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https://www.readbyqxmd.com/read/28731947/early-stage-cancer-in-older-adults-prostate-avoiding-overtreatment-and-undertreatment
#1
Vikram Narayan, Song Jiang, Christopher A Warlick
The diagnosis of prostate cancer in elderly men is likely to increase over the next several decades, owing to changing demographics and a rising population of men older than 65 years. Given the heterogeneity and well-documented challenges in screening, diagnosing, and managing indolent versus aggressive prostate cancer, the geriatric patient population is particularly vulnerable to prostate cancer treatment nuances. Clinicians must become familiar with geriatric assessment tools to better answer life-expectancy questions prior to counseling patients on treatment options...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#2
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28728093/obsessive-compulsive-disorder-in-the-elderly-a-report-from-the-international-college-of-obsessive-compulsive-disorders-icocs
#3
B Dell'Osso, B Benatti, C I Rodriguez, C Arici, C Palazzo, A C Altamura, E Hollander, N Fineberg, D J Stein, H Nicolini, N Lanzagorta, D Marazziti, S Pallanti, M Van Ameringen, C Lochner, O Karamustafalioglu, L Hranov, M Figee, L Drummond, J Grant, D Denys, D Cath, J M Menchon, J Zohar
INTRODUCTION: Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD≥65years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample. METHODS: Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age<vs≥65years, and then divided on the basis of the median age of the sample (age<vs≥42years)...
July 4, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28721433/oral-health-and-the-frail-elderly
#4
L Rapp, S Sourdet, B Vellas, M-H Lacoste-Ferré
INTRODUCTION: The relationships between oral health conditions and frailty have rarely been explored. A systematic review of frailty components and oral health concluded that differences in study population endpoint criteria and study design cannot establish a relationship between frailty and oral health. OBJECTIVE: This study aims to describe the distribution of the OHAT (Oral Health Assessment Tool) score in a population of frail subjects and to assess associated parameters (age, socio-economic status, living conditions, education level, nutritional habits, cognitive functioning, autonomy)...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28721431/depressive-symptoms-falls-and-fear-of-falling-in-old-korean-adults-the-korean-longitudinal-study-on-health-and-aging-klosha
#5
Y Park, N-J Paik, K W Kim, H-C Jang, J-Y Lim
Fall is a common cause of disability and death in old adults, and much research has been focused on identifying risk factors and developing preventive measures. Yet the majority of preceding research has been focused on physical performance. This study aims to evaluate the association between fall and depressive symptoms in community-dwelling elderly. Cross-sectional data of 431 men and 546 women was collected from old Korean adults living in Seongnam, Korea. Geriatric fall assessment was conducted by self-report questionnaires...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28721029/the-impact-of-transient-and-persistent-acute-kidney-injury-on-short-term-outcomes-in-very-elderly-patients
#6
Qinglin Li, Meng Zhao, Xiaodan Wang
OBJECTIVES: Acute kidney injury (AKI) is a common complication in elderly patients and is associated with poor outcomes. However, the effect of transient and persistent geriatric AKI on short-term mortality is unclear. We aimed to study the incidence, clinical characteristics, and prognostic impact of transient and persistent AKI in such patients. METHODS: We retrospectively enrolled very elderly patients (≥75 years) from the geriatric department of the Chinese PLA General Hospital between 2007 and 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#7
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28716855/frailty-screening-tools-for-elderly-patients-incident-to-dialysis
#8
Ismay N van Loon, Namiko A Goto, Franciscus T J Boereboom, Michiel L Bots, Marianne C Verhaar, Marije E Hamaker
BACKGROUND AND OBJECTIVES: A geriatric assessment is an appropriate method for identifying frail elderly patients. In CKD, it may contribute to optimize personalized care. However, a geriatric assessment is time consuming. The purpose of our study was to compare easy to apply frailty screening tools with the geriatric assessment in patients eligible for dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 123 patients on incident dialysis ≥65 years old were included <3 weeks before to ≤2 weeks after dialysis initiation, and all underwent a geriatric assessment...
July 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28712980/association-of-selective-serotonin-reuptake-inhibitors-and-bone-mineral-density-in-elderly-women
#9
Smita Saraykar, Vineeth John, Bo Cao, Matthew Hnatow, Catherine G Ambrose, Nahid Rianon
Depression and osteoporosis are 2 common comorbidities in geriatric patients. There are concerns about the deleterious effects of selective serotonin reuptake inhibitor (SSRI) antidepressant use on bone mineral density (BMD). We examined the association between SSRI use and BMD in elderly women (≥65 yr) referred to a geriatric osteoporosis clinic for bone health evaluation. Cross-sectional analyses using the general linear model were performed on data collected retrospectively from August 2010 to April 2015...
July 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28711765/functional-magnetic-resonance-imaging-response-as-an-early-biomarker-of-cognitive-decline-in-elderly-patients-with-metabolic-syndrome
#10
Nadia Shigaeff, Edson Amaro, Fabio G M Franco, Alessandro F Jacinto, Gabriela Chiochetta, Maysa S Cendoroglo, Vanessa A Citero
OBJECTIVES: We assessed whether potential changes in brain activation patterns of elderly individuals with metabolic syndrome (MetS) who were cognitively healthy (without mild cognitive impairment or dementia) were associated with cognitive decline in executive function in the short-term. METHOD: We analyzed 43 individuals (23 MetS, 20 controls) using a global geriatric evaluation, a neuropsychological battery, and task-related (attention) fMRI exam. Correlation analysis between the fMRI signal at baseline and cognitive impairment after 1year was based on the voxel-based Pearson coefficient, corrected for multiple comparisons...
July 8, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28711131/care-of-special-populations-in-an-observation-unit-pediatrics-and-geriatrics
#11
REVIEW
Sharon E Mace
Infants and children and the elderly comprise a large and growing (especially the elderly) segment of the US population. The benefits of observation medicine have been documented in these two age groups: Based on the success of observation medicine, and recognizing the growth of these special populations, it is likely that observation medicine will be expanding in the future, especially within the pediatric and geriatric populations. Future studies should be able to provide further evidence regarding the value of observation medicine in these two diverse population age groups...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28708810/role-of-normalized-t-cell-subsets-in-predicting-comorbidities-in-a-large-cohort-of-geriatric-hiv-infected-patient
#12
A Calcagno, S Piconi, E Focà, S Nozza, F Carli, C Montrucchio, A M Cattelan, G Orofino, B M Celesia, V Morena, G V De Socio, G Guaraldi
BACKGROUND: Adults aging with HIV are at greater risk for several comorbidities. The CD4+ cell count and CD4+/CD8+ ratio often fail to normalize in elderly patients despite prolonged antiretroviral therapy; this has been associated with concomitant diseases and poor prognosis. METHODS: A cross-sectional analysis in antiretroviral-treated HIV-positive patients aged ≥65 years. Aim of the study was to describe the predictors of normalized T cell subsets ("nT", CD4+/CD8+ ratio ≥1 and CD4+ ≥500 cells/uL) in a cohort of geriatric HIV-positive patients and its association with HIV-associated non-AIDS conditions (HANA)...
July 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28707343/peroral-endoscopic-myotomy-is-safe-and-effective-in-achalasia-patients-aged-older-than-60%C3%A2-years-compared-with-younger-patients
#13
Xiaowei Tang, Yutang Ren, Qiaoping Gao, Silin Huang, Jieqiong Zhou, Xiaofeng Zhang, Jianfeng Yang, Zhengjie Wei, Zhenyu Chen, Bo Jiang, Wei Gong
AIM: Peroral endoscopic myotomy (POEM) has been proven to be effective for treating achalasia, but there are limited data on POEM in elderly patients. We therefore aimed to assess the role of POEM for achalasia in patients aged ≥60 years. METHODS: All consecutive patients that underwent POEM between December 2011 and November 2015 at a single center were retrospectively reviewed. Patients aged ≥60 years were assigned to group A, whereas patients aged <60 years were assigned to group B...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28707303/prediction-of-geriatric-rehabilitation-outcomes-comparison-between-three-cognitive-screening-tools
#14
Noemi Heyman, Tatyana Tsirulnicov, Merav Ben Natan
AIM: Comparison between the predictions of functional rehabilitation outcomes at a department of geriatric rehabilitation using three cognitive screening tools - Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). METHODS: This study is a prospective study. The study participants were 212 patients aged 65 and older admitted to rehabilitation departments at a geriatric facility in central Israel, from April 2016 to October 2016...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28707192/-geriatrics-or-geriatricization-of-medicine-quo-vadis-geriatrics
#15
REVIEW
G F Kolb
This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence...
July 13, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#16
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28705182/chemoradiation-in-elderly-esophageal-cancer-patients-rationale-and-design-of-a-phase-i-ii-multicenter-study-osage
#17
Stéphanie Servagi-Vernat, Gilles Créhange, Franck Bonnetain, Cécile Mertens, Etienne Brain, Jean François Bosset
BACKGROUND: The management of elderly patients with cancer is a therapeutic challenge and a public health problem. Definitive chemoradiotherapy (CRT) is an accepted standard treatment for patients with locally advanced esophageal cancer who cannot undergo surgery. However, there are few reports regarding tolerance to CRT in elderly patients. We previously reported results for CRT in patients aged ≥75 years. Following this first phase II trial, we propose to conduct a phase I/II study to evaluate the combination of carboplatin and paclitaxel, with concurrent RT in unresectable esophageal cancer patients aged 75 years or older...
July 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28705163/a-comprehensive-intervention-following-the-clinical-pathway-of-eating-and-swallowing-disorder-in-the-elderly-with-dementia-historically-controlled-study
#18
Masahisa Arahata, Makoto Oura, Yuka Tomiyama, Naoe Morikawa, Hatsue Fujii, Shinji Minani, Yukihiro Shimizu
BACKGROUND: Eating problems in patients with advanced dementia are strongly associated with their deteriorating survival. Food and drink intake in people with dementia may be supported by specific interventions, but the effectiveness of such interventions is backed by almost no evidence. However, comprehensive geriatric assessment (CGA) might potentially clarify the etiology of decreased oral intake in people with dementia; thus improving their clinical outcomes. METHODS: This study was a single-arm, non-randomized trial that included historically controlled patients for comparison...
July 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28700153/-frequent-uro-geriatric-symptoms-helpful-tools-for-general-practitioners
#19
Guillaume Altwegg, Jacques Klein, Grégory Wirth, Christophe E Iselin
Each developed country faces an aging population. Increase of age rises the risk to develop urologic pathology especially in men. Routine investigation and diagnostic of urologic pathology important, however must take into account the patient in his globality (including age, comorbidities, drug medication as well as sociocultural environment). The aim of this article is to help the general practitioner in taking decisions with frequent uro-geriatric symptoms. Bladder catheterization remains an invasive treatment and indication should be regularly re-evaluated...
November 30, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28699992/changes-in-frailty-conditions-and-phenotype-components-in-elderly-after-hospitalization
#20
Gianna Fiori Marchiori, Darlene Mara Dos Santos Tavares
Objective: describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups. Method: a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used...
July 10, 2017: Revista Latino-americana de Enfermagem
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