Geriatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Geriatrics, including details on old age, psychiatry, depression, medicine.

Geriatric Conditions and Subsequent Mortality in Older Patients With Heart Failure.

Chaudhry SI, Wang Y, Gill TM, Krumholz HM

Department of Internal Medicine, Section of General Medicine, Yale University School of Medicine, New Haven, Connecticut.

OBJECTIVES: This study was designed to develop models for short- (30-day) and long- (5-year) term mortality after heart failure (HF) hospitalization that include geriatric conditions, specifically mobility disability and dementia, to determine whether these conditions emerge as strong and independent risk factors. BACKGROUND: Although 80% of patients with HF are 65 years of age or older, no large studies have focused on the prognostic importance of geriatric conditions. METHODS: We analyzed medical record data from a national sample of Medicare beneficiaries hospitalized for HF. To identify independent predictors of mortality, we performed stepwise selection in multivariable logistic regression models. We used net reclassification improvement to assess the incremental benefit of adding geriatric conditions to a model containing traditional risk factors for mortality. RESULTS: The mean age of patients included in the analysis was 80 years; 59% were women, 13% were nonwhite, 10% had dementia, and 39% had mobility disability. Mortality rates were 9.8% at 30 days and 74.7% at 5 years. Twenty-one variables were considered for inclusion in the final multivariable model. Dementia and mobility disability were among the top predictors of short- and long-term mortality, with among the top 6 largest absolute standardized estimates in the final model for 30-day mortality, and among the top 7 largest standardized estimates for 5-year mortality. The net reclassification improvement when geriatric conditions were added to traditional factors was 5.1% at 30 days and 4.2% at 5 years. CONCLUSIONS: Geriatric conditions are strongly and independently associated with short- and long-term mortality among older patients with HF.

Published 1 February 2010 in J Am Coll Cardiol, 55(4): 309-316.
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Articles on Geriatrics published 1 February 2010:

Use of a simplified geriatric evaluation in thoracic oncology.   Lung Cancer, 67(2): 232-236.

Management of elderly patients with bronchial cancer should take into account specific factors linked to the patient's age, and the presence of co-morbidities. A geriatric evaluation enables us to use relevant information in the therapeutic decision-making process. However, the Comprehensive Geriatric Assessment described in the literature is tedious and time-consuming. We describe the use of a simplified geriatric evaluation (SGE), in 57 patients aged >/=75 years (mean age: 80.8 years) with ... [Abstract] [Full-text]

A mini geriatric assessment helps treatment decision in elderly patients with digestive cancer. A pilot study.   Crit Rev Oncol Hematol.

Comprehensive geriatric assessment (CGA) is advocate to improved care of elderly with cancer but is not available in every hospital within a short delay. Therefore, a tool allowing gastroenterologist to detect rapidly specific abnormalities in elderly is needed. PATIENTS AND METHODS: The aim of our pilot study was to evaluate feasibility of a mini geriatric assessment (MGA) to adapt the anticancer treatments. MGA was done by a gastroenterologist and was taken into account during the cancer ... [Abstract] [Full-text]

Assessment of urinary N-acetyl-beta-D-glucosaminidase activity in geriatric cats with variable plasma creatinine concentrations with and without azotemia.   Am J Vet Res, 71(2): 241-7.

Objective-To validate a nonautomated technique for the measurement of urinary N-acetyl-beta-D-glucosaminidase (NAG) activity in cats and assess the correlation between NAG index, plasma creatinine concentration, and proteinuria. Animals-197 client-owned cats (>/= 9 years old; 119 neutered males and 78 neutered females) of which 103 had previously been determined to have chronic kidney disease (CKD). Procedures-Preliminary assay validation was performed for a nonautomated colorimetric ... [Abstract] [Full-text]

Articles on Geriatrics published 29 January 2010:

Validation of the activity inventory of the Chedoke-McMaster stroke assessment and the clinical outcome variables scale to evaluate mobility in geriatric clients.   J Rehabil Med, 42(1): 90-2.

OBJECTIVE: To evaluate the construct validity of the Activity Inventory of the Chedoke-McMaster Stroke Assessment and the Clinical Outcome Variables Scale (COVS), 2 measures of functional mobility. DESIGN: A retrospective longitudinal study of 24 inpatients (mean age 83 years (standard deviation 7)) on a geriatric rehabilitation unit. PARTICIPANTS: The primary reasons for admission were deconditioning (n=9) and hip fracture (n=7). METHOD: We tested hypotheses that Activity Inventory and COVS ... [Abstract] [Full-text]

Articles on Geriatrics published 27 January 2010:

Facial trauma in geriatric patients in a selected Malaysian hospital.   Geriatr Gerontol Int, 10(1): 64-9.

BACKGROUND: Road traffic accidents are the main cause of trauma in Malaysia. It has been shown that there was an increase in admissions for trauma patients older than 60 years in the last decade. The purpose of this study was to determine the pattern of maxillofacial injuries in the geriatric patients referred to Seremban Hospital, Malaysia. METHODS: Records of patients aged 60 years or older who sustained oral and maxillofacial injuries between 1998 and 2002 were reviewed. Data related to age, ... [Abstract] [Full-text]

A comparison of multisensory and traditional interventions on inpatient psychiatry and geriatric neuropsychiatry units.   J Psychosoc Nurs Ment Health Serv, 48(1): 24-31.

Sensory rooms and the use of multisensory interventions are becoming popular in inpatient psychiatry. The empirical data supporting their use are limited, and there is only anecdotal evidence indicating effectiveness in psychiatric populations. The specific aims of this observational pilot study were to determine whether multisensory-based therapies were effective in managing psychiatric symptoms and to evaluate how these interventions compared to traditional ones used in the milieu. The study ... [Abstract] [Full-text]

Articles on Geriatrics published 26 January 2010:

Functional Dysphagia Therapy and PEG Treatment in a Clinical Geriatric Setting.   Dysphagia.

Functional dysphagia therapy (FDT) is a noninvasive procedure that can accompany percutaneous endoscopic gastrostomy (PEG) treatment and supports transitioning from tube to oral feeding. In this retrospective study, we investigated the outcome of FDT with or without PEG feeding. Patients with dysphagia were divided into two groups: those with PEG feeding (N = 117) and those with exclusively oral feeding (N = 105). Both groups received functional training (oral motor skills/sensation, ... [Abstract] [Full-text]

Older adults and ulcers: chronic wounds in the geriatric population.   Adv Skin Wound Care, 23(1): 39-44; quiz 45-6.

PURPOSE: To provide the wound care practitioner with information about how chronic wound healing differs in the older adult population. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to: 1. Compare chronic wound healing processes and outcomes in older adults with those in younger persons. 2. Explain the ... [Abstract] [Full-text]

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