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Cognitive Frailty

Magnolia Cardona-Morrell, Amanda Chapman, Robin M Turner, Ebony Lewis, Blanca Gallego-Luxan, Michael Parr, Ken Hillman
AIM: To investigate associations between clinical parameters - beyond the evident physiological deterioration and limitations of medical treatment - with in-hospital death for patients receiving Rapid Response System (RRS) attendances. METHODS: Retrospective case-control analysis of clinical parameters for 328 patients aged 60 years and above at their last RRS call during admission to a single teaching hospital in the 2012-2013 calendar years. Generalised estimating equation modelling was used to compare the deceased with a randomly selected sample of those who had RRS calls and survived admission (controls), matched by age group, sex, and hospital ward...
October 18, 2016: Resuscitation
Suhitha Veeravelli, Bijan Najafi, Ivan Marin, Fernando Blumenkron, Shannon Smith, Stephen A Klotz
Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is aging. HIV-positive individuals have a high incidence of frailty (~20%) characterized by depression and sedentary behavior. Exercise would be healthy, but due to the frail status of many HIV-positive individuals, conventional exercise is too taxing. The aim of this study was to evaluate the effectiveness and acceptability of a novel game-based training program (exergame) in ameliorating some aspects of frailty in HIV-infected individuals...
October 6, 2016: Journal of Visualized Experiments: JoVE
Anna Lloyd, Marilyn Kendall, John M Starr, Scott A Murray
BACKGROUND: The experiences of people with cancer and organ disease have been described across different dimensions of need as they approach death. Such information is lacking for frail older people approaching death, but could highlight how a palliative approach might be relevant for this population. METHODS: Cognitively intact, community dwelling adults considered to be moderately or severely frail were recruited from a medical day hospital. Those recruited nominated an informal carer and case-linked professional...
October 20, 2016: BMC Geriatrics
Bao-Lin Li, Wei Li, Jia-Qi Bi, Qing-Gang Meng, Jian-Feng Fei
OBJECTIVES: To identify frail and pre-frail patients in a group of patients older than 60 years. METHODS: The phenotype model of Fried's method was used to identify frailty and pre-frailty in total of 78 participants. Cognitive ability and psychosocial function tests were also given to 59 of the 78 patients. RESULTS: Prevalence of frailty and pre-frailty was 14.1% (11/78) and 46.2% (36/78), respectively. Of the 5 phenotype variables, weak grip strength was the most commonly seen variable with 53...
October 20, 2016: Physician and Sportsmedicine
Katsuhiko Kohara
The effectiveness of antihypertensive treatment in elderly hypertensive patients has been established through numerous randomized clinical trials including the Hypertension in the Very Elderly Trial (HYVET). However, because of the diversity of biological aging among individuals, chronological age is not the sole determinant for the target blood pressure (BP) level at which antihypertensive medications are aimed. Several conditions, especially frailty, needed be evaluated in managing hypertension among elderly people...
September 2016: Journal of Hypertension
Ligia J Dominguez, Mario Barbagallo
PURPOSE OF REVIEW: Physical and cognitive frailty are interrelated and synergistic syndromes more frequently seen in old age, which represent intermediate stages between aging successfully and disability. Poor nutrition is a fundamental determinant for both conditions, while various dietary components are proposed to prevent and/or improve them. This updated review discusses the possible influence of nutritional factors on cognitive frailty and its potential mediators. RECENT FINDINGS: Oxidative stress, low-grade systemic inflammation, neuroinflammation, and altered autophagy, all associated with obesity, metabolic syndrome and insulin resistance, are proposed mechanisms to explain the influence of nutrition on cognitive health...
September 28, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Oliver Mauthner, Veerle Claes, Jeremy Walston, Sandra Engberg, Isabelle Binet, Michael Dickenmann, Déla Golshayan, Karine Hadaya, Uyen Huynh-Do, Stefano Calciolari, Sabina De Geest
AIM: To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. BACKGROUND: For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision-making and medical management...
October 12, 2016: Journal of Advanced Nursing
Kalpana J Kallianpur, Marissa Sakoda, Louie Mar A Gangcuangco, Lishomwa C Ndhlovu, Tracie Umaki, Dominic Chow, Suwarat Wongjittraporn, Cecilia M Shikuma
BACKGROUND: Chronic HIV disease is associated with neurocognitive impairment and age-related conditions such as frailty. OBJECTIVE: To determine whether regional brain volumetric changes correlate with frailty parameters in older (≥ 40 years) HIV+ patients on stable combination antiretroviral therapy. METHOD: Thirty-five HIV-infected participants in the Hawaii Aging with HIV Cohort - Cardiovascular Disease study underwent T1-weighted brain magnetic resonance imaging, frailty assessment and neuropsychological testing...
2016: Open Medicine Journal
V Soler, S Sourdet, L Balardy, G Abellan van Kan, D Brechemier, M E Rougé-Bugat, N Tavassoli, M Cassagne, F Malecaze, F Nourhashémi, B Vellas
OBJECTIVES: To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. DESIGN: Retrospective, observational cross-sectional, single-centre study. SETTING: Institutional practice. PARTICIPANTS: Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648)...
2016: Journal of Nutrition, Health & Aging
Champa Ranasinghe, Aisling Fleury, Nancye M Peel, Ruth E Hubbard
BACKGROUND: A consequence of pressure on hospitals to accommodate care needs of older patients is "boarding" or out-lying from their home ward. This may have greater adverse effects on older inpatients who are frail. METHODS: A retrospective matched cohort study was conducted in an outer metropolitan general hospital. Randomly selected patients hospitalized between July 2012 and June 2013 under the care of an Older Person Evaluation Review and Assessment (OPERA) team (n = 300) were age and sex matched with patients under the care of general physicians (n = 300)...
October 3, 2016: International Psychogeriatrics
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
DaeHyun Kim, Hidenori Arai, SungHi Kim
AIM: Social activity seems to be important for the prevention of cognitive impairment and frailty. The objective of the present study was to investigate whether social activities are associated with the development of cognitive impairment in Korean older people. METHODS: We analyzed data from the Korean National Longitudinal Study on Aging. A total of 2495 Korean community-dwelling older adults (1163 men and 1332 women) aged between 65 and 79 years at the first wave of the Korean National Longitudinal Study on Aging were used for analysis...
September 26, 2016: Geriatrics & Gerontology International
Marion Baillet, Bixente Dilharreguy, Karine Pérès, Jean-François Dartigues, Willy Mayo, Gwenaëlle Catheline
OBJECTIVE: Although aging is associated with alterations of both activity/rest cycle and brain structure, few studies have evaluated associations between these processes. The aim of this study was to examine relationship between activity/rest cycle quality and brain structural integrity in aging subjects by exploring both grey and white matter compartments. MATERIAL AND METHODS: Fifty-eight elderly subjects (76±0.5 years; 41% female) without dementia, sleep disorders and medications were included in the analysis...
September 21, 2016: NeuroImage
Chih-Jen Wang, Cheng-Hao Hung, Ting-Ching Tang, Liang-Yu Chen, Li-Ning Peng, Fei-Yuan Hsiao, Liang-Kung Chen
AIMS: To evaluate the prevalence of urinary incontinence (UI) and its association with frailty among men aged 80 years and older in Taiwan METHODS: Residents living in four veterans retirement communities were invited for study and 440 men aged 80 years and older weer enrolled. Comprehensive geriatric assessment was performed for them, including using the following measurements: Clinical Frailty Scale, Northern Health and Social Care Trust (HSC)-Continence Assessment Form, Charlson's Comorbidity Index (CCI), Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale-5 (GDS-5), Mini-Nutritional Assessment-Short Form (MNA-SF)...
September 21, 2016: Rejuvenation Research
Bertrand Fougère, Stéphane Oustric, Julien Delrieu, Bruno Chicoulaa, Emile Escourrou, Yves Rolland, Fati Nourhashémi, Bruno Vellas
BACKGROUND: Aging can be affected by frailty and chronic diseases causing physical, cognitive, sensory, and functional decline evolving gradually to disability. The assessment of older patients is carried out in some geriatric day hospitals (GDHFs). However, it seems difficult to assess all patients in these GDHFs. In this context, a care model, which uses a specialist nurse trained in primary care and geriatric assessment, has been developed. In this article, we describe the organization, details of the evaluation, and provide the main characteristics of the first 200 patients assessed over a 6-month period...
September 16, 2016: Journal of the American Medical Directors Association
J Amblàs-Novellas, S A Murray, J Espaulella, J C Martori, R Oller, M Martinez-Muñoz, N Molist, C Blay, X Gómez-Batiste
OBJECTIVES: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues...
September 19, 2016: BMJ Open
Katsuhiko Kohara
The effectiveness of antihypertensive treatment in elderly hypertensive patients has been established through numerous randomized clinical trials including the Hypertension in the Very Elderly Trial (HYVET). However, because of the diversity of biological aging among individuals, chronological age is not the sole determinant for the target blood pressure (BP) level at which antihypertensive medications are aimed. Several conditions, especially frailty, needed be evaluated in managing hypertension among elderly people...
September 2016: Journal of Hypertension
Isabel Montilla Padilla, Roberto Martín-Asenjo, Héctor Bueno
The mean age of patients presenting with acute coronary syndrome (ACS) has been increasing steadily in the last decades, so managing very old patients has become common practice. The oldest patients are under-represented in clinical trials, so specific evidence is scarce. Still, antithrombotic therapy and invasive strategy are the pillars of appropriate treatment even in the oldest patients. However, the elderly population is a heterogeneous group showing important divergences between chronological and biological age, which needs specific evaluation...
August 25, 2016: Heart, Lung & Circulation
Ciara McGlade, Edel Daly, Joan McCarthy, Nicola Cornally, Elizabeth Weathers, Rónán O'Caoimh, D William Molloy
BACKGROUND: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. RESEARCH AIM: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. RESEARCH DESIGN: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families...
September 16, 2016: Nursing Ethics
Peter Hartley, Kerry Alexander, Jennifer Adamson, Carol Cunningham, Georgina Embleton, Roman Romero-Ortuno
AIM: Impaired cognition is common among older patients admitted to acute hospitals, but its association with functional trajectories has not been well studied. METHODS: A retrospective observational study was carried out in an English tertiary university hospital. We analyzed all first episodes of county residents aged ≥75 years admitted to the Department of Medicine for the Elderly wards between December 2014 and May 2015. A history of dementia or a cognitive concern in the absence of a known diagnosis of dementia were recorded on admission...
September 16, 2016: Geriatrics & Gerontology International
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