collection
https://read.qxmd.com/read/17551132/does-this-patient-have-dementia
#1
REVIEW
Tracey Holsinger, Janie Deveau, Malaz Boustani, John W Williams
CONTEXT: While as many as 5 million individuals in the United States have dementia, many others have memory complaints. Brief tests to screen for cognitive impairment could help guide dementia diagnosis. OBJECTIVE: To review the literature concerning the practicality and accuracy of brief cognitive screening instruments in primary care. DATA SOURCES: A search of MEDLINE (including data from AIDSLINE, BioethicsLine, and HealthSTAR) and psycINFO was conducted from January 2000 through April 2006 to update previous reviews...
June 6, 2007: JAMA
https://read.qxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#2
EDITORIAL
Jonathan Afilalo
No abstract text is available yet for this article.
May 23, 2017: Circulation
https://read.qxmd.com/read/28693934/frailty-in-older-adults-undergoing-aortic%C3%A2-valve-replacement-the-frailty-avr-study
#3
MULTICENTER STUDY
Jonathan Afilalo, Sandra Lauck, Dae H Kim, Thierry Lefèvre, Nicolo Piazza, Kevin Lachapelle, Giuseppe Martucci, Andre Lamy, Marino Labinaz, Mark D Peterson, Rakesh C Arora, Nicolas Noiseux, Andrew Rassi, Igor F Palacios, Philippe Généreux, Brian R Lindman, Anita W Asgar, Caroline A Kim, Amanda Trnkus, José A Morais, Yves Langlois, Lawrence G Rudski, Jean-Francois Morin, Jeffrey J Popma, John G Webb, Louis P Perrault
BACKGROUND: Frailty is a geriatric syndrome that diminishes the potential for functional recovery after a transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) procedure; however, its integration in clinical practice has been limited by a lack of consensus on how to measure it. OBJECTIVES: This study sought to compare the incremental predictive value of 7 different frailty scales to predict poor outcomes following TAVR or SAVR...
August 8, 2017: Journal of the American College of Cardiology
https://read.qxmd.com/read/28408026/the-aging-cardiovascular-system-understanding-it-at-the-cellular-and-clinical-levels
#4
REVIEW
Francesco Paneni, Candela Diaz Cañestro, Peter Libby, Thomas F Lüscher, Giovanni G Camici
Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients...
April 18, 2017: Journal of the American College of Cardiology
https://read.qxmd.com/read/27776940/psoas-muscle-area-predicts-all-cause-mortality-after-endovascular-and-open-aortic-aneurysm-repair
#5
JOURNAL ARTICLE
L M Drudi, K Phung, M Ades, J Zuckerman, L Mullie, O K Steinmetz, D I Obrand, J Afilalo
OBJECTIVE: Psoas muscle area (PMA) is a validated surrogate for muscle mass that can be easily measured from a clinical CT scan. This study sought to determine whether PMA was associated with post-operative mortality after endovascular or open aortic aneurysm repair. METHODS: A retrospective review was undertaken of patients who underwent elective endovascular or open aortic aneurysm repair between 2010 and 2015 at a tertiary vascular center in Montreal, Quebec, Canada...
December 2016: European Journal of Vascular and Endovascular Surgery
https://read.qxmd.com/read/27438112/gait-speed-and-operative-mortality-in-older-adults-following-cardiac-surgery
#6
JOURNAL ARTICLE
Jonathan Afilalo, Sunghee Kim, Sean O'Brien, J Matthew Brennan, Fred H Edwards, Michael J Mack, James B McClurken, Joseph C Cleveland, Peter K Smith, David M Shahian, Karen P Alexander
IMPORTANCE: Prediction of operative risk is a critical step in decision making for cardiac surgery. Existing risk models may be improved by integrating a measure of frailty, such as 5-m gait speed, to better capture the heterogeneity of the older adult population. OBJECTIVE: To determine the association of 5-m gait speed with operative mortality and morbidity in older adults undergoing cardiac surgery. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted from July 1, 2011, to March 31, 2014, at 109 centers participating in the Society of Thoracic Surgeons Adult Cardiac Surgery Database...
June 1, 2016: JAMA Cardiology
https://read.qxmd.com/read/27568870/conceptual-models-of-frailty-the-sarcopenia-phenotype
#7
JOURNAL ARTICLE
Jonathan Afilalo
Population aging has redefined cardiovascular medicine toward multifaceted patient-oriented care, with frailty emerging as a fundamental concept. The definition of frailty is ardently debated between opposing constructs: phenotypic criteria and accumulated deficits. Phenotypic criteria revolve around age-related loss of muscle mass and strength, known as sarcopenia. Skeletal muscle is crucial for functioning, mobility, energetics, and is the body's primary reservoir for amino acids. Sarcopenia can be assessed objectively, serving as an incremental predictor of adverse health outcomes and a therapeutic target for muscle-building interventions...
September 2016: Canadian Journal of Cardiology
https://read.qxmd.com/read/27894734/training-geriatric-cardiologists-for-an-aging-population-time-to-get-going
#8
EDITORIAL
Scott L Hummel, Craig M Alpert, Christos Galatas, Jonathan Afilalo
No abstract text is available yet for this article.
April 2017: American Journal of Medicine
https://read.qxmd.com/read/27765189/prediction-of-poor-outcome-after-transcatheter-aortic-valve-replacement
#9
JOURNAL ARTICLE
Suzanne V Arnold, Jonathan Afilalo, John A Spertus, Yuanyuan Tang, Suzanne J Baron, Philip G Jones, Michael J Reardon, Steven J Yakubov, David H Adams, David J Cohen
BACKGROUND: A series of models have been developed to identify patients at high risk for poor outcomes after transcatheter aortic valve replacement (TAVR) to help guide treatment choices, offer patients realistic expectations of long-term outcomes, and support decision making. OBJECTIVES: This study examined the performance of the previously developed TAVR Poor Outcome risk models in an external dataset and explored the incremental contribution of geriatric domains to model performance...
October 25, 2016: Journal of the American College of Cardiology
https://read.qxmd.com/read/27443429/predicting-early-and-late-mortality-after-transcatheter-aortic-valve-replacement
#10
RANDOMIZED CONTROLLED TRIAL
James B Hermiller, Steven J Yakubov, Michael J Reardon, G Michael Deeb, David H Adams, Jonathan Afilalo, Jian Huang, Jeffrey J Popma
BACKGROUND: Few studies have examined the impact of novel indices of comorbidity, frailty, and disability on outcomes after transcatheter aortic valve replacement (TAVR). OBJECTIVES: This study analyzed patients from the Medtronic CoreValve U.S. Pivotal Trial program to develop a simple scoring system that incorporates standard and novel predictor variables. METHODS: A multidisciplinary heart team used objective criteria, such as The Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM), and subjective criteria to assess patients' eligibility for TAVR...
July 26, 2016: Journal of the American College of Cardiology
https://read.qxmd.com/read/27706136/evidence-for-a-limit-to-human-lifespan
#11
JOURNAL ARTICLE
Xiao Dong, Brandon Milholland, Jan Vijg
Driven by technological progress, human life expectancy has increased greatly since the nineteenth century. Demographic evidence has revealed an ongoing reduction in old-age mortality and a rise of the maximum age at death, which may gradually extend human longevity. Together with observations that lifespan in various animal species is flexible and can be increased by genetic or pharmaceutical intervention, these results have led to suggestions that longevity may not be subject to strict, species-specific genetic constraints...
October 13, 2016: Nature
https://read.qxmd.com/read/24126387/guide-to-the-assessment-of-physical-activity-clinical-and-research-applications-a-scientific-statement-from-the-american-heart-association
#12
JOURNAL ARTICLE
Scott J Strath, Leonard A Kaminsky, Barbara E Ainsworth, Ulf Ekelund, Patty S Freedson, Rebecca A Gary, Caroline R Richardson, Derek T Smith, Ann M Swartz
The deleterious health consequences of physical inactivity are vast, and they are of paramount clinical and research importance. Risk identification, benchmarks, efficacy, and evaluation of physical activity behavior change initiatives for clinicians and researchers all require a clear understanding of how to assess physical activity. In the present report, we have provided a clear rationale for the importance of assessing physical activity levels, and we have documented key concepts in understanding the different dimensions, domains, and terminology associated with physical activity measurement...
November 12, 2013: Circulation
https://read.qxmd.com/read/27673575/knowledge-gaps-in-cardiovascular-care-of-older-adults-a-scientific-statement-from-the-american-heart-association-american-college-of-cardiology-and-american-geriatrics-society-executive-summary
#13
REVIEW
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...
November 2016: Journal of the American Geriatrics Society
https://read.qxmd.com/read/26794722/invasive-versus-conservative-strategy-in-patients-aged-80-years-or-older-with-non-st-elevation-myocardial-infarction-or-unstable-angina-pectoris-after-eighty-study-an-open-label-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Nicolai Tegn, Michael Abdelnoor, Lars Aaberge, Knut Endresen, Pål Smith, Svend Aakhus, Erik Gjertsen, Ola Dahl-Hofseth, Anette Hylen Ranhoff, Lars Gullestad, Bjørn Bendz
BACKGROUND: Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris are frequent causes of hospital admission in the elderly. However, clinical trials targeting this population are scarce, and these patients are less likely to receive treatment according to guidelines. We aimed to investigate whether this population would benefit from an early invasive strategy versus a conservative strategy. METHODS: In this open-label randomised controlled multicentre trial, patients aged 80 years or older with NSTEMI or unstable angina admitted to 16 hospitals in the South-East Health Region of Norway were randomly assigned to an invasive strategy (including early coronary angiography with immediate assessment for percutaneous coronary intervention, coronary artery bypass graft, and optimum medical treatment) or to a conservative strategy (optimum medical treatment alone)...
March 12, 2016: Lancet
https://read.qxmd.com/read/26821840/psoas-muscle-area-and-all-cause-mortality-after-transcatheter-aortic-valve-replacement-the-montreal-munich-study
#15
MULTICENTER STUDY
Samuel Mamane, Louis Mullie, Nicolo Piazza, Giuseppe Martucci, José Morais, Antonio Vigano, Mark Levental, Kristoff Nelson, Ruediger Lange, Jonathan Afilalo
BACKGROUND: Psoas muscle area (PMA) is a novel measure of frailty that can be efficiently measured from computed tomography images to help predict risk in older adults referred for transcatheter aortic valve replacement (TAVR). The objective of this study was to determine if PMA would be incrementally predictive of mortality and morbidity after TAVR. METHODS: The pre-TAVR computed tomography scans of 208 consecutive patients at 2 hospitals in Montreal and Munich were analyzed to measure the cross-sectional area of the left and right psoas muscles on a single axial slice at the level of L4...
February 2016: Canadian Journal of Cardiology
https://read.qxmd.com/read/27407052/derivation-and-validation-of-prognosis-based-age-cutoffs-to-define-elderly-in-cardiac-surgery
#16
MULTICENTER STUDY
Jonathan Afilalo, Russell Steele, Warren J Manning, Kamal R Khabbaz, Lawrence G Rudski, Yves Langlois, Jean-Francois Morin, Michael H Picard
BACKGROUND: The age cutoff to define elderly is controversial in cardiac surgery, empirically ranging from ≥65 to ≥80 years. Beyond semantics, this has important implications as a starting point for clinical care pathways and inclusion in trials. We sought to characterize the relationship between age and adverse outcomes in patients undergoing cardiac surgery and to derive and validate prognosis-based age cutoffs. METHODS AND RESULTS: Six thousand five hundred seventy one consecutive adult patients undergoing cardiac surgery at 3 hospitals in the United States and Canada were included in the cohort...
July 2016: Circulation. Cardiovascular Quality and Outcomes
https://read.qxmd.com/read/27166212/the-road-to-frailty-is-paved-with-good-intentions
#17
EDITORIAL
Jonathan Afilalo
No abstract text is available yet for this article.
May 2016: Circulation. Cardiovascular Quality and Outcomes
https://read.qxmd.com/read/26920495/gait-speed-predicts-30-day-mortality-after-transcatheter-aortic-valve-replacement-results-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#18
COMPARATIVE STUDY
Joakim Alfredsson, Amanda Stebbins, J Matthew Brennan, Roland Matsouaka, Jonathan Afilalo, Eric D Peterson, Sreekanth Vemulapalli, John S Rumsfeld, David Shahian, Michael J Mack, Karen P Alexander
BACKGROUND: Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. METHODS AND RESULTS: We assessed the association of 5-m gait speed with outcomes in a cohort of 8039 patients who underwent transcatheter aortic valve replacement (November 2011-June 2014) and were included in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry...
April 5, 2016: Circulation
https://read.qxmd.com/read/26490492/association-of-habitual-dietary-resveratrol-exposure-with-the-development-of-frailty-in-older-age-the-invecchiare-in-chianti-study
#19
JOURNAL ARTICLE
Montserrat Rabassa, Raul Zamora-Ros, Mireia Urpi-Sarda, Stefania Bandinelli, Luigi Ferrucci, Cristina Andres-Lacueva, Antonio Cherubini
BACKGROUND: Resveratrol may play a protective role against the frailty syndrome (FS) because of its antioxidant and anti-inflammatory properties. OBJECTIVE: We prospectively evaluated the association between habitual dietary resveratrol exposure and the development of FS after 3-, 6-, and 9-y follow-up periods in a community-dwelling older population. DESIGN: We conducted a longitudinal analysis with the use of data from 769 participants aged ≥65 y from the Invecchiare in Chianti (Aging in Chianti) study...
December 2015: American Journal of Clinical Nutrition
https://read.qxmd.com/read/26483093/frailty-and-anticoagulation-prescription-rate-for-atrial-fibrillation-in-the-elderly
#20
LETTER
Frédéric Roca, Oarda Bahri, Philippe Chassagne
No abstract text is available yet for this article.
February 2016: Canadian Journal of Cardiology
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