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https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#1
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910810/production-of-tnf-alpha-ex-vivo-is-predictive-of-an-immune-response-to-flu-vaccination-in-a-frail-elderly-population
#2
Frédéric Bloch, Bénédicte Charmeteau, Michael Tovey, Jean-François Meritet, Corinne Desaint, Odile Launay, Pierre Lebon
OBJECTIVE: To investigate the relationship between the response to influenza vaccination and the ability to produce proinflamatory cytokines in elderly subjects. METHODS: Whole blood samples from 25 elderly subjects collected before influenza vaccination were stimulated with the influenza vaccine in order to evaluate the secretion of five specific cytokines: TNFα, IFNα, IFNγ, IL2 and IL10. The results were correlated with the increased HAI antibody titres two weeks after vaccination...
September 1, 2016: European Cytokine Network
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#3
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#4
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#5
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27901241/cardiovascular-risk-factors-associated-with-frailty-syndrome-among-hospitalized-elderly-people-a-cross-sectional-study
#6
Darlene Mara Dos Santos Tavares, Camila Gigante Colamego, Maycon Sousa Pegorari, Pollyana Cristina Dos Santos Ferreira, Flávia Aparecida Dias, Alisson Fernandes Bolina
CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27900928/-is-transcatheter-aortic-valve-implantation-superior-to-surgical-valve-replacement
#7
Y Schoon
Severe aortic valve stenosis is treated traditionally with surgical valve replacement. Transcatheter aortic valve implantation (TAVI) has experienced a rapid development in the last decade. Indications for TAVI have been broadened from inoperable and high surgical risk patients to intermediate-risk patients. Mortality rates are identical after TAVI compared with surgical valve replacement in intermediate-risk patients. However, mortality is not an appropriate outcome measure for a frail older person. Quality of life, autonomy and functioning independently are probably more suitable outcomes in this frail older population...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27897406/integrated-care-for-geriatric-frailty-and-sarcopenia-a-randomized-control-trial
#8
Ding-Cheng Derrick Chan, Hsiao-Hui Tsou, Chirn-Bin Chang, Rong-Sen Yang, Jau-Yih Tsauo, Ching-Yu Chen, Chin-Fu Hsiao, Ya-Ting Hsu, Chia-Hui Chen, Shu-Fang Chang, Chao Agnes Hsiung, Ken N Kuo
BACKGROUND: Exercise, nutrition, and psychological interventions may all have positive impacts on frailty and sarcopenia. However, it is not known whether an integrated care programme with all three components can be beneficial and the intensity of such programme is also not certain. In this study, we aim to determine the effectiveness of two levels of integrated care on frailty and sarcopenia. METHODS: A randomized control trial was conducted at two community hospitals in Taiwan...
August 26, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27896484/oral-health-status-and-need-for-oral-care-of-care-dependent-indwelling-elderly-from-admission-to-death
#9
Arie R Hoeksema, Lilian L Peters, Gerry M Raghoebar, Henny J A Meijer, Arjan Vissink, Anita Visser
OBJECTIVES: The objective of this study is to assess oral health and oral status of elderly patients newly admitted to a nursing home from admission until death. MATERIALS AND METHODS: Oral health, oral status, need for dental care, cooperation with dental treatment, and given dental care were assessed by two geriatric dentists in all new long-stay patients (n = 725) admitted to a nursing home between January 2009 and December 2013. All patients were followed from admission until death or until they left the nursing home...
November 28, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27890581/total-hip-arthroplasty-using-a-cementless-dual-mobility-cup-provides-increased-stability-and-favorable-gait-parameters-at-five-years-follow-up
#10
A Acker, J-F Fischer, K Aminian, E Lécureux, B M Jolles
BACKGROUND: Rates of dislocation following primary total hip arthroplasty (THA) vary from 0.5 to 10%. Dual-mobility cups in THA demonstrate increased stability. Clinical outcomes following THA with dual-mobility cups have been reported, but gait has not been assessed. Therefore we performed a retrospective case control study to answer: (1) is gait better in patients following THA with a dual-mobility cup than in frail, elderly patients of the same age? (2) Are clinical outcomes better in patients following THA with a dual-mobility cup than in frail, elderly patients? (3) What is the dislocation rate following THA with a dual-mobility cup? HYPOTHESIS: We hypothesized that patients who underwent THA with a dual-mobility cup have a better gait compared to frail, elderly patients of the same age...
November 24, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27884857/implementing-shared-decision-making-in-interprofessional-home-care-teams-the-ipsdm-sw-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#11
France Légaré, Nathalie Brière, Dawn Stacey, Guy Lacroix, Sophie Desroches, Serge Dumont, Kimberly D Fraser, Louis-Paul Rivest, Pierre J Durand, Stéphane Turcotte, Monica Taljaard, Henriette Bourassa, Lise Roy, Geneviève Painchaud Guérard
INTRODUCTION: The frail elderly in Canada face a tough decision when they start to lose autonomy: whether to stay at home or move to another location. This study seeks to scale up and evaluate the implementation of shared decision-making (SDM) in interprofessional (IP) home care teams caring for elderly clients or their caregivers facing a decision about staying at home or moving elsewhere. METHODS: A stepped wedge cluster randomised trial involving 8 Health and Social Service Centers (HSSCs) will be conducted with IP home care teams...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#12
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882453/-implementation-of-a%C3%A2-proactive-integrated-primary-care-program-for-frail-older-people-from-science-to-evidence-based-practice
#13
Nienke Bleijenberg, Artine de Jonge, Morris P Brand, Caitriona O'Flynn, Marieke J Schuurmans, Niek J de Wit
BACKGROUND: Multimorbidity, functional impairment and frailty among community-dwelling older people are causing increasing complexity in primary care. A proactive integrated primary care approach is therefore essential. Between October 2014-2015, an evidence-based proactive care program for frail older people was implemented in the region Noord-West Veluwe en Zeewolde, the Netherlands. This study evaluated the feasibility of the implementation, having a strong focus on the collaboration between the medical and social domain...
December 2016: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/27881697/adult-day-services-outcomes-delphi-review-of-an-integrated-participant-assessment-system
#14
Shannon Jarrott, Aaron M Ogletree
Adult day services (ADS) aim to help elders age in place, but evidence of impact on participants lags behind caregiver research. To play a larger role in the continuum of care, ADS participant outcomes should regularly be documented with standard measures. We conducted a Delphi review of one integrated participant assessment system. Capturing physical, mental, and cognitive health indicators and activity engagement of typical ADS participants (i.e., frail elders eligible for nursing home placement), experts evaluated the system on instrument validity, relevance, and application...
November 22, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/27876338/should-you-screen-nursing-home-residents-for-cancer
#15
REVIEW
Miriam B Rodin
When considering screening for early cancer detection physicians should anticipate how they plan to follow up a screen detected cancer. Geriatric oncology research has developed validated functional assessments to estimate the balance of risk and benefit for treating cancers in the elderly. Robust elderly can benefit from treatment and therefore might benefit from screening. However the majority of elderly in long term residential care (LTC, or "the nursing home") would not benefit from cancer screening. The 1...
November 18, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27875289/home-parenteral-nutrition-in-adult-patients-with-chronic-intestinal-failure-catheter-related-complications-over-4-decades-at-the-main-danish-tertiary-referral-center
#16
Christopher Filtenborg Brandt, Siri Tribler, Mark Hvistendahl, Rahim M Naimi, Per Brøbech, Michael Staun, Palle Bekker Jeppesen
BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and consequences of CRCs, their association to demographic characteristics, and potential risk factors in an effort to provide the rationale for preventive precautions to the relevant patients with IF at risk...
November 15, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#17
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27855641/development-and-validation-of-the-fragire-tool-for-assessment-an-older-person-s-risk-for-frailty
#18
Dewi Vernerey, Amelie Anota, Pierre Vandel, Sophie Paget-Bailly, Michele Dion, Vanessa Bailly, Marie Bonin, Astrid Pozet, Audrey Foubert, Magdalena Benetkiewicz, Patrick Mankoundia, Franck Bonnetain
BACKGROUND: Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults...
November 17, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27855351/targeted-therapy-and-elderly-people-a-review
#19
REVIEW
Amaury Daste, Camille Chakiba, Charlotte Domblides, Marine Gross-Goupil, Amandine Quivy, Alain Ravaud, Pierre Soubeyran
The use of targeted therapy (TT) has radically changed the outcome of various cancers and introduces the era of personalised medicine. Elderly patients (≥65 years) represent the majority of cancer diagnoses and deaths by age group with an increase expected over the next decade. This group of patients is heterogeneous with three categories of patients: fit, vulnerable and frail, with specific treatment for each subgroup. In this review, we assess safety and efficacy of TT in elderly patients, principally from data of pivotal clinical trials with subgroup analysis, but elderly people represented a small percentage of the total number of patients...
November 14, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27847264/dietary-patterns-and-12-year-risk-of-frailty-results-from-the-three-city-bordeaux-study
#20
Sophie Pilleron, Soufiane Ajana, Marthe-Aline Jutand, Catherine Helmer, Jean-François Dartigues, Cécilia Samieri, Catherine Féart
OBJECTIVE: To analyze the association between dietary patterns and the 12-year risk of frailty and its components in community-dwelling elderly French adults. DESIGN: A prospective cohort study. SETTING: The Bordeaux sample of the Three-City Study. PARTICIPANTS: A total of 972 initially nonfrail nondemented participants (336 men and 636 women) aged 73 years on average, re-examined at least once over 12 years. MEASUREMENTS: Five sex-specific dietary clusters were previously derived at baseline...
November 12, 2016: Journal of the American Medical Directors Association
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