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Comprehensive Geriatric Assessment (comprehensive + geriatric_assessment)

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Medical Sciences	100%

Selected Abstracts

Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderly

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2006
Hidenori Arai
Background: To determine the utility of various serum markers for assessment of cognitive and mental functions in the elderly, we performed a Comprehensive Geriatric Assessment (CGA) in the out-patient clinic in Kyoto University Hospital. Methods: We measured serum levels of dehydroepiandrosterone (DHEA), DHEA-S, malondialdehyde low-density lipoproteins (MDA-LDL), and high-sensitivity C-reactive protein (hs-CRP) in 145 patients to find the association of these markers with activities of daily living (ADL), cognitive impairment and depressive symptoms. Results: We found that the levels of hs-CRP were significantly higher in patients with lower scores in Mini-Mental State Examination (MMSE) and Kohs block design test, and higher scores in the button test, indicating that hs-CRP may be associated with the cognitive function in elderly patients. We also found that the levels of DHEA-S were lower in patients with higher scores (9 or over) on the Geriatric Depression Scale-15 (GDS), indicating that DHEA-S may be associated with depressive mode in elderly patients. Total cholesterol, high-density cholesterol (HDL-C), or albumin were not statistically different in each group studied. Conclusions: Thus, our data indicate that measuring hs-CRP and DHEA-S would be helpful to assess the cognitive function and depressive symptoms in elderly patients. [source]

A Randomized, Controlled Trial of Comprehensive Geriatric Assessment and Multidisciplinary Intervention After Discharge of Elderly from the Emergency Department,The DEED II Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2004
FRACP, Gideon A. Caplan MBBS
Objectives: To study the effects of comprehensive geriatric assessment (CGA) and multidisciplinary intervention on elderly patients sent home from the emergency department (ED). Design: Prospective, randomized, controlled trial with 18 months of follow-up. Setting: Large medical school,affiliated public hospital in an urban setting in Sydney, Australia. Participants: A total of 739 patients aged 75 and older discharged home from the ED were randomized into two groups. Intervention: Patients randomized to the treatment group underwent initial CGA and were followed at home for up to 28 days by a hospital-based multidisciplinary outreach team. The team implemented or coordinated recommendations. The control group received usual care. Measurements: The primary outcome measure was all admissions, to the hospital within 30 days of the initial ED visit. Secondary outcome measures were elective and emergency admissions, and nursing home admissions and mortality. Additional outcomes included physical function (Barthel Index (total possible score=20) and instrumental activities of daily living (/12) and cognitive function (mental status questionnaire (/10)). Results: Intervention patients had a lower rate of all admissions to the hospital during the first 30 days after the initial ED visit (16.5% vs 22.2%; P=.048), a lower rate of emergency admissions during the 18-month follow-up (44.4% vs 54.3%; P=.007), and longer time to first emergency admission (382 vs 348 days; P=.011). There was no difference in admission to nursing homes or mortality. Patients randomized to the intervention group maintained a greater degree of physical and mental function (Barthel Index change from baseline at 6 months: ,0.25 vs ,0.75; P<.001; mental status questionnaire change from baseline at 12 months: ,0.21 vs ,0.64; P<.001). Conclusion: CGA and multidisciplinary intervention can improve health outcomes of older people at risk of deteriorating health and admission to hospital. Patients aged 75 and older should be referred for CGA after an ED visit. [source]

Testosterone and Comprehensive Geriatric Assessment in Frail Elderly Men

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2003
Article first published online: 15 AUG 200
No abstract is available for this article. [source]

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2009
Kozo Matsubayashi
Aim: To reveal the comparison of comprehensive geriatric functions of elderly highlanders in Qinghai Plateau in China among three different ethnic groups. Methods: Activities of daily living (ADL), screening-based depression, quality of life (QOL) and checking-up of metabolic syndrome including community-based oral glucose tolerance test were assessed in 393 community-dwelling elderly subjects aged 60 years or more (247 Han elderly subjects, 49 Mongolian ones and 97 Tibetan ones). Results: Tibetan elderly highlanders were more disabled in ADL, but had higher QOL than Han elderly ones in Qinghai Plateau. Blood pressure measurements, rate of hypertension and hemoglobin concentrations in Tibetan elderly highlanders were lower than Han ones. Rates of diabetes and impaired glucose tolerance in elderly highlanders were relatively lower than other Asian elderly lowlanders. Conclusion: Prevalence of metabolic syndrome in elderly highlanders in Qinghai was still not high, however, we should pay attention to its tendency related with socialglobalism in the near future. Further investigation on physiological adaptability to hypoxic environment and human ageing phenomena in a global context may open a new research frontier for ageing science. [source]

Comprehensive geriatric assessment of elderly highlanders in Qinghai, China II: The association of polycythemia with lifestyle-related diseases among the three ethnicities

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2009
Kiyohito Okumiya
Aim: The objective of this study is to disclose the association of polycythemia with lifestyle-related diseases (hypertension, obesity and glucose intolerance) among the three ethnicities in Qinghai, China. Methods: The subjects were 393 elderly people (247 Han, 97 Tibetan and 49 Mongolian) aged 60 years and more living in Qinghai (3000 m a.s.l.) in China. The associated factors with polycythemia were analyzed in the subjects. Excessive polycythemia was defined as hemoglobin concentration over 20 mg/dL. Results: Polycythemia was associated with men, hypoxemia, obesity and high diastolic blood pressure (DBP) in the elderly in Qinghai. Male sex was associated with polycythemia in all ethnicities. Obesity was associated with Han and Tibetan men. Glucose intolerance and activities of daily living were not directly associated with polycythemia after adjustment for sex. There were 7.9% with excessive polycythemia. Independently-associated factors for excessive polycythemia were male sex, body mass index of 25 or more, SpO2 of less than 85%, DBP of 85 mmHg or more and Han ethnicity (vs Tibetan) by multiple logistic regression. Conclusion: There was a close association of polycythemia with diastolic hypertension and obesity in lifestyle-related diseases in high-altitude elderly people. Han people had a higher hemoglobin concentration after adjustment of lifestyle-related diseases compared with Tibetan people. The difference of hemoglobin concentration may be due to Tibetans undergoing a much longer period of adaptation than Han people. Further study is needed to disclose the association between the difference of hypoxic adaptation, lifestyle-related diseases and chronic mountain sickness for their prevention. [source]

Diabetes mellitus and geriatric syndromes

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2009
Atsushi Araki
Diabetes mellitus is associated with an increased prevalence and incidence of geriatric syndrome: functional disabilities, depression, fall, urinary incontinence, malnutrition and cognitive impairment. Geriatric syndrome not only leads to frailty, loss of independence and low quality of life, but also becomes a major obstacle in the treatment and care of diabetic people. The risk factors or contributing factors of geriatric symptoms are micro- and macrovascular complications, age-rated comorbid disease and aging per se. Comprehensive geriatric assessment of geriatric syndrome, including basic activities of daily living, instrumental activities of daily living, gait and balance, visual acuity, the Mini-Mental State Examination, depression scores, history and risk of fall, urination and nutrition, should be performed as part of the care of elderly diabetic patients, in particular old-old patients. Because geriatric syndromes are multifactorial and share risk factors, diabetic people with any geriatric symptoms should be treated with a common concentric strategy, such as supervised exercise therapy including muscle-strengthening training, psychological support, social support for adherence, and good glycemic control with avoidance of hypoglycemia. [source]

Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: VI.

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2005
Maubin in Myanmar
Background: The objective of the present study is to compare the findings of comprehensive geriatric assessments of community-dwelling elderly in Maubin township, Myanmar with those in Japan. Methods: A cross-sectional, study was undertaken of community-dwelling people aged 60 years and over who were living in downtown Maubin and two rural villages near Maubin city, and 411 people aged 65 years and over who were living in Sonobe, Kyoto, Japan. They were examined using a common comprehensive geriatric assessment tool, which included interviews regarding activities of daily living (ADL), medical and social history, quality of life (QOL) and the 15-item Geriatric Depression Scale. Anthropometric, neurobehavioral and blood chemical examinations were also conducted. Using anova and Post Hoc Scheffe's F -test, findings from the three groups were compared. Results: Scores of basic ADL, instrumental self-maintenance, intellectual activities, social roles, QOL, Tokyo Metropolitan Institute of Gerontology Index of Competence, body mass index, total cholesterol levels, blood hemoglobin levels and HDL levels were lower in Myanmar's elderly subjects than in Japanese ones. There was no significant difference in prevalence of depression. Mean blood pressure measurements and rates of subjects with systolic pressure > 140 mmHg or diastolic pressure > 90 mmHg and prevalence of stroke were higher in downtown Maubin than in Japan. The atherogenic index was higher in Myanmar's elderly than in Japanese. Conclusion: In Myanmar subjects had lower ADL and QOL scores than Japanese elderly. Of particular note is the higher prevalence of anemia and subjects with history of stroke in Myanmar than in Japan. Further study is needed to detect the cause of high prevalence of stroke in Myanmar. [source]

Comprehensive geriatric assessment for the private hospital inpatient

AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2009
Salih A Salih
No abstract is available for this article. [source]

Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderly

Do the ABCS 135 short cognitive screen and its subtests discriminate between normal cognition, mild cognitive impairment and dementia?

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2007
Timothy I. M. Standish
Abstract Background Cognitive screening instruments are either too long for routine clinical use or not sensitive to distinguish mild cognitive impairment (MCI) from normal cognition (NC) or dementia. Objective To evaluate the sensitivity and specificity of the AB Cognitive Screen (ABCS) and its subtests with a view to improving its ability to differentiate between dementia, MCI and NC. The influence of age and education on sensitivity and specificity is also examined. Design Cross-sectional study. Methods Participants with dementia and MCI were recruited from those presenting to four specialty geriatric clinics in southern Ontario. Participants with NC were recruited from the family and friends of patients. A comprehensive geriatric assessment was done including ABCS, SMMSE and 15 point Geriatric Depression Scale. Analysis of variance and receiver operating characteristic (ROC) curves compared test scores. SMMSE scores were also analysed for comparison purposes. Results Three hundred and two participants had dementia, 166 had MCI and 174 had NC. ABCS total scores were significantly different between NC and MCI (mean difference 7.1, 1.8,12.5 CI, p,=,0.000) while SMMSE scores were not (mean difference 0.5, ,0.7,1.7, p,<,0.628). Of individual ABCS subtests, verbal fluency and delayed recall were most sensitive to differences between NC and MCI. ROC curve analysis, which presents sensitivity and specificity, showed verbal fluency was better than delayed recall in distinguishing between NC and MCI, among participants 75 years of age or older. Conclusion The AB Cognitive Screen (ABCS) can be administered in 3,5,min. The SMMSE and ABCS total and subtests significantly distinguished between dementia and MCI or NC. Verbal fluency and delayed recall were best at distinguishing between MCI and NC. The analysis illustrates how each subtest contributes to the sensitivity of the ABCS and suggests ways that sensitivity might be improved. Copyright © 2006 John Wiley & Sons, Ltd. [source]

A Randomized, Controlled Trial of Comprehensive Geriatric Assessment and Multidisciplinary Intervention After Discharge of Elderly from the Emergency Department,The DEED II Study

Emergency Department Case-finding for High-risk Older Adults: The Brief Risk Identification for Geriatric Health Tool (BRIGHT)

ACADEMIC EMERGENCY MEDICINE, Issue 7 2008
Michal Boyd RN
Abstract Objective:, The objective was to test the ability of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify older emergency department (ED) patients with functional and physical impairment. Methods:, This was a cross-sectional study in which 139 persons ,75 years, who presented to an urban New Zealand ED over a 12-week period, completed the 11-item BRIGHT case-finding tool. Then, within 10 days of their index ED visit, 114 persons completed a comprehensive geriatric assessment. A "yes" response to at least 3 of the 11 BRIGHT items was considered "positive." Primary outcome measures were instrumental activities of daily living (IADL), cognitive performance scale (CPS), and activities of daily living (ADL). Results:, The BRIGHT-identified IADL deficit (64% prevalence) with a sensitivity of 0.76, specificity of 0.79, and receiver operating characteristic (ROC) of 0.83 (95% confidence interval [CI] = 0.74 to 0.91, p < 0.01); cognitive deficit (35% prevalence) sensitivity of 0.78, specificity of 0.54, and ROC of 0.66 (95% CI = 0.55 to 0.76, p = 0.006); and ADL deficit (29% prevalence) sensitivity of 0.83, specificity of 0.53, and ROC of 0.64 (95% CI = 0.53 to 0.75, p = 0.020). Positive likelihood ratios (LR+) for the three outcomes of interest were 3.6, 1.7, and 1.8, respectively. Negative likelihood ratios (LR,) were 0.3, 0.4, and 0.3. Conclusions:, The 11-item BRIGHT successfully identifies older adults in the ED with decreased function and may be useful in differentiating elder patients in need of comprehensive assessment. [source]