this study was to compare the medication management problems of patients who were about to start with a MDD system (MDD patients) and patients who continued manually dispensed medication (non-MDD users) in order to identify if the appropriate patients receive a MDD system. METHODS: Patient interviews (semi-structured) were conducted by 44 community pharmacists at the patient's home...
May 16, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29769026/cost-effectiveness-of-a-multicomponent-primary-care-program-targeting-frail-elderly-people
#20
Franca G H Ruikes, Eddy M Adang, Willem J J Assendelft, Henk J Schers, Raymond T C M Koopmans, Sytse U Zuidema
BACKGROUND: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. METHODS: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen...
May 16, 2018: BMC Family Practice
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