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.

The value of a comprehensive geriatric assessment for patient care in acutely hospitalized older patients with cancer.

Hamaker ME, Buurman BM, van Munster BC, Kuper IM, Smorenburg CH, de Rooij SE

Academic Medical Center, Department of Internal Medicine, F4-108, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. mhamaker@diakhuis.nl.

Introduction. A comprehensive geriatric assessment systematically collects information on geriatric conditions and is propagated in oncology as a useful tool when assessing older cancer patients. Objectives. The objectives were: (a) to study the prevalence of geriatric conditions in cancer patients aged ≥65 years, acutely admitted to a general medicine ward; (b) to determine functional decline and mortality within 12 months after admission; and (c) to assess which geriatric conditions and cancer-related variables are associated with 12-month mortality. Methods. This was an observational cohort study of 292 cancer patients aged ≥65 years, acutely admitted to the general medicine and oncology wards of two university hospitals and one secondary teaching hospital. Baseline assessments included patient characteristics, reason for admission, comorbidity, and geriatric conditions. Follow-up at 3 and 12 months was aimed at functional decline (loss of one or more activities of daily living [ADL]) and mortality. Results. The median patient age was 74.9 years, and 95% lived independently; 126 patients (43%) had metastatic disease. A high prevalence of geriatric conditions was found for instrumental ADL impairment (78%), depressive symptoms (65%), pain (65%), impaired mobility (48%), malnutrition (46%), and ADL impairment (38%). Functional decline was observed in 8% and 33% of patients at 3 and 12 months, respectively. Mortality rates were 38% at 3 months and 64% at 12 months. Mortality was associated with cancer-related factors only. Conclusion. In these acutely hospitalized older cancer patients, mortality was only associated with cancer-related factors. The prevalence of geriatric conditions in this population was high. Future research is needed to elucidate if addressing these conditions can improve quality of life.

Published 21 October 2011 in Oncologist, 16(10): 1403-12.
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Articles on Geriatrics published 21 October 2011:

The terminal phase of life as a team-based clinical global judgment : Prevalence and associations in an acute geriatric unit.   Z Gerontol Geriatr, 44(5): 329-335.

BACKGROUND: In most elderly people, the final-terminal-phase of life is characterized by permanent dependency and a complete inability to perform activities of daily living. Treatment targets usually switch from rehabilitation to palliation. However, the prevalence of the clinical judgment "last phase of life" and its association with in-hospital death is unknown in geriatric patients. PATIENTS AND METHODS: ... [Abstract] [Full-text]

Articles on Geriatrics published 18 October 2011:

Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial.   Clin Rehabil.

Objective: To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain. Design: Three-year geriatric development project with randomized assignment to intervention and control group. Setting: Research centre, community and assisted living facilities. ... [Abstract] [Full-text]

Articles on Geriatrics published 17 October 2011:

Gynecologic Issues in Geriatric Women.   J Womens Health (Larchmt).

Abstract The number of women over the age of 65 is projected to almost double in the next 20 years, and clinicians need to be comfortable treating conditions common to this cohort. This review covers several common gynecologic conditions seen in older women, including atrophic vaginitis, lichen sclerosis, pelvic floor disorders, and postmenopausal bleeding. We conclude with evidence-based screening recommendations for gynecologic cancers in older women and tips on doing a pelvic examination. [Abstract] [Full-text]

Articles on Geriatrics published 14 October 2011:

Stochastic modulations of the pace and patterns of ageing: Impacts on quasi-stochastic distributions of multiple geriatric pathologies.   Mech Ageing Dev.

All phenotypes result from interactions between Nature, Nurture and Chance. The constitutional genome is clearly the dominant factor in explaining the striking differences in the pace and patterns of ageing among species. We are now in a position to reveal salient features underlying these differential modulations, which are likely to be dominated by regulatory domains. By contrast, I shall argue that stochastic events are the major players underlying the surprisingly large intra-specific ... [Abstract] [Full-text]

Exotoxin gene backgrounds in bloodstream and wound Staphylococcus aureus isolates from geriatric patients attending a long-term care Spanish hospital.   J Med Microbiol, 60: 1605-12.

The exotoxin gene content was established for 62 Staphylococcus aureus isolates causing bloodstream (n = 31) and wound (n = 31) infections in geriatric patients attending a long-term care Spanish hospital from 1996 to 2006. Content was determined based on PCR screening of genes encoding five haemolysins, three exfoliatins, three leukotoxins and 21 pyrogenic toxin superantigens (PTSAgs), in addition to markers of genomic (νSaβ) and pathogenicity (SaPIs) islands. Exotoxin genes were ... [Abstract] [Full-text]

Articles on Geriatrics published 12 October 2011:

A multicentre phase II randomised trial of weekly docetaxel/gemcitabine followed by erlotinib on progression, vs the reverse sequence, in elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0504 study).   Br J Cancer, 105(8): 1123-30.

Background:Elderly cancer patients form a heterogeneous population in which therapeutic decision-making is often difficult. The aim of this randomised phase II trial was to evaluate the feasibility and activity of weekly docetaxel/gemcitabine (DG) followed by erlotinib after progression (arm A) vs erlotinib followed by DG after progression (arm B) in fit elderly patients with advanced non small-cell lung cancer (NSCLC).Methods:Elderly chemotherapy-naive patients with stage IIIB/IV NSCLC were ... [Abstract] [Full-text]

Articles on Geriatrics published 11 October 2011:

Vascular trauma in geriatric patients: a national trauma databank review.   J Trauma, 71(4): 909-16.

[Abstract] [Full-text]

Articles on Geriatrics published 10 October 2011:

A single mid-gestation exposure to TCDD yields a postnatal autoimmune signature, differing by sex, in early geriatric C57BL/6 mice.   Toxicology.

We recently observed an autoimmune profile in 24-week-old C57BL/6 mice that received a 2.5 or 5.0μg/kg mid-gestation dose of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (Mustafa et al., 2008). The clinical signs were consistent with a lupus-like syndrome and included: increased autoantibody levels, renal IgG and C3 immune complex deposition with associated inflammation, and increased peripheral Vβ(+) T cells. No studies currently exist following the progression of such disease into middle or ... [Abstract] [Full-text]

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