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https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#1
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28087677/incorporating-persistent-pain-in-phenotypic-frailty-measurement-and-prediction-of-adverse-health-outcomes
#2
Matthew C Lohman, Karen L Whiteman, Rebecca L Greenberg, Martha L Bruce
BACKGROUND: Frailty, a syndrome of physiological deficits, is prevalent among older adults and predicts elevated risk of adverse health outcomes. Although persistent pain predicts similar risk, it is seldom considered in frailty measurement. This article evaluated the construct and predictive validity of including persistent pain in phenotypic frailty measurement. METHODS: Frailty and persistent pain were operationalized using data from the Health and Retirement Study (2006-2012 waves)...
February 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28065454/the-prevalence-association-and-clinical-outcomes-of-frailty-in-maintenance-dialysis-patients
#3
So-Young Lee, Dong Ho Yang, Eunah Hwang, Seock Hui Kang, Sun-Hee Park, Tae Woo Kim, Duk Hyun Lee, Kisoo Park, Jun Chul Kim
OBJECTIVE: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis. DESIGN: In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28060439/factors-associated-with-unexpected-admissions-and-mortality-among-low-functioning-older-patients-receiving-home-medical-care
#4
Hiroyuki Umegaki, Atushi Asai, Shigeru Kanda, Keiko Maeda, Takuya Shimojima, Hideki Nomura, Masafumi Kuzuya
AIM: The need for and availability of home medical care for elderly patients with limitations in terms of access to medical facilities has been increasing. We investigated the association between low function, malnutrition, dementia and multicomorbidity with patient prognosis, focusing on unexpected hospital admissions and mortality in elderly non-cancer patients receiving home care. METHODS: The study included 124 Japanese patients receiving home medical care in the form of regular visits from doctors and nurses for physical and/or mental disability...
January 6, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28043934/sex-differences-in-frailty-a-systematic-review-and-meta-analysis
#5
REVIEW
E H Gordon, N M Peel, M Samanta, O Theou, S E Howlett, R E Hubbard
BACKGROUND: It is a well-described clinical phenomenon that females live longer than males, yet tend to experience greater levels of co-morbidity and disability. Females can therefore be considered both more frail (because they have poorer health status) and less frail (because they have a lower risk of mortality). This systematic review aimed to determine whether this ageing paradox is demonstrated when the Frailty Index (FI) is used to measure frailty. METHODS: Medline, EMBASE and CINAHL databases were searched for observational studies that measured FI and mortality in community-dwellers over 65years of age...
December 30, 2016: Experimental Gerontology
https://www.readbyqxmd.com/read/28039855/use-of-oral-anticoagulant-therapy-in-older-adults-with-atrial-fibrillation-after-acute-ischemic-stroke
#6
Emer R McGrath, Alan S Go, Yuchiao Chang, Leila H Borowsky, Margaret C Fang, Kristi Reynolds, Daniel E Singer
OBJECTIVES: To explore barriers to anticoagulation in older adults with atrial fibrillation (AF) at high risk of stroke and to identify opportunities for interventions that might increase use of oral anticoagulants (OACs). DESIGN: Retrospective cohort study. SETTING: Two large community-based AF cohorts. PARTICIPANTS: Individuals with ischemic stroke surviving hospitalization (N = 1,405, mean age 79). MEASUREMENTS: Using structured chart review, reasons for nonuse of OAC were identified, and 1-year poststroke survival was assessed...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28039014/what-can-five-high-cost-patients-teach-us-about-healthcare-spending
#7
Ishani Ganguli, Ryan W Thompson, Timothy G Ferris
The highest cost patients account for a disproportionately large share of American healthcare costs and are increasingly the focus of research and policy efforts to stem the rapid growth of these costs. These patients tend to be medically complex and frail, but we know little about how such characteristics influence healthcare spending from the perspectives of the patients and their caregivers. Therefore, we examined five of the highest cost patients at an academic medical center in a case series. We interviewed the patients, their family members, and their clinicians and analyzed their claims data and medical charts to explore how patient and health system characteristics influenced their health costs...
December 27, 2016: Healthcare
https://www.readbyqxmd.com/read/28035938/dementia-and-pressure-ulcers-is-there-a%C3%A2-close-pathophysiological-interrelation
#8
Efraim Jaul, Oded Meiron
The current theoretical investigation aimed to explore common pathophysiological mechanisms underlying dementia and pressure ulcers (PU). Along with the increased longevity, especially in frail elderly patients, there is a higher rate of functional and cognitive impairment with dementia coinciding with disabilities, immobility resulting in a higher rate of PU. Understanding common etiological paths resulting in pressure ulcers and dementia is likely to produce new treatment strategies that could lead to the prevention of comorbid complications...
December 30, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28004031/caregiving-and-mental-health-among-workers-longitudinal-evidence-from-a-large-cohort-of-adults-in-thailand
#9
Vasoontara Yiengprugsawan, Liana Leach, Janneke Berecki-Gisolf, Hal Kendig, David Harley, Sam-Ang Seubsman, Adrian C Sleigh
BACKGROUND: As people in middle and lower income countries live longer, more people become sick, disabled, and frail and the demand for family caregiving grows. Thailand faces such challenges. This study investigates the relationship between caregiving and mental health among workers drawn from a large longitudinal cohort of Thai adults. METHODS: Participants were drawn from the Thai Health-Risk Transition Study, a cohort study since 2005 of distance-learning adult Open University students residing nationwide...
December 2016: SSM—Population Health
https://www.readbyqxmd.com/read/27964962/improving-community-ambulation-after-hip-fracture-protocol-for-a-randomised-controlled-trial
#10
D Orwig, K K Mangione, M Baumgarten, M Terrin, R Fortinsky, A M Kenny, A L Gruber-Baldini, B Beamer, Ana Tosteson, M Shardell, L Magder, E Binder, K Koval, B Resnick, R L Craik, J Magaziner
INTRODUCTION: After a hip fracture in older persons, significant disability often remains; dependency in functional activities commonly persists beyond 3 months after surgery. Endurance, dynamic balance, quadriceps strength, and function are compromised, and contribute to an inability to walk independently in the community. In the United States, people aged 65 years and older are eligible to receive Medicare funding for physiotherapy for a limited time after a hip fracture. A goal of outpatient physiotherapy is independent and safe household ambulation 2 to 3 months after surgery...
January 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/27942948/potentially-inappropriate-prescribing-in-a-population-of-frail-elderly-people
#11
Isabelle Récoché, Cécile Lebaudy, Charlène Cool, Sandrine Sourdet, Antoine Piau, Maryse Lapeyre-Mestre, Bruno Vellas, Philippe Cestac
Background Frailty is a clinical syndrome highly predictive of functional decline after a stress or a medical event, such as adverse drug events. Objective To describe the prevalence of potentially inappropriate prescribing in a population of frail elderly patients. Setting Geriatric day hospital for assessment of frailty and prevention of disability, Toulouse, France. Method A cross-sectional study performed from January to April 2014. Two pharmacists retrospectively analyzed the prescriptions of elderly patients who were sent to the day hospital to assess their frailty and to be given a personalized plan of care and prevention...
December 10, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#12
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#13
Nathan E Brummel, Susan P Bell, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Alessandro Morandi, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, Thomas M Gill, E Wesley Ely
INTRODUCTION The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those ≥18 years old with critical illness is unclear. We hypothesized greater frailty would be associated with subsequent mortality, disability, and cognitive impairment, regardless of age. METHODS At enrollment, we measured frailty using the Clinical Frailty Scale (CFS, range 1 [very fit] to 7 [severely frail]). At 3 and 12 months post-discharge, we assessed vital status, instrumental and basic activities of daily living (IADLs and BADLs), and cognition...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#14
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27855417/testosterone-deficiency-and-testosterone-treatment-in-older-men
#15
Farid Saad, Gabriele Röhrig, Stephan von Haehling, Abdulmaged Traish
Frailty is a clinical condition related to changes in metabolism, to sarcopenia, and to decline in muscle mass and strength, bone mineral density, and physical function with aging. The pathophysiology of frailty is multifactorial and associated with comorbidities. Testosterone is implicated in regulating metabolic functions, maintenance of muscle and bone, and inhibition of adipogenesis. In older individuals, reduced testosterone is thought to contribute to an altered state of metabolism, loss of muscle and bone, and increased fat, leading to sarcopenia, sarcopenic obesity, and frailty...
November 18, 2016: Gerontology
https://www.readbyqxmd.com/read/27842511/comparative-assessment-of-two-frailty-instruments-for-risk-stratification-in-elderly-surgical-patients-study-protocol-for-a-prospective-cohort-study
#16
Daniel I McIsaac, Monica Taljaard, Gregory L Bryson, Paul E Beaule, Sylvain Gagne, Gavin Hamilton, Emily Hladkowicz, Allen Huang, John Joanisse, Luke T Lavallée, Hussein Moloo, Kednapa Thavorn, Carl van Walraven, Homer Yang, Alan J Forster
BACKGROUND: Frailty is an aggregate expression of susceptibility to poor outcomes, owing to age-, and disease-related deficits that accumulate within multiple domains. Older patients who are frail before surgery are at an increased risk of morbidity and mortality, and use a disproportionately high amount of healthcare resources. While frailty is now a well-established risk factor for adverse postoperative outcomes, the perioperative literature lacks studies that: 1) compare the predictive accuracy of different frailty instruments; 2) consider the impact of frailty on patient-reported outcome measures; and 3) consider the acceptability and feasibility of using frailty instruments in clinical practice...
November 14, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27791218/fruit-and-vegetable-intake-and-physical-activity-as-predictors-of-disability-risk-factors-in-african-american-middle-aged-individuals
#17
S M L Ribeiro, J E Morley, T K Malmstrom, D K Miller
OBJECTIVE: To investigate fruit and vegetable intake (FVI) and different dimensions of physical activity (PA) as predictors of change in disabilities and other known precursors of progressive disability in a population-based sample of African Americans. DESIGN: Longitudinal investigation of the independent associations of reported FVI and PA with six-year changes in disabilities and other known precursors of progressive disability. SETTING: Longitudinal study of a population-representative cohort of late middle-aged African Americans...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27779573/individual-frailty-components-and-mortality-in-kidney-transplant-recipients
#18
Mara A McAdams-DeMarco, Hao Ying, Israel Olorundare, Elizabeth A King, Christine Haugen, Brian Buta, Alden L Gross, Rita Kalyani, Niraj M Desai, Nabil N Dagher, Bonnie E Lonze, Robert A Montgomery, Karen Bandeen-Roche, Jeremy D Walston, Dorry L Segev
BACKGROUND: Frailty increases early hospital readmission and mortality risk among kidney transplant (KT) recipients. While frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear. METHODS: 663 KT recipients were enrolled in a cohort study of frailty in transplantation (12/2008-8/2015). Frailty, ADL/IADL disability, CESD depression, education, and HRQOL were measured...
October 25, 2016: Transplantation
https://www.readbyqxmd.com/read/27754000/db-02-2-strict-control-of-hypertension-in-the-frail-elderly-is-it-beneficial-con
#19
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27746669/the-value-of-a-gardening-service-for-the-frail-elderly-and-people-with-a-disability-living-in-the-community
#20
Anne Same, Elinda Ai Lim Lee, Beverley McNamara, Lorna Rosenwax
Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening (n = 38) and post-gardening service delivery interviews (n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health...
November 2016: Home Health Care Management & Practice
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