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Comprehensive geriatric assessment

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https://www.readbyqxmd.com/read/29348384/clinical-outcomes-of-geriatric-care-in-cipto-mangunkusumo-hospital-before-and-after-the-implementation-of-national-health-insurance-program
#1
Czeresna Heriawan Soejono, Retna S Padmawati, Adi Utarini
BACKGROUND: the National Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of life have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the efficiency care of this vulnarable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geriatric patients admitted to CMH between prior to and after NHI implementation...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29337017/management-of-diabetes-in-older-adults
#2
G Sesti, R Antonelli Incalzi, E Bonora, A Consoli, A Giaccari, S Maggi, G Paolisso, F Purrello, G Vendemiale, N Ferrara
Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population...
December 7, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29334783/frailty-a-global-measure-of-the-multisystem-impact-of-copd
#3
Nichola S Gale, Ali M Albarrati, Margaret M Munnery, Ruth E Hubbard, Ruth Tal-Singer, John R Cockcroft, Dennis J Shale
Chronic obstructive pulmonary disease (COPD) is a multisystem disease that resembles the accumulation of multiple impairments seen in aging. A comprehensive geriatric assessment (CGA) captures multisystem deficits, from which a frailty index (FI) can be derived. We hypothesized that patients with COPD would be frailer than a comparator group free from respiratory disease. In this cross-sectional analysis, the CGA questionnaire was completed and used to derive an FI in 520 patients diagnosed with COPD and 150 comparators...
January 1, 2018: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/29331624/comprehensive-geriatric-assessment-in-the-older-adult-with-cancer-a-review
#4
REVIEW
Catalina Hernandez Torres, Tina Hsu
CONTEXT: The number of older adults with cancer is expected to increase rapidly in the upcoming decades. Aging is heterogeneous and chronological age is often not reflective of biological age. A comprehensive geriatric assessment (CGA) is an in-depth assessment of multiple domains of health that results in better assessment of a patient's overall health and fitness and allows directed intervention to improve patient outcomes. OBJECTIVE: To review the value of CGA for older adults with cancer, CGA composition and tools that can be utilized, and the feasibility of including CGA in oncologic practice...
January 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29330585/potentially-inappropriate-medications-in-community-dwelling-older-adults-undertaken-as-a-comprehensive-geriatric-risk-assessment
#5
Sharmin S Bala, Sujita W Narayan, Prasad S Nishtala
PURPOSE: The prescription of potentially inappropriate medications (PIMs) is associated with an increase in adverse events, prescribing cascades, high health-care costs, morbidity, and mortality in the elderly. The overarching objective of this study is to examine the prevalence of PIMs in the elderly, applying the 2012 American Geriatrics Society Beers criteria for the study period 2012-2014, and the updated 2015 Beers criteria for 2015. METHODS: The study population (N = 70,479) included a continuously recruited national cohort of community-dwelling older (aged ≥ 65 years) New Zealanders who had undertaken the International Resident Assessment Instrument-Home Care (interRAI-HC) assessments between September 2012 and October 2015...
January 12, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29330399/geriatric-assessment-and-quality-of-life-in-older-patients-considered-for-allogeneic-hematopoietic-cell-transplantation-a-prospective-risk-factor-and-serial-assessment-analysis
#6
Barbara Deschler, Gabriele Ihorst, Susanne Schnitzler, Hartmut Bertz, Juergen Finke
Allogeneic hematopoietic cell transplantation (alloHCT) in older patients requires the weighing of risks and benefits for this potentially curative treatment while facing age-related limitations. Comprehensive geriatric and quality of life (EORTC QLQ C-30) assessements (CGA/QOL) in addition to disease-specific data were obtained in 108 consecutive patients (≥60 years) pre-HCT, at day +30, +100, and +180. Median follow-up of 106 patients alive at alloHCT was 43.5 months, median age 66 years (range 60-78). Eighty-six (81...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29324561/nursing-minimum-data-sets-for-documenting-nutritional-care-for-adults-in-primary-healthcare-a-scoping-review
#7
Sasja Jul Håkonsen, Preben Ulrich Pedersen, Merete Bjerrum, Ann Bygholm, Micah D J Peters
OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29321439/the-association-of-bite-instability-and-comorbidities-in-elderly-people
#8
Susumu Itakura, Masaaki Miyata, Atsushi Kuroda, Manabu Setoguchi, Atsushi Kusumoto, Daisuke Hokonohara, Mitsuru Ohishi
Objective The purpose was to evaluate the association between bite instability and comorbidities, comprehensive geriatric evaluations, or disabilities in elderly people. Methods A dentist examined the oral function, such as the bite stability, number of teeth, and the use of dentures, in 119 patients (93 women, mean age: 86.7±7.8) in 2 nursing homes for the elderly. The association between the oral function and the prevalence of diseases, including hypertension, diabetes mellitus, and dementia, was analyzed...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29318079/the-effect-of-an-in-hospital-comprehensive-geriatric-assessment-on-short-term-mortality-during-orthogeriatric-hip-fracture-program-which-patients-benefit-the-most
#9
Hanna M Pajulammi, Harri K Pihlajamäki, Tiina H Luukkaala, Janne J Jousmäki, Pekka H Jokipii, Maria S Nuotio
Aims: To examine the association of patient-related factors with the effect of an in-hospital comprehensive geriatric assessment (CGA) on hip fracture mortality. Methods: Population-based, prospective data were collected on 1425 consecutive hip fracture patients aged ≥65 in a central hospital providing orthogeriatric service. Outcome was mortality at 1 month after hip fracture associated with receiving versus not receiving CGA. Results: Of the patients receiving CGA compared to those who did not, 8...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318004/poly-de-prescribing-to-treat-polypharmacy-efficacy-and-safety
#10
Doron Garfinkel
Background: The aim of this study was to evaluate efficacy and safety of poly-de-prescribing (PDP) based on the Garfinkel method in older people with polypharmacy. Methods: A longitudinal, prospective, nonrandomized study in Israel was carried out between 2009 and 2016. Comprehensive geriatric assessments were performed at home in people age ⩾66 years consuming ⩾6 prescription drugs. Exclusion criteria were life expectancy <6 months and a seeming unwillingness to cooperate (poor compliance)...
January 2018: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29317552/validation-and-refinement-of-the-age-comorbidities-and-albumin-index-in-elderly-patients-with-diffuse-large-b-cell-lymphoma-an-effective-tool-for-comprehensive-geriatric-assessment
#11
Hui Liu, Chun-Li Zhang, Ru Feng, Jiang-Tao Li, Yuan Tian, Ting Wang
BACKGROUND: We aimed to validate and refine the Age, Comorbidities, and Albumin (ACA) index in elderly Chinese patients with diffuse large B-cell lymphoma (DLBCL) and propose a more effective method for comprehensive geriatric assessment (CGA). MATERIALS AND METHODS: Patients ≥65 years of age who had been diagnosed with de novo DLBCL in the Institute of Hematology, Beijing Hospital, were screened for eligibility (n = 99). RESULTS: Based on the ACA index, 39, 31, 26, and 3 patients were categorized into the "excellent," "good," "moderate," and "poor" groups, respectively...
January 9, 2018: Oncologist
https://www.readbyqxmd.com/read/29313883/simple-method-of-screening-for-frailty-in-older-adults-using-a-chronometer-and-tape-measure-in-clinic
#12
Hee-Won Jung, Min-Gu Kang, Jung-Yeon Choi, Sol-Ji Yoon, Sun-Wook Kim, Kwang-Il Kim, Cheol-Ho Kim
OBJECTIVES: Detecting frailty in older adults scheduled for surgery is important to predict the occurrence of adverse outcomes, but because of its complexity, frailty screening is not commonly performed. The objective of the current study was to assess whether frailty can be screened for using automatically measured usual gait speed (UGS) and mid-arm circumference (MAC) in the outpatient clinic. DESIGN: Prospective, cross-sectional study. SETTING: Geriatric center of a tertiary hospital...
January 4, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29304069/naso-and-oropharyngeal-bacterial-carriage-in-nursing-home-residents-impact-of-multimorbidity-and-functional-impairment
#13
Anja Kwetkat, Wolfgang Pfister, Diana Pansow, Mathias W Pletz, Cornel C Sieber, Heike Hoyer
OBJECTIVE: From April 2013 to February 2014 we performed a multicentre prospective cross-sectional study in 541 German nursing home residents. We determined pharyngeal carriage of Streptococcus pneumoniae (primary objective) and other bacteria (secondary objective) in naso- and oropharyngeal swabs by culture-based standard procedures and explored the influence of multimorbidity and functional status on bacterial carriage. METHODS: Socio-demographic data, vaccination status, multimorbidity, nutrition and functional status defined by Comprehensive Geriatric Assessment were evaluated...
2018: PloS One
https://www.readbyqxmd.com/read/29302797/proactive-care-of-older-people-undergoing-surgery
#14
Judith Partridge, Magda Sbai, Jugdeep Dhesi
The number of older patients undergoing surgery is increasing due to changing demographics, surgical and anaesthetic advances and shifts in patient expectations of healthcare. The benefits of surgery in older people are well documented and include symptom control and increased life expectancy. However, older surgical patients present not only with the index pathology requiring surgery but with concurrent age related physiological decline, multimorbidity and geriatric syndromes. These additional issues increase the risk of adverse postoperative outcome, in particular of postoperative medical and functional complications...
January 4, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29301486/comprehensive-geriatric-assessment-in-patients-undergoing-transcatheter-aortic-valve-implantation-results-from-the-cga-tavi-multicentre-registry
#15
Andrea Ungar, Giulio Mannarino, Nathalie van der Velde, Jan Baan, Marie-Pierre Thibodeau, Jean-Bernard Masson, Gennaro Santoro, Martijn van Mourik, Sofie Jansen, Cornelia Deutsch, Peter Bramlage, Jana Kurucova, Martin Thoenes, Stefania Maggi, Andreas W Schoenenberger
BACKGROUND: In older patients with aortic stenosis (AS) undergoing TAVI, the potential role of prior CGA is not well established. To explore the value of comprehensive geriatric assessment (CGA) for predicting mortality and/or hospitalisation within the first 3 months after transcatheter aortic valve implantation (TAVI). METHODS: An international, multi-centre, prospective registry (CGA-TAVI) was established to gather data on CGA results and medium-term outcomes in geriatric patients undergoing TAVI...
January 4, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#16
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29300425/aging-and-adherence-to-the-mediterranean-diet-relationship-with-cardiometabolic-disorders-and-polypharmacy
#17
R Vicinanza, G Troisi, R Cangemi, M Ulderico De Martino, D Pastori, S Bernardini, F Crisciotti, F Di Violante, A Frizza, M Cacciafesta, P Pignatelli, V Marigliano
OBJECTIVES: To investigate the association between adherence to the Mediterranean Diet (Med-Diet), cardiometabolic disorders and polypharmacy. DESIGN: Cross-sectional study. SETTING: Geriatrics outpatient clinic, Policlinico Umberto I, Sapienza University of Rome. PARTICIPANTS: 508 patients (219 male, 289 female) aged 50 to 89 who were evaluated for cardiovascular and metabolic disorders. METHODS AND MEASUREMENTS: Patients underwent a comprehensive medical assessment including medical history and the use of medications...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29250775/most-impactful-factors-on-the-health-related-quality-of-life-of-a-geriatric-population-with-cancer
#18
Maria Pisu, Andres Azuero, Karina I Halilova, Courtney P Williams, Kelly M Kenzik, Elizabeth A Kvale, Grant R Williams, Karen Meneses, Margaret Sullivan, Supriya Kumar Yagnik, Hans-Peter Goertz, Gabrielle B Rocque
BACKGROUND: As the population of older adults with cancer continues to grow, the most important factors contributing to their health-related quality of life (HRQOL) remain unclear. METHODS: A total of 1457 older adults (aged ≥65 years) with cancer participated in a telephone survey. Outcomes were measured using the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-Item Short Form Survey (SF-12) from the Medical Outcomes Study (version 2)...
December 18, 2017: Cancer
https://www.readbyqxmd.com/read/29249644/current-systemic-therapies-for-metastatic-renal-cell-carcinoma-in-older-adults-a-comprehensive-review
#19
REVIEW
Manuel Caitano Maia, Jacob Adashek, Paulo Bergerot, Lorena Almeida, Simone Fernandes Dos Santos, Sumanta K Pal
Physiological changes that occur during the aging process may impact drug metabolism and availability, consequently affecting treatment efficacy and tolerability. Despite being a disease of older adults, there is little data to guide treatment decisions for older patients with metastatic renal cell carcinoma (mRCC). The recent approval of many new agents for this disease poses a clinical challenge: how to best utilize these drugs in a population (older adults) who has been generally under-represented in clinical studies...
December 14, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29248435/delphi-consensus-of-an-expert-committee-in-oncogeriatrics-regarding-comprehensive-geriatric-assessment-in-seniors-with-cancer-in-spain
#20
Maria-Jose Molina-Garrido, Carmen Guillén-Ponce, Remei Blanco, Juana Saldaña, Jaime Feliú, Maite Antonio, Rosa López-Mongil, Primitivo Ramos Cordero, Regina Gironés
OBJECTIVES: The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. MATERIAL AND METHODS: The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66...
December 13, 2017: Journal of Geriatric Oncology
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