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with Multiple Chronic Condit PRODUCT DETAILS × PIN Subscriprion Validating... Product Titile : Framework for Decision-making for Older Adults with Multiple Chronic Conditions: Action Steps for the AGS Guiding Principles on the Care of Older Adults with Multimorbidity Enter PIN * × PIN Subscriprion Subscription is completed successfully. Click OK button to go to MyLibrary page. Product Type : Guidelines, Recommendations & Position Statements Language : ENGLISH Publisher : American Geriatrics Society Year (...) Framework for Decision-making for Older Adults with Multiple Chronic Conditions: Action Steps for the AGS Guiding Principles on the Care of Older Adults with Multimorbidity Framework for Decision-making for Older Adults with Multiple Chronic Conditions: Action Steps for the AGS Guiding Principles on the Care of Older Adults with Multimorbidity Logging In... × Welcome to GeriatricsCareOnline! AGS or ADGAP MEMBER Attention AGS Members! As an AGS Member, you already have an account automatically
released its latest update to one of geriatrics’ most frequently cited reference tools: The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. With more than 90% of olderpeople using at least one prescription and more than 66% using three or more in any given month, the AGS Beers Criteria® plays a vital role in helping health professionals, older adults, and caregivers work together to ensure medications are appropriate. DIGITAL : × Best Value To get the most for your (...) American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Logging In... × Welcome to GeriatricsCareOnline! AGS or ADGAP MEMBER Attention AGS Members! As an AGS Member, you already have an account automatically set up on GeriatricsCareOnline.org. Your username and password are the same that you use to log onto MyAGS. (If you do
Comparison of Heart Rate Blood Pressure Product Versus Age-Predicted Maximum Heart Rate as Predictors of Cardiovascular Events During Exercise Stress Echocardiography Exercise stress echocardiograms (ESEs) are a functional cardiovascular (CV) test typically used for the investigation of coronary artery disease. ESEs are often terminated at a predetermined age-predicted maximum heart rate (APMHR) to facilitate timely acquisition of ultrasound images at peak exercise. Although an APMHR of 85
Ethnic and socioeconomic variation in cause-specific preterm infant mortality by gestational age at birth: national cohort study To describe ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth.National birth cohort study.England and Wales 2006-2012.Singleton live births at 24-36 completed weeks' gestation (n=256 142).Adjusted rate ratios for death in infancy by cause (three groups), within categories of gestational age at birth (24
Frailty assessment in older adults undergoing interventions for peripheral arterial disease Frailty is a multidimensional syndrome that influences postoperative morbidity and mortality after vascular procedures; however, its integration in clinical practice has been limited, given the lack of consensus on how to measure it. This study sought to compare the incremental predictive value of six different nonphysical performance frailty scales to predict poor outcomes after interventions (...) with a mean age of 70 years. Depending on the scale used, the prevalence of frailty ranged from 16% to 70%. Frailty as measured by the GFI (adjusted odds ratio, 1.76; 95% confidence interval, 1.14-2.72) and mEFT (adjusted odds ratio, 2.71; 95% confidence interval, 1.29-5.73) predicted mortality and worsening disability at 12 months after interventions for PAD. Furthermore, there was statistically significant C-statistic, Bayesian information criterion, and integrated discrimination improvement when
Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years. Attention deficit hyperactivity disorder (ADHD) in children is associated with hyperactivity and impulsivity, attention problems, and difficulties with social interactions. Pharmacological treatment may alleviate the symptoms of ADHD but this rarely solves difficulties with social interactions. Children with ADHD may benefit from interventions designed to improve their social skills. We (...) in accordance with the Cochrane Handbook for Systematic Reviews of Intervention. We performed the analyses using Review Manager 5 software and Trial Sequential Analysis. We assessed bias according to domains for systematic errors. We assessed the certainty of the evidence with the GRADE approach.We included 25 randomised clinical trials described in 45 reports. The trials included a total of 2690 participants aged between five and 17 years. In 17 trials, participants were also diagnosed with various
Comparison of Universal Versus Age-Restricted Screening of Colorectal Tumors for Lynch Syndrome Using Mismatch Repair Immunohistochemistry: A Cohort Study. Guidelines recommend screening all patients with newly diagnosed colorectal cancer (CRC) for Lynch syndrome (LS). However, the efficiency of universal LS screening in elderly populations has not been well studied.To compare the performance of age-restricted and universal LS screening using reflex mismatch repair (MMR) immunohistochemistry (...) (IHC) of CRC tumors.Retrospective cohort study.A large, diverse, community-based health care system.3891 persons with newly diagnosed CRC who had LS screening between 2011 and 2016.Diagnostic yield of different LS screening strategies.Sixty-three LS cases (diagnostic yield, 1.62%) were identified by universal screening, with only 5 (7.9%) detected after age 70 years and 1 (1.6%) detected after age 80 years. When all patients with CRC who had universal screening were used as the denominator, 58 LS
of antihypertensive treatment for hypertension in this age group, as well as separately for people 60 to 79 years old and people 80 years or older.Primary objective• To quantify the effects of antihypertensive drug treatment as compared with placebo or no treatment on all-cause mortality in people 60 years and older with mild to moderate systolic or diastolic hypertensionSecondary objectives• To quantify the effects of antihypertensive drug treatment as compared with placebo or no treatment on cardiovascular (...) Pharmacotherapy for hypertension in adults 60 years or older. This is the second substantive update of this review. It was originally published in 1998 and was previously updated in 2009. Elevated blood pressure (known as 'hypertension') increases with age - most rapidly over age 60. Systolic hypertension is more strongly associated with cardiovascular disease than is diastolic hypertension, and it occurs more commonly in olderpeople. It is important to know the benefits and harms
Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. Whether exercise reduces subsequent falls in high-risk older adults who have already experienced a fall is unknown.To assess the effect of a home-based exercise program as a fall prevention strategy in older adults who were referred to a fall prevention clinic after an index fall.A 12-month, single-blind, randomized clinical trial conducted from (...) April 22, 2009, to June 5, 2018, among adults aged at least 70 years who had a fall within the past 12 months and were recruited from a fall prevention clinic.Participants were randomized to receive usual care plus a home-based strength and balance retraining exercise program delivered by a physical therapist (intervention group; n = 173) or usual care, consisting of fall prevention care provided by a geriatrician (usual care group; n = 172). Both were provided for 12 months.The primary outcome
isolation and loneliness 16 Malnutrition 18 Improving public mental health 21 Further information, tools and resources 23 References 25 A Menu of Interventions for Productive Healthy Ageing 4 Introduction The Menu of Interventions (MOIs) for productive health ageing is a guide that pharmacy teams working in different healthcare settings can use to support olderpeople to improve the quality of their lives. It suggests opportunistic, evidence-based interventions that can help provide benefits for healthy (...) ageing. For example, supporting olderpeople and their carers to prevent or reduce falls, increasing levels of physical activity, maintaining a healthy weight, reducing the risk of social isolation and loneliness, reducing the risk of dementia, supporting people diagnosed with dementia, delaying the progress of dementia and reducing the need for medicines. This is a menu of interventions that could be undertaken by pharmacy teams in the different sectors. It is recognised that not all pharmacy teams
Fractures and Subsequent Graft Loss and Mortality among Older Kidney Transplant Recipients Older adults who undergo kidney transplantation (KT) are living longer with a functioning graft and are at risk for age-related adverse events including fractures. Understanding recipient, transplant, and donor factors and the outcomes associated with fractures may help identify older KT recipients at increased risk. We determined incidence of hip, vertebral, and extremity fractures; assessed factors (...) associated with incident fractures; and estimated associations between fractures and subsequent death-censored graft loss (DCGL) and mortality.This was a prospective cohort study of patients who underwent their first KT between January 1, 1999, and December 31, 2014.We linked data from the Scientific Registry of Transplant Recipients to Medicare claims through the US Renal Data System.The analytic population included 47 815 KT recipients aged 55 years or older.We assessed the cumulative incidence
Mortality in adult-onset and elderly-onset IBD: a nationwide register-based cohort study 1964-2014 To examine all-cause and cause-specific mortality in adult-onset and elderly-onset IBD and to describe time trends in mortality over the past 50 years.Swedish nationwide register-based cohort study 1964-2014, comparing mortality in 82 718 incident IBD cases (inpatient and non-primary outpatient care) with 10 times as many matched general population reference individuals (n=801 180) using (...) multivariable Cox regression to estimate HRs. Among patients with IBD, the number of participants with elderly-onset (≥60 years) IBD was 17 873.During 984 330 person-years of follow-up, 15 698/82 718 (19%) of all patients with IBD died (15.9/1000 person-years) compared with 121 095/801 180 (15.1%) of reference individuals, corresponding to an HR of 1.5 for IBD (95% CI=1.5 to 1.5 (HR=1.5; 95% CI=1.5 to 1.5 in elderly-onset IBD)) or one extra death each year per 263 patients. Mortality was increased
hospital in Ireland.Retrospective cohort study.Acute hospital.Patients aged 65 years or older cared for by inpatient geriatric medicine services from January 1, 2013, to March 6, 2015 (n = 1654). After excluding those who died during the index hospitalization (n = 206) and those with missing data (n = 39), the analytical sample included 1409 patients.Administrative data and information abstracted from hospital discharge reports were used to determine covariate values for each patient. One-year (...) Predicting 1-Year Mortality in Older Hospitalized Patients: External Validation of the HOMR Model Accurate prognostic information can enable patients and physicians to make better healthcare decisions. The Hospital-patient One-year Mortality Risk (HOMR) model accurately predicted mortality risk (concordance [C] statistic = .92) in adult hospitalized patients in a recent study in North America. We evaluated the performance of the HOMR model in a population of older inpatients in a large teaching
The effectiveness of high molecular weight hyaluronic acid for knee osteoarthritis in patients in the working age: a randomised controlled trial High molecular weight (HMW) hyaluronic acid (HA) is a treatment option for knee osteoarthritis (OA). The efficacy of HMW-HA in knee OA is investigated extensively, but the effectiveness in patients in the working age is unknown. Nevertheless, the number knee OA patients in the working age is increasing. Surgical treatment options are less eligible (...) in these patients and productivity losses are high. In this study the effectiveness of intra-articular HMW-HA added to regular non-surgical usual care in everyday clinical practice (UC) compared to UC over 52 weeks in symptomatic knee OA patients in the working age was investigated.In this open labelled randomized controlled trial, subjects aged between 18 and 65 years with symptomatic knee OA (Kellgren and Lawrence I-III) were enrolled and randomized to UC + 3 weekly injections with HMW-HA (intervention) or UC
Digital media: Promoting healthy screen use in school-aged children and adolescents Digital media are integrated into the everyday lives of children and adolescents, with potential benefits and risks for learning, mental and physical health, and for social life. This statement examines the cognitive, psychosocial, and physical effects of digital media on school-aged children and adolescents, with a focus on family routines, context, and activities. Evidence-based guidance for clinicians
Effect of Targeting Mean Arterial Pressure During Cardiopulmonary Bypass by Monitoring Cerebral Autoregulation on Postsurgical Delirium Among Older Patients: A Nested Randomized Clinical Trial Delirium occurs in up to 52% of patients after cardiac surgery and may result from changes in cerebral perfusion. Using intraoperative cerebral autoregulation monitoring to individualize and optimize cerebral perfusion may be a useful strategy to reduce the incidence of delirium after cardiac surgery.To (...) determine whether targeting mean arterial pressure during cardiopulmonary bypass (CPB) using cerebral autoregulation monitoring reduces the incidence of delirium compared with usual care.This randomized clinical trial nested within a larger trial enrolled patients older than 55 years who underwent nonemergency cardiac surgery at a single US academic medical center between October 11, 2012, and May 10, 2016, and had a high risk for neurologic complications. Patients, physicians, and outcome assessors
Comparative Effectiveness of Behavioral Interventions on Quality of Life for Older Adults With Mild Cognitive Impairment: A Randomized Clinical Trial Recommendations to engage in behavioral strategies to combat clinically significant cognitive and behavioral symptoms are routinely given to persons with mild cognitive impairment (MCI). The comparative effectiveness of these behavioral interventions is not well understood.To compare the incremental effects of combinations of 5 behavioral (...) interventions on outcomes of highest importance to patients with MCI.In this multisite, cluster randomized, multicomponent comparative effectiveness trial, 272 patients from 4 academic medical outpatient centers (Mayo Clinic, Rochester, Minnesota; Mayo Clinic, Scottsdale, Arizona; Mayo Clinic, Jacksonville, Florida; and University of Washington, Seattle) were recruited from September 1, 2014, to August 31, 2016, with last follow-up March 31, 2019. All participants met the National Institute on Aging