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Geriatric Medicine (geriatric + medicine)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Proceedings of the Annual Scientific Meeting of the Australian Society for Geriatric Medicine, 2003

INTERNAL MEDICINE JOURNAL, Issue 6 2004
Article first published online: 24 JUN 200
First page of article [source]

Proceedings of the Annual Scientific Meeting of the Australian Society for Geriatric Medicine, 2001

INTERNAL MEDICINE JOURNAL, Issue 5-6 2002
Article first published online: 27 MAY 200
First page of article [source]

Proceedings of the Annual Scientific Meeting of the Australian Society for Geriatric Medicine, 2000

INTERNAL MEDICINE JOURNAL, Issue 4 2002
Article first published online: 27 MAY 200
First page of article [source]

Interest in Geriatric Medicine in Canada: How Can We Secure a Next Generation of Geriatricians?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006
FRCP(C), Laura L. Diachun MEd
In Canada, there is minimal training of geriatrics for physicians, a shortage of geriatricians, and extremely low numbers of students entering geriatrics. This study explored student interest in and barriers and enticements to geriatric medicine as a career choice. Medical students attending a university in Ontario, Canada, were surveyed in their first year (N=121), after a geriatric education session, and again in their second year (N=118) about their interest in a career in geriatrics. In the first year, less than 20% of students were interested in geriatrics; in the second year this decreased to 16%. In both years, female students were more interested than male students. Those students interested in geriatrics had higher hopes that their practice would involve primarily adults and seniors. Students not interested in geriatrics rated performing procedures and technical skills, not wanting to work with chronically ill patients, and caring for younger patients as important practice characteristics. Although the importance of prestige was low for all students, it was significantly higher for those not interested in geriatrics. Although changes to prestige, income, lifestyle, and length of residency training were identified as potential enticements to geriatrics, they were not major deterrents to a career in geriatrics. The findings suggest strategies that may affect student interest in geriatrics, such as increased and early student exposure to geriatrics with emphasis on fostering and nurturing student interest, consideration of various enticements to this specialty, and the development of health system,specific solutions to this problem. Knowledge of student and practice characteristics that increase the likelihood of selecting geriatrics as a specialty may allow for early identification and support of future geriatricians. [source]

Caring for Older Americans: The Future of Geriatric Medicine

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue S6 2005
American Geriatrics Society Core Writing Group of the Task Force on the Future of Geriatric Medicine
In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: ,,To ensure that every older person receives high-quality, patient-centered health care ,,To expand the geriatrics knowledge base ,,To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons ,,To recruit physicians and other healthcare professionals into careers in geriatric medicine ,,To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics. [source]

Early Clinical Exposure to Geriatric Medicine in Second-Year Medical School Students,The McGill Experience

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2003
Gustavo Duque MD
This study examined the effect of a curriculum change on early clinical exposure to geriatrics for second-year medical students at McGill University and its effects on learning and students' appreciation of geriatrics as a subspecialty. Second-year medical students (N = 200) were exposed to a change in the curriculum involving the integration of 10 weekly sessions into one integrated week in geriatric medicine. Students participating in 10 weekly sessions were Group 1 and students participating in one integrated week were Group 2. Students rated their rotation using two different scales. The students completed 12-item questionnaires during their feedback sessions at the end of the 10-week session experience or the integrated week. The first six items assessed the students' appreciation of their improvement of knowledge in the subject of geriatrics and aging. The second and third part of the survey (questions 7 and 8) included the students' opinions about the quality of the instruction (teaching feedback) and evaluation. Students in Group 2 found their rotation more effective as a learning experience and expressed greater satisfaction with interaction with the tutors, community settings, and multidisciplinary team sessions. Grades obtained on final examinations showed a better and more-effective acquisition of knowledge by Group 2. The integrated week is a more-effective learning tool in the early clinical experience for medical students in geriatric medicine than 10 weekly sessions as the first introductory experience to the field of geriatric medicine. [source]

Teaching Geriatric Medicine in Vietnam: Introduction of an interactive learning module for medical students

AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2010
Anthea Broadfoot
No abstract is available for this article. [source]

Australian Society for Geriatric Medicine

AUSTRALASIAN JOURNAL ON AGEING, Issue 2 2006
Position Statement No. 13 Delirium in Older People
First page of article [source]

Caring for Older Americans: The Future of Geriatric Medicine

Which parameters differ in very old patients with chronic atrial fibrillation treated by anticoagulant or aspirin?

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2008
Antithrombotic treatment of atrial fibrillation in the elderly
Abstract The objective was to determine the main parameters taken into account for the decision of antithrombotic treatment of atrial fibrillation (AF) by vitamin K antagonist or aspirin. This was a prospective clinical study of four clinical services of geriatric medicine. Two hundred and nine inpatients, 84.7 ± 7 years (women 60.8%), with chronic AF were included. The patients were distributed into two groups (anticoagulant or aspirin) according to medical decision. All the decision criteria for treatment were recorded: cardiopathy, conditions of life, clinical examination (nutrition and autonomy, mini-mental state examination (MMSE), walking evaluation, comorbidity), subjective evaluation of risk of falls and glomerular filtration rate. The thromboembolic risk and the bleeding risk, evaluated subjectively for each patient, were compared with two scores of thrombo-embolic risk and bleeding risk. The evolution of the patients was recorded after 3 months. Student's t -test and chi-squared tests were used for statistical analysis. One hundred and two patients (48.8%) received anticoagulant and 107 patients received aspirin. Patients in the aspirin group were significantly older (86.5 ± 6.5 vs. 82.9 ± 7.1 years), with more frequent social isolation, higher systolic blood pressure, and had more important subjective bleeding risk and risk of falls. Patients in the anticoagulant group had significantly more valvulopathies and a more important subjective thromboembolic risk. Thrombo-phlebitis antecedents, dementia, denutrition and walking alterations were only slightly more frequent in patients in the aspirin group. Physicians underestimated thromboembolic risk (one-third of patients) and they overestimated bleeding risk (half of the patients). After 3 months, the two groups did not significantly differ for death, bleeding or ischaemic events. In common practice, the decision of antithrombotic treatment for AF should take into account not only cardiovascular but also geriatric criteria. [source]

Measuring disability in older adults: The International Classification System of Functioning, Disability and Health (ICF) framework

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2008
W Jack Rejeski
Background: Despite the importance of disability to geriatric medicine, no large scale study has validated the activity and participation domains of the International Classification System of Functioning, Disability, and Health (ICF) in older adults. The current project was designed to conduct such as analysis, and then to examine the psychometric properties of a measure that is based on this conceptual structure. Methods: This was an archival analysis of older adults (n = 1388) who had participated in studies within our Claude D Pepper Older Americans Independence Center. Assessments included demographics and chronic disease status, a 23-item Pepper Assessment Tool for Disability (PAT-D) and 6-min walk performance. Results: Analysis of the PAT-D produced a three-factor structure that was consistent across several datasets: activities of daily living disability, mobility disability and instrumental activities of daily living disability. The first two factors are activities in the ICF framework, whereas the final factor falls into the participation domain. All factors had acceptable internal consistency reliability (>0.70) and test,retest (>0.70) reliability coefficients. Fast walkers self-reported better function on the PAT-D scales than slow walkers: effect sizes ranged from moderate to large (0.41,0.95); individuals with cardiovascular disease had poorer scores on all scales than those free of cardiovascular disease. In an 18-month randomized clinical trial, individuals who received a lifestyle intervention for weight loss had greater improvements in their mobility disability scores than those in a control condition. Conclusion: The ICF is a useful model for conceptualizing disability in aging research, and the PAT-D has acceptable psychometric properties as a measure for use in clinical research. [source]

Capturing the power of academic medicine to enhance health and health care of the elderly in the USA

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2004
William R Hazzard
As in Japan, the US population is aging progressively, a trend that will challenge the health-care system to provide for the chronic, multiple and complex needs of its elderly citizens. and as in Japan, the US academic health enterprise has only belatedly mounted a response to that challenge. Herein is reviewed a quarter of a century of the author's personal experience in developing new programs in gerontology and geriatric medicine from a base in the Department of Internal Medicine at three US academic health centers (AHC): The University of Washington (as Division Head), Johns Hopkins University (as Vice-Chair), and Wake Forest University (as Chair). Rather than to build a program from a new department of geriatrics, this strategy was chosen to capture the power and resources of the department of internal medicine, the largest university department, to ,gerontologize' the institution, beginning with general internal medicine and all of the medical subspecialties (the approach also chosen to date at all but a handful of US AHC). The keystone of success at each institution has been careful faculty development through fellowship training in clinical geriatrics, education and research. Over the same interval major national progress has occurred, including expanded research and training at the National Institute on Aging and the Department of Veterans Affairs, and accreditation of more than 100 fellowship programs for training and certification of geriatricians. However, less than 1% of US medical graduates elect to pursue such training. Hence such geriatricians will remain concentrated at AHC, and most future geriatric care in the USA will be provided by a broad array of specialists, who will be educated and trained in geriatrics by these academic geriatricians. [source]

Dementia services in Canada

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2010
Kenneth Rockwood
Canadians with dementia have access to Medicare, a universal, single payer healthcare program. Implementation of Medicare is through the provinces and territories, giving variation in the level of care available. At present, there is no national strategy for dementia, although a recent report from the Alzheimer Society of Canada is expected to catalyze one. Most dementia care is provided by primary care practitioners, with three specialties (geriatric psychiatry, geriatric medicine and neurology) providing consultant expertise. Primary care reforms are aimed at developing a more coordinated approach to the complex needs of people with dementia, and have especially emphasized education of providers. Any national strategy is expected to underscore prevention and research, the latter building on Canada's strong contribution to this international undertaking. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Don't seize the day hospital!

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2005
Recent research on the effectiveness of day hospitals for older people with mental health problems
Abstract Background Day hospital (DH) care remains a core component of mental health services for older people. However, there has been an ongoing debate about the effectiveness and value for money of DHs in comparison to day centres (DC). Aim The aim was to review the recent research on the effectiveness of day hospitals for older people with mental health problems. Method A systematic search of relevant research literature over the last decade using the major electronic healthcare databases examining the quality and effectiveness of mental health DHs for older people. Results In the last decade the evidence for the effectiveness of DHs has continued to increase, but still lags behind research on DHs in general adult psychiatry and geriatric medicine. The review found that DHs appear effective at assessing and meeting needs and that a systematic approach to evaluating quality can be used to improve services. Conclusion Recent research supports the effectiveness of day hospitals, but further studies are needed in order to provide a more robust evidence base. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Are Internal Medicine Residency Programs Adequately Preparing Physicians to Care for the Baby Boomers?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2006
A National Survey from the Association of Directors of Geriatric Academic Programs Status of Geriatrics Workforce Study
Patients aged 65 and older account for 39% of ambulatory visits to internal medicine physicians. This article describes the progress made in training internal medicine residents to care for older Americans. Program directors in internal medicine residency programs accredited by the Accreditation Council for Graduate Medical Education were surveyed in the spring of 2005. Findings from this survey were compared with those from a similar 2002 survey to determine whether any changes had occurred. A 60% response rate was achieved (n=235). In these 3-year residency training programs, 20 programs (9%) required less than 2 weeks of clinical instruction that was specifically structured to teach geriatric care principles, 48 (21%) at least 2 weeks but less than 4 weeks, 144 (62%) at least 4 weeks but less than 6 weeks, and 21 (9%) required 6 or more weeks. As in 2002, internal medicine residency programs continue to depend on nursing home facilities, geriatric preceptors in nongeriatric clinical ambulatory settings, and outpatient geriatric assessment centers for their geriatrics training. Training was most often offered in a block format. The mean number of physician faculty per residency program dedicated to teaching geriatric medicine was 3.5 full-time equivalents (FTEs) (range 0,50), compared with a mean of 2.2 FTE faculty in 2002 (P,.001). Internal medicine educators are continuing to improve the training of residents so that, as they become practicing physicians, they will have the knowledge and skills in geriatric medicine to care for older adults. [source]

Interest in Geriatric Medicine in Canada: How Can We Secure a Next Generation of Geriatricians?

Caring for Older Americans: The Future of Geriatric Medicine

Early Clinical Exposure to Geriatric Medicine in Second-Year Medical School Students,The McGill Experience

Geriatricians Health Survey 2000

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2001
David Watts MD
OBJECTIVES: To characterize geriatricians' preventive health behaviors including vitamin/supplement use, exercise, smoking, alcohol use, and weight control. DESIGN: Mailed questionnaire. SETTING: United States. PARTICIPANTS: Two thousand six hundred eleven U.S. physicians certified as having added qualifications in geriatric medicine and who were members in the American Geriatrics Society; 1,524 returned completed questionnaires (58%). MEASUREMENTS: Rates of supplement use and recommendations, preventive health visits, advance directive completion, exercise, religious service attendance, smoking, alcohol use, and amount of adult weight gain. RESULTS: Most responding geriatricians took at least one vitamin supplement: 50% vitamin E, 50% a multivitamin (MVI), and 31% vitamin C. Calcium ingestion was common among women. Other supplement use was uncommon: ginkgo compounds were consumed by 47 (3%), and 77 (5%) took a variety of other nonvitamin supplements. Over 90% recommended vitamins, especially multivitamins and vitamin E, at least sometimes. Recommendations for ginkgo (38%) and St. John's wort (33%) were also common. Almost half of respondents had completed a formal advance directive. Exercise was practiced at least weekly by 88%. Cigarette smoking was rare (1%), but at least occasional alcohol use was common (85%). Most of respondents were men (74%), and 35% had completed fellowship training. CONCLUSION: Vitamin/supplement use was common among responding geriatricians but not universal. Respondents often recommended MVI, vitamin E, and vitamin C, but were less likely to consume or recommend other supplements. The most common preventive health behavior among our respondents was exercise. [source]

ABC of geriatric medicine

AUSTRALASIAN JOURNAL ON AGEING, Issue 2 2010
Associate Professor Vasikaran Naganathan
No abstract is available for this article. [source]

Principles of geriatric medicine and gerontology (5th edition)

AUSTRALASIAN JOURNAL ON AGEING, Issue 3 2006
Michael Woodward
No abstract is available for this article. [source]