Psilocybin in Palliative Care: An Update
AbstractPurpose of ReviewThis review article summarizes clinically and socially relevant developments over the past five years in the therapeutic use of the classical tryptamine psychedelic substance psilocybin, with respect to the common challenges faced by palliative care patients and their care teams. Psilocybin is available in whole fungal and isolated forms but is not yet approved for therapeutic use in the United States. Using targeted database and gray literature searches, and author recall, key sources were identified, reviewed, and synthesized as to the safety and efficacy of psilocybin in palliative care.Recent F...
Source: Current Geriatrics Reports - April 14, 2023 Category: Geriatrics Source Type: research
Interprofessional Specialty Palliative Care Education and Training
This article reviews current specialty palliative care education and training and highlights areas for future development.Recent FindingsSpecialty palliative care is delivered by professionals with the education and qualifications necessary to deliver comprehensive care. The core team includes chaplains, physicians, physician assistants, advanced practice registered nurses, registered nurses, pharmacists, and social workers. In the last forty years, specialty palliative care education and training has successfully developed within the various professions. This includes academic education, residencies, fellowships and immer...
Source: Current Geriatrics Reports - March 31, 2023 Category: Geriatrics Source Type: research
Obliterative Surgery for Vaginal Prolapse: An Update
AbstractPurpose of ReviewPelvic organ prolapse is a common diagnosis especially within the older female population. There are many options for treatment; this article provides a comprehensive review of new and contributory literature on obliterative surgeries as well as a review of their unique advantages and disadvantages compared to non-surgical options and other reconstructive surgeries.Recent FindingsRecent literature on obliterative surgeries for pelvic organ prolapse provides further information on body image, post-operative regret, and sexual function after obliterative surgery. In addition, a unique post-operative ...
Source: Current Geriatrics Reports - March 22, 2023 Category: Geriatrics Source Type: research
Anticholinergic Use for OAB in the Older Woman: An Update
AbstractPurposeThis expert narrative review discusses the role of anticholinergic therapy for overactive bladder in older women with a focus on recent evidence regarding serious safety concerns.Recent FindingsAnticholinergics are the most commonly utilized treatment for overactive bladder; however, recent large observational studies suggest a significant association between anticholinergic use for overactive bladder and increased risk of dementia. Additional studies have also raised concerns for increased risk of falls, fractures, and all-cause mortality. Differences may exist among various specific anticholinergic drugs, ...
Source: Current Geriatrics Reports - March 1, 2023 Category: Geriatrics Source Type: research
Neuromodulation in the Older Woman: An Advanced Treatment Option for Urgency Urinary Incontinence
AbstractPurpose of ReviewUrgency urinary incontinence (UUI) disproportionately impacts older women, and treatment strategies should minimize known harms while optimizing benefits. In the present review, we seek to provide an overview of the recent literature as it relates to neuromodulation and the treatment of older women with UUI. We also highlight recent innovations to neuromodulation therapy which have the potential to significantly improve access to neuromodulation for older women, in addition to improvements in longevity and cost-effectiveness.Recent FindingsWith respect to sacral neuromodulation (SNM) in older women...
Source: Current Geriatrics Reports - February 7, 2023 Category: Geriatrics Source Type: research
Disparities in Heart Failure Management in Older Adults
AbstractPurpose of the Review:Patients with a heart failure diagnosis face early mortality and impaired quality of life. Optimal management requires close follow up and appropriate management of guideline-directed medial therapy (GDMT). The purpose of this review is to identify the sources of outcome disparities amongst elderly patients with heart failure, examine which can be acted upon, and propose potential measures to improve care moving forward.Recent Findings:Disparities in heart failure outcomes have been observed in comparing the older population to the younger, in blacks or Hispanics vs. whites, and in male vs. fe...
Source: Current Geriatrics Reports - November 22, 2022 Category: Geriatrics Source Type: research
The 4 M’s: What Every Specialist Should Know
AbstractProviding individualized care to older adults hinges on understanding their goals. The “Four M’s” - ?What matters most, medication, mentation and mobility - provides a framework for understanding an individual’s health care goals. “What matters most” is perhaps the anchor of the four and is often the most difficult to determine. Starting with understanding “what matters most” to an individuals helps those providing health care align diagnostic and treatment decisions with the patient’s health care preferences. (Source: Current Geriatrics Reports)
Source: Current Geriatrics Reports - September 1, 2022 Category: Geriatrics Source Type: research
An Approach to Cardiac Syncope in the Elderly Patient
AbstractPurpose of ReviewSyncope in the geriatric population remains a considerable diagnostic challenge due to its often atypical presentation and multifactorial etiology. This is compounded by the rising incidence of coexisting medical conditions, frailty, and polypharmacy in this population. Patients who have a history of cardiovascular disease or whose presentations have historical factors suggestive of a cardiac etiology should undergo evaluation for potential cardiac causes of syncope. Here we outline a framework for the evaluation of cardiac syncope in the elderly patient.Recent FindingsAssessment should include eli...
Source: Current Geriatrics Reports - August 4, 2022 Category: Geriatrics Source Type: research
Challenges and New Insights in the Management of Urinary Incontinence in Older Women
This article highlights the potential challenges in the management of urinary incontinence in older women.Recent FindingsUrinary incontinence is a highly prevalent condition associated with profound morbidity and psychosocial consequences especially among older women. Simple conservative approaches including life-style modification and behavioral management can be quite effective in improving urinary incontinence symptoms. However, options beyond first-line management are limited due to adverse effects related to medications or surgery.SummaryUrinary incontinence is a multifactorial condition in older women, and management...
Source: Current Geriatrics Reports - March 31, 2022 Category: Geriatrics Source Type: research
Optimizing Cardiac Performance During the Perioperative Period
AbstractPurpose of ReviewPerioperative adverse cardiac events commonly affect patients undergoing surgery and are even increasingly more common as patients age. The purpose of this paper is to review recent literature and society guidelines regarding screening and optimizing these patients in the perioperative period.Recent FindingsThere remains a relative paucity of prospective, randomized control trials regarding cardiac optimization/risk-reduction in patients undergoing noncardiac surgery. Current guidelines are focused primarily on identifying patients at an increased risk of perioperative cardiac adverse events, perfo...
Source: Current Geriatrics Reports - February 15, 2022 Category: Geriatrics Source Type: research
Amyloid Cardiomyopathy in Older Adults
AbstractPurpose of ReviewWild type transthyretin cardiac amyloidosis (ATTRwt, formerly called senile cardiac amyloidosis) is almost exclusively a disorder of adults over 60 years old and represents a quintessential type of diastolic heart failure in the older adult population. Cardiac amyloidosis is an infiltrative/restrictive cardiomyopathy that causes heart failure, atrial and ventricular arrhythmias, and conduction disease, and is associated with significant morbi dity and mortality. Early suspicion by geriatricians including clinical clues or suggestive features when coupled with non-invasive cardiac testing that del...
Source: Current Geriatrics Reports - February 12, 2022 Category: Geriatrics Source Type: research
Disparities and Racism Experienced Among Older African Americans Nearing End of Life
AbstractPurpose of ReviewThe purpose of this review is to examine racism in healthcare as it relates to older African American adults. We focus on health disparities in old age and medical mismanagement throughout their lifespan.Recent FindingsIn the United States there have been extensive medical advances over the past several decades. Individuals are living longer, and illnesses that were deemed terminal in the past are now considered chronic illnesses. While most individuals living with chronic illness have experienced better quality of life, this is not the case for many African American older adults.SummaryOlder Afric...
Source: Current Geriatrics Reports - December 14, 2021 Category: Geriatrics Source Type: research
Home Based Palliative Care: Known Benefits and Future Directions
AbstractPurpose of ReviewTo summarize key recent evidence regarding the impact of Home-Based Palliative Care (HBPalC) and to highlight opportunities for future study.Recent FindingsHBPalC is cost effective and benefits patients and caregivers across the health care continuum.SummaryHigh-quality data support the cost effectiveness of HBPalC. A growing literature base supports the benefits of HBPalC for patients, families, and informal caregivers by alleviating symptoms, reducing unwanted hospitalizations, and offering support at the end of life. Numerous innovative HBPalC models exist, but there is a lack of high-quality ev...
Source: Current Geriatrics Reports - November 25, 2021 Category: Geriatrics Source Type: research
Iron Deficiency in Heart Failure: Characteristics and Treatment
AbstractPurpose of the ReviewIron deficiency in heart failure has been associated with impaired functional capacity and quality of life. The purpose of this paper is to review mechanisms of iron homeostasis and current clinical data exploring mechanisms of iron repletion in heart failure.Recent FindingMultiple international societies now advise iron repletion for symptomatic heart failure patients with iron deficiency. Due to the chronic inflammation in heart failure, iron deficiency in heart failure is classically defined as ferritin < 100 µg/L or ferritin 100–300 µg/L and transferrin saturation < 2...
Source: Current Geriatrics Reports - November 25, 2021 Category: Geriatrics Source Type: research
Review of Grief Therapies for Older Adults
The objective of this review is to provide background on common theories of grief, describe the impact of grief on older adults and to introduce various modalities that are currently used and/or being researched for treatment. The objective is also to condense information and identify what has been found beneficial versus what has been found lacking. A brief examination of overlap of other disorders is done. It also will suggest what further research is necessary on this subject, and highlight what research is being done during the COVID-19 Pandemic.FindingsThe latest research of grief primarily involves refining the defin...
Source: Current Geriatrics Reports - November 18, 2021 Category: Geriatrics Source Type: research
