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https://www.readbyqxmd.com/read/29239943/achieving-milestones-as-a-prerequisite-for-proceeding-with-a-clinical-trial
#1
Angela M Mickle, Hannah R Maybrier, Anke C Winter, Sherry L McKinnon, Brian A Torres, Nan Lin, Eric J Lenze, Susan Stark, Maxwell R Muench, Eric Jacobsohn, Sharon K Inouye, Michael S Avidan, Troy S Wildes
BACKGROUND: Although the National Institutes of Health (NIH) invests $30 billion in research annually, many funded studies fail to generate results that can inform practice. The National Institutes of Health introduced a phased funding mechanism as one potential solution. Study-specific milestones are established for an initial pilot phase. We assess the utility of this phased approach through the ongoing Electroencephalography (EEG) Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) pragmatic clinical trial...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29226660/bone-and-joint-diseases-in-present-and-future
#2
Yasuharu Nakashima, Ken Okazak, Koichiet Nakayama, Seiji Okada, Hideki Mizu-uchi
With the increase of elderly population, orthopaedic surgeons need to deal with the diseases related to aging, such as joint disorders and fragility fractures. The number of total joint replacements, for example, is two times more than it was 10 years ago. With these backgrounds, the Japanese Orthopaedic Association (JOA) has proposed the concept of locomotive syndrome; conditions under which the elderly have been receiving care services due to problems of the locomotive organs. To prevent geriatric or disuse syndrome, JOA is currently providing the care‒prevention programs such as the loco-check and loco-training...
January 2017: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
https://www.readbyqxmd.com/read/29223403/older-adults-undergoing-total-hip-or-knee-arthroplasty-chronicling-changes-in-their-multimorbidity-profile-in-the-last-two-decades
#3
Siran M Koroukian, Nicholas K Schiltz, David F Warner, Alison K Klika, Carlos A Higuera-Rueda, Wael K Barsoum
BACKGROUND: Despite the ubiquitous use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older adults, little is known about the multimorbidity (MM) profile of this patient population. This study evaluates the temporal trends of MM, hypothesizing that patients with MM have had an increasingly greater representation in THA and TKA patients over time. METHODS: Data on a US representative sample of older adults from the linked Health and Retirement Study and Medicare data from 1993 to 2012 were used...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29214924/different-protein-and-derivatives-supplementation-strategies-combined-with-resistance-training-in-pre-frail-and-frail-elderly-rationale-and-protocol-for-the-pro-elderly-study
#4
Alan Lins Fernandes, Ana Paula Hayashi, José Claudio Jambassi-Filho, Mariana Dutilh de Capitani, Davi Alves de Santana, Bruno Gualano, Hamilton Roschel
BACKGROUND: Frailty is a multifactorial geriatric syndrome characterized by progressive decline in health and associated with decreased muscle mass, strength, and functional capacity. Resistance training (RT) combined with protein or amino acids supplementation has been shown to be promising for mitigating age-related impairments. AIM: To investigate the chronic effects of different strategies of protein and derivatives supplementation in association with RT on selected health-related parameters in pre-frail and frail elderly...
December 2017: Nutrition and Health
https://www.readbyqxmd.com/read/29213155/frailty-syndrome-and-socioeconomic-and-health-characteristics-among-older-adults
#5
Darlene Mara Dos Santos Tavares, Thais Aline de Freitas Corrêa, Flavia Aparecida Dias, Pollyana Cristina Dos Santos Ferreira, Maycon Sousa Pegorari
Objective: To investigate the association of frailty syndrome with socioeconomic and health variables among older adults. Methods: This is a cross-sectional, observational and analytical household research conducted with a sample of 1,609 urban elderly. We used: semi-structured questionnaire, scales (Katz, Lawton and shortened version of Geriatric Depression Scale) and Fragility Phenotype proposed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p <0...
September 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/29210840/conoscere-e-curare-il-cuore-1986-2016-how-the-heart-has-changed
#6
Alessandro Boccanelli
: The demographic transition, with longer life expectancy, is mainly due to prevention and care of atherosclerotic vascular and heart disease. The cardiovascular patient is now much older and often presents with coexisting geriatric syndromes that affect healthcare goals, outcomes, and the process of care. Numerous mechanisms at cellular level are responsible for cardiovascular aging such as replicative senescence, apoptosis, proteins misfolding, and inflammation. Aging-related modifications are increase in left-ventricular mass, increased left atrial size, myocardial collagen deposition, and calcium deposition in valvular structures and the coronary arteries...
November 27, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29206692/individualizing-the-care-of-older-heart-failure-patients
#7
George A Heckman, Robert S McKelvie, Kenneth Rockwood
PURPOSE OF REVIEW: The heart failure epidemic is driven mainly by population aging and the improving survival of patients with cardiovascular risk factors. Aging heart failure patients are affected by multiple concurrent comorbidities and geriatric syndromes, the most important of which are frailty and cognitive impairment. The purpose of this review is to provide clinicians with practical advice on how to individualize the care of older heart failure patients. RECENT FINDINGS: Frailty and cognitive impairment are common in older heart failure patients...
December 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29205261/report-and-research-agenda-of-the-american-geriatrics-society-and-national-institute-on-aging-bedside-to-bench-conference-on-urinary-incontinence-in-older-adults-a-translational-research-agenda-for-a-complex-geriatric-syndrome
#8
Camille P Vaughan, Alayne D Markland, Phillip P Smith, Kathryn L Burgio, George A Kuchel
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its ninth Bedside-to-Bench research conference, entitled "Urinary Incontinence in the Older Adult: A Translational Research Agenda for a Complex Geriatric Syndrome," October 16 to 18, 2016, in Bethesda, Maryland. As part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm disturbance, and urinary incontinence-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these conditions...
December 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#9
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29193629/relationship-between-the-severity-of-cerebral-white-matter-hyperintensities-and-sympathetic-nervous-activity-in-older-adults
#10
Toshimasa Obara, Kumiko Nagai, Shigeki Shibata, Ai Hirasawa, Hitomi Koshiba, Hiroshi Hasegawa, Takae Ebihara, Koichi Kozaki
AIM: White matter hyperintensities (WMH), visualized on brain magnetic resonance imaging, represent an abnormality related to the development of geriatric syndromes. Recently, it has been found that low sympathetic nervous activity might be associated with physical and cognitive dysfunction in older adults. Therefore, we investigated the relationship between the severity of cerebral WMH and sympathetic nervous activity, measured by the heart rate variability. METHODS: We carried out a cross-sectional study of 39 older patients...
November 28, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29176368/changes-in-case-mix-and-health-outcomes-of-medicare-fee-for-service-beneficiaries-and-managed-care-enrollees-during-the-years-1992-2011
#11
Siran M Koroukian, Jayasree Basu, Nicholas K Schiltz, Suparna Navale, Paul M Bakaki, David F Warner, Avi Dor, Charles W Given, Kurt C Stange
BACKGROUND: Recent studies suggest that managed care enrollees (MCEs) and fee-for-service beneficiaries (FFSBs) have become similar in case-mix over time; but comparisons of health outcomes have yielded mixed results. OBJECTIVE: To examine changes in differentials between MCEs and FFSBs both in case-mix and health outcomes over time. DESIGN: Temporal study of the linked Health and Retirement Study (HRS) and Medicare data, comparing case-mix and health outcomes between MCEs and FFSBs across 3 time periods: 1992-1998, 1999-2004, and 2005-2011...
November 23, 2017: Medical Care
https://www.readbyqxmd.com/read/29171993/prevalence-of-delirium-in-a-population-of%C3%A2-elderly-outpatients-with-dementia-a%C3%A2-retrospective-study
#12
Desirée Addesi, Raffaele Maio, Nicoletta Smirne, Valentina Laganà, Natalia Altomari, Gianfranco Puccio, Rosanna Colao, Chiara Cupidi, Francesco Perticone, Amalia Cecilia Bruni
BACKGROUND: Delirium is a multifactorial geriatric syndrome and often occurs in patients with cognitive impairment. It also remains under-recognized, specifically in elderly outpatients, because signs of delirium might overlap with symptoms of dementia. OBJECTIVE: The aim of the present study is to retrospectively apply the chart-based delirium instrument on a cohort of elderly outpatients with dementia, to assess prevalence and features of delirium in this population...
November 20, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29171838/frailty-is-thy-name%C3%A2-universal-evolving-challenges-of-managing-effectively-treated-older-people-living-with-hiv
#13
Julian Falutz
The increased survival of treated people living with HIV (PLWH) represents a tremendous accomplishment. However, this has not been accompanied by uniform improvements in quality of life. Many PLWH prematurely develop age-related complications and traditional geriatric syndromes, including frailty. This is a potentially reversible state of vulnerability to adverse outcomes. Its operationalization remains challenging. The most commonly used tools, the frailty phenotype and the frailty index, have their advantages and limitations, but predict similar poor outcomes...
November 24, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/29168883/prevalence-of-frailty-and-associated-factors-in-the-community-dwelling-population-of-china
#14
Lina Ma, Zhe Tang, Li Zhang, Fei Sun, Yun Li, Piu Chan
BACKGROUND/OBJECTIVES: Frailty in older adults predicts dependence and mortality and is a major challenge for healthcare systems in countries with rapidly aging populations. Little is known about frailty in China. We investigated the prevalence and associated risk factors of frailty in older adults in China. DESIGN: Cross-sectional. SETTING: Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011-12, which was the first uniform comprehensive assessment system adopted in China...
November 23, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29166451/factors-associated-with-frailty-in-a-community-dwelling-population-of-older-adults
#15
Danielle Teles da Cruz, Marcel de Toledo Vieira, Ronaldo Rocha Bastos, Isabel Cristina Gonçalves Leite
OBJECTIVE: To analyze if demographic and socioeconomic factors and factors related to health and health services are associated with frailty in community-dwelling older adults. METHODS: This is a cross-sectional study with 339 older adults (60 years old or more) living in Juiz de Fora, State of Minas Gerais, Brazil, in 2015. A household survey was carried out and frailty was evaluated using the Edmonton Frail Scale. For the analysis of the factors associated with outcome, a theoretical model of determination was constructed with three hierarchical blocks: block 1 with demographic and socioeconomic characteristics, block 2 with the health of the older adult (divided into three sub-levels: 2...
2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29165537/frailty-is-not-associated-with-mistreatment
#16
S D Piña-Escudero, J M A García-Lara, J A Avila-Funes
Muscle Frailty has been previously associated with increased vulnerability for adverse health-related outcomes that could lead to social consequences such as mistreatment. The aim of this cross-sectional study is to determine the association between frailty and mistreatment in 852 community-dwelling persons aged 70 or older. Mistreatment was defined as one positive answer in the Geriatric Mistreatment Scale and frailty was used as a continuum where the greater number of positive criteria according to Fried et al...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29165098/effects-of-olive-oil-on-tnf-%C3%AE-and-il-6-in-humans-implication-in-obesity-and-frailty
#17
Nagendra Sastry Yarla, Angela Polito, Ilaria Peluso
BACKGROUND AND OBJECTIVE: Tumor necrosis factor-alpha (TNF)-α and interleukin (IL)-6 are important mediators of chronic low-grade systemic inflammation. The latter plays a central role in several obesity-related pathologies, such as diabetes, metabolic syndrome and cardiovascular diseases. Besides, these cytokines have been also implicated in geriatric and cancer-induced anorexia, cachexia, sarcopenia and frailty. Potential interventions for both obesity and frailty include dietary advice and nutraceuticals...
November 20, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29164173/factors-related-to-the-severity-of-delirium-in-the-elderly-patients-with-infection
#18
R A Tuty Kuswardhani, Yosef Samon Sugi
Objective: Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behavior. Infection is one of the most important risk factors for delirium. The objective of this study is to elaborate the factors related to the severity of delirium in the elderly patients with infection. Method: An observational study on the relationship of several clinical parameters and the severity of delirium in elderly patients (more than 60 years) with infection was conducted at Geriatric Inpatient Ward, Sanglah Hospital...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29162276/-oropharyngeal-dysphagia-a-new-geriatric-syndrome
#19
EDITORIAL
Alberto Martín, Omar Ortega, Pere Clavé
No abstract text is available yet for this article.
November 18, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29156483/-interventions-for-assisting-geriatric-patients-with-frailty-before-surgery
#20
Jörn Kiselev
Frailty is a complex syndrome leading to a higher vulnerability in elderly patients, especially during and after surgery. It is characterized by the simultaneous presence of at least three of five phenotypical symptoms: unintentional weight loss, exhaustion, muscle weakness, slow walking speed, and low activity levels. The presence of two of these symptoms is often labelled as pre-frailty.By identifying these symptoms of frailty, medical teams can plan and perform suitable interventions prior to a planned surgery in order to lower these risk factors and to avoid complications, such as delir, hospital re-admission, loss of independence, and increased mortality...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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