1,818 results match your criteria Clinics in Geriatric Medicine[Journal]


New Strategies for Falls Prevention.

Authors:
Steven C Castle

Clin Geriatr Med 2019 05;35(2):xi-xiv

Geriatric Medicine, UCLA School of Medicine, VA Greater Los Angeles, DrBalance, Inc, California State University, Fullerton, 11301 Wilshire Blvd, GRECC 11G Bld 158 Rm 117, Los Angeles, CA 90073, USA. Electronic address:

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May 2019
1 Read

Erratum.

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Clin Geriatr Med 2019 05;35(2):ix-x

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http://dx.doi.org/10.1016/j.cger.2019.01.001DOI Listing

Preventing Falls in Hospitalized Patients: State of the Science.

Clin Geriatr Med 2019 05 1;35(2):273-283. Epub 2019 Mar 1.

Geriatric Research Education and Clinical Center (GRECC), University of Florida, Malcom Randall VA Medical Center, 1601 SW Archer Road, GRECC (182), Gainesville, FL 32608, USA. Electronic address:

Falls in hospitalized patients are a pressing patient safety concern, but there is a limited body of evidence demonstrating the effectiveness of commonly used fall prevention interventions in hospitals. This article reviews common study designs and the evidence for various hospital fall prevention interventions. There is a need for more rigorous research on fall prevention in the hospital setting. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446937PMC
May 2019
13 Reads

Redesigning a Fall Prevention Program in Acute Care: Building on Evidence.

Clin Geriatr Med 2019 05 1;35(2):265-271. Epub 2019 Mar 1.

Hunter-Bellevue School of Nursing, New York, NY, USA. Electronic address:

Through education, frontline nurse involvement, and redesigning fall prevention approach, hourly rounding was promoted as a proactive falls prevention strategy with the goal of decreasing falls and promoting patient safety, health, and comfort. Nurses in health care organizations increase patient safety and reduce patient falls in the hospital setting through hourly rounding with a purpose. Current practices must be redesigned to ensure that acute care fall prevention initiatives are consistent and transformational. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.006DOI Listing
May 2019
1 Read

Outcomes of Patient-Engaged Video Surveillance on Falls and Other Adverse Events.

Clin Geriatr Med 2019 05 1;35(2):253-263. Epub 2019 Mar 1.

AvaSure, LLC, 5801 Safety Drive, Belmont, MI 49306, USA.

Patient-engaged video surveillance implemented in 71 hospitals over 1 year revealed low rates in assisted and unassisted falls, room elopement, and line, tube, or drain dislodgement per 1000 days of surveillance. Monitor technicians interacted 20.5 times per day with patients who fell and initiated alarms for urgent unit staff response 2. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.005DOI Listing
May 2019
1 Read

Optimizing Function and Physical Activity in Hospitalized Older Adults to Prevent Functional Decline and Falls.

Clin Geriatr Med 2019 05 1;35(2):237-251. Epub 2019 Mar 1.

Pennsylvania State University, College of Nursing, 201 Nursing Sciences Building, University Park, PA 16802, USA.

Physical activity, defined as bodily movement that expends energy including such things as bed mobility, transfers, bathing, dressing, and walking, has a positive impact on physical and psychosocial outcomes among older adults during their hospitalization and the post hospitalization recovery period. Despite benefits, physical activity is not the focus of care in the acute care setting. Further there are many barriers to engaging patients in physical activity and fall prevention activities including patient, family and provider beliefs, environmental challenges and limitations, hospital policies, and medical and nursing interventions. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.003DOI Listing

The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review.

Clin Geriatr Med 2019 05 5;35(2):221-236. Epub 2019 Mar 5.

Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center (650), 830 Chalkstone Avenue, Providence, RI 02908 USA; Department of Medicine, Warren Alpert Medical School, Brown University, Box G-A1, Providence, RI 02912, USA; Center of Gerontology and Health Research, Brown University School of Public Health, Providence, RI, USA. Electronic address:

Falls frequently occur in persons with cognitive impairment, including delirium. This article presents a systematic review of the association between falls and delirium in adults aged 65 years or older. For the studies that compared falls and delirium, the risk ratio was consistently elevated (median RR 4. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.004DOI Listing
May 2019
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Older Adult Falls in Emergency Medicine: 2019 Update.

Clin Geriatr Med 2019 05 1;35(2):205-219. Epub 2019 Mar 1.

Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, 5 Emerson, 119C, Boston, MA 02114, USA.

"Standing-level falls represent the most frequent cause of trauma-related death in older adults and a common emergency department (ED) presentation. However, these patients rarely receive guideline-directed screening and interventions during or following an episode of care. Reducing injurious falls in an aging society begins with prehospital evaluations and continues through definitive risk assessments and interventions that usually occur after ED care. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.009DOI Listing

Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk: 2019 Update.

Clin Geriatr Med 2019 05 1;35(2):185-204. Epub 2019 Mar 1.

North Carolina Association of Pharmacists, 1101 Slater Road, Suite 110, Durham, NC 27703, USA.

This article highlights the significant health impact of falls among older adults. An emphasis is placed on the vital role of the pharmacist, regardless of practice setting, in assessing and reducing falls risk for this growing population. In addition, the importance of a stepwise comprehensive approach to falls assessment by pharmacists in collaboration with other clinicians is elucidated. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.010DOI Listing

Balance Problems and Fall Risks in the Elderly.

Clin Geriatr Med 2019 05;35(2):173-183

Physical Medicine and Rehabilitation Service, West Palm Beach VA Medical Center, University of Miami Miller School of Medicine, Nova Southeastern University College of Osteopathic Medicine, 7305 North Military Trail, PM&RS (117), West Palm Beach, FL 33410-6400, USA. Electronic address:

Falls in the elderly are an increasing problem causing a high degree of morbidity, mortality, and use of health care services. Identification of risk factors through medical assessment supports the provision of appropriate interventions that reduce rates of falling. Evaluation and intervention strategies are generally challenging because of the complex and multifactorial nature of falls. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.008DOI Listing
May 2019
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Falls, Footwear, and Podiatric Interventions in Older Adults.

Clin Geriatr Med 2019 05 1;35(2):161-171. Epub 2019 Mar 1.

School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, AA Building, Northcote, Auckland 0627, New Zealand.

Footwear is a modifiable risk factor for falls in older adults, including populations with metabolic disease, inflammatory arthritis, and neurodegenerative disease. Ill-fitting footwear, and specific design features, such as elevated heels and backless styles, can impair balance control and heighten the risk of falling. Although foot care is routine practice for some older adults to prevent ulceration (eg, diabetes) or relieve symptoms (eg, foot pain), new footwear interventions are emerging with the potential to ameliorate balance and walking impairments. Read More

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http://dx.doi.org/10.1016/j.cger.2018.12.001DOI Listing

Despite Active Public Health Campaigns, Death from Falls Increased 30% in the Past Decade: Is Ageism Part of the Barrier to Self-Awareness?

Authors:
Steven C Castle

Clin Geriatr Med 2019 05 1;35(2):147-159. Epub 2019 Mar 1.

UCLA School of Medicine, VA Greater Los Angeles, DrBalance, Inc, California State University, Fullerton, 11301 Wilshire Blvd, GRECC 11G Bld 158 Rm 117, Los Angeles, CA 90073, USA. Electronic address:

Public health messaging campaigns stating that falls are bad and can be prevented are not effective, as evidenced by a 30% increase in death from falls over the past decade. A first approach is to use measures of balance to show the magnitude of the problem. Second, the role of ageism as a barrier to required behavioral change should be addressed. Read More

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http://dx.doi.org/10.1016/j.cger.2019.01.002DOI Listing

Nuances of Surgical Care for the Elderly.

Clin Geriatr Med 2019 02;35(1):xiii-xiv

Lehigh Valley Health Network, Department of Surgery, University of South Florida, Morsani College of Medicine, Lehigh Valley Campus, Department of Education, 1247 South Cedar Crest Boulevard Suite 202, Allentown, PA 18103, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cger.2018.10.001DOI Listing
February 2019
2 Reads

Vascular Surgery and Geriatric Patients.

Clin Geriatr Med 2019 02 11;35(1):93-101. Epub 2018 Oct 11.

Department of Vascular Surgery and Endovascular Surgery, Loyola University Chicago, Stritch School of Medicine, 2160 South First Avenue, EMS Building 110, Room 3220, Maywood, IL 60153, USA. Electronic address:

As the population ages, surgical decision-making in vascular surgery has become more complex. Older patients may not have been offered vascular surgical intervention in the past because of prohibitive physiologic demands and poor health. Patients now have more aggressive management of vascular risk factors with medications, such as statin therapy, and less invasive endovascular or hybrid treatment options. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.008DOI Listing
February 2019
3 Reads

Orthopedic Surgery and the Geriatric Patient.

Clin Geriatr Med 2019 02 11;35(1):65-92. Epub 2018 Oct 11.

Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, USA. Electronic address:

As more patients live longer, it is probable that an increasing number of geriatric patients will require surgery. An organized, systematic, coordinated, multidisciplinary approach to the perioperative management of these patients will result in fewer complications, improved outcomes, and reduced cost of care. Details are herein provided on the preoperative diagnostic evaluation and assessment as well as perioperative care provided to optimize outcomes. Read More

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February 2019
19 Reads

Surgical Oncology and Geriatric Patients.

Clin Geriatr Med 2019 02;35(1):53-63

Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267-0558, USA. Electronic address:

Geriatric medicine is a growing field filled with complicated patients who are susceptible to developing cancer. Surgical oncology is expanding while adapting to the increasing elderly population and creating novel treatment regimens for this group of patients. This article reviews surgical oncology in elderly patients and addresses surgical optimization, management of several cancer subtypes, surgical advances in minimally invasive surgery, and ethical considerations. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.006DOI Listing
February 2019
1 Read

Transitions of Care in Geriatric Medicine.

Clin Geriatr Med 2019 02 3;35(1):45-52. Epub 2018 Oct 3.

Shock Trauma Center, University of Maryland School of Medicine, T1R40, 22 South Green Street, Baltimore, MD 21201, USA. Electronic address:

Elderly patients are at increased risk for morbidity and mortality after injury or surgery in both the inpatient and postdischarge settings. The importance of discharge destination after the index hospitalization is increasingly recognized as a determinant of long-term survival, with discharge to a post-acute care facility portending a worse prognosis. Efforts to minimize discharge to post-acute care facilities should include early discharge planning. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.005DOI Listing
February 2019
7 Reads

Palliative Care and Geriatric Surgery.

Clin Geriatr Med 2019 02 28;35(1):35-44. Epub 2018 Sep 28.

Department of Surgery, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address:

Although many seniors cite maintaining independence and a desire to die at home as health priorities, admission to the ICU and the use of invasive procedures are common near the end of life. Palliative care aims to relieve pain and other symptoms to maintain the highest quality of life for the longest period of time, but surgical patients are less likely to be referred to palliative care than patients with chronic medical conditions. Meeting the palliative care needs of elderly surgical patients requires early recognition, advance care planning, and multidisciplinary interventions that align patient goals with possible outcomes. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.004DOI Listing
February 2019
3 Reads

Utilization of Geriatric Consultation and Team-Based Care.

Clin Geriatr Med 2019 02 8;35(1):27-33. Epub 2018 Oct 8.

HonorHealth John C Lincoln Hospital, 250 E. Dunlap, Phoenix, AZ 85250, USA.

Geriatric surgical patients experience higher mortality and morbidity rates than their younger counterparts. Three models of geriatric surgical care are described, with a focus on people, plans, and evaluation. These models include geriatric consultation services, geriatric wards, and geriatric multidisciplinary teams. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.003DOI Listing
February 2019
14 Reads
3.190 Impact Factor

Frailty and Prognostication in Geriatric Surgery and Trauma.

Clin Geriatr Med 2019 02 3;35(1):13-26. Epub 2018 Oct 3.

Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, 1211 21st Avenue South, Nashville, TN 37212-1750, USA.

Frailty is a predominant predictor of poor outcomes in older populations. This article presents a review of the concept of frailty and its role for prognostication among geriatric trauma and surgery patients. We discuss models of frailty defined in the scientific literature, emphasizing that frailty is a process of biologic aging. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.002DOI Listing
February 2019
22 Reads

Driving in the Geriatric Population.

Clin Geriatr Med 2019 02 5;35(1):127-131. Epub 2018 Oct 5.

Emory University School of Medicine, Grady Hospital, 80 Jesse Hill Jr. Drive Southeast, Atlanta, GA 30303, USA.

Driving helps older adults stay mobile and independent. The risk of being injured or killed in a motor vehicle crash increases with age. This trend has been attributed more to an increased susceptibility to injury and medical complications among older drivers rather than an increased risk of crash involvement. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.011DOI Listing
February 2019
5 Reads

Falls in the Geriatric Patient.

Clin Geriatr Med 2019 02 8;35(1):115-126. Epub 2018 Oct 8.

Trauma Service, Stanford Health Care, 300 Pasteur Drive, MC 5898, Stanford, CA 94305, USA; Injury Prevention and Community Engagement, Stanford Health Care/Stanford Medicine, Stanford, CA, USA. Electronic address:

Falls in older adults are multifaceted, and are caused by biologic, behavioral, environmental, and socioeconomic risk factors. An estimated 25% of older adults fall each year. With 10,000 people turning 65 each day, it is essential that those at highest risk receive intervention to decrease the risk and rate of falls. Read More

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February 2019
12 Reads

Elder Abuse.

Clin Geriatr Med 2019 02 5;35(1):103-113. Epub 2018 Oct 5.

Department of Surgery, University of Florida College of Medicine Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, USA. Electronic address:

Elder abuse is generally defined as the maltreatment of individuals over the age of 60, although no precise definition exists in the literature. Types of abuse include, but are not limited to, psychological/emotional, physical, sexual abuse, and financial exploitation. Certain risk factors exist leaving an individual more susceptible to abuse, and many obstacles exist preventing the elimination of abuse. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.009DOI Listing
February 2019
3 Reads

Changing Epidemiology of the American Population.

Clin Geriatr Med 2019 02 11;35(1):1-12. Epub 2018 Oct 11.

Department of Surgery, Division of Trauma, Critical Care and Emergency Surgery, The University of Arizona, 1501 North Campbell Avenue, Room 5411, PO Box 245063, Tucson, AZ 85724, USA. Electronic address:

The changing epidemiology of the geriatric population in the United States has diverse social, medical, and financial implications that will continue to expand over the next few decades. According to the US Census Bureau, 20% of the US population will be 65 years or older by 2030 and more than 50% will eventually belong to a minority group. These changes are expected to be accompanied by several effects on the geriatric population's demographics, injury characteristics, surgical interventions, and the cost of caring for the geriatric population, which will ultimately broaden the financial burden. Read More

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http://dx.doi.org/10.1016/j.cger.2018.08.001DOI Listing
February 2019
1 Read

Patient-Centered Care and Cognitive Dysfunction.

Authors:
John E Morley

Clin Geriatr Med 2018 11;34(4):ix-x

Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, Room M238, St. Louis, MO 63104, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cger.2018.08.013DOI Listing
November 2018
16 Reads

Nutrition and Alzheimer Disease.

Clin Geriatr Med 2018 11 24;34(4):677-697. Epub 2018 Aug 24.

School of Public Health and School of Arts, Sciences and Humanities, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo CEP - 01246-904, Brazil and Av. Arlindo Bettio, 1000 CEP 03828-000, São Paulo, SP, Brazil. Electronic address:

We gathered some theoretic and practical concepts related to the importance of nutrition in the prevention and management of Alzheimer disease (AD). Besides the role of nutrients in brain development and functioning, some nutrients exert special control in the development of AD, due to their participation in neurotransmitter synthesis, their modulation in epigenetics mechanisms, and as antioxidants. In addition, some non-nutrient food-derived substances have shown potential in the control of neuroinflammation and consequently in the prevention of AD. Read More

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http://dx.doi.org/10.1016/j.cger.2018.06.012DOI Listing
November 2018
2 Reads

Cognitive Frailty in Geriatrics.

Clin Geriatr Med 2018 11 16;34(4):667-675. Epub 2018 Aug 16.

Department of Geriatric Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.

Since the operational definition of "cognitive frailty" was proposed in 2013 by the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics, several studies have shown the prevalence and outcomes of cognitive frailty. The prevalence of cognitive frailty is quite low in the community settings when the original definition is applied, but higher in clinical settings. In longitudinal studies, cognitive frailty is a risk for disability, poor quality of life, dementia, and death. Read More

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http://dx.doi.org/10.1016/j.cger.2018.06.011DOI Listing
November 2018
12 Reads

Cognitive Stimulation Therapy for Dementia.

Clin Geriatr Med 2018 11 20;34(4):653-665. Epub 2018 Aug 20.

Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Jubilee Campus, University of Nottingham Innovation Park, Triumph Road, Nottingham NG7 2TU, UK.

Cognitive stimulation therapy has proven to be both an effective and enjoyable psychological treatment for people with dementia. Over the past 20 years, cognitive stimulation therapy has grown from a national, localized treatment in the UK to a more global phenomenon currently being used in more than 25 countries around the world. Much has been accomplished during the cognitive stimulation therapy journey and there is still much to be explored; it is a dynamic field. Read More

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November 2018
18 Reads

Behavioral Problems and Dementia.

Authors:
Ladislav Volicer

Clin Geriatr Med 2018 11 24;34(4):637-651. Epub 2018 Aug 24.

University of South Florida, Tampa, FL, USA. Electronic address:

Behavioral problems decrease quality of life of people with dementia and their care providers. Three main consequences of dementia are functional impairment and in some cases also mood disorders and psychosis. These consequences, alone or in combination, result in 3 main behavioral problems: apathy, agitation, and rejection of care/aggression. Read More

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November 2018
9 Reads

Traumatic Brain Injury, Chronic Traumatic Encephalopathy, and Alzheimer Disease.

Clin Geriatr Med 2018 11 21;34(4):617-635. Epub 2018 Aug 21.

Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA.

Traumatic brain injury (TBI) is a major health and economic burden. With increasing aging population, this issue is expected to continue to rise. Neurodegenerative disorders are more common with aging population in general regardless of history of TBI. Read More

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http://dx.doi.org/10.1016/j.cger.2018.06.008DOI Listing
November 2018
5 Reads

Lewy Body Dementia.

Authors:
Angela M Sanford

Clin Geriatr Med 2018 11 21;34(4):603-615. Epub 2018 Aug 21.

Division of Geriatrics, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA. Electronic address:

Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causing clinically apparent symptoms. Read More

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http://dx.doi.org/10.1016/j.cger.2018.06.007DOI Listing
November 2018
2 Reads

Alzheimer Disease.

Clin Geriatr Med 2018 11 21;34(4):591-601. Epub 2018 Aug 21.

Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA.

Alzheimer disease is due to increased amyloid-β coupled with low progranulin. Several brain imaging techniques are helpful in the diagnosis. Drugs available for treating Alzheimer disease have limited clinical utility. Read More

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November 2018
16 Reads

Mild Cognitive Impairment in Geriatrics.

Clin Geriatr Med 2018 11 21;34(4):563-589. Epub 2018 Aug 21.

Department of Medicine, Division of Community Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.

Mild cognitive impairment remains a clinical diagnosis, aided by history, neurologic examination, screening mental status examination, and secondary testing. It can be difficult to distinguish from normal aging without understanding a patient's prior level of intellectual function and new complaint. Geriatricians encounter patients with mild cognitive impairment in all long-term care settings. Read More

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November 2018
5 Reads

Reversible Dementias.

Authors:
Milta O Little

Clin Geriatr Med 2018 11 28;34(4):537-562. Epub 2018 Aug 28.

Division of Geriatric Medicine, Department of Internal Medicine, Saint Louis University Health Center, 1402 South Grand Boulevard Room M238, St Louis, MO 63104, USA. Electronic address:

As the worldwide prevalence of dementia increases, there is a greater and more urgent need for all health care providers to understand how to evaluate and manage cognitive impairment. Many people presenting with a dementing illness have one or more reversible underlying conditions that worsen prognosis and, if treated, can improve cognitive function. This article reviews the major potentially reversible dementias, including the basic workup and management of each condition. Read More

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http://dx.doi.org/10.1016/j.cger.2018.07.001DOI Listing
November 2018
1 Read

Screening for Cognitive Impairment in Geriatrics.

Clin Geriatr Med 2018 11;34(4):515-536

The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China 610041. Electronic address:

There are many instruments for screening cognitive impairment. The common tools for screening cognitive impairment are categorized into 4 groups (very brief, brief, self-administered, and test batteries) in geriatrics. There are some tests used for specific tests of 6 cognitive domains (learning and memory, language, executive function, complex attention, and social cognition) by following the DSM-V criteria. Read More

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November 2018
1 Read
3.190 Impact Factor

An Overview of Cognitive Impairment.

Authors:
John E Morley

Clin Geriatr Med 2018 11 21;34(4):505-513. Epub 2018 Aug 21.

Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA. Electronic address:

Cognitive decline occurs in all persons during the aging process. Eventually, this can result in mild cognitive impairment and dementia. There are more than 100 causes of dementia. Read More

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http://dx.doi.org/10.1016/j.cger.2018.06.003DOI Listing
November 2018
28 Reads

Clin Geriatr Med 2018 08 23;34(3):xvii-xix. Epub 2018 Jun 23.

The John A. Hartford Foundation, 55 East 59th Street, New York, NY 10022, USA. Electronic address:

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http://dx.doi.org/10.1016/j.cger.2018.06.002DOI Listing
August 2018
7 Reads

Improving the Emergency Department Care of Older Adults in North America.

Clin Geriatr Med 2018 08 20;34(3):xiii-xv. Epub 2018 Jun 20.

University of North Carolina at Chapel Hill, Emergency Medicine and Internal Medicine, Division of Geriatrics, West Health Consultant, Physicians Office Building, 170 Manning Drive, CB# 7594, Chapel Hill, NC 27599-7594, USA. Electronic address:

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August 2018
2 Reads

Older Adult Emergency Department Pain Management Strategies.

Clin Geriatr Med 2018 08 13;34(3):491-504. Epub 2018 Jun 13.

Section of Geriatrics and Palliative Medicine, 5841 South Maryland Avenue, MC6098, Chicago, IL 60637, USA; Section of Emergency Medicine, L-550A (MC 5068), 5841 S, Maryland Avenue, Chicago, IL 60637, USA. Electronic address:

Older adults frequently present to the emergency department (ED) with pain, which is often underrecognized and undertreated. There is high variability of pain management and prescribing practices by ED providers. This article focuses on treatment of older adults in the ED who present with pain and addresses special considerations for this population. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.009DOI Listing
August 2018
2 Reads

Behavioral Health Needs of Older Adults in the Emergency Department.

Clin Geriatr Med 2018 08 15;34(3):469-489. Epub 2018 Jun 15.

Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, 800 University Bay Drive, Suite 310, MC9123, Madison, WI 53705, USA.

Behavioral health disorders are common among older adults and, owing to limited access to resources for mental health care in the community, emergency department providers are often on the front lines of mental health crises. This article reviews the available literature regarding the care of behavioral health emergencies in older adults and provides a framework for navigating the evaluation and management of older adults presenting to the emergency department with behavioral health concerns. Read More

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http://dx.doi.org/10.1016/j.cger.2018.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363347PMC
August 2018
2 Reads

Care of Geriatric Patients with Advanced Illnesses and End-of-Life Needs in the Emergency Department.

Clin Geriatr Med 2018 08;34(3):453-467

Geriatrics and Palliative Medicine Inpatient Services, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1970, New York, NY 10029, USA.

Older patients with advanced illness are presenting more frequently to emergency departments (EDs). These patients have complex needs, which challenge busy EDs tuned to provide emergent, life-sustaining interventions, and rapid dispositions. This article outlines communication skills to assess patient goals so that the ED provider can create a care plan that matches level of medical intervention with patient wishes. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.008DOI Listing
August 2018
11 Reads

Identifying and Initiating Intervention for Elder Abuse and Neglect in the Emergency Department.

Clin Geriatr Med 2018 08 15;34(3):435-451. Epub 2018 Jun 15.

Division of Emergency Medicine, Emergency Department, Weill Cornell Medical College, NewYork-Presbyterian/Weill Cornell Medical Center, 525 East 68th Street, Room M130, New York, NY 10065, USA.

Elder abuse and neglect are common and may have serious medical and social consequences but are infrequently identified. An emergency department (ED) visit represents a unique but usually missed opportunity to identify potential abuse and initiate intervention. ED assessment should include observation of patient-caregiver interaction, comprehensive medical history, and head-to-toe physical examination. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057151PMC
August 2018
3 Reads

Common Medication Management Approaches for Older Adults in the Emergency Department.

Clin Geriatr Med 2018 08 15;34(3):415-433. Epub 2018 Jun 15.

Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Chicago, IL 60611, USA; Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.

Adverse drug events (ADEs) can lead to emergency department (ED) visits and hospitalizations. Many ADEs are preventable. Incomplete information, poor understanding, and time constraints often lead to use of potentially inappropriate medications and drug-drug interactions. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.006DOI Listing
August 2018
7 Reads

Systems-Based Practice to Improve Care Within and Beyond the Emergency Department.

Clin Geriatr Med 2018 08 13;34(3):399-413. Epub 2018 Jun 13.

Department of Medicine, Division of Geriatrics, Duke University, DUMC 3003, Durham, NC 27710, USA.

There is evidence that an emergency department (ED) visit signifies a period of vulnerability for older adults. Transition between the ED and community care can be fraught with challenges. There are essential elements for improved care transition from the ED to the community. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.005DOI Listing
August 2018
22 Reads

Communication Strategies for Better Care of Older Individuals in the Emergency Department.

Clin Geriatr Med 2018 08;34(3):387-397

Aurora Senior Services, Aurora Health Care, Aurora Sinai Medical Center, 1020 North 12th Street, Milwaukee, WI 53233, USA.

The need for teamwork and communication among emergency department staff is central to excellent health care and of particular importance for the complex older adult population. Communication can decrease error, enhance safety, and improve throughput. Communication strategies both among multiple health care professionals, and between professionals and family and/or patients can improve care for older adults in the unique emergency department environment. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.004DOI Listing
August 2018
2 Reads

Older Adults in the Emergency Department with Frailty.

Clin Geriatr Med 2018 08;34(3):369-386

Department of Medicine, Dalhousie University, 5955 Veterans' Memorial Lane, Halifax, Nova Scotia B3H2E1, Canada. Electronic address:

In the emergency department (ED), frailty represents the vulnerability of an individual because of their underlying health status. An older patient can be identified as frail by using a frailty index, the Clinical Frailty Scale, a frailty phenotype, or a screening measure such as the Identification of Seniors at Risk (ISAR). In the ED, the frail older person should have an interdisciplinary assessment, a thoughtful review of their medications, a screen for other geriatric syndromes, and a care plan that addresses the individual's needs, includes the patient's goals and preferences, and follows the patient beyond the ED. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.003DOI Listing
August 2018
4 Reads

Older Adult Falls in Emergency Medicine-A Sentinel Event.

Clin Geriatr Med 2018 08;34(3):355-367

Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, 5 Emerson, 119C, Boston, MA 02114, USA.

Standing-level falls represent the most frequent cause of trauma-related death in older adults and a common emergency department presentation. However, these patients rarely receive guideline-directed screening and interventions during or following an episode of care. Reducing injurious falls in an aging society begins with prehospital evaluations and continues through risk assessments and interventions that occur after emergency department care. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.002DOI Listing
August 2018
2 Reads

Delirium and Dementia.

Clin Geriatr Med 2018 08;34(3):327-354

Department of Emergency Medicine, Magee-Womens Hospital of UPMC, University of Pittsburgh School of Medicine, 3600 Forbes Tower, Pittsburgh, PA 15213, USA.

Approximately 35% to 37% of older emergency department (ED) patients will have delirium or dementia, which can negatively affect safe and appropriate clinical care. This article describes the epidemiology of delirium and dementia in the ED and how it affects clinical care and patient outcomes. Screening for delirium and dementia in the context of the busy ED environment, as well as their diagnostic evaluation and management, is discussed. Read More

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http://dx.doi.org/10.1016/j.cger.2018.05.001DOI Listing
August 2018
11 Reads

Ten Best Practices for the Older Patient in the Emergency Department.

Clin Geriatr Med 2018 08 20;34(3):313-326. Epub 2018 Jun 20.

Department of Medicine, The Geisinger Commonwealth Medical College, 525 Pine Street, Scranton PA 18509, USA; Wilkes Barre General Hospital, 575 North River St Wilkes Barre, PA 18764, USA.

This article reviews 10 best practices that integrate geriatric principles into emergency department processes of care. These best practices are grouped around ten words: complexity; clinician education; geriatric-specific; atypical; medication; variability; cognitive impairment; psychosocial issues; end-of-life care; and interdisciplinary. Read More

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http://dx.doi.org/10.1016/j.cger.2018.04.001DOI Listing
August 2018
9 Reads