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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/28436194/impact-of-living-arrangements-on-clinical-outcomes-among-older-patients-with-dementia-or-cognitive-impairment-admitted-to-the-geriatric-evaluation-and-management-unit-in-taiwan
#1
Cheng-Hao Hung, Ting-Ching Tang, Chih-Jen Wang, Li-Kuo Liu, Li-Ning Peng, Liang-Kung Chen
AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436191/hospitalization-and-associated-factors-in-people-with-alzheimer-s-disease-residing-in-a-long-term-care-facility-in-southern-taiwan
#2
Chu-Sheng Lin, Shih-Yi Lin, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Liang-Kung Chen, Yu-Te Lin, Ching-Hui Loh
AIM: It has been reported that many people with dementia require hospitalizations. The objective of the present study was to determine predictive factors for hospitalizations in people with dementia. METHODS: A total of 70 individuals with dementia living in a veterans' home in southern Taiwan were consecutively enrolled. During prospective follow up, all hospitalization events were recorded. RESULTS: The mean age of residents with dementia was 86...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436185/predictive-factors-for-dementia-and-cognitive-impairment-among-residents-living-in-the-veterans-retirement-communities-in-taiwan-implications-for-cognitive-health-promotion-activities
#3
Liang-Yu Chen, Yi-Hui Wu, Chung-Yu Huang, Li-Kuo Liu, An-Chun Hwang, Li-Ning Peng, Ming-Hsieh Lin, Liang-Kung Chen
AIM: To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28420324/evaluation-of-a-technology-enhanced-integrated-care-model-for-frail-older-persons-protocol-of-the-spec-study-a-stepped-wedge-cluster-randomized-trial-in-nursing-homes
#4
Hongsoo Kim, Yeon-Hwan Park, Young-Il Jung, Hyoungshim Choi, Seyune Lee, Gi-Soo Kim, Dong-Wook Yang, Myunghee Cho Paik, Tae-Jin Lee
BACKGROUND: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. METHODS/DESIGN: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate...
April 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28417242/combined-use-of-the-multidimensional-prognostic-index-mpi-and-procalcitonin-serum-levels-in-predicting-1-month-mortality-risk-in-older-patients-hospitalized-with-community-acquired-pneumonia-cap-a-prospective-study
#5
Alberto Pilotto, Simone Dini, Julia Daragjati, Manuela Miolo, Monica Maria Mion, Andrea Fontana, Mario Lo Storto, Martina Zaninotto, Alberto Cella, Paolo Carraro, Filomena Addante, Massimiliano Copetti, Mario Plebani
BACKGROUND: Several scores and biomarkers, i.e., procalcitonin (PCT), were proposed to stratify the mortality risk in community-acquired pneumonia (CAP). AIM: Evaluating prognostic accuracy of PCT and Multidimensional Prognostic Index (MPI) for 1-month mortality risk in older patients with CAP. METHODS: At hospital admission and at discharge, patients were evaluated by a Comprehensive Geriatric Assessment to calculate MPI. Serum PCT was measured at admission and 1, 3, and 5 days after hospital admission...
April 17, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28416075/muscle-strength-rather-than-muscle-mass-is-associated-with-osteoporosis-in-older-chinese-adults
#6
Yixuan Ma, Liyuan Fu, Liye Jia, Peipei Han, Li Kang, Hairui Yu, XiaoYu Chen, Xing Yu, Lin Hou, Lu Wang, Wen Zhang, Kaijun Niu, Qi Guo
BACKGROUND: Assessment of the association of muscle strength and muscle mass with osteoporosis (OP) is of special interest as muscles are a potential target for interventions (i.e., strength training). METHODS: A cross-sectional descriptive study encompassing people aged ≥ 60 years (average age: 66.9 ± 6.2 years; men, n = 516; women, n = 652) in the Hangu area of Tianjin, China. The study populations were invited to participate in a comprehensive geriatric assessment...
April 13, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28414806/cost-effectiveness-of-nurse-led-multifactorial-care-to-prevent-or-postpone-new-disabilities-in-community-living-older-people-results-of-a-cluster-randomized-trial
#7
Jacqueline J Suijker, Janet L MacNeil-Vroomen, Marjon van Rijn, Bianca M Buurman, Sophia E de Rooij, Eric P Moll van Charante, Judith E Bosmans
OBJECTIVE: To evaluate the cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people in comparison with usual care. METHODS: We conducted cost-effectiveness and cost-utility analyses alongside a cluster randomized trial with one-year follow-up. Participants were aged ≥ 70 years and at increased risk of functional decline. Participants in the intervention group (n = 1209) received a comprehensive geriatric assessment and individually tailored multifactorial interventions coordinated by a community-care registered nurse with multiple follow-up visits...
2017: PloS One
https://www.readbyqxmd.com/read/28413364/delivering-integrated-care-to-the-frail-elderly-the-impact-on-professionals-objective-burden-and-job-satisfaction
#8
Benjamin Janse, Robbert Huijsman, Ruben Dennis Maurice de Kuyper, Isabelle Natalina Fabbricotti
BACKGROUND: The impact of integrated working on professionals' objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding...
August 17, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28411479/aged-patients-with-metastatic-castration-resistant-prostate-cancer-should-we-treat-with-chemotherapy
#9
REVIEW
Miguel Ángel Climent, Ma Dolores Torregrosa, Sergio Vázquez, Regina Gironés, José Angel Arranz
Prostate cancer largely affects aged men and as life expectancy continues to increase, it is likely to be a growing burden requiring an adequate management. Aging is a heterogeneous process, thus, to assess the individual state of health when making decisions is essential. Comprehensive geriatric assessment allows a detailed evaluation of the state of health of a specific subject and can modify the therapeutic decision. It is still not commonly used because it is time consuming. Chemotherapy should be administered equally in aged well-fit patients as in the general population as per the SIOG (International society of geriatric oncology) recommendations for geriatric evaluation and treatment in prostate cancer patients...
April 3, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#10
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
April 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28398987/predicting-risk-and-outcomes-for-frail-older-adults-an-umbrella-review-of-frailty-screening-tools
#11
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Carol Holland
BACKGROUND: A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. OBJECTIVES: To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. INCLUSION CRITERIA POPULATION: Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#12
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28364992/geriatric-polypharmacy-pharmacist-as-key-facilitator-in-assessing-for-falls-risk
#13
REVIEW
Michelle A Fritsch, Penny S Shelton
This article highlights the significant health impact of falls among older adults. An emphasis is placed on the vital role of the pharmacist, regardless of practice setting, in assessing and reducing falls risk for this growing population. In addition, the importance of a stepwise comprehensive approach to falls assessment by pharmacists in collaboration with other clinicians is elucidated.
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28350792/association-between-delirium-superimposed-on-dementia-and-mortality-in-hospitalized-older-adults-a-prospective-cohort-study
#14
Thiago J Avelino-Silva, Flavia Campora, Jose A E Curiati, Wilson Jacob-Filho
BACKGROUND: Hospitalized older adults with preexisting dementia have increased risk of having delirium, but little is known regarding the effect of delirium superimposed on dementia (DSD) on the outcomes of these patients. Our aim was to investigate the association between DSD and hospital mortality and 12-mo mortality in hospitalized older adults. METHODS AND FINDINGS: This was a prospective cohort study completed in the geriatric ward of a university hospital in São Paulo, Brazil...
March 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28342121/can-comprehensive-imaging-analysis-with-analytic-morphomics-and-geriatric-assessment-predict-serious-complications-in-patients-undergoing-pancreatic-surgery
#15
Andrew J Benjamin, Mary M Buschmann, Andrew Schneider, Brian A Derstine, Jeffrey F Friedman, Stewart C Wang, William Dale, Kevin K Roggin
We aimed to determine whether comprehensive imaging analysis with analytic morphomics (AM) enhances or replaces geriatric assessment (GA) in risk-stratifying pancreatic surgery patients. One hundred thirty-four pancreatic surgery patients were identified from a prospective cohort. Sixty-three patients in the cohort had preoperative CT scans in addition to comprehensive geriatric assessments. CT scans were processed using AM. Associations with National Surgical Quality Improvement Program (NSQIP) serious complications were evaluated using univariate analysis and robust elastic net modeling to obtain AUROC curves by adding AM and GA measures to our previously defined clinical base risk model (age, body mass index, American Society of Anesthesiologists classification, and Charlson comorbidity index)...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28340600/an-evaluation-of-the-comparative-effectiveness-of-geriatrician-led-comprehensive-geriatric-assessment-for-improving-patient-and-healthcare-system-outcomes-for-older-adults-a-protocol-for-a-systematic-review-and-network-meta-analysis
#16
Charlene Soobiah, Caitlin Daly, Erik Blondal, Joycelyne Ewusie, Joanne Ho, Meghan J Elliott, Rossini Yue, Jayna Holroyd-Leduc, Barbara Liu, Sharon Marr, Jenny Basran, Andrea C Tricco, Jemila Hamid, Sharon E Straus
BACKGROUND: Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective...
March 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#17
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
#18
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
#19
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
#20
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
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