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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/29150094/-geriatric-assessment-and-prognostic-scores-in-older-cancer-patient-additional-support-to-the-therapeutic-decision
#1
REVIEW
Frédéric Pamoukdjian, Evelyne Liuu, Philippe Caillet, Mathilde Gisselbrecht, Stéphane Herbaud, Pascaline Boudou-Rouquette, Laurent Zelek, Elena Paillaud
Cancer is a disease of the elderly as demonstrated by the epidemiological evolution of Western countries. Indeed, two third of cancers newly diagnosed occur over 65 years. However, older cancer patients have been often excluded from clinical trials in oncology and the extrapolation of cancer treatments in this population remains difficult in practice. Scientific societies recommend that a comprehensive geriatric assessment (CGA) be performed in patients aged 70 and over and selected using screening tools for frailty such as the G8 index...
November 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29149866/prevalence-and-risk-factors-of-frailty-among-home-care-clients
#2
Minna Miettinen, Miia Tiihonen, Sirpa Hartikainen, Irma Nykänen
BACKGROUND: Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. METHODS: The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland...
November 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29145553/tumour-boards-in-geriatric-oncology
#3
Tanya Marya Wildes, Anita O'Donovan, Giuseppe Ferdinando Colloca, Kwok-Leung Cheung
Multidisciplinary tumour board is an integral part of cancer treatment planning. Although no definite survival benefits have yet been shown by mostly observational studies, other benefits of multidisciplinary tumour board have been identified. Traditionally the multidisciplinary tumour board involves participation of treating clinicians-medical, radiation and surgical oncologists. They tend to focus on the cancer alone. There is an increasing awareness that the treatment goal for cancer in older adults is not primarily on prolonging survival, with functional preservation and quality of life being particularly important for this population...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#4
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136185/cognitive-dysfunction-among-newly-diagnosed-older-patients-with-hematological-malignancy-frequency-clinical-indicators-and-predictors
#5
Sayo Aiki, Toru Okuyama, Koji Sugano, Yosuke Kubota, Fuminobu Imai, Masahiro Nishioka, Yoshinori Ito, Shinsuke Iida, Hirokazu Komatsu, Takashi Ishida, Shigeru Kusumoto, Tatsuo Akechi
Background: Medical staff often overlook or underestimate the presence or severity of cognitive dysfunction. The purpose of this study was to clarify the frequency, clinical indicators and predictors of cognitive dysfunction among newly diagnosed older patients with hematologic malignancy receiving first-line chemotherapy. Methods: Patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were consecutively recruited. Cognitive dysfunction was evaluated using the Mini-Mental State Examination (MMSE) twice: before starting chemotherapy (T1) and 1 month later (T2)...
November 10, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29132657/-assessment-to-carry-out-with-a-patient-who-has-suffered-a-fall
#6
Cyril Sellier
A fall in an elderly person can lead to severe complications. It is a serious event which must not be minimised in any way and which must serve as a warning signal for the caregiver. The exploration of the factors involved requires a detailed and comprehensive evaluation of the patient. A complete assessment coordinated by a geriatric doctor is recommended.
November 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/29128297/role-of-geriatric-oncologists-in-optimizing-care-of-urological-oncology-patients
#7
REVIEW
Jean-Pierre Droz, Helen Boyle, Gilles Albrand, Nicolas Mottet, Martine Puts
CONTEXT: Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. OBJECTIVE: To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being...
November 8, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29126383/predictive-performance-of-four-frailty-screening-tools-in-community-dwelling-elderly
#8
Bienvenu Bongue, Aurélie Buisson, Caroline Dupre, François Beland, Régis Gonthier, Émilie Crawford-Achour
BACKGROUND: This study compares the performance of four frailty screening tools in predicting relevant adverse outcome (disability, institutionalization and mortality) in community-dwelling elderly. METHODS: Our study involved a secondary analysis of data from the FréLE cohort study. We focused on the following four frailty screening tools: the abbreviated Comprehensive Geriatric Assessment (aCGA), the Groningen Frailty Indicator (GFI), the Vulnerable Elders Survey-13 (VES-13) and the Fried scale...
November 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29125861/identification-of-hospitalized-elderly-patients-at-risk-for-adverse-in-hospital-outcomes-in-a-university-orthopedics-and-trauma-surgery-environment
#9
Janine Gronewold, Christian Dahlmann, Marcus Jäger, Dirk M Hermann
BACKGROUND: As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA) and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29118292/-impact-of-frailty-and-metabolic-syndrome-on-the-incidence-of-loss-of-independence-in-community-dwelling-older-japanese-the-kusatsu-town-study
#10
Akihiko Kitamura, Shoji Shinkai, Yu Taniguchi, Hidenori Amano, Satoshi Seino, Yuri Yokoyama, Mariko Nishi, Yoshinori Fujiwara
Objectives To investigate the relationship between frailty, metabolic syndrome (MetS), and loss of independence leading to the onset of disability or death among community-dwelling older Japanese.Methods Between 2002 and 2011, we conducted a 7-year prospective study involving 1,453 residents aged 65 years and over, initially free of disability, who underwent a comprehensive geriatric assessment in Kusatsu town. Statistical analysis was conducted for those with complete values, resulting in a variable number of subjects for each data point...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/29115922/the-prevalence-of-dementia-in-a-portuguese-community-sample-a-10-66-dementia-research-group-study
#11
Manuel Gonçalves-Pereira, Ana Cardoso, Ana Verdelho, Joaquim Alves da Silva, Manuel Caldas de Almeida, Alexandra Fernandes, Cátia Raminhos, Cleusa P Ferri, A Matthew Prina, Martin Prince, Miguel Xavier
BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high...
November 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29114830/comparisons-of-interventions-for-preventing-falls-in-older-adults-a-systematic-review-and-meta-analysis
#12
Andrea C Tricco, Sonia M Thomas, Areti Angeliki Veroniki, Jemila S Hamid, Elise Cogo, Lisa Strifler, Paul A Khan, Reid Robson, Kathryn M Sibley, Heather MacDonald, John J Riva, Kednapa Thavorn, Charlotte Wilson, Jayna Holroyd-Leduc, Gillian D Kerr, Fabio Feldman, Sumit R Majumdar, Susan B Jaglal, Wing Hui, Sharon E Straus
Importance: Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise. Objective: To assess the potential effectiveness of interventions for preventing falls. Data Sources: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Ageline databases from inception until April 2017. Reference lists of included studies were scanned...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29106548/comprehensive-geriatric-assessment-for-identifying-older-people-at-risk-of-hip-fracture-cross-sectional-study-with-comparative-group
#13
Raquel Ramírez-Martín, María Victoria Castell Alcalá, Teresa Alarcón, Rocío Queipo, Peggy Paola Ríos Germán, Ángel Otero Puime, Juan Ignacio González-Montalvo
Background: Hip fracture (HF) is by far the most common serious fragility fracture. Its care is a major challenge to all healthcare systems. Aim: To determine whether there are characteristics of older people identified via comprehensive geriatric assessment (CGA) that help identify those with an increased risk of HF. Methods: The demographic, functional, cognitive and nutritional data of a cohort of patients admitted for acute HF were compared with those of a population cohort representing community-dwelling older people in the same urban district without HF...
July 4, 2017: Family Practice
https://www.readbyqxmd.com/read/29104866/cognitive-frailty-in-china-results-from-china-comprehensive-geriatric-assessment-study
#14
Lina Ma, Li Zhang, Yaxin Zhang, Yun Li, Zhe Tang, Piu Chan
Objective: Cognitive frailty (CF) refers to the co-occurrence of physical frailty (PF) and cognitive impairment in persons without dementia. We aimed to explore the prevalence and associated factors of CF in China. Method: Data were obtained from the China Comprehensive Geriatric Assessment Study. A total of 5,708 community-dwelling older adults without dementia were included. CF was assessed using the Mini-Mental State Examination for the evaluation of cognitive status and the Comprehensive Geriatric Assessment-Frailty Index for the evaluation of PF...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29089884/systemic-and-disease-specific-risk-factors-in-vascular-dementia-diagnosis-and-prevention
#15
Efraim Jaul, Oded Meiron
In order to prevent the onset of vascular dementia (VaD) in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29084321/frailty-phenotype-and-neuropsychological-test-performance-a-preliminary-analysis
#16
Terrie B Ginsberg, Leonard Powell, Arif Patel, Sheina Emrani, Anita Chopra, Thomas Cavalieri, David J Libon
Context: Frailty is a common problem that affects adults older than 65 years. Correlations between the frailty phenotype and neuropsychological impairment have not been thoroughly researched. Objective: To examine the association between frailty phenotype, neuropsychological screening test results, and neuropsychological domains known to characterize patients with mild cognitive impairment and dementia. Methods: This retrospective medical record analysis consisted of ambulatory patients aged 65 years or older seen in an outpatient geriatric practice...
November 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29083441/measuring-active-and-healthy-ageing-applying-a-generic-interdisciplinary-assessment-model-incorporating-icf
#17
P Stute, N Bitterlich, J Bousquet, F Meissner, M von Wolff, D Poethig
OBJECTIVES: In this study we compared the chronological and bio-functional age between two German speaking cohorts 30 years apart applying a comprehensive and generic Active and Healthy Aging (AHA) assessment model incorporating ICF. METHODS: Single-centre, cross-sectional, observational, non-interventional, non-randomized trial at an University based women's hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and additional validated psychometric questionnaires...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29077231/disseminating-and-sustaining-emergency-department-innovations-for-older-adults-good-ideas-deserve-better-policies
#18
Alexander X Lo, Kevin Biese
Older adults often visit the emergency department (ED) with chief complaints that understate or detract from their true complex health care needs. These needs are frequently missed because addressing them requires a time-consuming effort that is antithetical to the (necessarily) rapid, complaint-specific protocols of the ED. Key ED performance indices (e.g., length of stay; through-put) also create a disincentive against undertaking comprehensive geriatric assessments when not clearly germane to the chief complaint...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29075972/clinical-benefits-of-single-incision-laparoscopic-surgery-for-postoperative-delirium-in-elderly-colon-cancer-patients
#19
Yujiro Nishizawa, Taishi Hata, Ichiro Takemasa, Makoto Yamasaki, Hiroshi Akasaka, Ken Sugimoto, Koki Tamai, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Chu Matsuda, Tsunekazu Mizushima, Masakazu Ikenaga, Hirofumi Yamamoto, Kohei Murata, Hiromi Rakugi, Yuichiro Doki, Masaki Mori
BACKGROUND: The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer...
October 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29069953/personalized-treatment-strategies-for-elderly-patients-with-myelodysplastic-syndromes
#20
Roberto Castelli, Luigi Bergamaschini, Riccardo Schiavon, Giorgio Lambertenghi-Deliliers
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenia, and their possible transformation into acute myeloid leukemia (AML). They typically affect the elderly but, when making treatment decisions, considering chronological age may be insufficient because it poorly correlates with patient frailty: the challenge is to select the optimal treatment in these patients by balancing efficacy and toxicity. Areas covered: This review discusses the rationale for and methods of personalizing the treatment of elderly MDS patients...
October 25, 2017: Expert Review of Hematology
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