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Frailty in the elderly

Juan Sanchis, Albert Ariza-Solé, Emad Abu-Assi, Oriol Alegre, Fernando Alfonso, José Antonio Barrabés, José Antonio Baz, Antonio Carol, Pablo Díez Villanueva, Bruno García Del Blanco, Jaime Elízaga, Eduard Fernandez, Abel García Del Egido, Joan García Picard, Iván Gómez Blázquez, Joan Antoni Gómez Hospital, Rosana Hernández-Antolín, Cinta Llibre, Francisco Marín, David Martí Sánchez, Roberto Martín, Manuel Martínez Sellés, Gema Miñana, María José Morales Gallardo, Julio Núñez, Armando Pérez de Prado, Eduardo Pinar, Marcelo Sanmartín, Alessandro Sionis, Adolfo Villa, Jaume Marrugat, Héctor Bueno
INTRODUCTION AND OBJECTIVES: Although clinical guidelines recommend invasive management in non-ST-segment elevation myocardial infarction (NSTEMI), this strategy is underused in frail elderly patients in the real world. Furthermore, these patients are underrepresented in clinical trials and therefore the evidence is scarce. Our hypothesis is that an invasive strategy will improve prognosis in elderly frail patients with NSTEMI. METHODS: This will be a prospective, multicenter, randomized trial, in which the conservative and invasive strategies will be compared in patients meeting all of the following inclusion criteria: NSTEMI diagnosis, age ≥ 70 years, and frailty defined by a category ≥ 4 in the Clinical Frailty Scale...
March 7, 2018: Revista Española de Cardiología
Haruo Hanyu
There is a wide range of potentially modifiable risk factors for Alzheimer's disease and dementia, including cardiovascular risk factors (e.g. hypertension, diabetes, dyslipidemia, obesity, sleep-apnea syndrome), psychosocial factors (e.g., depression), health behaviors (e.g., low level of physical or mental activity, smoking status), and head trauma. In the elderly, weight loss associated with frailty and sarcopenia is another risk factor for dementia. Recent epidemiological studies have shown that the prevalence of dementia has declined in the US and European countries during the last 20 years...
March 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Gila Albert, Tsippy Lotan, Penina Weiss, Yoram Shiftan
The challenge of ageing has two key aspects with regard to driving: mobility and safety. It is necessary for elderly adults to preserve independent mobility and activity; however, physical frailty and cognitive limitations have negative effects on their safety. Therefore, the issue of driving, and more specifically, the fostering of safe driving of old people, is crucial, especially due the increasing number of elderly people holding a driving license. The purpose of this Letter is to point out the complexity of elderly driving and to suggest countermeasures by acknowledging that obtaining the correct balance between safety and mobility of older drivers is a complicated and sensitive task...
February 2018: Healthcare Technology Letters
Fiammetta Monacelli, Alessio Signori, Matteo Prefumo, Chiara Giannotti, Alessio Nencioni, Emanuele Romairone, Stefano Scabini, Patrizio Odetti
Background/Aims: Postoperative delirium (POD) is more frequent in elderly patients undergoing major cancer surgery. The interplay between individual clinical vulnerability and a series of perioperative factors seems to play a relevant role. Surgery is the first-line treatment option for cancer, and fast-track surgery (FTS) has been documented to decrease postoperative complications. The study sought to assess, after comprehensive geriatric assessment (CGA) and frailty stratification (Rockwood 40 items index), which perioperative parameters were predictive of POD development in elderly patients undergoing FTS for colorectal cancer...
January 2018: Dementia and Geriatric Cognitive Disorders Extra
Carmen de Labra, Ana Maseda, Laura Lorenzo-López, Rocío López-López, Ana Buján, José L Rodríguez-Villamil, José Carlos Millán-Calenti
BACKGROUND: Frailty is a multidimensional clinical geriatric syndrome that may be reversed in its early stages. Most studies have paid attention to its physical or phenotypic boundaries, however, little is known about the social aspects surrounding this geriatric syndrome. The study examined the relationship between socio-demographic factors, social resources, quality of life and frailty in older adults. METHODS: This cross-sectional study included a representative sample (n = 749) of adults aged ≥65 years enrolled in forty-three senior centers located in North-West Spain...
March 7, 2018: BMC Geriatrics
Angela Atinga, Andreas Shekkeris, Michael Fertleman, Nicola Batrick, Elika Kashef, Elizabeth Dick
Major Trauma Centres and Emergency Departments are treating an increasing number of geriatric trauma patients in the UK. Elderly patients, generally defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of geriatric trauma cases is rising yearly, accounting for > 25% of all major trauma cases nationally. The elderly have different physiological reserves and a different response to trauma, due to premorbid frailty, co-existing conditions and prescribed medication...
March 6, 2018: British Journal of Radiology
Darlene Mara Dos Santos Tavares, Pedro Martins Faria, Maycon Sousa Pegorari, Pollyana Cristina Dos Santos Ferreira, Janaína Santos Nascimento, Gianna Fiori Marchiori
We sought to examine the frailty association with depression and functional disability in hospitalized older adults. In particular, we compared non-frail, pre-frail, and frail elderly hospitalized individuals. We performed a cross-sectional study with 255 hospitalized Brazilian elderly patients. We used a structured instrument to assess socio-economic data, the Fried frailty phenotype and used morbidity scales (Geriatric Depression; Katz; Lawton and Brody). The adjusted analysis revealed that frail elderly exhibit increased odds ratios (OR) for depressive symptoms (OR = 2...
March 5, 2018: Issues in Mental Health Nursing
Koki Yamaguchi, Tatsuya Hirase, Tetsuji Koizumi, Sigeru Inoguchi
AIM: Efforts to improve the treatment of frail elderly patients in acute care hospitals are urgently needed because a low physical activity level due to hospitalization is reported to be associated with a risk of disability. The aim of this study was to clarify the characteristics of frail elderly patients in acute care hospitals. METHODS: We assessed 198 elderly patients who were admitted to acute care hospitals. The factors that were evaluated included the presence of frailty, the age, gender, and nutritional status of the patients, and complications that developed during hospitalization...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Meera Balasubramaniam
Geriatricians are increasingly encountering older adults expressing suicidal wishes in the absence of overt mental illness. This is expected to grow as life expectancy increases. This article describes the case of an older adult who expressed the wish to end his life in the absence of a diagnosable mental illness. Although he had chronic medical illnesses, he was not terminally ill. The complex subject of rational suicide in elderly adults is approached from a clinician's perspective. Issues of ageism, gerontophobia, and changing perspectives on death are highlighted...
March 2, 2018: Journal of the American Geriatrics Society
Hülya Eskiizmirli Aygör, Çiçek Fadıloğlu, Sevnaz Şahin, Fisun Şenuzun Aykar, Fehmi Akçiçek
PURPOSE: The purpose of this methodological study was to assess the validity and reliability of Turkish version of the "Edmonton Frail Scale" (EFS). METHOD: 130 individuals aged 65 and over residing at the Izmir Narlıdere Nursing Home between September 2011 - April 2012 who agreed to participate in the study constituted the sample for the research. Individuals with communication problems (deafness, blindness or language barriers) and problems with manual dexterity were not included in the study...
February 16, 2018: Archives of Gerontology and Geriatrics
Lívia Maria Santiago, Robbert J J Gobbens, Marcel A L M van Assen, Cleber Nascimento Carmo, Daniele Bittencourt Ferreira, Inês Echenique Mattos
PURPOSE: This study aimed to determine the predictive value of the Brazilian Tilburg Frailty Indicator (TFI) for adverse health outcomes (falls, hospitalization, disability and death), in a follow-up period of twelve months. METHODS: This longitudinal study was carried out with a sample of people using primary health care services in Rio de Janeiro, Brazil. At baseline the sample consisted of 963 people aged 60 years and older. A subset of all respondents participated again one year later (n = 640, 66...
February 22, 2018: Archives of Gerontology and Geriatrics
Clara J Bohm, Leroy J Storsley, Brett M Hiebert, Serena Nelko, Navdeep Tangri, Lawrence J Cheskin, Mara A McAdams-DeMarco, Claudio Rigatto
Background: Individuals with chronic kidney disease (CKD) have low levels of physical activity and physical function. Although guidelines endorse exercise counseling for individuals with CKD, it is not yet part of routine care. Objective: We investigated the effect of attending a real-life exercise counseling clinic (ECC) on physical function in individuals with CKD. Design: Retrospective analysis of prospectively collected observational data with quasi-experimental design...
2018: Canadian Journal of Kidney Health and Disease
Yu-Ri Choe, Ju-Youn Joh, Duk Sunwoo, Yeon-Pyo Kim
OBJECTIVES: Although it is well known that nutritional deficiency influences frailty, and both nutritional status and frailty are closely related to mortality and morbidity in older people, there are no studies concerning this interaction. In this study, we evaluated whether the interaction of frailty and nutritional deficiency is additive and/or multiplicative. METHODS: We analyzed data from 8907 individuals (≥65 years old) who took part in the 2008 Survey on Health and Welfare Status of the Elderly in Korea...
February 9, 2018: Archives of Gerontology and Geriatrics
Shang-Jui Wang, Lara Hathout, Usha Malhotra, Nell Maloney-Patel, Sarah Kilic, Elizabeth Poplin, Salma K Jabbour
Rectal cancer predominantly affects patients older than 70 years, with peak incidence at age 80 to 85 years. However, the standard treatment paradigm for rectal cancer oftentimes cannot be feasibly applied to these patients owing to frailty or comorbid conditions. There are currently little information and no treatment guidelines to help direct therapy for patients who are elderly and/or have significant comorbidities, because most are not included or specifically studied in clinical trials. More recently various alternative treatment options have been brought to light that may potentially be utilized in this group of patients...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Thomas Windhaber, Maria Lamprini Koula, Evangelia Ntzani, Alexandra Velivasi, Evangelos Rizos, Michail Theofilos Doumas, Evangelos Elias Pappas, Graziano Onder, Davide Liborio Vetrano, Angel Roudriguez Laso, Leocadio Roudriguez Manjas, Maddalena Illario, Regina Elisabeth Roller-Wirnsberger
BACKGROUND: In addition to the normal process of ageing, frailty, defined as a geriatric syndrome, is becoming more prevalent. Around 10% of people over 65 years and 25-50% of those aged over 85 years are frail. Frail elderly are more vulnerable to external stressors and have an increased risk of adverse health outcomes. To tackle these challenges, European Union (EU) member states need to develop a health work force capable of the right skills mix. A goal-centred education and training of professionals is crucial for effective and efficient health care delivery for Europe's greying population...
February 23, 2018: Aging Clinical and Experimental Research
Dirk Müller-Wieland
Diabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual...
February 2018: Deutsche Medizinische Wochenschrift
F Gilardi, A Capanna, M Ferraro, P Scarcella, M C Marazzi, L Palombi, G Liotta
INTRODUCTION: Frailty screening and assessment are a fundamental issue in Public Health in order to plan prevention programs and services. METHODOLOGY: By a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aims to develop an updated framework for the main procedures and measurement tools to assess frailty in older adults, paying attention to the use in the primary care setting. RESULTS: The study selected 10 reviews published between January 2010 and December 2016 that define some characteristics of the main tools used to measure the frailty...
March 2018: Annali di Igiene: Medicina Preventiva e di Comunità
Amal Nishantha Vadysinghe, Prabath Senasinghe, Murugupillai Sivasubramanium, Pemasiri Jayasooriya, Bhatiya G Premarathna, Rathnayake Mudiyanselage Isuri Saumya D Rathnayake, Wickramasinghe Mudiyanselage Medhani Hasanthika P Wickramasinghe
As people age, they may become more vulnerable to injury because of frailty, ill health, or dependency on others. Data from medicolegal death investigation including autopsy and statements from cases reported to 3 medicolegal units in Sri Lanka were analyzed in this study under the strict ethical framework. Of the study population, 265 were male and 75 were female. Mean age was 71.14 years. Commonest manner of death was accidental (62.1%) followed by suicide (32.1%) and homicide (5.6%). Commonest types of incidents were road traffic accidents (26...
February 15, 2018: American Journal of Forensic Medicine and Pathology
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
A R Hoeksema, L L Peters, G M Raghoebar, H J A Meijer, A Vissink, A Visser
OBJECTIVE: To assess oral health, health, and quality of life (QoL) of care-dependent community-living older people with and without remaining teeth who recently received formal home care. MATERIALS AND METHODS: For this cross-sectional observational study, community-living older people (≥ 65 years), who recently (< 6 months) received formal home care, were interviewed with validated questionnaires and underwent an oral examination. Oral health, general health, medicines usage, frailty (Groningen Frailty Indicator), cognition (Minimal Mental State Examination), QoL (RAND 36), and oral health-related QoL (Oral Health Impact Profile-14) were assessed...
February 15, 2018: Clinical Oral Investigations
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