Tailoring Assessments and Prescription in Cardiac Rehabilitation for Older Adults
Older adults have distinctive health challenges that are relevant to the prevention and treatment of cardiovascular diseases and are potentially modifiable by cardiac rehabilitation. Cardiac rehabilitation in older adults provides opportunity to assess sarcopenia, obesity, osteoporosis, frailty, falls risk, arthritis, cognition, special senses, self-efficacy, depression, social support, polypharmacy, and nutritional adequacy. Therefore, broadening standard assessments to include these domains can help detect modifiable vulnerabilities and inform therapeutic priorities. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 31, 2019 Category: Geriatrics Authors: Maria Antoinette Fiatarone Singh Source Type: research

Cardiac Rehabilitation for Older Adults: Vital Opportunity to Improve Patient-Centered Cardiovascular Disease Care amid Worldwide Patient Aging
Cardiac rehabilitation (CR) has particular value for contemporary patients with cardiovascular disease (CVD) as it provides a unique opportunity to evaluate and address the distinctive needs of adults who are, on average, much older and complex than patients of years past. People are living longer in the United States and in much of the world, and aging is the number 1 risk factor for CVD as well as to its presentation in a context of multimorbidity, frailty, polypharmacy, and other geriatric complexities of care (also commonly including cognitive decline, sensory impairments, and increased falls). (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 31, 2019 Category: Geriatrics Authors: Daniel E. Forman Tags: Preface Source Type: research

Gender Disparities in Cardiac Rehabilitation Among Older Women
Older women with cardiovascular disease experience lower referral, participation, and completion rates of cardiac rehabilitation (CR), despite its well-established benefits (improved morbidity, mortality, quality of life, and functional capacity). Multiple social and health care system barriers affect participation of this population, including limitations in accessibility and transportation, competing responsibilities as caregivers, and lack of insight among patients and provider regarding the value of CR. With continued advances in technology and the ubiquity of smartphones, alternative CR programs may be able to better ...
Source: Clinics in Geriatric Medicine - August 22, 2019 Category: Geriatrics Authors: Bianca W. Yoo, Nanette K. Wenger Source Type: research

Prehabilitation
The wait before elective cardiac intervention or surgery presents an opportunity to prevent further physiologic decline preoperatively in older patients. Implementation of prehabilitation programs decreases length of hospital stay postoperatively, decreases time spent in the intensive care unit, decreases postoperative complications, and improves self-reported quality of life postsurgery. Prehabilitation programs should adopt multimodal approaches including nutrition, exercise, and worry reduction to improve patient resilience in the preoperative period. High-quality research in larger cohorts is needed, and interventions ...
Source: Clinics in Geriatric Medicine - August 19, 2019 Category: Geriatrics Authors: Kevin F. Boreskie, Jacqueline L. Hay, D. Scott Kehler, Nicole M. Johnston, Alexandra V. Rose, Christopher J. Oldfield, Kanwal Kumar, Olga Toleva, Rakesh C. Arora, Todd A. Duhamel Source Type: research

High-Intensity Interval Training in Cardiac Rehabilitation
Recently, high-intensity interval training (HIIT) has been recognized as a safe and effective alternative to moderate-intensity continuous training for older patients with cardiovascular disease (CVD) in cardiac rehabilitation settings in an effort to improve health outcomes. This brief review considers general principles and suggestions for prescription of HIIT for older patients with CVD, specific challenges pertaining to older adults, the physiologic mechanisms by which HIIT contributes to improvements in peak Vo2, and the effects of HIIT on cardiovascular health in older patients with coronary artery disease and heart ...
Source: Clinics in Geriatric Medicine - August 13, 2019 Category: Geriatrics Authors: Yaoshan Dun, Joshua R. Smith, Suixin Liu, Thomas P. Olson Source Type: research

Evaluating and Treating Frailty in Cardiac Rehabilitation
The benefits of cardiac rehabilitation (CR) are well-suited to counteract the deficits of frailty such as sarcopenia, inactivity, fatigue, cognitive decline, and depression. After a cardiovascular hospitalization, older patients are at increased risk for deconditioning and functional decline and thus should be evaluated for frailty and targeted for early CR referral. At the initial CR visit, frail older patients should undergo a 6-minute walk test and short physical performance battery to tailor their aerobic and resistance exercise plan, and they should be screened for geriatric impairments and environmental barriers to f...
Source: Clinics in Geriatric Medicine - August 10, 2019 Category: Geriatrics Authors: Jonathan Afilalo Source Type: research

Utility of Home-Based Cardiac Rehabilitation for Older Adults
Center-based cardiac rehabilitation is an evidence-based secondary prevention intervention comprising exercise training, education, and counseling for behavior change in patients with cardiovascular disease. Unfortunately, these programs are often financially and logistically prohibitive and thus underused. Home-based cardiac rehabilitation is an alternative that may better enable participation of older adults. This review highlights conceptual benefits and considerations of home-based cardiac rehabilitation. Additional research is required about the efficacy of home-based cardiac rehabilitation in relation to these challe...
Source: Clinics in Geriatric Medicine - August 10, 2019 Category: Geriatrics Authors: Theresa M. Beckie Source Type: research

Can Older Adults Benefit from Smart Devices, Wearables, and Other Digital Health Options to Enhance Cardiac Rehabilitation?
Cardiovascular disease (CVD) is the leading cause of death and disease burden globally. Improving reach, access, and effectiveness of postdischarge care through cardiac rehabilitation and secondary prevention strategies is an international priority. The current proliferation of mobile technology has resulted in widespread development and availability of digital health interventions that can reduce cardiovascular risk. Text-messaging programs and apps have been shown to improve health outcomes. Other areas of research investigating the use of wearable devices are still emerging but lack robust data. Mobile and smartphone ow...
Source: Clinics in Geriatric Medicine - August 10, 2019 Category: Geriatrics Authors: Julie Redfern Source Type: research

Resistance Training for Older Adults in Cardiac Rehabilitation
Cardiac rehabilitation plays a key role in the care of older patients after a coronary event. Hospitalizations are prevented and quality of life, exercise capacity, and physical function are improved. Almost 50% of cardiac rehabilitation participants are older adults (>65  years), many of whom are frail or deconditioned. Resistance training, as a component of cardiac rehabilitation, improves muscle strength, endurance, and physical function. The purpose of this review is to describe the effects of resistance training in cardiac rehabilitation for older adults with a particular focus on physical function. (Source: C...
Source: Clinics in Geriatric Medicine - August 10, 2019 Category: Geriatrics Authors: Sherrie Khadanga, Patrick D. Savage, Philip A. Ades Source Type: research

Never Too Old for Cardiac Rehabilitation
Prevalence of cardiovascular disease (CVD) increases with age and is endemic in the burgeoning population of older adults. Older adults with CVD are susceptible not only to high mortality but also to increased likelihood of disability, dependency, functional decline, and poor quality of life. Cardiac rehabilitation (CR) is a multidimensional and comprehensive treatment program that can potentially address many of the distinctive challenges of older adults with CVD. In this review, the wide range of potential benefits of CR for older adults with CVD is summarized. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 9, 2019 Category: Geriatrics Authors: Deirdre O ’Neill, Daniel E. Forman Source Type: research

Cardiac Rehabilitation for Transcatheter Aortic Valve Replacement
More than 300,000 patients worldwide have undergone transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). The rise in TAVR as a treatment option is driven in large part by evidence showing its benefits compared with medical treatment in patients with symptomatic severe AS who were too ill to undergo surgical aortic valve replacement. Cardiac rehabilitation (CR) is recommended after valvular cardiac surgery for improving exercise capacity, with data also now showing its utility to improve quality of life, moderate frailty, and increase survival. This review describes the state of the art of CR for T...
Source: Clinics in Geriatric Medicine - August 9, 2019 Category: Geriatrics Authors: Franco Tarro Genta Source Type: research

Cardiac Rehabilitation in Older Adults with Heart Failure
Cardiac rehabilitation (CR) is a structured exercise and lifestyle program that improves mortality and quality of life in patients with heart failure (HF) with reduced ejection fraction. However, significant gaps remain in optimizing CR for older adults with HF. This review summarizes the state of the science and specific knowledge gaps regarding older adults with HF. The authors discuss the importance of geriatric complexities in the design and implementation of CR, summarize promising future research in this area, and provide a clinical framework for current CR clinicians to follow when considering the specific needs of ...
Source: Clinics in Geriatric Medicine - August 9, 2019 Category: Geriatrics Authors: Kelsey M. Flint, Amy M. Pastva, Gordon R. Reeves Source Type: research

Peripheral Arterial Disease
Peripheral arterial disease (PAD) is frequently underdiagnosed and undertreated. This review identifies specific subgroups within older adults more likely to develop PAD, and describes methods to diagnose PAD and provide evidence in support of systematic referral to cardiac rehabilitation programs to enhance successful comprehensive management. Clear evidence and guidelines support the routine use of supervised exercise therapy to improve function, reduce risk of cardiovascular morbidity and mortality, and enhance the success of endovascular interventions. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 9, 2019 Category: Geriatrics Authors: Scott G. Thomas, Susan Marzolini, Edward Lin, Cindy H. Nguyen, Paul Oh Source Type: research

Cardiac Rehabilitation as Part of Management in Postacute Care
This article reviews the current state of reimbursement and use of cardiac rehabilitation, gaps in services, and opportunities to improve the use of cardiac rehabilitation, and provides recommendations for future research. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - August 9, 2019 Category: Geriatrics Authors: Mary Ann C. Podlogar, Mary A. Dolansky Source Type: research

Cardiac Rehabilitation to Optimize Medication Regimens in Heart Failure
Cardiac rehabilitation (CR) is an inherently patient-centered program that provides holistic care to adults with cardiovascular conditions to promote lifelong health and fitness, facilitate self-care and self-efficacy, and improve clinical outcomes. CR offers an excellent platform for patient-centered optimization of medication regimens for older adults with heart failure through its potential to address several aspects of care that have historically served as major challenges to clinicians —diuretic management, the use of guideline-directed medical therapy, review and reconciliation of noncardiovascular medications,...
Source: Clinics in Geriatric Medicine - July 25, 2019 Category: Geriatrics Authors: Parag Goyal, Eiran Z. Gorodeski, Zachary A. Marcum, Daniel E. Forman Source Type: research

Anemia in the Elderly: Not to be Ignored
Readers of Clinics in Geriatric Medicine are well aware of the demographic shifts throughout all world populations —industrialized or not—resulting in constantly increasing numbers of old and very-old individuals. Some of this is based upon increased birth rates after the Second World War, but also longer survival resulting from healthier life style and reduction in early deaths from acute illnesses includin g infection, coronary artery disease and cancer. As a consequence, chronic diseases such as diabetes, atherosclerotic vascular disease, arthritis and Alzheimer’s have become more prevalent, as has the...
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Authors: William B. Ershler Tags: Preface Source Type: research

Anemia in Older Adults
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Authors: William B. Ershler Source Type: research

Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Source Type: research

Contributors
WILLIAM B. ERSHLER, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Source Type: research

Contents
William B. Ershler (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Source Type: research

Forthcoming Issues
Cardiac Rehabilitation (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 21, 2019 Category: Geriatrics Source Type: research

Treatment of Iron Deficiency in the Elderly
This article outlines situations in which oral iron should be proscribed and offers an approach to administration of available formulations. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Michael Auerbach, Jerry Spivak Source Type: research

Late Life Vitamin B12 Deficiency
Vitamin B12 deficiency may present with a wide array of symptoms and, if unrecognized, lead to significant morbidity particularly in terms of the hematologic and neurologic complications. This is of particular concern in the elderly because of its high prevalence with advancing age and the enhanced difficulty of recognizing subtle changes in symptoms and distinguishing those from normal aging. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Chad Zik Source Type: research

Heyde Syndrome
Heyde described aortic stenosis and gastrointestinal bleeding in the 1950s. Since then, a link with intestinal angiodysplasia and abnormalities of von Willebrand factor (VWF) has been noted. Loss of the highest-molecular-weight multimers of VWF and bleeding also have been described in subaortic stenosis in hypertrophic cardiomyopathy, in isolated mitral and aortic insufficiency, in endocarditis, in patients with prosthetic valve stenosis or regurgitation, and in patients with left ventricular assist devices (LVADs). Bleeding tends to recur with local treatment of angiodysplasias, whereas cardiac repair or removal of LVAD e...
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Joseph L. Blackshear Source Type: research

Anemia in the Long-Term Care Setting
Anemia has a higher prevalence among residents of long-term care setting. Signs and symptoms of anemia in this group are more insidious and can be overlooked and attributed to other disease manifestations or old age. Available data on the consequences of anemia suggest worse outcomes in heart failure; cognitive and functional decline; and increased rates of falls, hospitalizations, and mortality. Diagnosis and treatment of anemia in long-term care residents should be considered based on cost and benefit to the patient and patient ’s and/or caregiver’s preferences. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Syed Ashad Abid, Stefan Gravenstein, Aman Nanda Source Type: research

Kidney Disease and Anemia in Elderly Patients
Anemia is a very common complicating feature of chronic kidney disease (CKD) in the elderly. Noninvasive assessment of renal function in the elderly may include several equations although they may actually underestimate the true glomerular filtration rate (GFR). In summary, anemia in the setting of CKD in the elderly is generally underrecognized and undertreated, leading to associations of increased morbidity and mortality. The likelihood of benefits of treatment of anemia in this rapidly increasing subset of patients with CKD remains very high. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Franco Musio Source Type: research

Implications of Anemia in the Elderly undergoing Surgery
Anemia in the elderly is common and is associated with exposure to blood transfusion and higher perioperative morbidity and mortality. These patients would benefit from early diagnosis and work-up of the cause of preoperative anemia systematically. This can be done in preoperative anemia clinics as part of an overall patient blood management program. Iron-deficiency anemia is amenable to treatment with oral or intravenous iron. Intravenous iron leads to a more rapid hemoglobin response, and is devoid of gastrointestinal side effects. More data are needed to determine if preoperative correction of iron-deficiency anemia red...
Source: Clinics in Geriatric Medicine - May 27, 2019 Category: Geriatrics Authors: Yilin Eileen Sim, Hairil Rizal Abdullah Source Type: research

Aging and Hematopoiesis
In hematopoiesis, mature blood cells, granulocytes, erythrocytes, and megakaryocytes originate from hematopoietic stem cells. With age, changes in hematopoiesis may have clinical consequences: defective immune responses, cytopenias (most commonly anemia and lymphopenia), hematological malignancy, and effects mediated by hematopoietic cells in other organs. Clonal hematopoiesis is commonly seen with aging and has been associated with both blood concerns and atherosclerosis, but further study is required to determine a causative link. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 9, 2019 Category: Geriatrics Authors: Emma M. Groarke, Neal S. Young Source Type: research

Unexplained Anemia in the Elderly
The prevalence of anemia increases with advancing age, and despite thorough investigation, approximately one-third will be classified as “unexplained.” Unexplained anemia (UA) is typically hypoproliferative, normocytic, and with low reticulocyte count. Serum erythropoietin levels are lower than expected for degree of anemia. Chronic inflammation, low testosterone levels, malnutrition, and possibly nascent myelodysplasia are varia bly contributing factors. No clearly established beneficial treatment strategy has been established, but the association of UA with a wide range of adverse outcomes, including impaired...
Source: Clinics in Geriatric Medicine - May 9, 2019 Category: Geriatrics Authors: William B. Ershler Source Type: research

Inflammatory Pathways to Anemia in the Frail Elderly
Anemia is a common, yet often overlooked, geriatric syndrome characterized by reduced hemoglobin levels and associated with adverse health outcomes and early mortality. Evidence suggests that anemia is an independent risk factor for frailty in older adults. In this article, the authors review the evidence for the role of chronic inflammation in the pathogenesis of anemia in the frail elderly. Understanding the relationships between anemia, frailty, and chronic inflammation will pave the way for the development of novel interventional strategies for the treatment and prevention of anemia and, likely, also frailty in older a...
Source: Clinics in Geriatric Medicine - May 9, 2019 Category: Geriatrics Authors: Juliette Tavenier, Sean X. Leng Source Type: research

A Growing Population of Older Adults with Sickle Cell Disease
In countries with organized access to health care, survival of patients with sickle cell disease (SCD) has greatly improved, shifting the burden of care from a pediatrician to an internal medicine physician. As a consequence, cumulative disease complications related to chronic vasculopathy are becoming more apparent, adding to organ dysfunction from physiologic aging. The time has come for us to reevaluate the approach to managing the older adult with SCD by putting a greater emphasis on geriatric conditions while proactively considering curative options once previously offered only to younger patients, with comprehensive ...
Source: Clinics in Geriatric Medicine - May 9, 2019 Category: Geriatrics Authors: Arun S. Shet, Swee Lay Thein Source Type: research

Erratum
This article was plagiarised from the following sources: (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Source Type: research

Balance Problems and Fall Risks in the Elderly
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. The clinician should consider screening for falls an important part of the functional evaluation in older adults. Several potential interventions have proven helpful as preventive strategies. Optimal approaches involve interdisciplinary co...
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Authors: Ramon Cuevas-Trisan Source Type: research

New Strategies for Falls Prevention
Despite committed effort of our nation ’s experts to develop falls prevention strategies to address this major public health issue for older adults, death from falls continues to increase, by 30% over the past decade. Projections suggest that by 2030 seven older adults will die from a fall every hour (https://www.cdc.gov/homeandre creationalsafety/falls/adultfalls.html). This issue of Clinics of Geriatric Medicine is meant to help health care stop doing what is not working and instead pivot to develop better “behaviors” to address this crisis. To do so, I ...
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Authors: Steven C. Castle Tags: Preface Source Type: research

Falls Prevention
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Authors: Steven C. Castle Source Type: research

Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Source Type: research

Contributors
STEVEN C. CASTLE, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Source Type: research

Contents
Erratumix (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Source Type: research

Forthcoming Issues
Anemia in Older Adults (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 29, 2019 Category: Geriatrics Source Type: research

The Overlap Between Falls and Delirium in Hospitalized Older Adults
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 4.5, range 1.4–12.6) and statistically significant in all but one study. These results suggest that falls and delirium are inextricably linked. There is a need to further refine fall risk assessment tools and protocols to specifically include delirium for consideration as a risk factor that needs additional assessment and management. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 5, 2019 Category: Geriatrics Authors: Andrea Yevchak Sillner, Cynthia L. Holle, James L. Rudolph Source Type: research

Falls, Footwear, and Podiatric Interventions in Older Adults
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. Multifaceted podiatric interventions, which include appropriate foo...
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Anna Lucy Hatton, Keith Rome Source Type: research

Despite Active Public Health Campaigns, Death from Falls Increased 30% in the Past Decade
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. Third, explanations should be provided regarding why mobility and balance have changed. As a counter to ageism, pros and cons for specific interventions and how these maximize momentum and mobility should be discussed (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Steven C. Castle Source Type: research

Optimizing Function and Physical Activity in Hospitalized Older Adults to Prevent Functional Decline and Falls
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 in...
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Barbara Resnick, Marie Boltz Source Type: research

Outcomes of Patient-Engaged Video Surveillance on Falls and Other Adverse Events
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 2.38 times per day, and this accounted for the low fall rate (1.50 falls/1000 days of surveillance) in an adult population. Data on adverse events and timeliness of nursing response to actual urgent and emergent patient conditions provides evidence of the rapid contribution o...
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Patricia A. Quigley, Lisbeth Votruba, Jill Kaminski Source Type: research

Redesigning a Fall Prevention Program in Acute Care
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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Viktoriya Fridman Source Type: research

Preventing Falls in Hospitalized Patients
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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Jennifer H. LeLaurin, Ronald I. Shorr Source Type: research

Older Adult Falls in Emergency Medicine
“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 fall s in an aging society begins with prehospital evaluations and continues through definitive risk assessments and interventions that usually occur after ED care. Although ongoing obstacles to ED-initiated, evidence-based older adult fall-reduction strategies include the absence of a compelling emergen cy medicine evidence bas...
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Christopher R. Carpenter, Amy Cameron, David A. Ganz, Shan Liu Source Type: research

Geriatric Polypharmacy
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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 1, 2019 Category: Geriatrics Authors: Michelle A. Fritsch, Penny S. Shelton Source Type: research

Surgical Oncology and Geriatric 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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 1, 2018 Category: Geriatrics Authors: Michael E. Johnston, Jeffrey J. Sussman, Sameer H. Patel Source Type: research

Nuances of Surgical Care for the Elderly
Unprecedented population growth, complex medical problems, and widespread use of anticoagulants: the perfect storm for the Silver Tsunami. Those aged 65 and over will number 98.2 million in the United States in the year 2060, with 19.7 million aged 85 and over.1 Arthritis, heart disease, cancer, pulmonary disease, and Alzheimer round out the top five health concerns in the elderly per the Centers for Disease Control and Prevention. However, the unspoken epidemic is that of frailty, with 44% of the elderly prefrail and 10% frail. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - November 1, 2018 Category: Geriatrics Authors: Fred A. Luchette, Robert D. Barraco Tags: Preface Source Type: research