Best Practice for Home Physical Therapy for Older Adults with Heart Failure
AbstractPurpose of ReviewThis review elucidates the key considerations applicable to the physical therapist in effectively managing patients with heart failure in the home health setting.Recent FindingsThe paper accentuates various examination strategies that support an appreciation for patient stability prior to exercise. Additionally, organized clinical decision-making and effective treatment techniques including aerobic exercise, strength training, interval training, energy conservation techniques, inspiratory muscle training, and positioning are reviewed in an effort to improve the activity and participation of patient...
Source: Current Geriatrics Reports - January 30, 2018 Category: Geriatrics Source Type: research
Using Informant and Performance Screening Methods to Detect Mild Cognitive Impairment and Dementia
AbstractPurpose of ReviewDementia detection in the community is challenging. The purpose of this paper is to review methods of dementia screening and provide a useable algorithm for screening for dementia a variety of clinical settings.Recent FindingsIn recent years, a number of brief performance and informant-based assessments have been developed and validated in research, clinical, and community samples. These assessments are now complemented by patient self-reports that afford the ability to detect subjective cognitive impairment.SummaryAn optimal approach to dementia screening is to combine performance, informant, and ...
Source: Current Geriatrics Reports - January 26, 2018 Category: Geriatrics Source Type: research
Aging and the Pelvic Floor
AbstractPurpose of ReviewTo define the unique effects of age on the pelvic floor muscle and to outline current treatments of pelvic floor dysfunction in the older population.Recent FindingsAging has muscular, hormonal, and neurological effects on the pelvic floor that may lead to pelvic floor dysfunction. Muscular changes lead to decreased force output and weakness on clinical examination. Hormonal effects exacerbate pelvic tissue changes, most notably in the postmenopausal woman. Neurological changes are less well-defined, but gradual denervation of the pelvic floor, especially noted in parous women, has been implicated a...
Source: Current Geriatrics Reports - January 17, 2018 Category: Geriatrics Source Type: research
Recent Advances in Cholinergic Imaging and Cognitive Decline —Revisiting the Cholinergic Hypothesis of Dementia
AbstractPurpose of ReviewAlthough the cholinergic hypothesis of dementia provided a successful paradigm for the development of new drugs for dementia, this hypothesis has waned in popularity. Cholinergic brain imaging may provide novel insights into the viability of this hypothesis.Recent FindingsCholinergic receptor and forebrain volumetric studies suggest an important role of the cholinergic system in maintaining brain network integrity that may deteriorate with cognitive decline in Alzheimer disease (AD) and Lewy body disorders (LBD). Bidirectional changes in regional receptor expression may suggest the presence of comp...
Source: Current Geriatrics Reports - January 13, 2018 Category: Geriatrics Source Type: research
Correction to: Management of Osteoporotic and Neuropathic Ankle Fractures in the Elderly
AbstractThe original version of this article unfortunately contained an incorrect version of authors ’ names and surnames (underlined) for Dr. C.J.A. Van Bergen and Dr. M.P.J. Van den Bekerom. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - November 25, 2017 Category: Geriatrics Source Type: research
Care of the Elderly Patient with Infective Endocarditis
AbstractPurpose of ReviewThis review analyzes the presentation, manifestations, and management decisions for elderly patients with infectious endocarditis (IE).Recent FindingsThere are significant differences in IE across ages. Whereas the major risk factors for younger individuals include intravenous drug use and complex congenital heart disease, older adults tend to develop IE on prosthetic valves or in the setting of degenerative valve disease. Nosocomial disease is important regardless of age. The microbiology differs too for elderly patients. AlthoughStaphylococcus aureus is universally an important pathogen, elderly ...
Source: Current Geriatrics Reports - November 17, 2017 Category: Geriatrics Source Type: research
Implantable Cardioverter-Defibrillator Implantation, Continuation, and Deactivation in Elderly Patients
AbstractPurpose of ReviewWe review the major randomized trials and recent literature which address the impact of age on the decisions to implant, replace, and deactivate implantable cardioverter-defibrillators (ICDs) in elderly patients ( ≥75 years).Recent FindingsCurrent national trends indicate that increasing numbers of ICD recipients are elderly and that elderly patients receive ICDs in a much higher proportion than was represented in randomized controlled trials. Increasing age and increasing comorbidity burden reduce the potential survival benefit from ICD implantation. Multiple risk assessment models are reviewed...
Source: Current Geriatrics Reports - November 14, 2017 Category: Geriatrics Source Type: research
Polypharmacy in Older Adults with Cancer: Evaluating Polypharmacy as Part of the Geriatric Assessment
AbstractPurpose of ReviewPolypharmacy is a significant public health problem that disproportionally affects older adults who are considered to be the highest consumers of medications. Cancer-related therapy can intensify the prevalence of polypharmacy; however, polypharmacy has inconsistently been included as part of the comprehensive geriatric assessment (CGA). This inconsistency is likely attributed to conflicting study results demonstrating a correlation between polypharmacy and clinical outcomes in older adults with cancer. Despite these inconsistencies, several national and international organization guidelines recomm...
Source: Current Geriatrics Reports - October 27, 2017 Category: Geriatrics Source Type: research
Primary Endocrine Therapy in Older Women with Breast Cancer
AbstractPurpose of ReviewBreast cancer incidence increases with age. In recent years, primary endocrine therapy has been increasingly used as a treatment option for frail elderly women with breast cancer, although surgery is still the guideline-recommended treatment. In this review, we discuss the evidence for primary endocrine therapy versus surgical treatment in older women with early breast cancer.Recent FindingsBoth randomised controlled trials and recent observational studies showed a favourable progression-free survival but not overall survival for surgery plus adjuvant endocrine therapy versus primary endocrine ther...
Source: Current Geriatrics Reports - October 19, 2017 Category: Geriatrics Source Type: research
Rehabilitation Strategies in Older Adult Oncology Patients: a Focus on Occupational and Physical Therapy
AbstractPurpose of ReviewOlder adults with cancer experience several functional implications from cancer and its treatment. The challenges these individuals experience throughout the cancer trajectory can be addressed by rehabilitation specialists, such as occupational and physical therapies. This paper provides a review of occupational and physical therapy rehabilitative strategies in older adults with cancer from 2014 to 2017.Recent FindingsBoth occupational and physical therapies are well supported within the literature to address functional deficits for older adults with cancer via numerous rehabilitative approaches by...
Source: Current Geriatrics Reports - October 16, 2017 Category: Geriatrics Source Type: research
Atherosclerotic Cardiovascular Disease in Older Adults
AbstractPurpose of ReviewAtherosclerotic coronary disease is a major cause of morbidity and mortality in older adults. The purposes of this review are to summarize our current knowledge about best practices in the management of coronary artery disease in this population and to highlight remaining gaps in our understanding.Recent FindingsElderly patients are far less likely than their younger counterparts to receive guideline-based care after presenting with an acute coronary syndrome (ACS). However, despite some attenuation of benefit with increasing age, recent studies have shown improved outcomes with an early invasive s...
Source: Current Geriatrics Reports - October 16, 2017 Category: Geriatrics Source Type: research
Comorbidity, Physical Function, and Quality of Life in Older Adults with Acute Myeloid Leukemia
AbstractPurpose of ReviewThe purpose of this study is to describe the pathology, impact of comorbidities, functional limitations, symptoms, and quality of life (QOL) related to treatment of acute myeloid leukemia (AML) in older adults.Recent FindingsAML is a rare aggressive hematologic disease that occurs most often in older adults. The prognosis for older patients with AML is markedly worse due to genetic mutations and patient characteristics such as comorbidities and functional limitations. Patient characteristics may influence treatment decisions, as well as impact symptoms, functional ability, health-related outcomes, ...
Source: Current Geriatrics Reports - October 11, 2017 Category: Geriatrics Source Type: research
Cardiac Rehabilitation and Exercise Training in the Elderly
AbstractPurpose of ReviewWith recent improvements in cardiovascular care and prevention, the demographic of individuals enrolled into cardiac rehabilitation (CR) is shifting towards an older set of individuals. Management plans for elderly cardiovascular patients must consider processes associated with aging, sarcopenia, cognitive impairment, and inflammation all contributing to declining functional capacity.Recent FindingsIncreased debility at baseline does not translate into a significantly higher risk associated with physical activity but does require better access. High-intensity interval training protocols have shown ...
Source: Current Geriatrics Reports - October 9, 2017 Category: Geriatrics Source Type: research
Assessing Frailty and Vulnerability in Older Adults with Cancer
AbstractPurpose of ReviewAging is associated with decreased physiologic reserve, and older adults are more susceptible to cancer treatment toxicity. In this review, we discuss the implications of frailty and vulnerability in older patients with cancer. We also review a number of instruments that can be used to assess frailty and vulnerability and propose a practical approach to incorporate these tools in a general oncology or geriatric clinic.Recent FindingsIn older patients with cancer, frailty and vulnerability are associated with all-cause mortality, postoperative complications, and treatment intolerance/toxicities. If ...
Source: Current Geriatrics Reports - October 7, 2017 Category: Geriatrics Source Type: research
Sarcopenia in Oncology or Gerontology: What Is the Difference?
AbstractPurpose of ReviewLow muscle mass, commonly known as sarcopenia, has been a focus of gerontologic research for many years and is related to reduced health-related quality of life, functional impairment, and shortened survival.Recent FindingsIn oncology, body composition research, including sarcopenia, has emerged as an area of particular interest in the last several years, as sarcopenia is highly prevalent in patients with cancer regardless of age and is correlated with adverse treatment outcomes and shorter survival.SummaryIn this review, we discuss the differences between sarcopenia in gerontology and oncology, in...
Source: Current Geriatrics Reports - October 6, 2017 Category: Geriatrics Source Type: research
