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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/29784592/short-term-resource-utilization-and-cost-effectiveness-of-comprehensive-geriatric-assessment-in-acute-hospital-care-for-severely-frail-elderly-patients
#1
Niklas Ekerstad, Björn W Karlson, David Andersson, Magnus Husberg, Per Carlsson, Emelie Heintz, Jenny Alwin
OBJECTIVE: The objective of this study was to estimate the 3-month within-trial cost-effectiveness of comprehensive geriatric assessment (CGA) in acute medical care for frail elderly patients compared to usual medical care, by estimating health-related quality of life and costs from a societal perspective. DESIGN: Clinical, prospective, controlled, 1-center intervention trial with 2 parallel groups. INTERVENTION: Structured, systematic interdisciplinary CGA-based care in an acute elderly care unit...
May 18, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29784245/use-of-comprehensive-geriatric-assessment-and-geriatric-screening-for-older-adults-in-the-radiation-oncology-setting-a-systematic-review
#2
E Szumacher, S Sattar, M Neve, K Do, A P Ayala, M Gray, J Lee, S Alibhai, M Puts
AIMS: Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process that evaluates medical, psychological, social and functional capacity. No systematic review of the use of CGA in radiation oncology has been conducted. This paper reviews the use of CGA in radiation oncology, examines whether such assessments are feasible and evaluates the effectiveness of these assessments in predicting and modifying outcomes. MATERIALS AND METHODS: We searched Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library for articles published between 1 January 1996 and 24 January 2017...
May 18, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#3
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29781467/comprehensive-geriatric-assessment-interprofessional-team-recommendations-for-older-adult-women-with-breast-cancer
#4
Janine Overcash
BACKGROUND: Geriatric oncology incorporates comprehensive geriatric assessment (CGA) and traditional oncology care. OBJECTIVES: The aims are to identify limitations reflected by mean scores on the CGA instruments and describe the CGA recommendations documented in the medical record. METHODS: CGA was administered and consisted of the Timed Up and Go Test, the Activities of Daily Living Scale, the Instrumental Activities of Daily Living Scale, grip strength, falls, pain, the Brief Fatigue Inventory, the Pittsburgh Sleep Quality Index, the Geriatric Depression Scale, the Mini-Cog, and the Mini Nutritional Assessment...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29780093/-a-retrospective-analysis-of-chemotherapy-for-gastric-cancer-in-later-stage-elderly-patients
#5
Kenji Ina, Hiroko Ina, Masahiko Yoneda, Megumi Kabeya, Syuu Yuasa, Yuko Tomomatsu, Ryuichi Furuta
AIM: Despite the significant advances in chemotherapy, the prognosis of unresectable or recurrent gastric cancer is still very poor. Given that older adults are likely to have a number of concomitant diseases and an impaired major organ function, cancer chemotherapy in elderly patients requires particular caution. We examined what factors are associated with the overall survival of gastric cancer patients undergoing chemotherapy. METHODS: A retrospective chart review of gastric cancer patients receiving oral fluoropyrimidines (N=130) was performed at Nagoya Memorial Hospital over 9 years...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29779613/facial-plastic-surgery-in-the-geriatric-population
#6
REVIEW
Ian Newberry, Eric W Cerrati, J Regan Thomas
Greater life expectancy with advancements in technology and medicine has led to an increasing interest in facial rejuvenation. Facial aging is an inevitable process that largely results from soft tissue descent and volumetric deflation. However, a comprehensive knowledge of the aging process and precise assessment of the exact pathologies yielding the patient's senescent appearance is essential to produce the best cosmetic outcome. The surgeon must evaluate each region independently and the aging face as a whole to ensure a pleasing, natural appearance...
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779319/-comprehensive-geriatric-assessment-can-predict-the-clinical-outcomes-of-elderly-patients-with-diffuse-large-b-cell-lymphoma-in-china
#7
C L Zhang, R Feng, J T Li, Y Tian, T Wang, H Liu
Objective: To validate comprehensive geriatric assessment (CGA) system in Chinese elderly diffuse large B cell lymphoma (DLBCL) patients. Methods: Patients ≥ 65 years of age who had been diagnosed with de novo DLBCL were screened for eligibility ( n =99). CGA was performed during staging procedures through application of the following instruments: age, comorbidity score according to the Cumulative Illness Rating Score for Geriatrics(CIRS-G), activities of daily living (ADL), and instrumental activities of daily living (IADL)...
April 14, 2018: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29774174/outpatient-interventions-that-may-enhance-the-care-of-a-patient-with-co-existing-moyamoya-and-down-syndromes
#8
Anita Lwanga, Waldo Herrera, Katya Cruz Madrid, Antony Irungu
Moyamoya vasculopathy is a condition of chronic, progressive occlusion of the distal internal carotid arteries and the Circle of Willis. The resultant ischemia produces compensatory angiogenesis and the growth of a network of collateral blood vessels, which on angiography resemble a "puff of smoke" or "moyamoya" in Japanese. The objective of this case report is to describe the clinical course of a patient with Down and moyamoya syndromes and to enlighten clinicians about strategies that can be taken to enhance the care of similar patients...
March 16, 2018: Curēus
https://www.readbyqxmd.com/read/29770467/anticholinergic-load-negatively-correlates-with-recovery-of-cognitive-activities-of-daily-living-for-geriatric-patients-after-stroke-in-the-convalescent-stage
#9
E Kose, T Hirai, T Seki, S Hidaka, T Hamamoto
WHAT IS KNOWN AND OBJECTIVE: Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. METHOD: Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study...
May 16, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29761827/factors-related-to-dissociation-between-objective-and-subjective-masticatory-function-in-japanese-community-dwelling-elderly-adults
#10
Murakami Masaharu, Yutaka Watanabe, Edahiro Ayako, Yuki Ohara, Obuchi Shuichi, Kawai Hisashi, Hunkyung Kim, Yoshinori Fujiwara, Ihara Kazushige, Murakami Masato, Hirohiko Hirano
OBJECTIVE: Clinicians' evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. METHODS: Study participants included 635 elderly community-dwelling Japanese adults who underwent a comprehensive geriatric health examination in 2012...
May 15, 2018: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29759834/utility-of-frailty-assessment-for-elderly-patients-undergoing-cardiac-resynchronization-therapy
#11
Maciej Kubala, Laurence Guédon-Moreau, Frédéric Anselme, Didier Klug, Geneviève Bertaina, Sarah Traullé, Otilia Buiciuc, Arnaud Savouré, Momar Diouf, Jean-Sylvain Hermida
OBJECTIVES: The aim of this study was to evaluate the impact of frailty in the elderly on response to cardiac resynchronization therapy (CRT). BACKGROUND: CRT has been shown to improve symptoms and outcome of patients with congestive heart failure (HF) and impaired left ventricular ejection fraction (LVEF). The impact of frailty on the results of CRT is unknown. METHODS: Frailty defined as <14 of 17 points using the ONCODAGE (Outil de dépistage gériatrique en oncologie) G8 score was assessed before device implantation in candidates for CRT who were >70 years of age...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29748444/rituximab-plus-bendamustine-as-front-line-treatment-in-frail-elderly-70-years-patients-with-diffuse-large-b-cell-non-hodgkin-s-lymphoma-a-phase-ii-multicenter-study-of-the-fondazione-italiana-linfomi
#12
Sergio Storti, Michele Spina, Emanuela Anna Pesce, Flavia Salvi, Michele Merli, Alessia Ruffini, Giuseppina Cabras, Annalisa Chiappella, Emanuele Angelucci, Alberto Fabbri, Anna Marina Liberati, Monica Tani, Gerardo Musuraca, Annalia Molinari, Maria Pia Petrilli, Carmela Palladino, Rosanna Ciancia, Andrea Ferrario, Cristiana Gasbarrino, Federico Monaco, Vincenzo Fraticelli, Annalisa De Vellis, Francesco Merli, Stefano Luminari
We conducted a phase II study to assess activity and safety profile of bendamustine and rituximab in elderly patients with untreated Diffuse Large B Cell Lymphoma who were prospectively defined as frail using a simplified version of a Comprehensive Geriatric Assessment. Patients had to be > 70 years of age, with histologically confirmed Diffuse Large B Cell Lymphoma. Frail patients were those younger than 80 years with a frail profile at Comprehensive Geriatric Assessment or older than 80 years with an unfit profile...
May 10, 2018: Haematologica
https://www.readbyqxmd.com/read/29747287/-a-comparative-study-of-comprehensive-geriatric-assessment-in-elder-patients-with-non-hodgkin-s-lymphoma
#13
H Liu, M Gao, D Mei, H X Han, J T Li, J F Bai, C L Zhang, R Feng, J P Wei, Y Tian, T Wang
Objective: To measure the comprehensive geriatric assessment (CGA) in elder non-Hodgkin's Lymphoma (NHL) patients in a cross-sectional study; to compare the differences between Eastern Cooperative Oncology Group (ECOG)-performance status (PS) and CGA. Methods: CGA stratification included the following 3 instrument assessments: activity of daily living (ADL);instrumental activity of daily living (IADL);comorbidity score according to the modified cumulative illness rating score for geriatrics (MCIRS-G). According to CGA and age, NHL patients, aged ≥60 years, were classified as"fit","unfit"and"frail"groups...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29744236/brief-assessments-and-screening-for-geriatric-conditions-in-older-primary-care-patients-a-pragmatic-approach
#14
REVIEW
Laurence Seematter-Bagnoud, Christophe Büla
This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status...
2018: Public Health Reviews
https://www.readbyqxmd.com/read/29741200/the-utility-of-the-frailty-index-in-clinical-decision-making
#15
K Khatry, N M Peel, L C Gray, R E Hubbard
Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29737457/a-physiologically-based-pharmacokinetic-model-to-describe-ciprofloxacin-pharmacokinetics-over-the-entire-span-of-life
#16
Jan-Frederik Schlender, Donato Teutonico, Katrin Coboeken, Katrin Schnizler, Thomas Eissing, Stefan Willmann, Ulrich Jaehde, Heino Stass
BACKGROUND: Physiologically-based pharmacokinetic (PBPK) modeling has received growing interest as a useful tool for the assessment of drug pharmacokinetics by continuous knowledge integration. OBJECTIVE: The objective of this study was to build a ciprofloxacin PBPK model for intravenous and oral dosing based on a comprehensive literature review, and evaluate the predictive performance towards pediatric and geriatric patients. METHODS: The aim of this report was to establish confidence in simulations of the ciprofloxacin PBPK model along the development process to facilitate reliable predictions outside of the tested adult age range towards the extremes of ages...
May 8, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29731614/comprehensive-geriatric-assessment-prediction-of-postoperative-complications-in-gastrointestinal-cancer-patients-a-meta-analysis
#17
REVIEW
Dan-Dan Xue, Yun Cheng, Mei Wu, Yan Zhang
Background: Gastrointestinal cancer is an age-associated disease, and geriatric patients are mostly likely to suffer from postoperative complications. Some studies indicated that comprehensive geriatric assessment (CGA) could predict postoperative complications in gastrointestinal cancer patients. However, the evidence is mixed. Objective: This study aimed to conduct a meta-analysis to identify the effectiveness of CGA for predicting postoperative complications in gastrointestinal cancer patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29728064/validation-of-an-automatically-generated-screening-score-for-frailty-the-care-assessment-need-can-score
#18
Jorge G Ruiz, Shivani Priyadarshni, Zubair Rahaman, Kimberly Cabrera, Stuti Dang, Willy M Valencia, Michael J Mintzer
BACKGROUND: Frailty is a state of vulnerability to stressors that is prevalent in older adults and is associated with higher morbidity, mortality and healthcare utilization. Multiple instruments are used to measure frailty; most are time-consuming. The Care Assessment Need (CAN) score is automatically generated from electronic health record data using a statistical model. The methodology for calculation of the CAN score is consistent with the deficit accumulation model of frailty. At a 95 percentile, the CAN score is a predictor of hospitalization and mortality in Veteran populations...
May 4, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29723848/risk-factors-and-outcomes-of-delirium-in-older-patients-admitted-to-postacute-care-with-and-without-dementia
#19
Neus Gual, Alessandro Morandi, Laura Monica Pérez, Laura Brítez, Pamela Burbano, Flor Man, Marco Inzitari
BACKGROUND: Delirium research is poorly studied in postacute care, a growing setting due to aging populations, as well as in dementia, a critical risk factor for delirium and particularly prevalent in postacute care. We investigated risk factors for delirium and its outcomes in older adults with and without dementia admitted to a subacute care unit (SCU) after exacerbated chronic conditions. METHODS: This is a prospective cohort study including patients ≥65 years old admitted to an SCU for 12 months...
May 3, 2018: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/29718079/the-integrated-care-team-approach-of-the-department-of-veterans-affairs-va-geriatric-primary-care
#20
Donna Rasin-Waters, Valerie Abel, Lisa K Kearney, Antonette Zeiss
Historically, integrated mental and behavioral healthcare in the Department of Veterans Affairs (VA) commenced with initiatives in geriatrics. Innovation and system-wide expansion has occurred over decades and culminated in a unified vision for training and practice in the VA medical home model: Patient Aligned Care Team or PACT approach. In one VA hospital, the integration of neuropsychological services in geriatric primary care is pivotal and increases access for patients, as well as contributing to timely and effective care on an interprofessional team...
May 1, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
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