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"Frail elderly"

Masaya Shinohara, Tadashi Fujino, Shinntaro Yao, Kensuke Yano, Katsuya Akitsu, Hideki Koike, Toshio Kinoshita, Hitomi Yuzawa, Takeya Suzuki, Kenzaburo Kobayashi, Takanori Ikeda
BACKGROUND: Physicians estimate the frailty in elderly patients with atrial fibrillation (AF) to aid in the decision making with respect to oral anticoagulant (OAC) therapy. There are limited data on the safety of OAC therapy in non-severe frail elderly patients. We evaluated the risk factors of bleeding among non-severe frail octogenarians with AF taking OACs. METHODS: Among 430 consecutive AF patients aged 80 years and over with non-severe frailty, we enrolled 346 patients [167 men, 83...
June 10, 2018: Journal of Cardiology
Nitish Rai, G Venugopalan, Rashmita Pradhan, Akash Ambastha, Ashish Datt Upadhyay, Sadanand Dwivedi, Aparajit B Dey, Sharmistha Dey
Frailty in elderly is very much familiar with a decline in the musculoskeletal system. Muscle degeneration in the lower organism was observed due to loss of anti-oxidant protein Sestrin. The aim of the study is to determine the level of Sestrin1 and Sestrin2 in the serum of frail and non-frail elderly to associate their impact in frailty syndrome. Subjects with age ≥ 65 years were enrolled from Geriatric Medicine OPD of All India Institute of Medical Sciences, New Delhi (N= 92). Among them, 51 subjects were identified as frail and rest 41 were regarded as non-frail according to "deficit accumulation model of Rockwood...
April 2018: Aging and Disease
Arya Biragyn, Luigi Ferrucci
Cancer incidence substantially increases with ageing in both men and women, although the reason for this increase is unknown. In this Series paper, we propose that age-associated changes in gut commensal microbes, otherwise known as the microbiota, facilitate cancer development and growth by compromising immune fitness. Ageing is associated with a reduction in the beneficial commensal microbes, which control the expansion of pathogenic commensals and maintain the integrity of the intestinal barrier through the production of mucus and lipid metabolites, such as short-chain fatty acids...
June 2018: Lancet Oncology
Marilyn R ElBestawi, Catherine Kohm
Healthcare organizations and governments are exploring new methods to deliver cost-effective, quality care to the frail elderly. Given the projected increase in Canada's elderly population, ensuring that residents receive the right care, at the right time, in the right location is pivotal to this goal. Practical Routine Elder Variants Indicate Early Warning for Emergency Department has been developed as a quality improvement tool. Two pilot studies, one in Ontario and one in British Columbia, have shown promising results...
January 1, 2018: Healthcare Management Forum
Johanna Gustavsson, Carolina Jernbro, Finn Nilson
PURPOSE: Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring...
December 2018: International Journal of Qualitative Studies on Health and Well-being
Giuseppe Coppolino, Davide Bolignano, Pietro Gareri, Carmen Ruberto, Michele Andreucci, Giovanni Ruotolo, Maurizio Rocca, Alberto Castagna
BACKGROUND AND AIMS: Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-population with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. METHODS: 2229 geriatric subjects were screened for frailty and CKD...
June 4, 2018: International Urology and Nephrology
Pénélope A Andreux, Marcus P J van Diemen, Maxime R Heezen, Johan Auwerx, Chris Rinsch, Geert Jan Groeneveld, Anurag Singh
Aging is accompanied by a gradual decline in both muscle mass and strength over time, which can eventually lead to pathologies, such as frailty and sarcopenia. While these two conditions are well characterized, further investigation of the early biological signs present in pre-frail elderly is still needed to help identify strategies for preventative therapeutic intervention. The goal of the present clinical study was to evaluate the level of mitochondrial (dys)function in a well-defined population of pre-frail elderly (>60 years of age)...
June 4, 2018: Scientific Reports
Satoshi Suzuki, Shingo Kanaji, Yoshiko Matsuda, Masashi Yamamoto, Hiroshi Hasegawa, Kimihiro Yamashita, Taro Oshikiri, Takeru Matsuda, Yasuo Sumi, Tetsu Nakamura, Yoshihiro Kakeji
With the extension of life expectancy, cancer has been increasing in elderly populations. Postoperative pneumonia can negatively influence immediate mortality following gastrectomy for elderly patients, but its impact on long-term survival remains unclear. We retrospectively reviewed the cases of patients aged ≥75 years who underwent curative gastrectomy for gastric cancer from 2000 to 2014 to determine the long-term effects of postoperative pneumonia and to identify independent risk factors along with physical status and surgical procedure...
January 2018: Annals of gastroenterological surgery
Emile Escourrou, Mickael Herault, Samy Gdoura, André Stillmunkés, Stéphane Oustric, Bruno Chicoulaa
Background: The frailty concept requires that practices should be adapted to meet the challenge of dependence. The GP is in the front line of management of frail elderly patients. Objectives: To explore the perception of elderly persons of the term and concept of frailty and to understand their perception of the risk of loss of independence. Methods: Two qualitative studies by individual interviews in the homes of elderly persons identified as potentially frail by their GP, or diagnosed as frail and at risk of loss of independence...
May 24, 2018: Family Practice
Kosaku Komiya, Yuko Usagawa, Jun-Ichi Kadota, Naoki Ikegami
OBJECTIVES: To identify trends in percutaneous endoscopic gastrostomy (PEG) tube placement and intravenous hyperalimentation (IVH) in nonhospital settings (as a potential alternative to tube feeding for nutrition) and to summarize published reports concerning the decision-making process for PEG placement. DESIGN: National survey and systematic review. SETTING: Japan. PARTICIPANTS: All Japanese people. MEASUREMENTS: Data on numbers of individuals with a PEG tube and IVH were obtained from the website of the Japanese Ministry of Health, Labour, and Welfare and published reports concerning the decision-making process for PEG placement in Japan were summarized...
May 25, 2018: Journal of the American Geriatrics Society
Christine Yuanxin Chen, Peiying Gan, Choon How How
Frailty is a distinct clinical syndrome wherein the individual has low reserves and is highly vulnerable to internal and external stressors. Although it is associated with disability and multiple comorbidities, it can also be present in individuals who seem healthy. Frailty is multidimensional and its pathophysiology is complex. Early identification and intervention can potentially decrease or reverse frailty, especially in the early stages. Primary care physicians, community nurses and community social networks have important roles in the identification of pre-frail and frail elderly through the use of simple frailty screening tools and rapid geriatric assessments...
May 2018: Singapore Medical Journal
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
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
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
Sergio Storti, Michele Spina, Emanuela Anna Pesce, Flavia Salvi, Michele Merli, Alessia Ruffini, Giuseppina Cabras, Annalisa Chiappella, Emanuele Angelucci, Alberto Fabbri, Anna Marina Liberati, Monica Tani, Gerardo Musuraca, Annalia Molinari, Maria Pia Petrilli, Carmela Palladino, Rosanna Ciancia, Andrea Ferrario, Cristiana Gasbarrino, Federico Monaco, Vincenzo Fraticelli, Annalisa De Vellis, Francesco Merli, Stefano Luminari
We conducted a phase II study to assess activity and safety profile of bendamustine and rituximab in elderly patients with untreated Diffuse Large B Cell Lymphoma who were prospectively defined as frail using a simplified version of a Comprehensive Geriatric Assessment. Patients had to be > 70 years of age, with histologically confirmed Diffuse Large B Cell Lymphoma. Frail patients were those younger than 80 years with a frail profile at Comprehensive Geriatric Assessment or older than 80 years with an unfit profile...
May 10, 2018: Haematologica
Cristina Pacho, Mar Domingo, Raquel Núñez, Josep Lupón, Julio Núñez, Jaume Barallat, Pedro Moliner, Marta de Antonio, Javier Santesmases, Germán Cediel, Santiago Roura, M Cruz Pastor, Jordi Tor, Antoni Bayes-Genis
BACKGROUND: Heart failure (HF) is associated with a high rate of readmissions within 30 days post-discharge and in the following year, especially in frail elderly patients. Biomarker data are scarce in this high-risk population. This study assessed the value of early post-discharge circulating levels of ST2, NT-proBNP, CA125, and hs-TnI for predicting 30-day and 1-year outcomes in comorbid frail elderly patients with HF with mainly preserved ejection fraction (HFpEF). METHODS: Blood samples were obtained at the first visit shortly after discharge (4...
May 9, 2018: BMC Geriatrics
J de Kerimel, N Tavassoli, C Lafont, M Soto, M Pedra, F Nourhashemi, C Lagourdette, L Bouchon, A Chaléon, S Sourdet, Y Rolland, M Cesari, B Vellas
BACKGROUND: Health promotion programs could prevent and delay frailty and functional decline. However, in practice, the planning and establishment of such a program is a challenge for health care providers. We report an experimental model of screening and management for frail elderly conducted in Cugnaux, city of 16,638 inhabitants in France, by the Toulouse Gerontopole and the social care service of the Cugnaux City Hall. METHODS: A frailty screening self-administered questionnaire (FiND questionnaire) was sent to community-dwelling residents of 70 years old and over of Cugnaux...
2018: Journal of Frailty & Aging
Rosanna Irene Comoretto, Federico Rea, Ersilia Lucenteforte, Alessandro Mugelli, Gianluca Trifirò, Silvia Cascini, Giuseppe Roberto, Alessandro Chinellato, Amelia Filippelli, Giovanni Corrao
PURPOSE: The aim of this study was to estimate the proportion of bleedings that occurred among warfarin users attributable to the concomitant use of other medications. A general approach for measuring the impact of the prescriptive inappropriateness on drug adverse outcomes at the population level is described. METHODS: A meta-analysis was conducted to obtain summary relative risks of bleeding associated with concurrent use of warfarin and other medications compared to warfarin use alone...
May 7, 2018: European Journal of Clinical Pharmacology
Niklas Ekerstad, Thomas Karlsson, Sara Söderqvist, Björn W Karlson
Background and objective: Multiple chronic conditions and recurring acute illness are frequent among elderly people. One such condition is atrial fibrillation (AF), which increases the risk of stroke up to fivefold. The aim of this study was to investigate the prevalence of AF among hospitalized frail elderly patients, their use of anticoagulation and their 12-month outcomes. Patients and methods: This was a clinical observational study of acutely hospitalized frail patients over the age of 75 years...
2018: Clinical Interventions in Aging
Geoffrey Shouse, Miemie Thinn
Diffuse large B-cell lymphoma (DLBCL) is a molecularly heterogeneous disease consisting of different subtypes with varying clinical behaviors. For example, the activated B-cell-like (ABC) type of DLBCL has lower cure rates with traditional chemotherapy regimens. The molecular pathway promoting tumorigenic growth of the ABC type includes a dependence on intracellular signaling by Bruton's agammaglobulinemia tyrosine kinase (BTK). This specific pathway has led to the investigation of the utility of ibrutinib in treatment of this type of lymphoma at relapse or in combination with standard chemotherapy...
2018: Case Reports in Hematology
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