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Geriatric review

Mark A Oldham, Jacqueline Vachon, David Yuh, Hochang B Lee
OBJECTIVES: To summarize evidence on cognitive outcomes after heart valve surgery; secondary aim, to examine whether aortic and mitral valve surgery are associated with different cognitive outcomes. DESIGN: Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review and meta-analysis. SETTING: Cardiac surgery. PARTICIPANTS: Individuals undergoing heart valve surgery. MEASUREMENTS: We searched MEDLINE, EMBASE, and PsycINFO for peer-reviewed reports of individuals undergoing heart valve surgery who underwent pre- and postoperative cognitive assessment...
October 11, 2018: Journal of the American Geriatrics Society
Daniel Kopf, Walter Hewer
BACKGROUND: Aged patients with severe mental illness (SMI) suffer from a high risk for functional impairment and a high load of somatic comorbidities. Until now, there has been a lack of systematic studies on this patient population in later life. This review summarizes the most significant somatic comorbidities and discusses the consequences for the medical care of this elderly group of patients. METHODS: A selective narrative review based on PubMed research and observations in clinical practice...
October 10, 2018: Zeitschrift Für Gerontologie und Geriatrie
Egle Tamuleviciute-Prasciene, Kristina Drulyte, Greta Jurenaite, Raimondas Kubilius, Birna Bjarnason-Wehrens
The aim of this literature review was to evaluate existing evidence on exercise-based cardiac rehabilitation (CR) as a treatment option for elderly frail patients with valvular heart disease (VHD). Pubmed database was searched for articles between 1980 and January 2018. From 2623 articles screened, 61 on frailty and VHD and 12 on exercise-based training for patients with VHD were included in the analysis. We studied and described frailty assessment in this patient population. Studies reporting results of exercise training in patients after surgical/interventional VHD treatment were analyzed regarding contents and outcomes...
2018: BioMed Research International
Lore Decoster, Denis Schallier
With a median age of 70 years at diagnosis, lung cancer is a disease of older persons. As a consequence oncologists are confronted with an increasing older lung cancer population for which treatment decisions are needed. In the past years, the therapeutic landscape of advanced non-small cell lung cancer (NSCLC) has changed impressively with the introduction of targeted therapies and immunotherapy next to chemotherapy. Treatment choices for advanced NSCLC are mainly guided by different tumor-related characteristics...
October 6, 2018: Journal of Geriatric Oncology
Annemieke Vink, Suzanne Hanser
The growing population of people with dementia worldwide calls attention to the burdens associated with age-related decline that affects physiology, psychological and cognitive status, and social/emotional wellbeing. The current standards in geriatric care recommend non-pharmacological approaches to these challenges, including safe approaches to managing pain and stress, enhancing symptom relief, and fostering independent lifestyles with the highest quality of life possible. The purpose of this article is to provide definitions of music-based interventions, music therapy applications and clinician qualifications, as well as an umbrella mini-review of meta-analyses regarding music-based interventions for individuals with dementia...
October 8, 2018: Medicines (Basel, Switzerland)
Allison Navis, Rocio Garcia-Santibanez, Maryna Skliut
BACKGROUND: Rate of ischemic strokes and transient ischemic attacks (TIAs) increases with age. There is lack of evidence on how age affects treatment strategies and outcomes. Our aim is to compare epidemiology of ischemic strokes and TIAs in adult and geriatric populations including risk factors, treatment delivered, and outcomes. DESIGN: We designed a retrospective cross-sectional review of patients admitted to neurology with diagnosis of stroke or TIA from 2010 to 2015...
October 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Aref Trigui, Sami Hached, Ahmed Ammari, Yvon Savaria, Mohamad Sawan
Due to the constantly growing geriatric population and the projected increase of the prevalence of chronic diseases that are refractory to drugs, Implantable Medical Devices (IMDs) such as neurostimulators, endoscopic capsules, artificial retinal prostheses, and brain-machine interfaces are being developed. According to many business forecast firms, the IMD market is expected to grow and they are subject to much research aiming to overcome the numerous challenges of their development. One of these challenges consists of designing a wireless power and data transmission system that has high power efficiency, highdata rates, low power consumption, and high-robustness against noise...
October 4, 2018: IEEE Reviews in Biomedical Engineering
Elita Santosaputri, Kate Laver, Timothy To
OBJECTIVE: To determine the efficacy of interventions, delivered by geriatrics-trained staff for nursing home residents, in reducing hospitalisation. METHODS: Multiple databases and clinical trial registers were searched. Studies that provided comparative data and involved residents aged ≥65 years evaluating patient-level interventions delivered by geriatrics-trained staff were included. The systematic review protocol was made available on PROSPERO (registration number CRD42017079928; www...
October 7, 2018: Australasian Journal on Ageing
Jaime Feliu, Victoria Heredia-Soto, Regina Gironés, Beatriz Jiménez-Munarriz, Juana Saldaña, Carmen Guillén-Ponce, M J Molina-Garrido
Although approximately 50% of cancer patients are 70 years of age or older, cancer treatment in the elderly remains a therapeutic challenge. The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, for which therapeutic decisions must be made in an individualized manner. In addition, changes in pharmacokinetics and pharmacodynamics of the drugs occur with age, as well as the tolerance of the tissues, leading to a narrowing of the therapeutic margin and an increase in toxicity...
November 2018: Critical Reviews in Oncology/hematology
Mar Radovicco, Ravindran Kanesvaran, Achim Rittmeyer, Martin Früh, Fabrizio Minervini, Markus Glatzer, Paul Martin Putora
Lung cancer is the leading cause of cancer death worldwide. Older patients represent approximately half of the patient population and optimal management of these patients is challenging. In early-stagenon-small cell lung cancer (NSCLC), lobectomy should be considered in fit older patients. For unfit patients, stereotactic body radiotherapy (SBRT) represents a good alternative. While data on the benefit and risk of concurrent chemo-radiotherapy (cCRT) in older patients with locally advanced NSCLC is conflicting, age alone should not preclude cCRT...
October 3, 2018: Journal of Geriatric Oncology
Mohsen Bazargan, James L Smith, Ebony O King
BACKGROUND: Inappropriate use of medications, particularly among minority older adults with co-morbidity, remains a major public health concern. The American Geriatrics Society (AGS) reports that Potentially Inappropriate Medication (PIM) continues to be prescribed for older adults, despite evidence of poor outcomes. The main objective of this study was to examine the prevalence of PIM use among underserved non-institutionalized hypertensive older African-American adults. Furthermore, this study examines potential correlations between PIM use and the number and type of chronic conditions...
October 5, 2018: BMC Geriatrics
Inderpal Singh, Shridhar Aithal
The population is aging worldwide, and hospitals are admitting a higher proportion of acutely unwell older people. Population-specific factors such as multimorbidity and frailty in older people compounded by deficient expertise contribute to longer lengths of stay, higher readmission rates, and increased rates of institutionalization. A wide range of acute geriatric care models are currently providing acute care to frail older people and these have been shown to provide a cost-effective high-quality service...
2018: Patient related Outcome Measures
Carrie Stewart, Selvarani Subbarayan, Pamela Paton, Elliot Gemmell, Iosief Abraha, Phyo Kyaw Myint, Denis O'Mahony, Alfonso J Cruz-Jentoft, Antonio Cherubini, Roy L Soiza
Globally, stroke remains a leading cause of death and disability, with older adults disproportionately affected. Numerous non-pharmacological stroke rehabilitation approaches are in use to address impairments, but their efficacy in older persons is largely unknown. This systematic review examined the evidence for such interventions as part of the Optimal Evidence-Based Non-Drug Therapies in Older Persons (ONTOP) project conducted under an European Union funded project called the Software Engine for the Assessment and Optimisation of Drug and Non-Drug Therapies in Older Persons (SENATOR) [http://www...
2018: PloS One
Laura K Triantafylidis, Chelsea E Hawley, Laura P Perry, Julie M Paik
Older adults with chronic kidney disease (CKD) often experience polypharmacy, a recognized predictor of prescribing problems including inappropriately dosed medications, drug-drug and drug-disease interactions, morbidity and mortality. Polypharmacy is also associated with nonadherence, which leads to recurrent hospitalizations and poorer hemodialysis outcomes in CKD patients. Further complicating medication management in this vulnerable population are the physiologic changes that occur with both age and CKD...
October 4, 2018: Drugs & Aging
Xiuyan Lan, Huimin Xiao, Ying Chen
ABSTRACTObjectives:To explore the acceptance and effects of life review on older adults. DESIGN: A mixed-method study design was utilized in this study. SETTING: Four nursing homes located in Fuzhou, China. PARTICIPANTS: Sixty-two older adults from four nursing homes were selected according to the criteria set for this study. METHOD: Sixty-two older adults were randomly assigned to either the life review group or the control group, and 55 of them completed the study...
October 2, 2018: International Psychogeriatrics
Kenneth Lam, Dov Gandell
We present the top 11 articles in geriatric medicine in the past two years. The topics range from new diagnostic criteria for Lewy Body dementia, advances in biomarker diagnosis of Alzheimer's disease, a major review of dementia and risk factors, the optimal cutoff for the Montreal Cognitive Assessment, antipsychotics in delirium prevention, mobilization of inpatients, intensive blood pressure treatment and statin therapy for primary prevention in older adults, and comprehensive geriatric assessment in vascular surgery and non-small cell lung cancer...
September 2018: Canadian Geriatrics Journal: CGJ
Loraine De Jesús Quintana-Pájaro, Yancarlos Ramos-Villegas, Eileen Cortecero-Sabalza, Andrei F Joaquim, Amit Agrawal, Alexis Rafael Narvaez-Rojas, Luis Rafael Moscote-Salazar
Background and Objectives: Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, used for the management of hypercholesterolemia and related atherosclerotic diseases. Several studies have indicated the neuroprotective effects of statins on several neuropathological conditions. However, the role of these medications in epilepsy is still unclear. The purpose is to evaluate and summarize the level of evidence on the efficacy of statins in neuronal hyperexcitability and the neuroinflammatory processes of epilepsy...
October 2018: Journal of Neurosciences in Rural Practice
Kannayiram Alagiakrishnan, Maciej Banach, Darren Mah, Ali Ahmed, Wilbert S Aronow
OBJECTIVES: Atrial fibrillation (AF) is common in older adults and associated with increased risk of cardiovascular events including thromboembolism. However, less is known about its association with noncardiovascular events, especially geriatric syndromes and conditions such as dementia, depression, impaired physical function, polypharmacy, falls, and poor quality of life. This review aims to help healthcare professionals integrate the special needs of older adults into their management of AF...
September 27, 2018: Journal of the American Medical Directors Association
Pablo Díez-Villanueva, Albert Arizá-Solé, María Teresa Vidán, Clara Bonanad, Francesc Formiga, Juan Sanchis, F Javier Martín-Sánchez, Vicente Ruiz Ros, Marcelo Sanmartín Fernández, Héctor Bueno, Manuel Martínez-Sellés
Frailty is an age-associated clinical syndrome characterized by a decrease in physiological reserve in situations of stress, constituting a state of vulnerability that involves a higher risk of adverse events. Its prevalence in Spain is high, especially in elderly individuals with comorbidity and chronic diseases. In cardiovascular disease, frailty is associated worse clinical outcomes and higher morbidity and mortality in all scenarios, in both acute and chronic settings, and could consequently influence diagnosis and treatment...
September 27, 2018: Revista Española de Cardiología
Vanessa Watts, Mikhail Daya Attie, Shawn McClure
PURPOSE: The purpose of this article is to review the current applications of dermal regeneration templates in reconstruction of full-thickness scalp defects, most commonly resulting from oncologic surgery, and show its success in reconstruction of a complex full-thickness scalp defect resulting from a dog-bite injury. MATERIALS AND METHODS: A systematic review conforming to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines was completed...
September 4, 2018: Journal of Oral and Maxillofacial Surgery
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