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 16, 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 15, 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, apixaban 2.5 mg, and edoxaban 3...
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 written c...
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 orthopedic c...
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 more...
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
