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Geriatrics,Medicine ,Ageing,Dementia,Frailty

X Y Chua, N H L Ha, C Y Cheong, S L Wee, P L K Yap
OBJECTIVES: Memory clinics play an important role in enabling early dementia diagnosis and intervention. Few studies have investigated the changing patient profiles at memory clinics over time. We studied the trend of patient characteristics in a geriatric medicine-led memory clinic over 12 years to improve services and care to meet their needs. SETTING AND PARTICIPANTS: Data from 2340 first-visit patients seen at a memory clinic from 2005-2017 were extracted from a registered database and analysed...
2019: Journal of Nutrition, Health & Aging
Roman Romero-Ortuno, Duncan R Forsyth, Kathryn Jane Wilson, Ewen Cameron, Stephen Wallis, Richard Biram, Victoria Keevil
BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. OBJECTIVE: To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery)...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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...
October 2017: Geriatrics & Gerontology International
P Hartley, J Adamson, C Cunningham, G Embleton, R Romero-Ortuno
Extra physiotherapy has been associated with better outcomes in hospitalized patients, but this remains an under-researched area in geriatric medicine wards. We retrospectively studied the association between average physiotherapy frequency and outcomes in hospitalized geriatric patients. High frequency physiotherapy (HFP) was defined as ≥0.5 contacts/day. Of 358 eligible patients, 131 (36.6%) received low, and 227 (63.4%) HFP. Functional improvement (discharge versus admission) in the modified Rankin scale was greater in the HFP group (1...
2016: Journal of Frailty & Aging
M Hawker, R Romero-Ortuno
The factors determining hospital discharge outcomes in older people are complex. This retrospective study was carried out in an in-patient geriatric ward over a month in 2015 and aimed to explore if self-reported feeling of loneliness and clinical frailty contribute to longer hospital stays or higher rates of readmission to hospital after discharge in the older population. Twenty-two men and twenty-five women (mean age 85.1 years) were assessed. There was a significant multivariate association between both self-reported loneliness (p=0...
2016: Journal of Frailty & Aging
David Basic, Tabitha J Hartwell
PURPOSE: To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness. MATERIALS AND METHODS: This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls...
2015: Clinical Interventions in Aging
Bruno Vellas
Geriatric medicine started to be developed approximately 40 years ago when the increasing number of older adults with disability and dementia admitted to hospital emergency units threatened the sustainability of the healthcare organizations. Today, almost 90% of the geriatric medicine forces are devoted to the care of age-related disabilities. The epidemiological scenario and the high healthcare costs required for the management of dependent individuals require the adoption of strategies aimed at preventing the loss of physical function and anticipate the take in charge of older persons at risk of negative outcomes...
2015: Nestlé Nutrition Institute Workshop Series
N Tavassoli, S Guyonnet, G Abellan Van Kan, S Sourdet, T Krams, M E Soto, J Subra, B Chicoulaa, A Ghisolfi, L Balardy, P Cestac, Y Rolland, S Andrieu, F Nourhashemi, S Oustric, M Cesari, B Vellas
INTRODUCTION: Frailty is considered as an early stage of disability which, differently from disability, is still amenable for preventive interventions and is reversible. In 2011, the "Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability" was created in Toulouse, France, in association with the University Department of General Medicine and the Midi-Pyrénées Regional Health Authority. This structure aims to support the comprehensive and multidisciplinary assessment of frail older persons, to identify the specific causes of frailty and to design a personalized preventive plan of intervention against disability...
May 2014: Journal of Nutrition, Health & Aging
Jean Woo
In caring for older people, geriatricians have always adopted a multi-domain approach, and this article reflects on the diverse aspects covered by journals in general medicine, geriatric medicine and gerontology in 2013. Topics were selected that represented developing or controversial areas that are important to care of increasingly frail older people. These include the increasing use of single physical performance measures in assessment, optimal body mass index, assessment of frailty and sarcopenia, dementia, diabetes treatment goals, end-of-life care, management of complexity and design of health and social services to meet complexity...
March 2014: Age and Ageing
Francisco Javier Alonso-Renedo, Leire González-Ercilla, Itziar Iráizoz-Apezteguía
OBJECTIVE: To analyze the literature as regards the knowledge, skills and attitudes that these disciplines can provide in improving technical, ethical and human quality health care in the elderly with advanced organ failure, multimorbidity, frailty and progressive dementia. MATERIAL AND METHODS: A comprehensive review focused on available references on the interrelationship between geriatric medicine and palliative medicine, education in bioethics, prognostic tools, functional status, and the humanization of health care...
September 2014: Revista Española de Geriatría y Gerontología
R Briggs, T Coughlan, R Collins, D O'Neill, S P Kennelly
Nursing home (NH) residents represent the frailest group of older people, and providing gerontologically attuned care that addresses these frailties is often a challenge within the emergency department (ED). This study sought to prospectively profile acutely unwell NH residents in order to clarify some of the challenges of providing emergency care to this group. Over an 18-week period, we prospectively reviewed all NH residents presenting to the ED of an urban university teaching hospital. Relevant data were retrieved by direct physician review (as part of a comprehensive geriatric assessment in the ED), collateral history from NH staff and primary carers, and review of electronic records...
September 2013: QJM: Monthly Journal of the Association of Physicians
Desmond O'Neill
Geriatric medicine has an encyclopaedic sweep, reflecting the complexity of both the ageing process and of our patient group. Keeping up with, and making sense of, the relevant scientific literature is challenging, especially as ageing has increased in prominence as a focus of research across many branches of the sciences and the humanities. This review of research published in 2012 in generalist, geriatric medicine and gerontology journals has been compiled with a view to extracting those aspects of research into ageing which could be considered relevant not only to the practice of geriatric medicine, but also to our understanding of the ageing process and the relationship of geriatric medicine to other medical specialties and public health...
March 2013: Age and Ageing
Barbara J Messinger-Rapport, Dulce M Cruz-Oliver, David R Thomas, John E Morley
This article is the sixth in the series of clinical updates on nursing home care. The topics covered are management of hypertension, antidepressant medications in people with dementia, peripheral arterial disease, probiotics in prevention, and treatment of Clostridium difficile-associated diarrhea, frailty, and falls.
September 2012: Journal of the American Medical Directors Association
Claudio Bilotta, Alessandra Casè, Paola Nicolini, Sabrina Mauri, Manuela Castelli, Carlo Vergani
OBJECTIVE: To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. METHOD: Cross-sectional survey of 302 community-dwelling outpatients aged 65+ (median age 82 years) consecutively referred to a geriatric medicine clinic in Italy from June to November 2009. Participants underwent a comprehensive geriatric assessment including frailty status evaluated by means of the study of osteoporotic fractures (SOF) criteria...
November 2010: Aging & Mental Health
Dana H Lee, Karen J Buth, Billie-Jean Martin, Alexandra M Yip, Gregory M Hirsch
BACKGROUND: Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. Where elderly patients are increasingly referred for cardiac surgery, the prevalence of a frail group among these is also on the rise. We assessed frailty as a risk factor for adverse outcomes after cardiac surgery. METHODS AND RESULTS: Functional measures of frailty and clinical data were collected prospectively for all cardiac surgery patients at a single center...
March 2, 2010: Circulation
E Pijpers, I Ferreira, R J J van de Laar, C D A Stehouwer, A C Nieuwenhuijzen Kruseman
BACKGROUND AND AIMS: Frailty and mortality in psychogeriatric patients are hard to predict but important in counselling and therapeutic decision making. We have therefore developed a simple frailty risk score to predict mortality this population. STUDY DESIGN: Prospective observational study including 401 community dwelling psychogeriatric patients (249 women; mean (SD) age 78.0 (6.5) years), who had been referred to a multidisciplinary diagnostic observation centre...
September 2009: Postgraduate Medical Journal
Keith Henry
The demographics of HIV-positive persons in the United States signal a steady shift toward an older population. The relationship between aging and HIV infection suggests that there is an additive and possibly synergistic effect increasing the risk for numerous common medical conditions, including heart disease, cancer, osteoporosis, frailty, depression, and dementia. Given the current crisis in the US health care system regarding universal access to quality primary and geriatric care, the aging of the HIV-positive population will pose numerous challenges to providers and policy makers...
August 2009: Current HIV/AIDS Reports
D Volkert, Y N Berner, E Berry, T Cederholm, P Coti Bertrand, A Milne, J Palmblad, St Schneider, L Sobotka, Z Stanga, R Lenzen-Grossimlinghaus, U Krys, M Pirlich, B Herbst, T Schütz, W Schröer, W Weinrebe, J Ockenga, H Lochs
Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985...
April 2006: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
M G Olde Rikkert, T L Lagro-Janssen, R Holdrinet, L Kollée, W H Hoefnagels
In 1995 the Medical Faculty of the University Medical Center of Nijmegen revised its curriculum to be more problem-oriented and student-centered. Each of the first four years now consists of ten four-week courses constructed around specific learning objectives. For the new curriculum the authors developed a fourth-year course on age-related health problems in which selected issues of pediatrics, general practice, and geriatrics are integrated. The primary objective of this course is to enable students to understand the differences and similarities in approaches to health problems in different age groups...
October 2001: Academic Medicine
M G Olde Rikkert, G M van Heteren, W H Hoefnagels
OBJECTIVE: To describe the methodological development of medical research regarding elderly subjects in the Netherlands. DESIGN: Descriptive. SETTING: Nijmegen University, the Netherlands. METHOD: All research on aging published in the Netherlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) starting from its first volume in 1857 up to 1983 was studied. Selected were those articles in which new research methods were introduced...
February 21, 1998: Nederlands Tijdschrift Voor Geneeskunde
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