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Frailty in the elderly

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https://www.readbyqxmd.com/read/28427345/variation-in-gp-decisions-on-antihypertensive-treatment-in-oldest-old-and-frail-individuals-across-29-countries
#1
Sven Streit, Marjolein Verschoor, Nicolas Rodondi, Daiana Bonfim, Robert A Burman, Claire Collins, Gerasimovska Kitanovska Biljana, Sandra Gintere, Raquel Gómez Bravo, Kathryn Hoffmann, Claudia Iftode, Kasper L Johansen, Ngaire Kerse, Tuomas H Koskela, Sanda Kreitmayer Peštić, Donata Kurpas, Christian D Mallen, Hubert Maisoneuve, Christoph Merlo, Yolanda Mueller, Christiane Muth, Marija Petek Šter, Ferdinando Petrazzuoli, Thomas Rosemann, Martin Sattler, Zuzana Švadlenková, Athina Tatsioni, Hans Thulesius, Victoria Tkachenko, Peter Torzsa, Rosy Tsopra, Tuz Canan, Rita P A Viegas, Shlomo Vinker, Margot W M de Waal, Andreas Zeller, Jacobijn Gussekloo, Rosalinde K E Poortvliet
BACKGROUND: In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28423084/immune-system-dysfunction-in-the-elderly
#2
Eduardo Fuentes, Manuel Fuentes, Marcelo Alarcón, Iván Palomo
Human aging is characterized by both physical and physiological frailty that profoundly affects the immune system. In this context aging is associated with declines in adaptive and innate immunity established as immunosenescence. Immunosenescence is a new concept that reflects the age-associated restructuring changes of innate and adaptive immune functions. Thus elderly individuals usually present chronic low-level inflammation, higher infection rates and chronic diseases. A study of alterations in the immune system during aging could provide a potentially useful biomarker for the evaluation of immune senescence treatment...
January 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28419681/oral-mycobiome-in-community-dwelling-elderly-and-its-relation-to-oral-and-general-health-conditions
#3
Myrna Nurlatifah Zakaria, Michiko Furuta, Toru Takeshita, Yukie Shibata, Rini Sundari, Nobuoki Eshima, Toshiharu Ninomiya, Yoshihisa Yamashita
OBJECTIVE: Oral fungal infection is generally associated with dysbiosis related to antibiotic use, immunodeficiency, or frailty. However, fungal colonization in a typical population without apparent symptoms, and its associated conditions are poorly understood. In this study, oral fungal colonization in community-dwelling and independently living elderly populations was evaluated and factors affecting fungal colonization were analyzed. SUBJECTS AND METHODS: The subjects (410; 181 males and 229 females) were 75-99 years of age; those under prior antibiotic use were excluded...
April 18, 2017: Oral Diseases
https://www.readbyqxmd.com/read/28413364/delivering-integrated-care-to-the-frail-elderly-the-impact-on-professionals-objective-burden-and-job-satisfaction
#4
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/28413012/-identifying-frailty-and-the-importance-of-personalised-support
#5
Mathilde Nicolas, Régis Gonthier, Émilie Crawford-Achour
Over recent years, many hospitals have been looking to promote optimum ageing by developing a strategy for identifying frailty in elderly people. This raises the question of prevention in the field of ageing and the capacities to change behaviour which is harmful to health at any age. Early and long-term support is essential.
March 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28412164/diagnosis-and-management-of-oropharyngeal-dysphagia-among-older-persons-state-of-the-art
#6
REVIEW
Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28411349/effect-of-low-appendicular-lean-mass-grip-strength-and-gait-speed-on-the-functional-outcome-after-surgery-for-distal-radius-fractures
#7
Young Hak Roh, Jung Ho Noh, Hyun Sik Gong, Goo Hyun Baek
Patients with low appendicular lean mass plus slow gait speed or weak grip strength are at risk for poor functional recovery after surgery for distal radius fracture, even when they have similar radiologic outcomes. INTRODUCTION: Loss of skeletal muscle mass and consequent loss in muscle function associate with aging, and this condition negatively impacts the activities of daily living and increases elderly individuals' frailty to falls. Thus, patients with low appendicular lean mass would show different functional recovery compared to those without this condition after surgery for distal radius fracture (DRF)...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28406166/office-based-simple-frailty-score-and-central-blood-pressure-predict-mild-cognitive-impairment-in-an-apparently-healthy-japanese-population-j-shipp-study
#8
Maya Ohara, Katsuhiko Kohara, Yoko Okada, Masayuki Ochi, Tokihisa Nagai, Yasumasa Ohyagi, Yasuharu Tabara, Michiya Igase
Frailty is associated with cognitive impairment and can be used to identify people at high risk for dementia. We developed a simple frailty (SF) score using a combination of low hand grip strength (<32.5 kg in men, <19.5 kg in women), and short one-leg standing time (<20 seconds). These can be easily measured in the clinician's office when seeing patients. We investigated the possible association between SF score and mild cognitive impairment (MCI) in a cross-sectional study with 838 independent middle-aged to elderly participants (319 men, mean age 65...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28405820/higher-dietary-acid-load-is-associated-with-a-higher-prevalence-of-frailty-particularly-slowness-weakness-and-low-physical-activity-in-elderly-japanese-women
#9
Yuki Kataya, Kentaro Murakami, Satomi Kobayashi, Hitomi Suga, Satoshi Sasaki
OBJECTIVE: Epidemiologic evidence on the potential effects of dietary acid load on frailty is lacking. This cross-sectional study examined the association between dietary acid load and frailty. METHODS: This study was based on self-reported data obtained from 2176 Japanese women aged 65-94 years. Dietary acid load was characterized as potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on information on nutrient intake, obtained from a validated brief diet history questionnaire...
April 12, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28400984/is-technology-present-in-frailty-technology-a-back-up-tool-for-dealing-with-frailty-in-the-elderly-a-systematic-review
#10
REVIEW
Iranzu Mugueta-Aguinaga, Begonya Garcia-Zapirain
This study analyzes the technologies used in dealing with frailty within the following areas: prevention, care, diagnosis and treatment. The aim of this paper is, on the one hand, to analyze the extent to which technology is present in terms of its relationship with frailty and what technological resources are used to treat it. Its other purpose is to define new challenges and contributions made by physiotherapy using technology. Eighty documents related to research, validation and/or the ascertaining of different types of hardware, software or both were reviewed in prominent areas...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28399218/timed-up-and-go-predicts-functional-decline-in-older-patients-presenting-to-the-emergency-department-following-minor-trauma%C3%A2
#11
Debra Eagles, Jeffrey J Perry, Marie-Josée Sirois, Eddy Lang, Raoul Daoust, Jacques Lee, Lauren Griffith, Laura Wilding, Xavier Neveu, Marcel Emond
Background: there is no standardised test for assessing mobility in the Emergency Department (ED). Objective: we wished to evaluate the relationship between the Timed Up and Go (TUG) and frailty, functional decline and falls in community dwelling elders that present to the ED following minor trauma. Methods: this was a secondary analysis of a prospective cohort study conducted at eight Canadian hospitals. Evaluations included: TUG; Study of Osteoporotic Fractures Frailty Index; Older American Resources and Service Functional Scale; and self-reported falls...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28398376/-efficacy-and-safety-of-oral-anticoagulants-in-frail-elderly-patients-with-atrial-fibrillation-an-unsolved-problem
#12
Paolo Alboni, Nicola Stucci, Elena Cojocaru, Andrea Ungar
At present, the efficacy and safety of anticoagulants, warfarin, or new oral anticoagulants in frail patients remain unknown, as these patients have largely been excluded from both randomized trials and "real-world" studies; as a result, the guidelines do not provide guidance for the management of this population. Frail patients with atrial fibrillation (AF) are significantly less likely to receive oral anticoagulants compared to their nonfrail counterparts; is that an expression of reasonable prudence or malpractice? In this regard, some aspects of physical frailty should be considered: (i) increased vulnerability to stressors, including pharmacological agents with potential severe adverse effects; (ii) frail elderly patients are at high risk of falls and, therefore, of severe traumatic hemorrhages on oral anticoagulation; (iii) frail patients are more likely to have complications during intercurrent affections, potentially responsible for hemorrhages...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28395196/body-composition-and-frailty-profiles-in-brazilian-older-people-frailty-in-brazilian-older-people-study-fibra-br
#13
Eduardo Ferriolli, Fernanda Pinheiro Amador Dos Santos Pessanha, Virgílio Garcia Moreira, Rosângela Corrêa Dias, Anita Liberalesso Neri, Roberto Alves Lourenço
OBJECTIVE: To determine the association between body composition and frailty in older Brazilian subjects. MATERIAL AND METHODS: This is a Cross-sectional study called FIBRA-BR and developed in community Brazilian aged ≥65 (n=5638). Frailty was assessed according to Fried et al. definition and body composition was determined by BMI, waist circumference and waist-hip ratio. RESULTS: The lowest prevalence of frailty was observed in subjects with BMI between 25...
March 27, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28391026/radiopharmaceuticals-in-the-elderly-cancer-patient-practical-considerations-with-a-focus-on-prostate-cancer-therapy-a-position-paper-from-the-international-society-of-geriatric-oncology-task-force
#14
John O Prior, Silke Gillessen, Manfred Wirth, William Dale, Matti Aapro, Wim J G Oyen
Molecular imaging using radiopharmaceuticals has a clear role in visualising the presence and extent of tumour at diagnosis and monitoring response to therapy. Such imaging provides prognostic and predictive information relevant to management, e.g. by quantifying active tumour mass using positron emission tomography/computed tomography (PET/CT). As these techniques require only pharmacologically inactive doses, age and potential frailty are generally not important. However, this may be different for therapy involving radionuclides because the radiation can impact normal bodily function (e...
April 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28380347/oral-health-care-behavior-and-frailty-related-factors-in-a-care-dependent-older-population
#15
Dominique Niesten, Dick Witter, Ewald Bronkhorst, Nico Creugers
OBJECTIVES: To assess, in older people with different levels of care-dependency 1) which frailty- and non-frailty related predisposing, enabling and need factors are associated with a) dental service use (DSU) frequency, b) changed DSU after the onset of care-dependency, c) brushing frequency, and d) changed brushing frequency since the onset of care-dependency; and 2) if unfavorable oral health care behavior is related to unfavorable oral health outcomes. METHODS: Bivariate analyses and multivariable logistic regression analyses were performed to evaluate data from 126 Dutch care-dependent people aged≥65 on oral and general health, psychological and social issues...
April 2, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28370849/2d-4d-digit-ratio-is-associated-with-cognitive-decline-but-not-frailty-in-community-dwelling-older-adults
#16
Celina Gonçalves, Tiago Coelho, Sérgio Machado, Nuno Barbosa Rocha
OBJECTIVES: To understand the relation between 2D:4D ratio, frailty, and cognitive decline in community-dwelling elderly people. METHODS: A total of 175 community-dwelling elderly people were included. To determine frailty, participants completed the Tilburg Frailty Indicator (TFI) and the Survey of Health, Ageing and Retirement in Europe (SHARE-FI). Cognitive functioning was determined using the Mini-Mental State Examination (MMSE). 2D and 4D finger lengths of each hand were measured using a scanner...
March 28, 2017: American Journal of Human Biology: the Official Journal of the Human Biology Council
https://www.readbyqxmd.com/read/28367285/are-frailty-scales-better-than-anesthesia-or-surgical-scales-to-determine-risk-in-cardiac-surgery
#17
Judit Kovacs, Liviu Moraru, Krisztina Antal, Adrian Cioc, Septimiu Voidazan, Attila Szabo
BACKGROUND: In the last year there has been an increasing interest for using frailty scales for risk stratification of elderly patients undergoing major surgery. We planned to compare two frailty scales with risk scales already used in cardiac surgery, to study which of these scores have better prognostic value predicting postoperative outcome in open heart surgery. METHODS: We conducted a prospective clinical trial, including 57 patients over 65 years. We calculated Cardiac Anesthesia Risk Evaluation score, EuroScore II, Clinical Frailty Scale, Edmonton Frail Scale for each patient and followed the postoperative complications, length of mechanical ventilation, length of stay in the intensive care unit and hospital, and in-hospital death related to these risk and frailty scores...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28359689/frailty-measure-is-more-predictive-of-outcomes-after-curative-therapy-for-endometrial-cancer-than-traditional-risk-factors-in-women-60-and-older
#18
Jane A Driver, Akila N Viswanathan
OBJECTIVES: To determine if readily obtainable markers of frailty predict disease-free survival (DFS) in elderly women with endometrial cancer treated with curative intent. METHODS: 88 consecutive women≥age 60 treated with surgery, chemotherapy and radiation for stage I-IV endometrial cancer were included. We considered the following health deficits as markers of "frailty": albumin <3.5mg/dL, hemoglobin <10mg/dL, BMI<20kg/m,(2) unintentional weight loss, ECOG performance status ≥2, history of osteopenia or osteoporosis and Charlson comorbidity score...
March 27, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28351218/association-among-serum-igf-1-frailty-muscle-mass-bone-mineral-density-and-physical-performance-among-community-dwelling-middle-aged-and-older-adults-in-taiwan
#19
Liang-Yu Chen, Yi-Hui Wu, Li-Kuo Liu, Wei-Ju Lee, An-Chun Hwang, Li-Ning Peng, Ming-Hsien Lin, Liang-Kung Chen
BACKGROUND: Aging is featured by the complex interrelationship between among body composition, frailty status and physical performance. The main aim of this study was to evaluate the association between among serum insulin-like growth factor-1 (IGF-1), body composition, and physical function among community-dwelling middle-aged and elderly population in Taiwan. METHODS: We conducted a cross-sectional study by using the data of I-Lan Longitudinal Aging Study (ILAS), which recruited a total of 1,833 community-dwelling people aged 50 years and older...
March 29, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28329793/oral-disease-and-3-year-incidence-of-frailty-in-mexican-older-adults
#20
Roberto Carlos Castrejón-Pérez, Aida Jiménez-Corona, Eduardo Bernabé, Antonio R Villa-Romero, Elise Arrivé, Jean-François Dartigues, Luis Miguel Gutiérrez-Robledo, S Aída Borges-Yáñez
Background: Poor oral health has been associated with some components of frailty. The objective of this study was to identify the association between clinical measures of oral health and the incidence of frailty among community-dwelling older adults aged 70 or older in Mexico City. Methods: A 3-year cohort study with a probabilistic representative sample of home-dwelling elders of one district of Mexico City was performed. Baseline and follow-up interview and oral clinical evaluations were carried out by standardized examiners in participants' homes...
October 25, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
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