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Comprehensive geriatric assessment

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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/28064173/interventions-to-prevent-or-reduce-the-level-of-frailty-in-community-dwelling-older-adults-a-scoping-review-of-the-literature-and-international-policies
#2
REVIEW
Martine T E Puts, Samar Toubasi, Melissa K Andrew, Maureen C Ashe, Jenny Ploeg, Esther Atkinson, Ana Patricia Ayala, Angelique Roy, Miriam Rodríguez Monforte, Howard Bergman, Kathy McGilton
BACKGROUND: frailty impacts older adults' ability to recover from an acute illness, injuries and other stresses. Currently, a systematic synthesis of available interventions to prevent or reduce frailty does not exist. Therefore, we conducted a scoping review of interventions and international policies designed to prevent or reduce the level of frailty in community-dwelling older adults. METHODS AND ANALYSIS: we conducted a scoping review using the framework of Arksey and O'Malley. We systematically searched articles and grey literature to identify interventions and policies that aimed to prevent or reduce the level of frailty...
January 6, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28062372/uric-acid-may-be-protective-against-cognitive-impairment-in-older-adults-but-only-in-those-without-cardiovascular-risk-factors
#3
Busra Tuven, Pinar Soysal, Gulcin Unutmaz, Derya Kaya, Ahmet Turan Isik
Uric acid (UA) may not only prevent development of cognitive dysfunction owing to its antioxidant efficacy, but also may worsen cognitive functions by gaining pro-oxidant character. The present study attempts to uncover this paradoxical association between UA and cognitive impairment in elderly. 1374 elderly patients were retrospectively evaluated and included in the study. Participants underwent determination of circulating UA levels and comprehensive geriatric assessment. A serum UA concentration≥7.0mg/dL in males and ≥5...
January 3, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28062326/the-impact-of-comorbidity-on-surgical-outcomes-in-older-adults-with-cancer
#4
REVIEW
Virginia Sun, Peggy S Burhenn, Lily Lai, Arti Hurria
OBJECTIVES: To provide an overview of the impact of comorbidity on surgical outcomes and postoperative geriatric events in older adults with cancer, and review key components of quality perioperative nursing care of older adults with cancer. DATA SOURCES: Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations. CONCLUSION: The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults after cancer surgery have a substantial impact on surgical outcomes, quality of life, and health care costs...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28056430/the-effects-of-sitagliptin-a-dpp-4-inhibitor-on-cognitive-functions-in-elderly-diabetic-patients-with-or-without-alzheimer-s-disease
#5
Ahmet Turan Isik, Pinar Soysal, Adnan Yay, Cansu Usarel
AIMS: The present study aimed to evaluate effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4I), on cognitive functions in elderly diabetic patients with and without cognitive impairment. METHODS: 253 elderly patients with type 2DM, were enrolled in this prospective and observational study. After comprehensive geriatric assessment, the patients were divided into either sitagliptin or non-sitagliptin group. RESULTS: A total of 205 patients who completed the study (52 with Alzheimer's Disease (AD)) were re-evaluated 6months later...
December 21, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28053513/metastatic-castration-resistant-prostate-cancer-in-very-elderly-patients-challenges-and-solutions
#6
REVIEW
Orazio Caffo, Francesca Maines, Mimma Rizzo, Stefania Kinspergher, Antonello Veccia
The treatment of elderly patients with cancer is usually viewed by clinicians as a challenge, because of the age-related decline in normal organ function and the frequent concomitant administration of multiple drugs for comorbid conditions. Clinicians therefore tend not to prescribe antineoplastic agents (mainly in the case of chemotherapy) to elderly patients, with the fear of excess toxicity leading to an unfavorable cost:benefit ratio. The cutoff age defining a cancer patient as elderly is usually 70 years, but over the last 10 years clinicians have paid more attention to functional status, as evaluated by means of a comprehensive geriatric assessment and comorbidity burden, rather than chronological age...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#7
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
December 31, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28031704/is-the-acute-care-of-frail-elderly-patients-in-a-comprehensive-geriatric-assessment-unit-superior-to-conventional-acute-medical-care
#8
Niklas Ekerstad, Björn W Karlson, Synneve Dahlin Ivanoff, Sten Landahl, David Andersson, Emelie Heintz, Magnus Husberg, Jenny Alwin
OBJECTIVE: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. DESIGN: This is a clinical, prospective, randomized, controlled, one-center intervention study. SETTING: This study was conducted in a large county hospital in western Sweden. PARTICIPANTS: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28030446/cancer-related-cognitive-impairment-in-older-adults
#9
Andrew Edelstein, Denise Pergolizzi, Yesne Alici
PURPOSE OF REVIEW: Cancer, aging, and cognition form a complicated interface that can challenge patients, caretakers, and healthcare professionals. Although the typical aging process allows for compensatory mechanisms to help maintain daily functioning, cancer and cancer treatments can remove the fail-safes and exacerbate cognitive decline. As a result, older cancer patients can experience increased morbidity and mortality. The goal of this article is to provide additional assessment strategies, diagnostic considerations, and treatment options for providers taking care of this growing population...
December 26, 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28029467/-frail-vig-index-design-and-evaluation-of-a-new-frailty-index-based-on-the-comprehensive-geriatric-assessment
#10
Jordi Amblàs-Novellas, Joan Carles Martori, Núria Molist Brunet, Ramon Oller, Xavier Gómez-Batiste, Joan Espaulella Panicot
INTRODUCTION: Frailty is closely linked to health results. Frailty indexes (FI) and the Comprehensive Geriatric Assessment (CGA) are multidimensional tools. FI serve to quantitatively measure frailty levels. They have shown to have an excellent correlation with mortality. However, they are infrequently used in clinical practice. Given the need for new, more concise, and pragmatic FI, a new FI is proposed based on a CGA (Frail-VIG Index). MATERIAL AND METHODS: A prospective, observational, longitudinal study was conducted, with cohort follow up at 12 months or death...
October 28, 2016: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28024799/assessment-of-older-patients-with-cancer-edmonton-frail-scale-efs-as-a-predictor-of-adverse-outcomes-in-older-patients-undergoing-radiotherapy
#11
Lorna G Keenan, Michelle O'Brien, Tim Ryan, Mary Dunne, Orla McArdle
OBJECTIVE: In this study we evaluate the usefulness of the Edmonton Frail Scale (EFS) in predicting which older patients are at risk of developing serious toxicities during radiotherapy. MATERIALS AND METHODS: This prospective study was carried out over an 18month period. Our primary aim was to examine the Edmonton Frail Scale (EFS) as a predictor of toxicity in patients over 70years undergoing radical radiotherapy for any malignant diagnosis. RESULTS: 63 patients were recruited: 29% experienced grade 3 or greater toxicities, with very few having multiple grade 3 or greater toxicities...
December 23, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28006693/clinical-implication-of-frailty-assessment-in-older-patients-with-atrial-fibrillation
#12
Sun-Wook Kim, Sol-Ji Yoon, Jung-Yeon Choi, Min-Gu Kang, Youngjin Cho, Il-Young Oh, Cheol-Ho Kim, Kwang-Il Kim
BACKGROUND: We aimed to show the frailty status in older AF patients, and to find the association between frailty and the scores of CHA2DS2-VASc and HAS-BLED. Ultimately, we sought to investigate the impact of frailty on cardiovascular and all-cause mortality in older AF patients. METHODS: We retrospectively evaluated 365 patients (≥65years old) with AF, who underwent comprehensive geriatric assessment (CGA) between 2007 and 2014 in a single tertiary hospital...
December 5, 2016: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27994985/mortality-in-tongue-cancer-patients-treated-by-curative-surgery-a-retrospective-cohort-study-from-cgrd
#13
Ming-Shao Tsai, Chia-Hsuan Lai, Chuan-Pin Lee, Yao-Hsu Yang, Pau-Chung Chen, Chung-Jan Kang, Geng-He Chang, Yao-Te Tsai, Chang-Hsien Lu, Chih-Yen Chien, Chi-Kuang Young, Ku-Hao Fang, Chin-Jui Liu, Re-Ming A Yeh, Wen-Cheng Chen
BACKGROUND: Our study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups. METHODS: From 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years)...
2016: PeerJ
https://www.readbyqxmd.com/read/27964884/abridged-geriatric-assessment-is-a-better-predictor-of-overall-survival-than-the-karnofski-performance-scale-and-physical-performance-test-in-elderly-cancer-patients
#14
Marwan Ghosn, Tony Ibrahim, Elie El Rassy, Najib Nassani, Sassine Ghanem, Tarek Assi
OBJECTIVES: Comprehensive geriatric assessment (CGA) is a complex and interdisciplinary approach to evaluate the health status of elderly patients. The Karnofsky Performance Scale (KPS) and Physical Performance Test (PPT) are less time-consuming tools that measure functional status. This study was designed to assess and compare abridged geriatric assessment (GA), KPS and PPT as predictive tools of mortality in elderly cancer patients. MATERIALS AND METHODS: This prospective interventional study included all individuals aged >70years who were diagnosed with cancer during the study period...
December 7, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27959354/delivering-comprehensive-geriatric-assessment-in-new-settings-advice-for-frontline-clinicians
#15
J R Gladman
Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27940568/can-consultant-geriatrician-led-comprehensive-geriatric-assessment-in-the-emergency-department-reduce-hospital-admission-rates-a-systematic-review
#16
Samuel Jay, Paula Whittaker, Jerome Mcintosh, Nicholas Hadden
OBJECTIVE: economic and demographic pressures are driving a need to reassess the way in which we care for older patients presenting to emergency departments (EDs). This systematic review seeks to assess the extent to which performing comprehensive geriatric assessment (CGA) in the ED can reduce admission rates. DESIGN: systematic search of both published and unpublished literature to identify studies reporting admission rates following the introduction of consultant geriatrician led teams performing CGA in the ED...
December 9, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27933555/pharmacist-s-comprehensive-geriatric-assessment-introduction-and-evaluation-at-elderly-patient-admission
#17
Faiza Rhalimi, Mounir Rhalimi, Alain Rauss
BACKGROUND: The role of the clinical pharmacist within the healthcare system remains unclear. OBJECTIVE: Our objective was to describe a pharmacist's comprehensive geriatric assessment (pCGA) at admission of elderly patients and to assess its relevance in terms of medication compliance and pharmacist interventions (PIs). METHODS: We conducted a prospective interventional study over 29 months in a 34-bed medical/rehabilitation geriatric ward in a French geriatric hospital...
December 8, 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27927586/rituximab-bendamustine-and-low-dose-cytarabine-as-induction-therapy-in-elderly-patients-with-mantle-cell-lymphoma-a-multicentre-phase-2-trial-from-fondazione-italiana-linfomi
#18
Carlo Visco, Annalisa Chiappella, Luca Nassi, Caterina Patti, Simone Ferrero, Daniela Barbero, Andrea Evangelista, Michele Spina, Annalia Molinari, Luigi Rigacci, Monica Tani, Alice Di Rocco, Graziella Pinotti, Alberto Fabbri, Renato Zambello, Silvia Finotto, Manuel Gotti, Angelo M Carella, Flavia Salvi, Stefano A Pileri, Marco Ladetto, Giovannino Ciccone, Gianluca Gaidano, Marco Ruggeri, Maurizio Martelli, Umberto Vitolo
BACKGROUND: The combination of rituximab, bendamustine, and cytarabine (R-BAC) was highly active in a pilot trial of mantle cell lymphoma, but its use was restricted by high haematological toxicity. We aimed to assess the efficacy and safety of an R-BAC regimen with low-dose cytarabine (RBAC500). METHODS: In this multicentre, phase 2 trial, we recruited previously untreated patients with an established histological diagnosis of mantle cell lymphoma from 29 Fondazione Italiana Linfomi centres in Italy...
January 2017: Lancet Haematology
https://www.readbyqxmd.com/read/27913598/describing-visible-acute-injuries-development-of-a-comprehensive-taxonomy-for-research-and-practice
#19
Tony Rosen, Christopher Reisig, Veronica M LoFaso, Elizabeth M Bloemen, Sunday Clark, Thomas J McCarthy, Estomih P Mtui, Neal E Flomenbaum, Mark S Lachs
BACKGROUND: Little literature exists classifying and comprehensively describing intentional and unintentional acute injuries, which would be valuable for research and practice. In preparation for a study of injury patterns in elder abuse, our goal was to develop a comprehensive taxonomy of relevant types and characteristics of visible acute injuries and evaluate it in geriatric patients. METHODS: We conducted an exhaustive review of the medical and forensic literature focusing on injury types, descriptions, patterns and analyses...
December 2, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/27913511/treatment-of-the-elderly-patient-with-mantle-cell-lymphoma
#20
Pierre Soubeyran, Rémy Gressin
Treatment options for mantle cell lymphomas have expanded considerably over recent years, offering hematologists solutions for older patients with an appropriate risk-to-benefit ratio. Indeed, unfit older patients are exposed to a higher risk of toxicity with a standard treatment. Although new treatments have generally good safety profiles, they may lead to unexpected consequences in unfit older patients. Involving geriatricians and a comprehensive geriatric assessment in patient care could help hematologists address these vulnerabilities...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
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