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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#1
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28331326/lithium-in-late-life-mania-a-systematic-review
#2
REVIEW
Pasquale De Fazio, Raffaele Gaetano, Mariarita Caroleo, Maria Pavia, Giovanbattista De Sarro, Andrea Fagiolini, Cristina Segura-Garcia
The prevalence of mania among >65-year-olds ranges from 0.1% to 0.4% and its treatment is a particular challenge for clinicians. Although lithium is the treatment of choice for bipolar disorder (BD), its use in elderly population was recently questioned. This study provides a comprehensive review of literature on the efficacy and tolerability of lithium as a pharmacologic treatment for mania in elderly BD patients. We conducted a systematic review, based on PRISMA guidelines, of articles published between 1970 and August 2016 and indexed in the following databases: EMBASE, MEDLINE, Cochrane Library Databases and PsycINFO...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28327973/modeling-individual-and-relative-accuracy-of-screening-tools-in-geriatric-oncology
#3
C A Bellera, F Artaud, M Rainfray, P L Soubeyran, S Mathoulin-Pélissier
Background: Classification probabilities reflect to what degree a screening test represents the true disease state and include true positive (TPF) and false positive fractions (FPF). With two tests, one can compare TPF and FPF using relative probabilities which offer advantages in terms of interpretation and statistical modeling. Our objective was to highlight how individual and relative TPF and FPF can be easily estimated and compared within a regression modeling framework. This allows the modeling of tests' accuracy while adjusting for multiple covariates, and thus provides valuable information in addition to the crude TPF and FPF...
February 21, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28314550/sense-of-life-worth-living-ikigai-and-incident-functional-disability-in-elderly-japanese-the-tsurugaya-project
#4
Kentaro Mori, Yu Kaiho, Yasutake Tomata, Mamoru Narita, Fumiya Tanji, Kemmyo Sugiyama, Yumi Sugawara, Ichiro Tsuji
OBJECTIVE: To test the hypothesis that elderly persons who feel ikigai (a sense of life worth living) have a lower risk of incident functional disability than those who do not. Recent studies have suggested that ikigai impacts on mortality. However, its impact upon disability is unknown. The aim of the present study was to investigate the association between ikigai and incident functional disability among elderly persons. METHODS: We conducted a prospective cohort study of 830 Japanese elderly persons aged ≥70years as a comprehensive geriatric assessment in 2003...
April 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28292646/follow-up-of-elderly-patients-with-urogenital-cancers-evaluation-of-geriatric-care-needs-and-related-actions
#5
Silvio Monfardini, Sara Morlino, Riccardo Valdagni, Mario Catanzaro, Ardit Tafa, Barbara Bortolato, Giovanni Petralia, Elisa Bonetto, Elisa Villa, Stefano Picozzi, Maria Cristina Locatelli, Giuseppe Galetti, Andrea Millul, Yasmin Albanese, Elisa Bianchi, Claudia Panzarino, Francesca Gerardi, Ettore Beghi
OBJECTIVES: To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans. MATERIAL AND METHODS: This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70+ years treated with radiotherapy or surgery at seven tertiary centers...
March 11, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28279606/frailty-and-multimorbidity-different-ways-of-thinking-about-geriatrics
#6
Matteo Cesari, Mario Ulises Pérez-Zepeda, Emanuele Marzetti
The terms multimorbidity and frailty are increasingly used in the medical literature to measure the risk profile of an older individual in order to support clinical decisions and design ad hoc interventions. The construct of multimorbidity was initially developed and used in nongeriatric settings. It generates a monodimensional nosological risk profile, grounding its roots in the somewhat inadequate framework of disease. On the other hand, frailty is a geriatric concept that implies a more exhaustive and comprehensive assessment of the individual and his/her environment, facilitating the implementation of multidimensional and tailored interventions...
April 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28270122/implementation-of-integrated-geriatric-care-at-a-german-hospital-a-case-study-to-understand-when-and-why-beneficial-outcomes-can-be-achieved
#7
Loraine Busetto, Jörn Kiselev, Katrien Ger Luijkx, Elisabeth Steinhagen-Thiessen, Hubertus Johannes Maria Vrijhoef
BACKGROUND: Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS: We conducted 15 semi-structured interviews with health professionals employed at the hospital...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28263371/association-between-preoperative-malnutrition-and-postoperative-delirium-after-hip-fracture-surgery-in-older-adults
#8
Paolo Mazzola, Libby Ward, Sara Zazzetta, Valentina Broggini, Alessandra Anzuini, Breanna Valcarcel, Justin S Brathwaite, Giulio M Pasinetti, Giuseppe Bellelli, Giorgio Annoni
OBJECTIVES: To determine whether poor nutritional status can predict postoperative delirium in elderly adults undergoing hip fracture surgery. DESIGN: Prospective observational cohort study. SETTING: Italian orthogeriatric unit. PARTICIPANTS: Individuals aged 70 and older (mean age 84.0 ± 6.6, 74.5% female) consecutively admitted for surgical repair of a proximal femur fracture between September 2012 and April 2016 (N = 415)...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28253275/impact-of-frontal-white-matter-hyperintensity-on-instrumental-activities-of-daily-living-in-elderly-women-with-alzheimer-disease-and-amnestic-mild-cognitive-impairment
#9
Noriko Ogama, Takashi Sakurai, Toshiharu Nakai, Shumpei Niida, Naoki Saji, Kenji Toba, Hiroyuki Umegaki, Masafumi Kuzuya
BACKGROUND: Instrumental activities of daily living (IADL) start to decline during the progression of amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD). Cognitive and physical decline are involved in the loss of functional independence. However, little is known about AD-related neural change that leads to IADL impairment. The purpose of this study was to clarify the effects of regional white matter hyperintensity (WMH) on IADL impairment in persons with AD and aMCI. METHODS: The participants were 347 female subjects aged 65-85 years diagnosed with AD (n = 227), aMCI (n = 44) or normal cognition (n = 76)...
2017: PloS One
https://www.readbyqxmd.com/read/28244577/high-technology-based-gait-assessment-in-frail-people-associations-between-spatio-temporal-and-three-dimensional-gait-characteristics-with-frailty-status-across-four-different-frailty-measures
#10
M Ritt, S Schülein, H Lubrich, L C Bollheimer, C C Sieber, K-G Gaßmann
OBJECTIVE: We analyzed associations between a battery of gait characteristics and frailty status across four different frailty instruments in old patients. DESIGN: Cross-sectional study. SETTING: Geriatric wards of a general hospital. PARTICIPANTS: 123 hospitalized patients aged ≥65 years. MEASUREMENTS: Spatio-temporal and three-dimensional gait characteristics were assessed by an electronic walkway and a shoe-mounted, inertial sensor-based mobile gait analysis system...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28244024/-geriatric-inpatients-with-iron-deficiency-associated-restless-legs-syndrome-a-retrospective-analysis
#11
Benjamin Lieske, Gabriele Röhrig, Ingrid Becker, Ralf-Joachim Schulz, Maria Cristina Polidori, Jan Kassubek
OBJECTIVE: The Restless Legs Syndrome (RLS) is a clinically relevant condition in geriatric patients. An association between iron deficiency and RLS is largely acknowledged. The clinical and therapeutic management of iron deficiency-associated RLS has been, however, poorly evaluated in geriatric patients. METHODS: Data from all RLS inpatients admitted to a geriatric unit between 2009 and 2011 were retrospectively collected on demographics and clinical characteristics, iron status, drug treatment including iron substitution, as well as comprehensive geriatric assessment (CGA) scores...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28241844/immune-profiles-of-elderly-breast-cancer-patients-are-altered-by-chemotherapy-and-relate-to-clinical-frailty
#12
Jithendra Kini Bailur, Graham Pawelec, Sigrid Hatse, Barbara Brouwers, Ann Smeets, Patrick Neven, Annouschka Laenen, Hans Wildiers, Christopher Shipp
BACKGROUND: Effective therapeutic management of elderly patients with cancer, on an individual basis, remains a clinical challenge. Here, we identify novel biomarkers to assess elderly patients (≥70 years of age) with breast cancer undergoing treatment with or without chemotherapy. METHODS: We performed comprehensive geriatric assessment and measured markers sensitive to alteration in ageing, including leukocyte telomere length, CMV serostatus, levels of circulating growth factors and cytokines, and immune profiling of T cell and myeloid populations in blood before and at 3 months and 12 months after initiation of therapy, using flow cytometry...
February 28, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28238508/using-a-multidimensional-prognostic-index-mpi-based-on-comprehensive-geriatric-assessment-cga-to-predict-mortality-in-elderly-undergoing-transcatheter-aortic-valve-implantation
#13
Marie-Laure Bureau, Evelyne Liuu, Luc Christiaens, Alberto Pilotto, Jean Mergy, Fabienne Bellarbre, Pierre Ingrand, Marc Paccalin
BACKGROUND: Selection of appropriate elderly who can benefit from transcatheter aortic valve implantation (TAVI) is challenging. We evaluated the prognosis of this procedure according to the comprehensive geriatric assessment (CGA) based on the multidimensional prognostic index (MPI). METHODS: Prospective observational monocentric study from January 2013 to December 2015. Consecutive patients aged ≥75 who underwent TAVI and a complete CGA were included. Baseline demographic, geriatric and cardiologic data were collected...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28236586/impaired-mobility-depressed-mood-cognitive-impairment-and-polypharmacy-are-independently-associated-with-disability-in-older-cancer-outpatients-the-prospective-physical-frailty-in-elderly-cancer-patients-pf-ec-cohort-study
#14
Frederic Pamoukdjian, Thomas Aparicio, Laurent Zelek, Marouane Boubaya, Philippe Caillet, Veronique François, Laure de Decker, Vincent Lévy, Georges Sebbane, Elena Paillaud
OBJECTIVE: To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer. MATERIALS AND METHODS: The Physical Frailty in Elderly Cancer patients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted...
February 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28214764/recurrent-falls-and-its-risk-factors-among-older-men-living-in-the-veterans-retirement-communities-a-cross-sectional-study
#15
Cheng-Hao Hung, Chih-Jen Wang, Ting-Ching Tang, Liang-Yu Chen, Li-Ning Peng, Fei-Yuan Hsiao, Liang-Kung Chen
AIM: To evaluate the prevalence of recurrent falls and their risk factors among older men living in the Veterans Homes in Taiwan. METHODS: This cross-sectional study enrolled 871 residents and all participants received the comprehensive geriatric assessment, including Barthel Index, Mini-Mental Status Examination (MMSE), Geriatric Depression Scale-5 questions (GDS-5), Mini-Nutrition Assessment Short Form (MNA-SF), the status of urinary incontinence, stool incontinence, polypharmacy, past history of falls, multimorbidity, and medication history...
May 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28211026/social-networks-and-health-status-in-the-elderly-the-anziani-in-rete-population-based-study
#16
Luca Bianchetti, Flaminio Squazzoni, Niccolò Casnici, Devis Bianchini, Emirena Garrafa, Claudia Archetti, Valentina Romano, Luca Rozzini, Michele Melchiori, Chiara Fiorentini, Daniela Uberti, Stefano Calza, Alessandra Marengoni
BACKGROUND: Certain features of the social environment could maintain and even improve not only psychological well-being, but also health and cognition of the elderly. AIMS: We tested the association between social network characteristics and the number of chronic diseases in the elderly. METHODS: A randomized sample of the elderly population of Brescia, Italy, was evaluated (N = 200, age ≥65 years). We performed a comprehensive geriatric assessment, including information on socio-demographic variables (family, friendships, and acquaintance contacts)...
February 16, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28203067/silent-strain-of-caregiving-exploring-the-best-predictors-of-distress-in-family-carers-of-geriatric-patients
#17
Katarzyna Bień-Barkowska, Halina Doroszkiewicz, Barbara Bień
OBJECTIVES: The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. METHODS: A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28198997/randomized-clinical-trial-of-comprehensive-geriatric-assessment-and-optimization-in-vascular-surgery
#18
J S L Partridge, D Harari, F C Martin, J L Peacock, R Bell, A Mohammed, J K Dhesi
BACKGROUND: Increasing numbers of older patients are undergoing vascular surgery. Inadequate preoperative assessment and optimization may contribute to increased postoperative morbidity and mortality. METHODS: Patients aged at least 65 years scheduled for elective aortic aneurysm repair or lower-limb arterial surgery were enrolled in an RCT of standard preoperative assessment or preoperative comprehensive geriatric assessment and optimization. Randomization was stratified by sex and surgical site (aorta/lower limb)...
February 15, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28182163/which-is-preferable-for-orthostatic-hypotension-diagnosis-in-older-adults-active-standing-test-or-head-up-tilt-table-test
#19
Ali Ekrem Aydin, Pinar Soysal, Ahmet Turan Isik
BACKGROUND: Correct evaluation of orthostatic hypotension (OH) is crucial in geriatric practice, since OH is associated with mortality and morbidity. The study aimed to determine the most appropriate method for measuring blood pressure in transition from supine to upright position in order to diagnose OH in older adults. METHODS: Active standing test (AST) and head-up tilt table (HUT) test as well as comprehensive geriatric assessment (CGA), including mini-mental state examination or the cognitive state test, mini-nutritional assessment, basic and instrumental activities of daily living, and Tinetti performance-oriented mobility assessment indexes, were performed in 290 geriatric patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28180932/-management-of-urinary-incontinence-in-a%C3%A2-geriatric-rehabilitation-department-global-urinary-incontinence-assessment-incorporating-the-international-consultation-on-incontinence-questionnare-urinary-incontinence-short-form-iciq-ui-sf
#20
Sigrid Ege
Although it is generally agree that older people have a high prevalence of urinary incontinence with a significant influence on health and quality of life, there is no standardized generally accepted assessment. The pathophysiology of urinary incontinence in frail elderly people requires a broad medical and functional scope to address the multifactorial nature of urinary incontinence, especially to identify treatable, potentially reversible conditions. To incorporate the multiple aspects into the daily routine, we developed a global urinary incontinence assessment at the Clinic for Geriatric Rehabilitation of the Robert Bosch Hospital including the validated International Consultation on Incontinence Questionnare - Urinary Incontinence Short Form (ICIQ-UI SF), a symptom score and results of a comprehensive geriatric assessment for mobility and cognition...
February 8, 2017: Zeitschrift Für Gerontologie und Geriatrie
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