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Geriatrics unit

Nicholas K Schiltz, David F Warner, Jiayang Sun, Paul M Bakaki, Avi Dor, Charles W Given, Kurt C Stange, Siran M Koroukian
BACKGROUND: Multimorbidity affects the majority of elderly adults and is associated with higher health costs and utilization, but how specific patterns of morbidity influence resource use is less understood. OBJECTIVE: The objective was to identify specific combinations of chronic conditions, functional limitations, and geriatric syndromes associated with direct medical costs and inpatient utilization. DESIGN: Retrospective cohort study using the Health and Retirement Study (2008-2010) linked to Medicare claims...
October 6, 2016: Medical Care
Ipsit V Vahia, Rujvi Kamat, Cheng Vang, Carolina Posada, Lisa Ross, Sarah Oreck, Alok Bhatt, Colin Depp, Dilip V Jeste, Daniel D Sewell
OBJECTIVE: To investigate the feasibility, safety, and utility of tablet devices as novel nonpharmacologic tools in managing older psychiatric inpatients with agitation and dementia. METHODS: Thirty-six patients at a geriatric psychiatry inpatient unit were provided with tablets when agitated and used various apps on the tablet related to communication, games, music, web browser, and photography during their stay. Study staff documented the frequency, duration, and app usage history and rated the extent to which agitation improved after tablet use...
August 4, 2016: American Journal of Geriatric Psychiatry
Dilip V Jeste, Dan G Blazer, Kathleen C Buckwalter, Keri-Leigh K Cassidy, Len Fishman, Lisa P Gwyther, Saul M Levin, Christopher Phillipson, Ramesh R Rao, Ellen Schmeding, William A Vega, Julie A Avanzino, Danielle K Glorioso, John Feather
Older adults consistently prefer aging in place, which requires a high level of community support and services that are currently lacking. With a rapidly aging population, the present infrastructure for healthcare will prove even more inadequate to meet seniors' physical and mental health needs. A paradigm shift away from the sole focus on delivery of interventions at an individual level to more prevention-focused, community-based approaches will become essential. Recent initiatives have been proposed to promote healthy lifestyles and preventive care to enable older adults to age in place...
July 28, 2016: American Journal of Geriatric Psychiatry
Lukshe Kanagaratnam, Moustapha Dramé, Jean-Luc Novella, Thierry Trenque, Clarisse Joachim, Pierre Nazeyrollas, Damien Jolly, Rachid Mahmoudi
OBJECTIVE: To identify risk factors for the occurrence of adverse drug reactions (ADRs) based on geriatric evaluation. DESIGN: Longitudinal prospective study from May 2010 to November 2011. SETTING: Dedicated acute geriatric care unit specializing in the management of patients with dementia syndrome (Alzheimer disease or related syndromes) at the University Hospital of Reims, France. PARTICIPANTS: Older patients with dementia syndrome (Alzheimer disease or related syndromes)...
September 1, 2016: American Journal of Geriatric Psychiatry
V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
: The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
Kilian Rapp, Johannes Ravindren, Clemens Becker, Ulrich Lindemann, Andrea Jaensch, Jochen Klenk
BACKGROUND: There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. METHODS: This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014...
October 7, 2016: BMC Geriatrics
Sara Modig, Cecilia Lenander, Nina Viberg, Patrik Midlöv
BACKGROUND: There is an urgent need to improve patient safety in the area of medication treatment among the elderly. The aim of this study was to explore which improvement needs and strengths, relating to medication safety, arise from a multi-professional intervention in primary care and further to describe and follow up on the agreements for change that were established within the intervention. METHODS: The SÄKLÄK project was a multi-professional intervention in primary care consisting of self-assessment, peer-review, feedback and written agreements for change...
October 4, 2016: BMC Family Practice
L Cortejoso, R A Dietz, G Hofmann, M Gosch, A Sattler
BACKGROUND: Inappropriate pharmacotherapy among older adults remains a critical issue in our health care systems. Besides polypharmacy and multiple comorbidities, the age-related pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug reactions and medication errors. OBJECTIVE: The main target of this study was to describe the characteristics of pharmaceutical interventions in two geriatric wards (orthogeriatric ward and geriatric day unit) of a general teaching hospital and to evaluate the clinical significance of the detected medication errors...
2016: Clinical Interventions in Aging
Daniel Sevilla-Sanchez, Núria Molist-Brunet, Jordi Amblàs-Novellas, Pere Roura-Poch, Joan Espaulella-Panicot, Carles Codina-Jané
PURPOSE: Adverse drug events (ADEs) lead to adverse clinical outcomes such as hospitalization. There is little information about the characteristics of ADEs in patients with advanced chronic conditions and have a prognosis of limited life expectancy. This study aimed to evaluate (i) the prevalence of ADEs at the time of admission to hospital, (ii) the causality, severity, and preventability of the ADEs, and (iii) the clinical and pharmacological characteristics associated with the ADEs...
October 4, 2016: European Journal of Clinical Pharmacology
Claire Schonheit, Hélène Le Petitcorps, Éric Pautas
: Proton pump inhibitors (PPI) are widely prescribed, particularly in elderly patients, and their side effects are underestimated. Recommendations of the french health authorities, some specific to the elderly, specify their indications. The main objective of this descriptive and prospective study was to assess in elderly patients the adequacy of PPI prescriptions to these recommendations and to the marketing authorization. METHODS: Analysis of all patients hospitalized in an acute geriatric unit over a period of 2 years for which the drug prescription on admission included a PPI...
September 29, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
J Keshav Kumar, Akila Sadasivan
OBJECTIVE: This is an invited paper for a special issue with the objective to provide information on neuropsychology in India. METHOD: Information was gathered from a literature search and personal communication with professionals working in the field of neuropsychology. RESULTS: Neuropsychology as a specialization started in India approximately 40 years ago. The early years witnessed the use of Western tools for assessing patients with organic brain damage...
November 2016: Clinical Neuropsychologist
Dorien De Meyer, Nele Van Damme, Karen Van den Bussche, Ann Van Hecke, Sofie Verhaeghe, Dimitri Beeckman
AIM: The aims of this trial were as follows: (1) to compare the (cost-) effectiveness of a turning and repositioning system and an algorithm for a tailored repositioning vs. usual care to improve reposition frequency in patients at risk; and (2) to compare the (cost-) effectiveness of standardized incontinence care vs. usual care. BACKGROUND: Pressure ulcers are a serious and common problem for hospitalized patients. In many countries, pressure ulcers are recognized as a national health issue and governments designate pressure ulcers as one of the most important sentinel events for health care...
September 28, 2016: Journal of Advanced Nursing
Annemarie de Vos, Jane-Murray Cramm, Jeroen D H van Wijngaarden, Ton J E M Bakker, Johan P Mackenbach, Anna P Nieboer
BACKGROUND: The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital-related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2-0.6]), lower depression (Geriatric Depression Scale 15; -0...
September 29, 2016: International Journal of Health Planning and Management
Chieh Grace Lau, Wai Kwong Tang, Xiang Xin Liu, Hua Jun Liang, Yan Liang, Vincent Mok, Adrian Wong, Gabor S Ungvari, Mansur A Kutlubaev, Ka Sing Wong
OBJECTIVE: To examine the relationship between neuroticism and fatigue in Chinese stroke patients. DESIGN: Cross-sectional. SETTING: PARTICIPANTS: One hundred and ninety-one ischemic stroke survivors recruited from the above-mentioned acute stroke unit between May 2010 and September 2011. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The personality trait of neuroticism was measured with the neuroticism subscale of the Chinese version of the NEO-five-factor Inventory (NEO-FFI)...
September 24, 2016: Archives of Physical Medicine and Rehabilitation
Jean-Pascal Devailly, Laurence Josse
OBJECTIVE: In all countries, the boundaries are ambiguous between acute and post-acute as well as defining the dimensions of care. The aim of this study is to analyze relations between segmentation of care and payment systems. In the new prospective payment system implemented in French SSR, the grouping unit is inpatient stay and the week for day hospitalization. In 1991, the field of SSR mixed structures as diverse in their purposes as public or private hospital units of rehabilitation and "nursing homes"...
September 2016: Annals of Physical and Rehabilitation Medicine
Michael W Rich, Deborah A Chyun, Adam H Skolnick, Karen P Alexander, Daniel E Forman, Dalane W Kitzman, Mathew S Maurer, James B McClurken, Barbara M Resnick, Win K Shen, David L Tirschwell
The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease (CVD) is the leading cause of death and major disability in adults aged 75 and older. Despite the effect of CVD on quality of life, morbidity, and mortality in older adults, individuals aged 75 and older have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older adults with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in nursing homes and assisted living facilities...
September 27, 2016: Journal of the American Geriatrics Society
Elizabeth A Phelan, Sally Aerts, David Dowler, Elizabeth Eckstrom, Colleen M Casey
A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions...
2016: Frontiers in Public Health
Bulent Yardimci, Sinan N Aran, Ismail Ozkaya, Sevki M Aksoy, Tarik Demir, Gulsen Tezcan, Aysegul Y Kaptanoglu
OBJECTIVES: To determine the relation among the risk of falls, geriatric assessment, and anthropometric measurements, including the mini mental state examination, geriatric depression scale, handgrip test, and key pinch test. METHODS: This prospective study included 89 residents hospitalized between May 2014 and September 2015 in the geriatric care unit of the Istanbul Balikli Rum Hospital, Istanbul, Turkey. Patients were followed-up for one year, and their falls were recorded...
October 2016: Saudi Medical Journal
Dolores Sánchez-Rodríguez, Ester Marco, Natalia Ronquillo-Moreno, Ramón Miralles, Olga Vázquez-Ibar, Ferran Escalada, Josep M Muniesa
BACKGROUNDS & AIMS: The European Society of Clinical Nutrition and Metabolism (ESPEN) consensus definition of malnutrition has been applied in hospitalized older diabetics and middle-aged patients, geriatric outpatients, and healthy elderly and young individuals. In a post-acute care setting, our aim was to assess malnutrition (ESPEN definition) and determine its relationship with sarcopenia in older in-patients deconditioned due to an acute process. METHODS: Eighty-eight in-patients aged ≥70 years with body mass index (BMI) <30 kg/m(2) were included (84...
September 9, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Tahar Chouihed, Stéphane Manzo-Silberman, Nicolas Peschanski, Sandrine Charpentier, Meyer Elbaz, Dominique Savary, Eric Bonnefoy-Cudraz, Said Laribi, Patrick Henry, Nicolas Girerd, Faiez Zannad, Carlos El Khoury
BACKGROUND: An appropriate diagnostic process is crucial for managing patients with acute heart failure (AHF) in emergency department (ED). Our study aims to describe the characteristics and therapeutic management of patients admitted to the ED for dyspnea suspected to have AHF, their in-hospital pathway of care and their in-hospital outcome. METHODS: Consecutive patients admitted in 26 French ED for dyspnea suspected to be the consequence of AHF, prior to in hospital diagnostic test, were prospectively included at the time of their admission in the DeFSSICA Survey...
September 17, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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