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 13, 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 professionals...
Source: Current Geriatrics Reports - June 12, 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 12, 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 12, 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 12, 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 6, 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” factors. “Intrins...
Source: Current Geriatrics Reports - June 6, 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 supple...
Source: Current Geriatrics Reports - June 6, 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 5, 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 5, 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 25, 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 24, 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 23, 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 21, 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 21, 2019 Category: Geriatrics Source Type: research
