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Frailty in the elderly

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https://www.readbyqxmd.com/read/28917516/impact-of-frailty-on-outcomes-in-patients%C3%A2-undergoing-percutaneous-mitral%C3%A2-valve-repair
#1
Clemens Metze, Anna-Sophie Matzik, Maximilian Scherner, Maria Isabel Körber, Guido Michels, Stephan Baldus, Volker Rudolph, Roman Pfister
OBJECTIVES: The aim of this study was to describe the impact of frailty in patients undergoing percutaneous mitral valve repair (PMVR). BACKGROUND: Frailty is common in elderly patients and those with comorbidities and is associated with adverse prognosis. METHODS: Frailty according to the Fried criteria was assessed in consecutive patients admitted for PMVR. Associations of frailty with 6-week (device success, changes in 6-minute walking distance and Minnesota Living With Heart Failure Questionnaire and Short Form 36 physical and mental component scores, and improvement ≥1 New York Heart Association functional class) and long-term outcomes during a median follow-up period of 429 days were examined...
September 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28916601/gait-speed-can-predict-advanced-clinical-outcomes-in-patients-who-undergo-transcatheter-aortic-valve-replacement-insights-from-a-japanese-multicenter-registry
#2
Seiji Kano, Masanori Yamamoto, Tetsuro Shimura, Ai Kagase, Masanao Tsuzuki, Atsuko Kodama, Yutaka Koyama, Toshihiro Kobayashi, Kenichi Shibata, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Akihiro Higashimori, Toshiaki Otsuka, Yusuke Watanabe, Kentaro Hayashida
BACKGROUND: Gait speed reflects an important factor of frailty and is associated with an increased risk of late mortality in patients with cardiac disease. This study sought to assess the prognostic value of gait speed in elderly patients who underwent transcatheter aortic valve replacement. METHODS AND RESULTS: We investigated the 5-m or 15-feet gait speed (m/sec) in 1256 patients who underwent transcatheter aortic valve implantation using data from the OCEAN-TAVI Japanese multicenter registry (Optimized Catheter Valvular Intervention-Transcatheter Aortic Valve Implantation)...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28906482/real-life-experience-with-bortezomib-based-regimens-in-elderly-comorbid-patients-with-newly-diagnosed-multiple-myeloma-polish-retrospective-multicenter-analysis
#3
Iwona Hus, Adam Walter-Croneck, Anna Masternak, Artur Jurczyszyn, Lidia Usnarska-Zubkiewicz, Łukasz Bołkun, Agnieszka Druzd-Sitek, Marcin Rymko, Jadwiga Łętowska, Ewa Lech-Marańda, Marcin Pasiarski, Anna Dmoszyńska
INTRODUCTION    Bortezomib was the first proteasome inhibitor approved in multiple myeloma therapy, initially for resistant/relapsed disease. Currently, VMP (bortezomib, melphalan, prednisone) is one of standard regimens recommended in a first line therapy for patients with multiple myeloma ineligible for high-dose chemotherapy/ autotransplantation (HDT/autoSCT) basing on the results of phase 3 clinical trial by Miguel et al that demonstrated its superiority to MP protocol.  OBJECTIVES    Patients participating in clinical trials are highly selected populations, so observations from clinical practice might provide important information for medical practitioners...
September 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28894183/gut-microbiota-composition-is-associated-with-polypharmacy-in-elderly-hospitalized-patients
#4
Andrea Ticinesi, Christian Milani, Fulvio Lauretani, Antonio Nouvenne, Leonardo Mancabelli, Gabriele Andrea Lugli, Francesca Turroni, Sabrina Duranti, Marta Mangifesta, Alice Viappiani, Chiara Ferrario, Marcello Maggio, Marco Ventura, Tiziana Meschi
Reduced biodiversity and increased representation of opportunistic pathogens are typical features of gut microbiota composition in aging. Few studies have investigated their correlation with polypharmacy, multimorbidity and frailty. To assess it, we analyzed the fecal microbiota from 76 inpatients, aged 83 ± 8. Microbiome biodiversity (Chao1 index) and relative abundance of individual bacterial taxa were determined by next-generation 16S rRNA microbial profiling. Their correlation with number of drugs, and indexes of multimorbidity and frailty were verified using multivariate linear regression models...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28894077/-experience-of-frailty-in-korean-elderly-a-phenomenological-study-utilizing-the-colaizzi-method
#5
Jin Kyoung Park
PURPOSE: This study attempts to explore the subjective experience of frailty among elderly individuals in Korea. METHODS: From June to August in 2014, 11 elderly persons who had experienced frailty in a community were interviewed. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. RESULTS: According to the analysis, the study participants' frailty process was structured in seven categories: (a) 'natural phenomenon with ageing,' (b) 'life force comes to an end,' (c) 'the light in my heart turns off,' (d) 'unavoidable situation,' (e) 'continuous and connected vicious cycle,' (f) 'the limit of recovery energy already passes,' and (g) 'life is supported by someones help...
August 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28892805/an-evaluation-of-the-central-nervous-system-medication-use-and-frailty-among-residents-of-aged-care-homes-in-malaysia
#6
Syed Shahzad Hasan, Chia Siang Kow, Kaeshaelya Thiruchelvam, David Weng Kwai Chong, Syed Imran Ahmed
BACKGROUND/AIMS: Old age and institutionalization in care homes are associated with increased use of risk medications affecting the central nervous system (CNS). This study evaluated medication utilization and appropriateness; and assessed frailty among residents of Malaysian aged care homes. METHODS: The subjects of this study included 202 elderly (≥65 years) residents of 17 aged care homes in suburban peninsular Malaysia. Frailty was measured using the Groningen Frailty Indicator (GFI) score and independence in daily living was measured as KATZ activity of daily living score...
September 12, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28884787/ultrasonic-echo-intensity-as-a-new-noninvasive-in-vivo-biomarker-of-frailty
#7
Rebeca Mirón Mombiela, Fernando Facal de Castro, Pilar Moreno, Consuelo Borras
OBJECTIVES: To investigate whether muscle quality based on echo intensity (EI) is associated with muscle strength (MS) and correlates with risk of frailty in elderly outpatients. DESIGN: Cross-sectional, experimental study. SETTING: Outpatient clinic. PARTICIPANTS: Individuals aged 20 to 90 (N = 112). Individuals aged 20 to 59 participated as controls. Those aged 60 and older participated in the experimental group and were subdivided into robust, prefrail, and frail according to the Fried frailty criteria...
September 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28872036/decision-making-for-gastrostomy-after-70-years-old-a-prospective-study-about-26-patients
#8
Angéline Mey, Amandine Devun, Marc Roussier, Régis Gonthier, Thomas Celarier
Management of undernutrition is based on young adults analysis. However, enteral nutrition is mainly discussed in the elderly. The aim of this study was to analyse factors related to laying gastrostomy, in geriatrics. A prospective, descriptive study, was conducted in the Loire department, from 2014 to 2016, in geriatric and palliative units. All patients over 70 years who had a theorical indication of gastrostomy were included. Decision-making process was analyzed from data affecting the reflection. Patients were followed for three months...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28869885/development-and-validation-of-a-prognostic-index-for-6-and-12-month-mortality-in-hospitalized-older-adults
#9
Eva Gallego González, Francisco Javier Ortiz Alonso, Maria Teresa Vidán Astiz, Selene Soria Felix, Verónica García Cárdenas, John Omonte Guzmán, Pedro Abizanda, Maria Isabel Valadés Malagón, Silvia Oreja Sevilla, José Antonio Serra Rexach
BACKGROUND/AIM: Estimation of mortality in elderly patients is difficult yet very important when planning care. Previous tools are complicated or do no take into account some major determinants of mortality (i.e., frailty). We designed a simple, accurate, and non-disease-specific tool to predict individual mortality risk after hospital discharge in older adults. METHODS: Patients admitted to the Acute Geriatric Unit were assessed at adission and at discharge and contacted 6 and 12 months later...
July 23, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28869034/plasticity-and-function-of-human-skeletal-muscle-in-relation-to-disuse-and-rehabilitation-influence-of-ageing-and-surgery
#10
Charlotte Suetta
In order to study the influence of disuse and aging on skeletal muscle homeostasis, different human models were employed. Effects of chronic disuse were investigated in elderly patients suffering from uni-lateral hip-osteoarthritis, whereas the effect of short-term disuse (4 and 14 days of unilateral lower limb immobilisation) was assessed in healthy young and old individuals. In summary, chronic muscle disuse in the elderly was associated with marked quantitative as well as qualitative neuromuscular impairments...
August 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28868074/update-on-pharmacological-treatment-of-acute-coronary-syndrome-without-persistent-st-segment-elevation-myocardial-infarction-in-the-elderly
#11
REVIEW
Coşkun Usta, Aslı Bedel
The increase in cardiovascular disease prevalence with ageing has been attributed to several age-related changes such as changes in the vascular wall elasticity, the coagulation and haemostatic system and endothelial dysfunction, among other causes. There is a 50% increased mortality risk per 10-year increase in age starting at 65 years old. Here, we aimed to discuss pharmacological treatment in acute coronary syndrome (ACS) without persistent ST segment elevation myocardial infarction in the elderly. The main aim of ACS treatment in elderly people is at preventing ischemia, myocardial damage and complications...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28868073/antithrombotic-treatment-tailoring-and-risk-score-evaluation-in-elderly-patients-diagnosed-with-an-acute-coronary-syndrome
#12
REVIEW
Alexandru Nicolae Mischie, Catalina Liliana Andrei, Crina Sinescu, Gani Bajraktari, Eugen Ivan, Georgios Nikolaos Chatziathanasiou, Michele Schiariti
Age is an important prognostic factor in the outcome of acute coronary syndromes (ACS). A substantial percentage of patients who experience ACS is more than 75 years old, and they represent the fastest-growing segment of the population treated in this setting. These patients present different patterns of responses to pharmacotherapy, namely, a higher ischemic and bleeding risk than do patients under 75 years of age. Our aim was to identify whether the currently available ACS ischemic and bleeding risk scores, which has been validated for the general population, may also apply to the elderly population...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28860729/aging-and-extrapulmonary-effects-of-chronic-obstructive-pulmonary-disease
#13
Emanuela Tudorache, Ariadna Petronela Fildan, Mirela Frandes, Elena Dantes, Doina Ecaterina Tofolean
INTRODUCTION: People with COPD have a decline in functional status, but little is known about the rate of decline and factors that contribute. Of particular concern is the decline in cognitive and functional performance. Decrease in cognitive and functional performance will finally lead to decreased health status, sedentary life style and premature frailty. AIM: The aim of this study is to compare functional performance and cognitive status in patients with COPD of different ages and to examine the changes in extrapulmonary effects...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28860423/prevalence-of-sarcopenia-in-a-population-of-nursing-home-residents-according-to-their-frailty-status-results-of-the-senior-cohort
#14
F Buckinx, J Y Reginster, T Brunois, C Lenaerts, C Beaudart, J L Croisier, J Petermans, O Bruyère
OBJECTIVE: To investigate the relationship between frailty and sarcopenia, by evaluating the prevalence of sarcopenia among frail, pre-frail and robust elderly nursing home residents in Belgium. METHODS: This is an analysis of baseline data collected from the SENIOR (Sample of Elderly Nursing home Individuals: an Observational Research) cohort. All subjects received a sarcopenia evaluation, based on the definition proposed by the European Working Group on Sarcopenia in Older People (EWGSOP)...
September 1, 2017: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/28858118/an-evaluation-of-medication-appropriateness-and-frailty-among-residents-of-aged-care-homes-in-malaysia-a-cross-sectional-study
#15
Syed Shahzad Hasan, Chia Siang Kow, Rohit Kumar Verma, Syed Imran Ahmed, Piyush Mittal, David W K Chong
Aging is significantly associated with the development of comorbid chronic conditions. These conditions indicate the use of multiple medications, and are often warranted by clinical guidelines. The aim of the present study was to evaluate medication appropriateness and frailty among Malaysian aged care home residents with chronic disease. The participants were 202 elderly (≥65 years) individuals, a cross-sectional sample from 17 aged care homes. After ethics approval, each participant was interviewed to collect data on sociodemographics, frailty status (Groningen Frailty Indicator [GFI]), medication appropriateness (Medication Appropriateness Index (MAI), the 2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP])...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28857797/a-comparison-of-3-frailty-indices-in-predicting-morbidity-and-mortality-after-on-pump-aortic-valve-replacement
#16
Gary Esses, Evie Andreopoulos, Hung-Mo Lin, Shipra Arya, Stacie Deiner
BACKGROUND: Aortic valve replacement is a high-risk surgery (3%-5%, 30-day mortality) performed on approximately 30,000 elderly patients a year in the United States. Currently, preoperative risk assessment is based on a composite of medical examination and a subjective evaluation for frailty ("eyeball test"). Objective frailty assessment using validated indices has the potential to improve risk stratification. The purpose of this study was to (1) establish whether frailty can predict 30-day mortality and composite morbidity in patients undergoing aortic valve replacement and (2) compare the predictive ability of 3 frailty indices in this population...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28855112/diseases-and-or-in-frailty-an-important-conceptual-difference
#17
Miguel Germán Borda, Daniela Patino-Hernandez
Frailty is a clinical state that increases an individual's vulnerability. It is an outcome marker in several medical scenarios. However, there is a lack of recognition in the medical field. Frailty should not be regarded as a condition superimposed to disease. Contrarily, it should be noticed as a state frequently found either as a component of diseases themselves or as their outcome. The work of a geriatrician is focused on the best possible approximation to the medical and psychosocial issues that an elder has, and must join the treatment team when the person has a considerable number of conditions that makes him/her frail...
August 30, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28843526/validation-of-the-korean-version-of-the-sarc-f-questionnaire-to-assess-sarcopenia-korean-frailty-and-aging-cohort-study
#18
Sunyoung Kim, Miji Kim, Chang Won Won
OBJECTIVES: The SARC-F is a simple sarcopenia screening tool comprising 5 assessment items: strength, assistance walking, rising from a chair, climbing stairs, and falls. The present study aimed to examine the validation of the Korean version of SARC-F for elderly individuals residing in communities. SETTING AND PARTICIPANTS: From the first year baseline data of Korean Frailty and Aging Cohort Study, a total of 1222 elderly individuals (70 years and older) who met the study's selection criteria were included in the analysis...
August 23, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28838148/serum-c-reactive-protein-and-congestive-heart-failure-as-significant-predictors-of-herpes-zoster-vaccine-response-in-elderly-nursing-home-residents
#19
Chris P Verschoor, Alina Lelic, Robin Parsons, Carole Evelegh, Jonathan L Bramson, Jennie Johnstone, Mark B Loeb, Dawn M E Bowdish
Background: Elderly long-term care residents often exhibit a myriad of risk factors for immune dysfunction, including chronic inflammation and multiple comorbid conditions, which undoubtedly contribute to their enhanced susceptibility to infection. Hence, understanding the factors required for optimal vaccine responsiveness is critical. Methods: We examined 187 elderly nursing home residents (aged 80-102 years) and 50 community-dwelling seniors (aged 60-75 years) immunized with the live-attenuated varicella-zoster virus (VZV) vaccine...
July 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28837277/-dpp-4-or-sglt2-inhibitor-added-to-metformin-alone-in-type-2-diabetes
#20
Nicolas Paquot, André J Scheen
After failure of a monotherapy with metformin, dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporters type 2 (gliflozins) offer an alternative to the add-on of a sulphonylurea, especially in diabetic patients at risk of hypoglycaemia. The choice between a gliptin and a gliflozin may be guided by the individual patient characteristics : rather a gliptin in a patient without obesity or severe hyperglycaemia, in an elderly patient, with a frailty profile or with renal impairment; rather a gliflozin in an obese patient, with hypertension, hyperuricaemia, antecedents of cardiovascular disease (especially heart failure), without advanced renal insufficiency and with a low risk of urinary/genital infections or events linked to dehydration such as hypotension...
August 23, 2017: Revue Médicale Suisse
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