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Cognitive Frailty

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https://www.readbyqxmd.com/read/29772594/-upper-age-limit-in-outpatient-anesthesia-opportunities-and-risks
#1
Tobias Hüppe, Nicole Kneller, Alexander Raddatz
Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770839/are-multidose-drug-dispensing-systems-initiated-for-the-appropriate-patients
#2
Bram J Mertens, H F Kwint, Rob J van Marum, Marcel L Bouvy
PURPOSE: It is unknown if multidose drug dispensing (MDD) systems are initiated for the appropriate patients. Therefore, the objective of this study was to compare the medication management problems of patients who were about to start with a MDD system (MDD patients) and patients who continued manually dispensed medication (non-MDD users) in order to identify if the appropriate patients receive a MDD system. METHODS: Patient interviews (semi-structured) were conducted by 44 community pharmacists at the patient's home...
May 16, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29765209/using-the-frailty-assessment-for-care-planning-tool-fact-to-screen-elderly-chronic-kidney-disease-patients-for-frailty-the-nurse-experience
#3
Heather Moffatt, Paige Moorhouse, Laurie Mallery, David Landry, Karthik Tennankore
Purpose: Recent evidence supports the prognostic significance of frailty for functional decline and poor health outcomes in patients with chronic kidney disease. Yet, despite the development of clinical tools to screen for frailty, little is known about the experiential impact of screening for frailty in this setting. The Frailty Assessment for Care Planning Tool (FACT) evaluates frailty across 4 domains: mobility, function, social circumstances, and cognition. The purpose of this qualitative study was as follows: 1) explore the nurse experience of screening for frailty using the FACT tool in a specialized outpatient renal clinic; 2) determine how, if at all, provider perceptions of frailty changed after implementation of the frailty screening tool; and 3) determine the perceived factors that influence uptake and administration of the FACT screening tool in a specialized clinical setting...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29764723/frailty-assessment-to-help-predict-patients-at-risk-of-delirium-when-consulting-the-emergency-department
#4
Marianne Giroux, Marie-Josée Sirois, Valérie Boucher, Raoul Daoust, Émilie Gouin, Mathieu Pelletier, Simon Berthelot, Philippe Voyer, Marcel Émond
BACKGROUND: Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium. OBJECTIVES: To assess if screening older patients for frailty in EDs could help identify those at risk of delirium. METHODOLOGY: This study was part of the multicenter prospective cohort INDEED study...
May 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759070/identifying-frailty-in-primary-care-a-qualitative-description-of-family-physicians-gestalt-impressions-of-their-older-adult-patients
#5
Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R Whitehead, Paula A Rochon, Lisa M McCarthy
BACKGROUND: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. METHODS: Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over...
May 14, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29754983/cognitive-impairment-in-intensive-care-unit-patients-a-pilot-mixed-methods-feasibility-study-exploring-incidence-and-experiences-for-recovering-patients
#6
Rosalind Elliott, Elizabeth Yarad, Sarah Webb, Katherine Cheung, Frances Bass, Naomi Hammond, Doug Elliott
BACKGROUND: Despite improvements in survival after critical illness and intensive care unit (ICU) treatment, some recovering patients still face ongoing challenges. There are few investigations exploring the incidence, risk factors, and trajectory for cognitive impairment (CI) in former ICU patients in Australia. OBJECTIVES: To test the feasibility of a study protocol designed to ascertain the incidence and impact of CI during recovery from a critical illness. METHODS: We conducted a mixed-methods longitudinal single-centre pilot study...
May 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29741555/lower-blood-pressure-during-antihypertensive-treatment-is-associated-with-higher-all-cause-mortality-and-accelerated-cognitive-decline-in-the-oldest-old-data-from-the-leiden-85-plus-study
#7
Sven Streit, Rosalinde K E Poortvliet, Jacobijn Gussekloo
Background: the appropriateness of lowering systolic blood pressure remains controversial in the oldest-old. We tested whether systolic blood pressure is associated with all-cause mortality and change in cognitive function for patients prescribed antihypertensive treatment and those without treatment. Methods: we studied participants in the population-based Leiden 85-plus cohort study. Baseline systolic blood pressure and use of antihypertensive treatment were predictors; all-cause mortality and change in cognitive function measured using the Mini-Mental State Examination were the outcomes...
May 8, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29741197/how-to-manage-frail-older-adults-in-the-community-proposal-of-a-health-promotion-program-experienced-in-a-city-of-16-638-inhabitants-in-france
#8
J de Kerimel, N Tavassoli, C Lafont, M Soto, M Pedra, F Nourhashemi, C Lagourdette, L Bouchon, A Chaléon, S Sourdet, Y Rolland, M Cesari, B Vellas
BACKGROUND: Health promotion programs could prevent and delay frailty and functional decline. However, in practice, the planning and establishment of such a program is a challenge for health care providers. We report an experimental model of screening and management for frail elderly conducted in Cugnaux, city of 16,638 inhabitants in France, by the Toulouse Gerontopole and the social care service of the Cugnaux City Hall. METHODS: A frailty screening self-administered questionnaire (FiND questionnaire) was sent to community-dwelling residents of 70 years old and over of Cugnaux...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29724357/arrhythmias-in-patients-%C3%A2-80-years-of-age-pathophysiology-management-and-outcomes
#9
REVIEW
Anne B Curtis, Roshan Karki, Alexander Hattoum, Umesh C Sharma
Advances in medical care have led to an increase in the number of octogenarians and even older patients, forming an important and unique patient subgroup. It is clear that advancing age is an independent risk factor for the development of most arrhythmias, causing substantial morbidity and mortality. Patients ≥80 years of age have significant structural and electrical remodeling of cardiac tissue; accrue competing comorbidities; react differently to drug therapy; and may experience falls, frailty, and cognitive impairment, presenting significant therapeutic challenges...
May 8, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29724356/coronary-artery-disease-in-patients-%C3%A2-80-years-of-age
#10
REVIEW
Mahesh V Madhavan, Bernard J Gersh, Karen P Alexander, Christopher B Granger, Gregg W Stone
Coronary artery disease (CAD) is a major cause of morbidity and mortality in patients ≥80 years of age. Nonetheless, older patients have typically been under-represented in cardiovascular clinical trials. Understanding the pathophysiology, epidemiology, and optimal means of diagnosis and treatment of CAD in older adults is crucial to improving outcomes in this high-risk population. A patient-centered approach, taking into account health status, functional ability and frailty, cognitive skills, and patient preferences is essential when caring for older adults with CAD...
May 8, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29719199/antioxidants-linked-with-physical-cognitive-and-psychological-frailty-analysis-of-candidate-biomarkers-and-markers-derived-from-the-mark-age-study
#11
M Liset Rietman, Annemieke M W Spijkerman, Albert Wong, Harry van Steeg, Alexander Bürkle, María Moreno-Villanueva, Thilo Sindlinger, Claudio Franceschi, Beatrix Grubeck-Loebenstein, Jürgen Bernhardt, P Eline Slagboom, Olivier Toussaint, Florence Debacq-Chainiaux, Ewa Sikora, Efstathios S Gonos, Nicolle Breusing, Wolfgang Stuetz, Daniela Weber, Tilman Grune, Andrea Basso, Francesco Piacenza, Marco Malavolta, Sebastiano Collino, Eugene H J M Jansen, W M Monique Verschuren, Martijn E T Dollé
Frailty among elderly people leads to an increased risk for negative health outcomes. To prevent frailty, we need a better understanding of the underlying mechanisms and early detection of individuals at risk. Both may be served by identifying candidate (bio)markers, i.e. biomarkers and markers, for the physical, cognitive, and psychological frailty domains. We used univariate (Rank-ANOVA) and multivariate (elastic net) approaches on the RASIG study population (age range: 35-74 years, n = 2220) of the MARK-AGE Study to study up to 331 (bio)markers between individuals with and without frailty for each domain...
April 29, 2018: Mechanisms of Ageing and Development
https://www.readbyqxmd.com/read/29717801/prevalence-of-and-factors-associated-with-successful-aging-in-brazilian-older-adults-frailty-in-brazilian-older-people-study-fibra-rj
#12
Ana C Canêdo, Claudia S Lopes, Roberto A Lourenço
AIM: We aimed to estimate the factors associated with the biomedical dimension of successful aging (SA) and its prevalence in older Brazilian individuals. The conceptual framework for this approach relies on the considerable variation in the biophysiological effects of aging and the need to understand the factors that influence this process. METHODS: Data from a total of 845 older adults were analyzed. SA operationalization included the following criteria: good physical and cognitive performance, absence of disabilities, and good health conditions...
May 2, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29712948/g-395a-polymorphism-in-the-promoter-region-of-the-klotho-gene-associates-with-frailty-among-the-oldest-old
#13
Qiukui Hao, Yuting Wang, Xiang Ding, Biao Dong, Ming Yang, Birong Dong, Yuquan Wei
Frailty is characterized by a decline in physiological reserve and increased vulnerability. Previous studies have shown that KLOTHO (KL) plays a protective role in several age-related diseases. We hypothesize a probable protective effect of KL on frailty in the elderly population and included a cohort of Chinese nonagenarians and centenarians for our study. This study is part of a cross-sectional study and secondary analysis of the Project of Longevity and Aging in Dujiangyan (PLAD) study, which was conducted in Southwest China...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29703687/social-frailty-has-a-stronger-impact-on-the-onset-of-depressive-symptoms-than-physical-frailty-or-cognitive-impairment-a-4-year-follow-up-longitudinal-cohort-study
#14
Kota Tsutsumimoto, Takehiko Doi, Hyuma Makizako, Ryo Hotta, Sho Nakakubo, Minji Kim, Satoshi Kurita, Takao Suzuki, Hiroyuki Shimada
OBJECTIVES: To examine the association between each type of frailty status and the incidence rate of depressive symptoms among community-dwelling older adults. DESIGN: Prospective cohort study. SETTING: General communities in Japan. PARTICIPANTS: Participants comprised 3538 older Japanese adults. MEASUREMENTS: We assessed our participants in terms of frailty status (physical frailty, cognitive impairment, and social frailty), depressive symptoms (geriatric depression scale ≥6), and other covariates, and excluded those who showed evidence of depression...
April 24, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29699619/domain-management-approach-to-heart-failure-in-the-geriatric-patient-present-and-future
#15
REVIEW
Eiran Z Gorodeski, Parag Goyal, Scott L Hummel, Ashok Krishnaswami, Sarah J Goodlin, Linda L Hart, Daniel E Forman, Nanette K Wenger, James N Kirkpatrick, Karen P Alexander
Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy...
May 1, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29697758/pathways-contributors-and-correlates-of-functional-limitation-across-specialties-workshop-summary
#16
Stephen B Kritchevsky, Daniel E Forman, Kathryn Callahan, E Wesley Ely, Kevin P High, Frances McFarland, Eliseo J Pérez-Stable, Kenneth Schmader, Stephanie Studenski, John Williams, Susan Zieman, Jack M Guralnik
Traditional clinical care models focus on the measurement and normalization of individual organ systems and de-emphasize aspects of health related to the integration of physiologic systems. Measures of physical, cognitive and sensory, and psychosocial or emotional function predict important health outcomes like death and disability independently from the severity of a specific disease, cumulative co-morbidity, or disease severity measures. A growing number of clinical scientists in several subspecialties are exploring the utility of functional assessment to predict complication risk, indicate stress resistance, inform disease screening approaches and risk factor interpretation, and evaluate care...
April 25, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29691431/biological-insights-into-muscular-strength-genetic-findings-in-the-uk-biobank
#17
Emmi Tikkanen, Stefan Gustafsson, David Amar, Anna Shcherbina, Daryl Waggott, Euan A Ashley, Erik Ingelsson
We performed a large genome-wide association study to discover genetic variation associated with muscular strength, and to evaluate shared genetic aetiology with and causal effects of muscular strength on several health indicators. In our discovery analysis of 223,315 individuals, we identified 101 loci associated with grip strength (P <5 × 10-8 ). Of these, 64 were associated (P < 0.01 and consistent direction) also in the replication dataset (N = 111,610). eQTL analyses highlighted several genes known to play a role in neuro-developmental disorders or brain function, and the results from meta-analysis showed a significant enrichment of gene expression of brain-related transcripts...
April 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29685884/incidence-risk-factors-and-sequelae-of-post-kidney-transplant-delirium
#18
Christine E Haugen, Alexandra Mountford, Fatima Warsame, Rachel Berkowitz, Sunjae Bae, Alvin G Thomas, Charles H Brown, Daniel C Brennan, Karin J Neufeld, Michelle C Carlson, Dorry L Segev, Mara McAdams-DeMarco
Background Frail kidney transplant (KT) recipients may be particularly vulnerable to surgical stressors, resulting in delirium and subsequent adverse outcomes. We sought to identify the incidence, risk factors, and sequelae of post-KT delirium. Methods We studied 125,304 adult KT recipients (1999-2014) to estimate delirium incidence in national registry claims. Additionally, we used a validated chart abstraction algorithm to identify post-KT delirium in 893 adult recipients (2009-2017) from a cohort study of frailty...
April 23, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29684237/frailty-phenotype-and-healthcare-costs-and-utilization-in-older-women
#19
Kristine E Ensrud, Allyson M Kats, John T Schousboe, Brent C Taylor, Peggy M Cawthon, Teresa A Hillier, Kristine Yaffe, Steve R Cummings, Jane A Cauley, Lisa Langsetmo
OBJECTIVES: To determine the association of the frailty phenotype with subsequent healthcare costs and utilization. DESIGN: Prospective cohort study (Study of Osteoporotic Fractures (SOF)). SETTING: Four U.S. sites. PARTICIPANTS: Community-dwelling women (mean age 80.2) participating in SOF Year 10 (Y10) examination linked with their Medicare claims data (N=2,150). MEASUREMENTS: At Y10, frailty phenotype defined using criteria similar to those used in the Cardiovascular Health Study frailty phenotype and categorized as robust, intermediate stage, or frail...
April 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29684114/exploring-genetic-outcomes-as-frailty-biomarkers
#20
Vanessa Valdiglesias, María Sánchez-Flores, Diego Marcos-Pérez, Laura Lorenzo-López, Ana Maseda, José C Millán-Calenti, Eduardo Pásaro, Blanca Laffon
Frailty has emerged as a reliable measure of the aging process. Since the early detection of frailty is crucial to prevent or even revert it, the use of biomarkers would allow an earlier and more objective identification of frail individuals. In order to improve the understanding of the biological features associated with frailty as well as to explore different biomarkers for its early identification, several genetic outcomes - mutagenicity, different types of genetic damage, and cellular repair capacity - were analysed in a population of older adults classified into frail, pre-frail and non-frail...
April 19, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
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