Comprehensive Geriatric Assessment
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January 12, 2016 5:33 PM
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The Effect of Adult Day Program Attendance on Emergency Room Registrations, Hospital Admissions, and Days in Hospital: A Propensity-Matching Study.

The Effect of Adult Day Program Attendance on Emergency Room Registrations, Hospital Admissions, and Days in Hospital: A Propensity-Matching Study. | Comprehensive Geriatric Assessment | Scoop.it

Kelly R. Gerontologist. 2015 Dec 6. pii: gnv145. [Epub ahead of print]

 

 

This study is an investigation of the effect of adult day program attendance by home care clients 65 years of age and older on numbers and rates of emergency room registrations, hospital admissions, and days in hospital.

DESIGN AND METHODS: 

Each adult day program attendee was matched to a single unique nonattendee (n = 812) on the basis of similar propensity scores which had been estimated from 19 demographic, psychosocial, clinical, and functional covariates. Evaluation of the propensity-matching procedure indicated that balance had been achieved on the covariates.

RESULTS: 

Subsequent analyses revealed significantly lower mean 100-day rates of emergency room registrations, hospital admissions, and days in hospitals for attendees, compared to matched nonattendees. Although lower rates were largely attributable to longer stays in the home care program for attendees, attendees' mean number of days in hospital was still significantly lower compared to nonattendees.

IMPLICATIONS: 

Findings replicate and extend results from previous research that reported a decreased reliance on costly health care services by seniors who attend adult day programs.



Compared to nonattendees, attendees demonstrated better results for days in hospital; stays in the home care program; and 100- day rates of emergency room registrations, hospital admis- sions, and days in hospitals.

 

 

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January 9, 2016 10:29 AM
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Zygmunt Bauman: “Las redes sociales son una trampa”

Zygmunt Bauman: “Las redes sociales son una trampa” | Comprehensive Geriatric Assessment | Scoop.it
Es la voz del precariado . El sociólogo denuncia la desigualdad y la caída de la clase media. Y avisa a los indignados de que su experimento puede durar poco. Por RICARDO DE QUEROL
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January 3, 2016 5:38 AM
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The digital revolution: eight technologies that will change health and care

The digital revolution: eight technologies that will change health and care | Comprehensive Geriatric Assessment | Scoop.it
Cosima Gretton and Matthew Honeyman explore the technologies likely to change health and care over the next few years. The past decade has seen rapid development and adoption of technologies that change the way we live. But which technologies will have a similarly transformative impact on health and care?
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January 3, 2016 4:52 AM
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Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review - Journal of the American Medical Directors Association

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January 3, 2016 4:50 AM
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Comprehensive Geriatric Care: Effectiveness as Well as Efficacy

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION

 

Grimley Evans coined the term “evidence biased medicine” to describe the way bad evidence can lead to bad treatment, and bad outcomes.

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January 3, 2016 4:43 AM
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Guías de práctica clínica en la osteoporosis posmenopáusica, glucocorticoidea y del varón. Sociedad Española de Investigación Ósea y del Metabolismo Mineral (3.ª versión actualizada 2014)

Guías de práctica clínica en la osteoporosis posmenopáusica, glucocorticoidea y del varón. Sociedad Española de Investigación Ósea y del Metabolismo Mineral (3.ª versión actualizada 2014) | Comprehensive Geriatric Assessment | Scoop.it
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December 21, 2015 8:03 PM
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Chronic diseases and geriatric syndromes: The different weight of comorbidity. European journal of internal medicine. 2015. In press

Chronic diseases and geriatric syndromes: The different weight of comorbidity. European journal of internal medicine. 2015. In press | Comprehensive Geriatric Assessment | Scoop.it

El articulo de Vetrano et al si bien focaliza el tema de la interacción entre multimorbilidad, multifactorialidad y sindromes geriátricos, no acaba de utilizar un nomenclatura homogénea en estos conceptos, por lo que este aspecto resta contundencia al artículo.

 

Añade como novedoso, la no relación directa de número de enfermedades y aumento de síndromes geriátricos. 

Esto refuerza la hipótesis de la necesidad de un abordaje desde la perspectiva de clusters de  multimorbiliad en lugar de comorbilidad, como ya apuntábamos antes.

 

También llama la atención la inclusión como síndromes geriátricos algunas entidades nosológicas como la discapacidad, el dolor y los mareos. Estamos de acuerdo en que existen infinidad de clasificaciones de Sd Geriátricos pero entre los 4 Gigantes de Isaacs y las 12 ies de Kane, quizás deberíamos ser más exigentes a la hora de clasificar una entidad com Sd Geriátrico.

 

Los autores concluyen en la necesidad de avanzar en el conocimiento de los mecanismos de como entidades especificas y multimorbilidades abocan en multiples deficits, fragilidad y síndromes geriátricos. Articulo pues interesante, que estimula a profundizar en el campo de los Síndromes Geriátricos y  Multimorbilidad.

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October 29, 2015 6:39 AM
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Launch of the World report on ageing and health

Launch of the World report on ageing and health | Comprehensive Geriatric Assessment | Scoop.it
Comprehensive public health action on population ageing is urgently needed. A longer life brings with it opportunities, not only for older people and their families, but also for societies as a whole. Additional years provide the chance to pursue new activities such as further education, a new career or pursuing a long neglected passion. Older people also contribute in many ways to their families and communities. Yet the extent of these opportunities and contributions depends heavily on one fact
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October 28, 2015 10:53 AM
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Vascular dementia - The Lancet

Vascular dementia - The Lancet | Comprehensive Geriatric Assessment | Scoop.it
Servicio de Geriatría's insight:

Lancet Series: Actualización en demencias no Alzheimer

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October 28, 2015 10:52 AM
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Circulating Biomarker Panels in Alzheimer's Disease - Abstract - Gerontology 2015, Vol. 61, No. 6 - Karger Publishers

The early diagnosis of diseases frequently represents an important unmet clinical need supporting in-time treatment of pathologies. This also applies to neurodegenerative diseases such as Alzheimer's
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October 28, 2015 10:52 AM
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Selecting Patients for Rehabilitation - Journal of the American Medical Directors Association

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October 28, 2015 10:49 AM
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A Frailty Index Based on Common Laboratory Tests in Comparison With a Clinical Frailty Index for Older Adults in Long-Term Care Facilities

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August 27, 2015 5:13 PM
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Anja Declercq on Twitter

Anja Declercq on Twitter | Comprehensive Geriatric Assessment | Scoop.it
Discussing InterRAI related research InSpire II #interRAI pic.twitter.com/1mGDWavKk9
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January 12, 2016 5:33 PM
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Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

Andrea D. Foebel1,2*, Hein P. van Hout3, Henriëtte G. van der Roest3, Eva Topinkova4, Vjenka Garms-Homolova5, Dinnus Frijters3, Harriet Finne-Soveri6, Pálmi V. Jónsson7, John P. Hirdes8, Roberto Bernabei2 and Graziano Onder2

 

BMC Geriatr. 2015 Nov 14;15(1):148. doi: 10.1186/s12877-015-0146-5.

 

Background: Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI’s second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales.

Methods: Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology.

Results: A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark.

Conclusions: The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions. 

 

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January 8, 2016 9:39 AM
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Management of lumbar spinal stenosis: State of the Art

Management of lumbar spinal stenosis: State of the Art | Comprehensive Geriatric Assessment | Scoop.it

 

 

 

BMJ 2016; 352doi: http://dx.doi.org/10.1136/bmj.h6234

Servicio de Geriatría's insight:

Lectura necesaria sobre la situación actual de los diferentes abordajes terapéuticos de una patología altamente prevalente en Geriatría

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January 3, 2016 4:54 AM
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Investigating the Challenges and Opportunities in Home Care to Facilitate Effective Information Technology Adoption - Journal of the American Medical Directors Association

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January 3, 2016 4:51 AM
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Quality of Life in Older Adults Receiving Long-Term Services and Supports: Is It What We Think It Is? - Journal of the American Medical Directors Association

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January 3, 2016 4:48 AM
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Telemedicine: Coming to Nursing Homes in the Near Future - Journal of the American Medical Directors Association

Telemedicine: Coming to Nursing Homes in the Near Future - Journal of the American Medical Directors Association | Comprehensive Geriatric Assessment | Scoop.it

“There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of thing.”

Niccolò Machiavelli (1469–1527)
 
Servicio de Geriatría's insight:

Las herramientas estandarizadas de valoración integral son de especial importancia en el proceso asistencial virtual. Aquí, al igual que en el escenario presencial, la elección del instrumento de valoración (contenido, extensión, nivel asistencial) será fundamental para la eficiencia del procedimiento.

 

El proyecto europeo de investigación "RADIO" pretende optimizar el proceso de valoración con el registro de determinados patrones funcionales de actividades básicas de la vida diaria a través de un sistema "unobtrusive"  domótico-robotico en el entorno residencial "The Near Future is There".

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January 3, 2016 4:29 AM
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Narcolepsy

Narcolepsy | Comprehensive Geriatric Assessment | Scoop.it
Review Article from The New England Journal of Medicine — Narcolepsy
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December 3, 2015 2:47 PM
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Anticoagulant Can Be Reversed

Anticoagulant Can Be Reversed | Comprehensive Geriatric Assessment | Scoop.it
A newly approved drug is available to reverse the blood-thinning effects of dabigatran, marketed as Pradaxa, in emergency or life-threatening situations when bleeding can’t be controlled. Idarucizumab, sold under the brand name Praxbind, binds specifically to dabigatran molecules and neutralizes...
Servicio de Geriatría's insight:

Noticias de la Food and Drug Administration

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October 28, 2015 10:53 AM
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Lewy body dementias - The Lancet

Lewy body dementias - The Lancet | Comprehensive Geriatric Assessment | Scoop.it
Servicio de Geriatría's insight:
Lancet Series: Actualización en demencias no Alzheimer
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October 28, 2015 10:52 AM
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Frontotemporal dementia - The Lancet

Frontotemporal dementia - The Lancet | Comprehensive Geriatric Assessment | Scoop.it
Servicio de Geriatría's insight:

Lancet Series: Actualización en demencias no Alzheimer

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October 28, 2015 10:52 AM
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Geriatric Screening Tools to Select Older Adults Susceptible for Direct Transfer From the Emergency Department to Subacute Intermediate-Care Hospitalization - Journal of the American Medical Direct...

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October 28, 2015 10:51 AM
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Concordance Between Anticholinergic Burden Scales - Naples - 2015 - Journal of the American Geriatrics Society - Wiley Online Library

Concordance Between Anticholinergic Burden Scales - Naples - 2015 - Journal of the American Geriatrics Society - Wiley Online Library | Comprehensive Geriatric Assessment | Scoop.it
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August 30, 2015 5:10 AM
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Cápsulas informativas

Cápsulas informativas | Comprehensive Geriatric Assessment | Scoop.it

Se presentan una serie de temas de debate relacionados con el ámbito de la Geriatría que se han mantenido a lo largo de estos años, en el Hospital General de Granollers.

 

Servicio de Geriatría's insight:

Mecanismo de acción y posología de "cápsulas" informativas (the facts) y la complejidad de la farmacocinética hospitalaria.

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