Synthetic Review of Financial Capacity in Cognitive Disorders: Foundations, Interventions, and Innovations
AbstractPurpose of ReviewFinancial capacity (FC) is a complex, multidimensional construct that changes over the lifespan and commonly becomes impaired as individuals age and develop dementia. Impaired FC results in several important negative outcomes including loss of independence and increased victimization and abuse. The goal of this review is to synthesize current knowledge of the assessment and intervention of impaired financial capacity in order to propose its further development in the context of technological advancements.Recent FindingsCurrent methods of assessing FC are based on conceptual foundations that include...
Source: Current Geriatrics Reports - November 26, 2019 Category: Geriatrics Source Type: research

Evolving Concepts in the Evaluation and Management of Bladder Cancer in Elderly Men
AbstractPurpose of ReviewIn this article, the contemporary knowledge regarding specific issues related to the care of older bladder cancer patients is reviewed. The status of radical cystectomy, bladder-sparing strategies, checkpoint inhibition, prostate-sparing surgery, and BCG distribution pertaining to older adults are discussed.Recent FindingsThe use of minimally invasive approaches for radical cystectomy in patients with invasive bladder cancer is on the rise, including those patients with advanced age. Enhanced recovery pathways are improving time-to-recovery for patients undergoing radical cystectomy which may be es...
Source: Current Geriatrics Reports - November 20, 2019 Category: Geriatrics Source Type: research

A Scoping Review of Dementia Symptom Management in Persons with Dementia Living in Home-Based Settings
AbstractBackgroundA large proportion of our older adults live with Alzheimer ’s disease and related dementias, and the number of those diagnosed in the future is expected to increase dramatically as the population ages. Persons with dementia bring unique healthcare challenges due to the manifestation of behavioral and psychological symptoms associated with the disease. The lack of geriatric clinicians as well as a properly trained non-geriatric specialist workforce capable of addressing the symptoms persons with dementia exacerbates the challenge of providing effective care. Pharmacological interventions are contrain...
Source: Current Geriatrics Reports - November 18, 2019 Category: Geriatrics Source Type: research

Caring for the Older Person Who Is Diagnosed with Cancer: a Toolbox for the Geriatric Nurse
AbstractPurpose of ReviewTo offer a “toolbox” for geriatric nurses consisting of a general understanding of geriatric oncology, use of a comprehensive geriatric assessment (CGA), role in the multidisciplinary team (MDT), and additional roles as leader, clinician, educator, advocate, and exemplar.Recent FindingsGeriatric oncology incorporates the use of the Ambulatory Geriatric Oncology Program (AGOC), CGA, and an MDT to determine functional status, comorbid conditions, social support, and emotional concerns in addition to diagnosing and treating cancer. Nurses have a role in all elements of geriatric oncology.S...
Source: Current Geriatrics Reports - November 11, 2019 Category: Geriatrics Source Type: research

Adverse Effects of Androgen Deprivation in Elderly Men with Prostate Cancer
AbstractPurpose of ReviewThe purpose of this review is to summarize the key literature of complications and adverse effects experienced by elderly men undergoing androgen deprivation therapy for prostate cancer, as well as evidence-based strategies to manage these complications.Recent FindingsCurrent research demonstrates several adverse effects associated with treatment with androgen deprivation therapy, including skeletal complications, possible cardiovascular effects, diabetes and metabolic complications, decreased sexual function and libido, depression, and cognitive decline.SummaryDespite the well-known side effect pr...
Source: Current Geriatrics Reports - November 7, 2019 Category: Geriatrics Source Type: research

Medical Therapies for Treatment of BPH: Special Considerations in Elderly Men
AbstractPurpose of ReviewBenign prostatic hyperplasia (BPH) is among the most common diseases worldwide, manifesting clinically with lower urinary tract symptoms (LUTS). The prevalence of BPH and LUTS increases with age. There has been an increase in the types of medication available for treatment. The purpose of this review is to examine the recent literature on medication for the treatment of BPH and LUTS as it relates to older adult men.Recent FindingsAlthough many different medication classes have studies showing benefits in the older male population for those with BPH, careful attention needs to be paid to their side ...
Source: Current Geriatrics Reports - November 7, 2019 Category: Geriatrics Source Type: research

Insomnia in Older Adults
AbstractPurpose of ReviewTo evaluate and summarize recent research articles pertaining to insomnia in older adults that can guide healthcare providers on factors to consider when assessing and managing insomnia.Recent FindingsUp to 75% of older adults experience symptoms of insomnia. Insomnia is associated with socioeconomic status, racial and ethnic classification, family relationships, medical and mental health disorders, cognitive function, and dementia. Although one-fifth of older adults are still prescribed sleep medications, cognitive behavioral therapy for insomnia is the first-line treatment for insomnia  and ...
Source: Current Geriatrics Reports - October 22, 2019 Category: Geriatrics Source Type: research

Mobility Challenges Among Older Adult Mobility Device Users
AbstractPurpose of ReviewThis review describes recent research regarding challenges to mobility experienced by older adult mobility device users.Recent FindingsDifferent elements that affect mobility in this population were highlighted using the Human Activity Assistive Technology model. Key constructs in this model include the human (personal factors); the desired activity (mobility); assistive technology (mobility devices); and context (physical and social environmental factors). Poor mobility skills and lack of mobility confidence are personal factors that can limit the places that older adults go. However, new mobility...
Source: Current Geriatrics Reports - June 25, 2019 Category: Geriatrics Source Type: research

Mental Health Care of Older Adults: Does Cultural Competence Matter?
AbstractPurpose of ReviewMinority and limited English proficiency seniors are consistently found to have multiple health care disparities, including higher incidence and prevalence of various mental health conditions. The purpose of this paper is to review current literature on culturally competent mental health care for older adults.Recent FindingsThe US population is aging and becoming increasingly more diverse. Minority and underserved groups of seniors are known to suffer from lower health literacy, limited English proficiency, and poorer health care outcomes. Quality mental health care is particularly dependent on bei...
Source: Current Geriatrics Reports - June 22, 2019 Category: Geriatrics Source Type: research

Delirium in the Elderly Surgical Patient
AbstractPurpose of ReviewDelirium is an unfortunately frequent complication in the postoperative course of elderly patients, affecting as much as half of all patients with even higher rates in the intensive care unit. Early recognition and diagnosis are tantamount to prevention of the associated increased morbidity and mortality. In this review, we will summarize the current literature pertaining to the diagnosis, prevention, and treatment of delirium in the elderly surgical patient population.Recent FindingsSeveral large randomized control trials looking at the treatment of delirium with neuroleptic medications have been ...
Source: Current Geriatrics Reports - June 18, 2019 Category: Geriatrics Source Type: research

Aging Patients in Correctional Settings
AbstractPurpose of the ReviewThe United States (US) has the highest number of incarcerated people in the world. This incarcerated population is aging disproportionately compared with the general population. Correctional facilities need to develop geriatric competencies to respond to this aging crisis.Recent FindingsOlder inmates have an increased burden of chronic medical conditions. This leads to higher healthcare utilization and costs across correctional systems. Daily symptoms, such as pain, and geriatric syndromes, such as cognitive impairment, frailty, and sensory impairment, are common but are frequently undertreated...
Source: Current Geriatrics Reports - June 18, 2019 Category: Geriatrics Source Type: research

Review of Forward-Head Posture and Vestibular Deficits in Older Adults
AbstractPurpose of ReviewForward-head posture (FHP) is a common postural deviation associated with older age, cervical muscle weakness, poor balance, anteriorly displaced center of mass, increased postural sway and fall risk, impaired cervical proprioception, and possibly vestibular dysfunction. Studies have found increased fall risk in older adults with FHP but have not identified a casual reason for this relationship. This review aims to examine the links between (FHP) and vestibular deficits.Recent FindingsWhile assessment of overall posture, including FHP, is a common component of a physical therapy evaluation, a stand...
Source: Current Geriatrics Reports - June 14, 2019 Category: Geriatrics Source Type: research

Living In Place: the Impact of Smart Technology
AbstractPurpose of ReviewTo discuss impact of smart technology and highlight specific types of technologies that would be supportive of older adults to Live In Place.Recent FindingsSmart technology has potential to increase the ability of older adults to remain in their homes by monitoring health, safety, and falls, preventing potential accidents and injuries. Several types of smart technology were identified in the literature as supportive of Living In Place. These include sensor systems with predictability analysis, wearable technology, information and communication technology, and smart homes. In general, the less intru...
Source: Current Geriatrics Reports - June 14, 2019 Category: Geriatrics Source Type: research

In-Home Video Telehealth for Dementia Management: Implications for Rehabilitation
AbstractPurpose of ReviewThe progressive nature of dementia requires ongoing care delivered by multidisciplinary teams, including rehabilitation professionals, that is individualized to patient and caregiver needs at various points on the disease trajectory. Video telehealth is a rapidly expanding model of care with the potential to expand dementia best practices by increasing the reach of dementia providers to flexible locations, including patients ’ homes. We review recent evidence for in-home video telehealth for patients with dementia and their caregivers with emphasis on implications for rehabilitation professio...
Source: Current Geriatrics Reports - June 13, 2019 Category: Geriatrics Source Type: research

Non-invasive Ventilatory Support in the Elderly
AbstractPurpose of ReviewThe first description of non-invasive ventilation use began in the 1920s. Since then, its role in patient care has evolved through increased clinical knowledge and scientific advancements. The utilization of non-invasive ventilation has broadened from initial application in acute in-hospital ICU settings to now include the outpatient settings. This review discusses the history of non-invasive ventilation and its role in acute in-hospital chronic obstructive pulmonary disease (COPD) exacerbations, cardiogenic pulmonary edema, and weaning from mechanical ventilation in the elderly. The elderly popula...
Source: Current Geriatrics Reports - June 13, 2019 Category: Geriatrics Source Type: research

Managing Infectious Disease in the Critically Ill Elderly Patient
AbstractPurpose of the ReviewInfections and subsequent sepsis are an increasing cause of hospital admission and critical illness in the elderly population. The risk factors that predispose elderly patients to infections, such as comorbidities and frailty, also contribute to prolonged recovery times and subsequent mortality.Recent FindingsElderly patients may present with atypical symptoms such as delirium and remain afebrile thus delaying the diagnosis of infections. White blood cell count is not as useful in the diagnosis of infection as other biomarkers such as procalcitonin. Once an infection has begun, the elderly pati...
Source: Current Geriatrics Reports - June 13, 2019 Category: Geriatrics Source Type: research

The Role of Palliative Care in the Elderly Surgical ICU Patient
AbstractPurpose of ReviewManagement of geriatric trauma patients is a multidisciplinary effort. The purpose of this paper is to review recent literature and further elucidate the role of palliative care in the geriatric trauma patient population.Recent FindingsRecognition of the resources provided by palliative care continues to increase. Adoption of early consultations may improve both patient and family experiences especially in end-of-life situations.SummaryEarly identification of at risk patients allows for proper utilization of consultative resources. Palliative care has several defined roles in the elderly trauma pop...
Source: Current Geriatrics Reports - June 13, 2019 Category: Geriatrics Source Type: research

Integrated Primary and Mental Health Care for Older Adults: Successes, Challenges, and Recommendations
We describe the successful implementation of real-world integrated care programs, discuss our own experience with integrated care, and share recommendations from our clinical practice.Recent FindingsIntegrated care increases access to treatment, produces better outcomes for patients, reduces costs, improves the patient experience, and decreases stigma. Despite extensive evidence supporting the effectiveness of integrated care, clinical, organizational, and financial challenges serve as barriers to its widespread implementation.SummaryIntegration of primary and mental health care is a highly effective treatment model for ol...
Source: Current Geriatrics Reports - June 7, 2019 Category: Geriatrics Source Type: research

Pressure Injury in the Critically Ill Elderly Patient
AbstractPurpose of ReviewPressure injuries are a major problem for all people, but they are especially problematic in the elderly patient. The goal of this review is to provide strategies for reducing the incidence of these problem wounds in the geriatric population. The review asks: what are the risk factors for developing pressure injuries? And how are these risks magnified in the elderly population?Recent FindingsThere are several wound healing organizations that have developed definitions and strategies for dealing with pressure injuries. Risks can be divided into “intrinsic” and “extrinsic” fac...
Source: Current Geriatrics Reports - June 7, 2019 Category: Geriatrics Source Type: research

Exercise and Protein Supplementation for Prevention and Treatment of Sarcopenia
AbstractPurpose of ReviewSarcopenia results in disability and negatively impacts older adults ’ ability to live independently. The purpose of this review is to summarize the recent literature regarding the effectiveness of exercise and nutritional supplementation as a treatment for sarcopenia.Recent FindingsA number of recent studies demonstrated improvements in muscle mass and function in sarcopenic adults through resistance training and combination resistance+aerobic exercise training. Variability in program design, duration, and intensity leads to inconsistent findings in the literature. The addition of protein su...
Source: Current Geriatrics Reports - June 7, 2019 Category: Geriatrics Source Type: research

Body Composition and Falls Risk in Older Adults
AbstractPurpose of ReviewTo explore evidence for associations between body composition and falls in older adults and interventions that may reduce falls through improving body composition.Recent FindingsBoth sarcopenia (low skeletal muscle mass, strength and quality) and obesity appear to increase falls risk, but relationships with falls-related injury may differ. Nevertheless, perceptions of obesity as a protective factor for fractures have been challenged in recent years. Emerging research suggests that combined entities such as sarcopenic obesity also increase risk of falls, although effects of conditions such as osteos...
Source: Current Geriatrics Reports - June 6, 2019 Category: Geriatrics Source Type: research

Consideration of Anticoagulation: Surgical Care for the Elderly in Current Geriatrics Reports
ConclusionThe use of anticoagulation therapy has changed dramatically over the last decade. These changes are multifactorial and include the increasing prevalence of OAC use, and the introduction of NOACs. Consequently, challenges associated with managing OAC in the elderly will only become more complicated over time. Surgical providers need to be aware of these changes and update their practice on the shifting epidemiology of this population, evolving guidelines, and new reversal agents. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - June 6, 2019 Category: Geriatrics Source Type: research

Holmium Laser Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia: a Safe and Effective Treatment Option in our Elderly Patients
AbstractPurpose of ReviewTreatment of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH) can present a surgical dilemma for elderly patients, especially in those with multiple comorbidities. The purpose of this paper is to review recent publications on this topic and highlight the benefits of holmium laser enucleation of the prostate (HoLEP) in such patients.Recent FindingsHoLEP is a safe and effective treatment option for patients with BPH of any age with any prostate size. It is superior to many other BPH treatment options. It can be safely completed in those on anticoagulants, in the re-treatm...
Source: Current Geriatrics Reports - April 26, 2019 Category: Geriatrics Source Type: research

Frailty, Successful Aging, Resilience, and Intrinsic Capacity: a Cross-disciplinary Discourse of the Aging Process
AbstractPurpose of ReviewThe relationship between successful aging, frailty, intrinsic capacity, and resilience is explored, in terms of underlying physiology, indicators, and utility.Recent FindingsFrailty may be regarded as the reverse of successful aging conceptually, but more appropriate for clinical management and health promotion programs. Intrinsic capacity may be used as indicator of healthy aging, and the concept of resilience more relevant in research efforts to understand the heterogeneous age-related changes. In prevention of geriatric syndromes and diseases, as well as in the formulation of health policies, th...
Source: Current Geriatrics Reports - April 25, 2019 Category: Geriatrics Source Type: research

Integrating Frailty and Cognitive Phenotypes: Why, How, Now What?
AbstractPurpose of ReviewThis review elucidates the concept of frailty in relationship to reserve and resilience, the relationships and shared pathophysiology between physical frailty and cognitive impairment, the theoretical underpinnings of three integrated phenotypes of physical and cognitive impairments, and the potential of incorporating biomarkers into phenotype refinement and validation.Recent FindingsThe fact that frailty and cognitive impairment are associated and often coexist in older adults has led to the popular view of expanding the definition of frailty to include cognitive impairment. However, there is grea...
Source: Current Geriatrics Reports - April 24, 2019 Category: Geriatrics Source Type: research

Frailty in Surgical Preoperative Evaluation and Postoperative Recovery
AbstractPurpose of ReviewMajor abdominal surgery in the elderly is challenging and complex. Frailty as a clinical entity in the elderly is increasingly recognized as a useful assessment tool to identify at-risk patients. We aim to review recent literature on frailty in surgical preoperative evaluation and postoperative recovery and determine its applications in emergency surgery.Recent FindingsFrailty has been established as an independent predictor of morbidity and mortality in elderly surgical patients. Individualized treatment goals and tailor-made interventions to optimize clinical conditions in frail patients before a...
Source: Current Geriatrics Reports - April 22, 2019 Category: Geriatrics Source Type: research

Update on Interventions to Prevent or Reduce Frailty in Community-Dwelling Older Adults: a Scoping Review and Community Translation
AbstractPurpose of ReviewWith increasing interest in frailty prevention and management globally, this scoping review provides an update to the current knowledge on interventions to reduce frailty in community-dwelling older adults and its state of translation in real-world settings.Recent FindingsUpdating previous findings of 14 studies from 2000 to 2016 by Puts et al., we reviewed 10 additional studies from 2016 to 2018 and found that up to date, 18 of 24 studies overall showed effective interventions in preventing or reducing frailty (as the intervention target) in community-dwelling older adults. Multidimensional frailt...
Source: Current Geriatrics Reports - April 22, 2019 Category: Geriatrics Source Type: research

Health for the Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Older Adults
AbstractPurpose for ReviewThe growing geriatric population includes gender minorities or the LGBTQ adults who present with a rich history of unique experiences that have invariably affected the provision and access to quality health care services. The purpose of this article is to review, understand, and discuss the differences and similarities of health-related geriatric issues within and between them.Recent FindingsBased on the existing literature, relevant findings include the identification of multiple marginalized identities within oppressive social systems, negative health outcomes, and the presence of health care di...
Source: Current Geriatrics Reports - April 17, 2019 Category: Geriatrics Source Type: research

Training Programs on Geriatrics in Rural Areas: a Review
AbstractPurpose of ReviewTo understand the current scope of training in geriatrics in rural areas for rural providers and teams, we reviewed current literature to identify training programs which pertain to geriatric education and training of the rural workforce.Recent FindingsOlder adults are one of the fastest growing demographics in the USA and represent a higher share of the population in rural areas than in other counties. Older adults in rural areas often have complex health challenges and may benefit from care from healthcare teams with geriatrics training. However, there is a paucity of geriatrics workforce in the ...
Source: Current Geriatrics Reports - April 16, 2019 Category: Geriatrics Source Type: research

Deprescribing: Right-Sizing Medication Regimens to Optimize Outcomes in Palliative Care
AbstractPurpose of ReviewThe purpose of this review is to describe the current state of polypharmacy in older adults and those with an advanced illness, evidence that supports deprescribing, and best practices to implement deprescribing in palliative care.Recent FindingsPractitioners and patients indicate they are interested in reducing the number of medications prescribed, but there are barriers to this practice. Over 90% of Medicare beneficiaries stated they would be willing to stop taking one or more of their medications if endorsed by their doctor. Several tools have become available in recent years to assist practitio...
Source: Current Geriatrics Reports - February 23, 2019 Category: Geriatrics Source Type: research

Wearable Sensor Technology to Measure Physical Activity (PA) in the Elderly
AbstractPurpose of ReviewThe goal of this paper is to provide a review of recent work on the use of wearable devices for measuring physical activity (PA) in the elderly.Recent FindingsIn older adults, PA is related to independence in activities of daily living and maintaining a good quality of life. With aging, there is a reduction in PA, which may explain reduced energy expenditure (EE) during rest and PA. In addition, there is also a reduction in the spatial extent of mobility (life-space). Sensors used for measuring PA include pedometers, uni-axial, bi-axial and tri-axial accelerometers, heart rate monitors combined wit...
Source: Current Geriatrics Reports - February 7, 2019 Category: Geriatrics Source Type: research

Reduced Dose Direct Oral Anticoagulants in Older Adults with Atrial Fibrillation
AbstractPurpose of ReviewDoses of direct oral anticoagulants (DOACs) are often reduced in older adults based on age, renal function, and bleeding risk. This review assesses recent evidence for safety and efficacy of reduced dose DOAC regimens in older adults.Recent FindingsDabigatran 110  mg twice daily shows similar efficacy and similar or lower bleeding risk compared to 150 mg twice daily in several studies. Dabigatran 110 mg is approved outside the USA and can be considered in ages>  75–80, or in patients with a propensity for higher dabigatran blood levels. Rivaroxaban 15 mg, apixaba...
Source: Current Geriatrics Reports - January 31, 2019 Category: Geriatrics Source Type: research

Mobile Health Technologies for Older Adults with Cardiovascular Disease: Current Evidence and Future Directions
AbstractPurpose of ReviewThis review documents the most promising domains of mobile health (mHealth) use in cardiovascular disease, current barriers to mHealth adoption in older adults, and future directions of mHealth utilization that may increase engagement in this population.Recent FindingsMobile health technologies are being rapidly adopted as smartphones and wearable biometric devices enable increasingly sophisticated health monitoring. Cardiovascular disease management is particularly conducive to mobile health utilization, as many mobile platforms currently support software capable of sophisticated cardiovascular da...
Source: Current Geriatrics Reports - January 28, 2019 Category: Geriatrics Source Type: research

Disease-Specific Advance Care Planning Interventions for Older Adults
AbstractPurpose of ReviewAdvance care planning is beneficial but underutilized for older patients with dementia, cancer, end-stage renal disease, lung disease, or heart failure. The purpose of this paper is to highlight recent disease-specific innovations aimed at improving the delivery of advance care planning for older adults.Recent FindingsWe highlight 13 studies within the last 5  years focusing on advance care planning models in older adults with the above diseases.SummaryUseful interventions include incorporation of non-physician facilitators, varying platforms of ACP delivery, surrogate participation, and writt...
Source: Current Geriatrics Reports - January 24, 2019 Category: Geriatrics Source Type: research

Pharmacologic Management of Agitation in Patients with Dementia
AbstractPurpose of ReviewAgitation is common among older adults with dementia; its origin may be multi-factorial, and it is often difficult to treat. In this paper, we summarize current knowledge and offer considerations on pharmacologic management of behavioral and psychological symptoms of dementia (BPSD).Recent FindingsWe reviewed human studies published from 2013 to 2018 evaluating pharmacologic management of BPSD manifestations including depressive symptoms, mania, psychosis, and other BPSD, as well as severe agitation without determination of underlying cause. After non-pharmacological management is exhausted, the ch...
Source: Current Geriatrics Reports - January 22, 2019 Category: Geriatrics Source Type: research

Workforce Issues in Geriatrics in Rural America
ConclusionFederal agencies have a lead role in supporting interprofessional training, adapting new technologies in curricula and facilitating academic, private, and public investments in the workforce. Veterans Health Administration has also undertaken a systematic evaluation strategy across various models with the goal of promoting broad dissemination and implementation. These training and continuing education models have reported successes and continue to be evaluated as innovations that may be broadly adopted to address the healthcare needs of older rural-dwelling populations. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - January 22, 2019 Category: Geriatrics Source Type: research

Academic Geriatric Orthopedics: a New Paradigm for Inpatient Care
AbstractPurpose of ReviewHealthcare systems are embarking on innovative, technologically savvy approaches to caring for our most rapidly growing population worldwide —the elderly. As healthcare systems respond, adapt, and strategically plan for this rapidly growing population, it is paramount that we develop new paradigms of care for older patients. This review highlights some of the approaches academic medical centers are taking to improve the musculoskeletal and orthopedic health of older adults.Recent FindingsAcademic health centers are posed to set and lead the standard of care for the next generation of orthoped...
Source: Current Geriatrics Reports - November 13, 2018 Category: Geriatrics Source Type: research

Current Evaluation and Management of Vertebral Compression Fractures
AbstractPurpose of ReviewVertebral compression fractures (VCFs) pose a significant burden of disease in an aging population. We aim to review current evidence for optimal management of this problem.Recent FindingsThere is little high-quality evidence to guide treatment. While non-surgical management is the mainstay of treatment, there is no strong evidence to recommend bed rest, bracing, or opioid analgesics. Calcitonin may have a role in the management of acute pain. Cement augmentation may have a benefit in acute VCFs involving the thoracolumbar junction. Clinicians should maintain a high index of suspicion for underlyin...
Source: Current Geriatrics Reports - November 9, 2018 Category: Geriatrics Source Type: research

Fragility Fractures in the Developing World: a Rising Challenge
AbstractPurpose of ReviewPresent the major aspects of fragility fractures, emphasizing their prevention and care in low- and middle-income countries (LMICs).Recent FindingsFragility fractures will increase significantly during the next few decades, especially in LMICs. Demographic and socioeconomic data remain limited. Fragility fractures have a low priority for most LMICs, as well as for global public health leadership.SummaryThe majority of the world ’s population lives in LMICs. Their socioeconomic features and healthcare resources are heterogeneous, but all lack access to medical and surgical care, especially in ...
Source: Current Geriatrics Reports - November 7, 2018 Category: Geriatrics Source Type: research

Autoimmune Blistering Disorders in the Geriatric Population
AbstractPurpose of ReviewIn this review, we seek to discuss the pathogenesis, clinical manifestations, treatments, and latest research developments for autoimmune blistering disorders including pemphigus vulgaris (PV) and bullous pemphigoid (BP). We also offer our clinical observations and personal experiences with these conditions as they relate to geriatric patients.Recent FindingsRecent studies have uncovered important disease associations and new information regarding the pathophysiology of disease. Novel treatments aimed at disease-specific targets hold therapeutic promise.SummaryAutoimmune blistering disorders are co...
Source: Current Geriatrics Reports - November 5, 2018 Category: Geriatrics Source Type: research

The Impact of Sunlight on Skin Aging
AbstractPurpose of ReviewIn this review, we summarize and discuss the current literature on photoaging. We focus on the molecular effects of UV radiation, and the histological and clinical features of chronically sun-exposed skin.Recent FindingsThe expression of numerous proteins is altered in habitually sun-exposed skin, including sirtuins and hedgehog signaling proteins. Pharmacological manipulation of the levels of these proteins can potentially downregulate the photoaging process.SummaryMitochondrial and nuclear DNA damage, reactive oxygen species (ROS) production, and altered gene expression patterns are critical comp...
Source: Current Geriatrics Reports - October 29, 2018 Category: Geriatrics Source Type: research

Treatment of Non-melanoma Skin Cancer in the Elderly
AbstractPurpose of ReviewWe seek to explain how the treatment of non-melanoma skin cancer (NMSC) should differ in certain geriatric patients. Our goal is to provide primary care physicians with a comprehensive methodology for approaching the evaluation and management of these patients.Recent FindingsRecent retrospective studies have revealed that the rates of aggressive surgical treatment of NMSCs are equivalent in non-age restricted and geriatric populations, including those with limited life expectancy. Geriatric patients have higher rates of post-operative complications without affecting disease specific survival. These...
Source: Current Geriatrics Reports - October 27, 2018 Category: Geriatrics Source Type: research

Skin Disease and Neurological Conditions of the Elderly
AbstractPurpose of ReviewSummarize and review the body of literature associating neurological diseases of the elderly with cutaneous disease.Recent FindingsA growing body of evidence supports a close association between Parkinson ’s disease and seborrheic dermatitis or rosacea, as well as a higher risk of melanoma. Development of bullous pemphigoid has also been found to be at higher incidence in those with multiple sclerosis. In some cases, skin disease may suggest early diagnosis of a developing neurologic condition, whi le in others, presence of a neurologic condition should prompt careful evaluation for cutaneous...
Source: Current Geriatrics Reports - October 3, 2018 Category: Geriatrics Source Type: research

Management of Complex Proximal Humerus Fractures: What Is the Role of Open Reduction and Internal Fixation?
AbstractPurpose of ReviewProximal humerus fractures are challenging injuries to treat and will become more common with an aging population. The purpose of this paper is to review the recent literature regarding the role of open reduction and internal fixation for this injury.Recent FindingsComplex proximal humerus fractures present a significant challenge in the elderly. The introduction of locked plating has improved surgical management of these injuries; however, complications including avascular necrosis, primary screw cutout, and secondary screw cutout remain obstacles. Newer technologies aim to combat these issues, wi...
Source: Current Geriatrics Reports - October 2, 2018 Category: Geriatrics Source Type: research

Vaccinations for Older Adults
AbstractPurpose of ReviewVaccinations are a preventative health priority for older adults. The purpose of this paper is to review recent publications on this topic and to provide updates on current research involving recommended vaccines.Recent FindingsIn the USA, older adults receive vaccinations at less than optimal rates. Vaccine-preventable illnesses, particularly influenza and pneumococcal disease, continue to cause high morbidity and mortality in this population. A recently introduced herpes zoster vaccine has increased efficacy against varicella-zoster virus reactivation and its sequelae.SummaryOlder adults can bene...
Source: Current Geriatrics Reports - October 1, 2018 Category: Geriatrics Source Type: research

Distinguishing Comorbidity, Disability, and Frailty
AbstractPurpose of ReviewOver half of the older adults in the USA have multimorbidity, defined broadly as the presence of two or more chronic diseases in an individual. Multimorbidity has significant overlap with disability and frailty. In this review, we broadly review the concepts of multimorbidity, disability, and frailty, as well as their interrelationships, and ability to predict future adverse health outcomes in older adults.Recent FindingsDepending on the study, the prevalence of individuals with all three of multimorbidity, disability, and frailty ranges from 2 to 20%. Multimorbidity and patterns of multimorbidity ...
Source: Current Geriatrics Reports - September 19, 2018 Category: Geriatrics Source Type: research