Wendy Zachary, Anu Kirupananthan, Shannon Cotter, Gionet Hasson Barbara, Ralph C Cooke, Munyaradzi Sipho
OBJECTIVE: This study investigated the impact of the Hospital Elder Life Program (HELP), a geriatric intervention program targeted at reducing delirium, on readmission rates. Secondary goals were to review HELP's impact on average length of stay (ALOS), discharge to the home, and falls. DESIGN: This retrospective 3-year study reviewed inpatients age 70 and older, with one or more of six impairments: functional, renal, cognitive, sleep, visual and hearing. Patients were from a 784 bed teaching hospital in California with admissions between January 1, 2014 and December 31, 2016...
October 12, 2019: Archives of Gerontology and Geriatrics
Elisa Pierpaoli, Katia Fabi, Federica Francesca Lenci, Maddalena Ricci, Mirko Di Rosa, Graziano Onder, Stefano Volpato, Carmelinda Ruggiero, Antonio Cherubini, Andrea Corsonello, Fabrizia Lattanzio
BACKGROUND: The relationship between the estimated glomerular filtration rate (eGFR) and cognitive impairment may change as a function of the equation used. We aimed at investigating the association between four different eGFR equations and cognitive impairment among older hospitalized patients. METHODS: Our series consisted of 795 older patients consecutively admitted to 7 geriatric and internal medicine acute care wards. The eGFR was calculated by Chronic Kidney Disease Epidemiologic Collaboration (CKD-EPI), Cockcroft-Gault (CG), Berlin Initiative Study (BIS) and Full Age Spectrum (FAS) equations...
November 15, 2019: Aging Clinical and Experimental Research
Blair N Honsey, Lauren O Erickson, Kathryn A Wyman-Chick
OBJECTIVE: Evaluate neuropsychological test performance in depressed patients with early-stage Parkinson's disease. METHOD: Data from 422 participants from the Parkinson's Progression Marker Initiative were examined. The Geriatric Depression Scale-15 was used to categorize depressed and non-depressed participants. Neuropsychological tests measured verbal learning/memory, processing speed, visuospatial ability, verbal fluency, and working memory. Demographic and clinical variables were compared using independent samples t tests and chi-square analyses...
November 15, 2019: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Rowan H Harwood, Hannah Enguell
Most people die when they are old, but predicting exactly when this will occur is unavoidably uncertain. The health of older people is challenged by multimorbidity, disability and frailty. Frailty is the tendency to crises or episodes of rapid deterioration. These are often functional or non-specific in nature, such as falls or delirium, and recovery is usually expected. Health-related problems can be defined in terms of distress and disability. Distress is as often mental as physical, especially for people with delirium and dementia...
November 15, 2019: BMJ Supportive & Palliative Care
Jugdeep K Dhesi, Nicholas P Lees, Judith Sl Partridge
The frailty syndrome is defined as a decrease in physiological reserve across multiple organ systems leading to increased vulnerability to external stressors. Studies across surgical subspecialties and in emergency and elective settings have identified frailty as an independent predictor of adverse postoperative clinician-reported, patient-reported and process-related outcomes. Although frailty is not specific to the older population, it is associated with ageing and therefore is increasingly observed in the ageing surgical population...
November 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
Tina Hsu, Enrique Soto-Perez-de-Celis, Peggy S Burhenn, Beatriz Korc-Grodzicki, Tanya M Wildes, Ravindran Kanesvaran, Ronald J Maggiore
The majority of patients with cancer are over the age of 65. This patient population often has unique care needs. Thus, clinicians require additional competencies and skills to care for this population. Most clinicians, however, receive little to no training in geriatrics. There has been increasing recognition of the importance of learning about geriatric oncology. However, teaching of geriatric oncology principles is not standard or widespread. Here we highlight educational work and scholarship accomplished thus far in the field of geriatric oncology and identify gaps in knowledge that need to be addressed in order to help accelerate the development, implementation, integration, and dissemination of geriatric oncology curricula...
November 12, 2019: Journal of Geriatric Oncology
Lauren T Southerland, Alexander X Lo, Kevin Biese, Glenn Arendts, Jay Banerjee, Ula Hwang, Scott Dresden, Vivian Argento, Maura Kennedy, Christina L Shenvi, Christopher R Carpenter
In 2018, the American College of Emergency Physicians (ACEP) began accrediting facilities as "geriatric emergency departments" (EDs) according to adherence to the multiorganizational guidelines published in 2014. The guidelines were developed to help every ED improve its care of older adults. The geriatric ED guideline recommendations span the care continuum from out-of-hospital care, ED staffing, protocols, infrastructure, and transitions to outpatient care. Hospitals interested in making their EDs more geriatric friendly thus face the challenge of adopting, adapting, and implementing extensive guideline recommendations in a cost-effective manner and within the capabilities of their facilities and staff...
November 13, 2019: Annals of Emergency Medicine
Koichi Sato, Jun Takahashi, Kiyotaka Hao, Satoshi Miyata, Akira Suda, Tomohiko Shindo, Shohei Ikeda, Yoku Kikuchi, Takashi Shiroto, Yasuharu Matsumoto, Yasuhiko Sakata, Hiroaki Shimokawa
BACKGROUND: Along with the global aging, the number of geriatric patients with acute myocardial infarction (AMI) has been increasing. However, temporal trends in the prevalence and outcomes of geriatric patients with AMI, with a special reference to heart failure (HF) on admission, remain to be elucidated. METHODS: The Miyagi AMI Registry is a prospective, multicenter, and observational study. This registry was established in 1979 and has been continued for 40 years...
November 12, 2019: Journal of Cardiology
Jinbo Le, Zhijie Dong, Jie Liang, Kun Zhang, Yanhua Li, Meijuan Cheng, Zhenshuan Zhao
Geriatric population is increasing rapidly worldwide, and fragility fracture and complication following orthopaedic surgery in elderly people have now become major challenges for surgeons. Further studies are required to identify potentially modifiable factors associated with surgical site infection (SSI) in geriatric patients. This retrospective, multicenter study was conducted at four level I hospitals in China. During the 31-month study period, a total of 2341 patients (65 years or older) underwent orthopaedic surgery and complete data were recorded from September 2015 to April 2018...
November 15, 2019: International Wound Journal
Claire Roubaud Baudron, Rachel Legeron, Julien Ollivier, Fabrice Bonnet, Carine Greib, Florent Guerville, Charles Cazanave, David Kobeh, Véronique Cressot, Nicolas Moneger, Marie-Neige Videau, Elise Thiel, Carine Foucaud, Aurélie Lafargue, Albane de Thezy, Jessica Durrieu, Isabelle Bourdel Marchasson, Geneviève Pinganaud, Dominique Breilh
BACKGROUND: Antibiotic administration by subcutaneous (SC) injection is common practice in French geriatric wards as an alternative to the intravenous (IV) route, but few pharmacokinetic/pharmacodynamic data are available. Ertapenem is useful for the treatment of infections with ESBL-producing enterobacteria. OBJECTIVES: To report and compare ertapenem pharmacokinetic data between IV and SC routes in older persons. METHODS: Patients >65 years of age receiving ertapenem (1 g once daily) for at least 48 h (IV or SC, steady-state) were prospectively enrolled...
December 1, 2019: Journal of Antimicrobial Chemotherapy
Zhongquan Li, Xia Zhao, Ang Sheng, Li Wang
BACKGROUND: Anxiety symptoms are pervasive among elderly populations around the world. The Geriatric Anxiety Inventory (the GAI) has been developed and widely used in screening those suffering from severe symptoms. Although debates about its dimensionality have been mostly resolved by Molde et al. (2019) with bifactor modeling, evidence regarding its measurement invariance across sex and somatic diseases is still missing. METHODS: This study attempted to provide complemental evidence to the dimensionality debates of the GAI with Mokken scale analysis and to examine its measurement invariance across sex and somatic diseases by conducting differential item functioning (DIF) analysis among a sample of older Chinese adults...
November 15, 2019: BMC Geriatrics
Merike Lang, Mónica Rosselli, Maria T Greig, Valeria L Torres, Idaly Vélez-Uribe, Fernanda Arruda, Warren W Barker, Patricia Garcia, David A Loewenstein, Rosie E Curiel, Ranjan Duara
OBJECTIVE: To analyze (1) whether there are ethnic differences in the severity of depressive symptoms between groups of elders classified as cognitively normal (CN) or amnestic mild cognitive impairment (aMCI) and (2) the influence of depressive symptoms on specific cognitive performance by ethnicity across diagnoses, controlling for covariates. METHODS: 164 Hispanics residing in the United States (HAs) and European Americans (EAs) (100 women; Mage = 72.1, SD = 8...
November 12, 2019: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Rachel C Ambagtsheer, Mark Q Thompson, Mandy M Archibald, Mavourneen G Casey, Timothy J Schultz
Against a backdrop of aging populations worldwide, it has become increasingly important to identify frailty screening instruments suitable for community settings. Self-reported and/or administered instruments might offer significant simplicity and efficiency advantages over clinician-administered instruments, but their comparative diagnostic test accuracy has yet to be systematically examined. The aim of this systematic review was to determine the diagnostic test accuracy of self-reported and/or self-administered frailty screening instruments against two widely accepted frailty reference standards (the frailty phenotype and the Frailty Index) within community-dwelling older adult populations...
November 14, 2019: Geriatrics & Gerontology International
Naoko Otsuki, Sakiko Fukui, Eiji Nakatani
AIM: This pilot study aimed to analyze the cost-effectiveness of visiting nursing care, to establish a new evaluation method considering both the quality and cost of visiting nursing care. METHOD: Participants were 384 caregivers from 10 certified home-visit nursing agencies that support patients in severe conditions in Japan. They completed a survey assessing the number of nursing care visits carried out in November 2016, visiting nursing receipt data for 1 month of study and quality of life (QOL), as measured by the EuroQol-5 Dimension at their last visit, which took place 1 month later...
November 14, 2019: Geriatrics & Gerontology International
Makoto Yamamoto, Yoshio Yoshida, Yoshio Itani, Shinya Sato, Masayuki Futagami, Hitomi Sakai, Hiroaki Kajiyama, Masaki Fujimura, Yoichi Aoki
BACKGROUND: The proportion of elderly Japanese people (age ≥ 65 years) is currently 27.7%, and the average life span of women is 87.14 years, both of which are unprecedented. In gynecologic cancer, evidence of treatment for the elderly is scarce, and treatment policies are determined by each facility. The aim of the present study was to investigate the status of treatment policies for elderly patients with gynecologic cancer. METHODS: A web-based questionnaire regarding how treatment strategies are currently determined for elderly patients with gynecologic cancer was conducted on gynecologic oncologists to develop a tool for the objective evaluation of treatment policy decisions for elderly patients...
November 14, 2019: International Journal of Clinical Oncology
Sooyeon Kim, Simon C Lee, Celette S Skinner, Cynthia J Brown, Courtney J Balentine
Purpose of review: Review strategies to improve outcomes of colorectal cancer treatment in older patients. Recent findings: Older colorectal patients face many barriers to recovery during their initial inpatient stay following surgery and after leaving the hospital. In addition to the risk of inpatient morbidity and mortality, older patients are more likely to require post-acute care services, to face nutritional deficits, and to experience complications of chemoradiation...
February 2019: Current Colorectal Cancer Reports
Emily M Abramsohn, Jessica Jerome, Kelsey Paradise, Tia Kostas, Wesley Alexandra Spacht, Stacy Tessler Lindau
BACKGROUND: African American caregivers of community-residing persons with dementia are mostly unpaid and have high rates of unmet basic and health needs. The National Alzheimer's Project Act (NAPA) mandates improved coordination of care for persons with dementia and calls for special attention to racial populations at higher risk for Alzheimer's Disease or related dementias (ADRD) to decrease health disparities. The purpose of this study is to describe the perceptions of African American caregivers of people with dementia about community resources needed to support caregiving as well as their own self-care...
November 14, 2019: BMC Geriatrics
Joseph Ali, Manting Chiang, Jong Bong Lee, Gregory O Voronin, Joanne Bennett, Anne Cram, Leonid Kagan, Martin C Garnett, Clive J Roberts, Pavel Gershkovich
Recently there has been an increased interest to develop specialised dosage forms that are better suited to specific patient populations, such as paediatrics and geriatrics. In these patient populations the acceptability of the oral dosage form can be paramount to the products success. However, many active pharmaceutical Ingredients (APIs) are known to cause an aversive taste response. One way to increase the acceptability and to enhance the palatability of the formulation is to design coated taste-masked particulate-based dosage forms...
November 11, 2019: European Journal of Pharmaceutics and Biopharmaceutics
Benjamin A Derman, Keriann Kordas, Jean Ridgeway, Selina Chow, William Dale, Sang Mee Lee, Elingel Aguada, Andrzej J Jakubowiak, Jagoda Jasielec, Justin Kline, Satyajit Kosuri, Richard A Larson, Hongtao Liu, Mylove Mortel, Olatoyosi Odenike, Jennifer Pisano, Peter Riedell, Wendy Stock, Michael R Bishop, Andrew S Artz
Limitations found on geriatric assessment (GA) track with worse outcomes after hematopoietic cell transplantation (HCT). We report on a multidisciplinary team clinic (MDC), consisting of a cancer-specific GA and a multidisciplinary team of providers, to assess candidacy and create an individualized optimization plan for allogeneic HCT candidates aged ≥60 years and autologous HCT and adoptive T-cell therapy candidates aged ≥70 years. Among the 247 patients evaluated in the MDC, allogeneic HCT candidates comprised the majority (60%), followed by autologous HCT (37%) with occasional older cellular therapy candidates (3%)...
November 26, 2019: Blood Advances
Nicola Polverelli, Paolo Tura, Giorgia Battipaglia, Gandolfi Lisa, Tatiana Zollner, Michele Malagola, Enrico Morello, Alessandro Turra, Simona Bernardi, Camilla Zanaglio, Federica Re, Mohamad Mohty, Domenico Russo
Mohty: Jazz Pharmaceuticals: Honoraria, Research Funding.
November 13, 2019: Blood
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