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Scooped by
Sergio Ariño Blasco
October 22, 12:22 PM
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Many older adults have complex needs and experience high rates of acute care use and institutionalization. Comprehensive Geriatric Assessment (CGA) is a specialized multidimensional interprofessional intervention to prevent such outcomes, but access to CGA in the community is limited. The Integrated Care Team (ICT) is a proactive case-finding intervention to support older adults with complex needs in primary care. The ICT provides nurse practitioner-led shared-care supported by a pharmacist, family physician, and geriatrician. Patients rostered to the NVFHT access the ICT either through family physician referral, identification of multiple ED visits or falls, or case-finding using the interRAI Assessment Urgency Algorithm (AUA). The AUA is a brief questionnaire assessing functional capacity, shortness of breath, self-rated health, mood, continence, and caregiver burden. Scores range from 1 to 6, with higher scores indicating a more urgent need for CGA. Referred patients and those with AUA scores of 4 to 6 undergo a CGA.
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Scooped by
Sergio Ariño Blasco
July 1, 7:00 AM
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Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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Scooped by
Sergio Ariño Blasco
April 25, 2:56 AM
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This Review summarizes current best practices for risk stratification, clinical assessment, and selection of risk reduction interventions for falls in community-dwelling older adults.
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Scooped by
Sergio Ariño Blasco
April 25, 2:50 AM
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Poor nutrition is a major risk factor for disease. In this first review in a new series on nutrition, the authors provide an overview of nutritional guidance, with a focus on energy and macronutrients.
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Scooped by
Sergio Ariño Blasco
April 5, 2:51 AM
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Scooped by
Sergio Ariño Blasco
April 4, 8:00 AM
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The authors address the issues that must be confronted if we are to integrate the use of wearable digital health technologies into clinical care in a way that provides an enduring benefit to patients.
STOPPFrail comprises 27 criteria relating to medications that are potentially inappropriate in frail older patients with limited life expectancy. STOPPFrail may assist physicians in deprescribing medications in these patients.
Chia JQ et al. examined the construct validity of 2 self-reported frailty questionnaires, the Frailty Phenotype Questionnaire (FPQ) and FRAIL, against the Cardiovascular Health Study frailty phenotype (CHS-FP).
The 4M Framework could be a cornerstone of quality metrics for the HaH population. Potential patient- reported measures include a return to prior function, receiving enough support to perform self-care during the HaH stay, and effective transitional care education, over- sight, and handoffs. Adding to this pragmatically collected patient-centered measures such as deprescribing and simplifying medication regimens, documentation of an advance care planning or serious illness communication discussion, and emergent transfers could provide a multi- layered PCC quality and safety approach all the while minimizing regulatory burdens and expense.
.- Clinicians are increasingly providing telehealth care to older adults despite a lack of comprehensive guidance on age-friendly implementation and practice. .- The reach of telehealth for older adults remains limited due to several factors, including existing or perceived challenges around physical and cognitive limitations, and a lack of comprehensive guidance on older-adult- focused implementation. .- This is the first comprehensive set of provider- focused telehealth principles and guidelines, developed by aging and telehealth experts, to address the specific needs of an aging population.
Las admisiones en urgencias por ACSC procedentes de entornos residenciales suponen un impacto significativo tanto en la frecuencia como en los costes. La disminución de estas enfermedades mediante la aplicación de intervenciones específicas podría redirigir los costes evitados hacia la mejora del apoyo asistencial en los entornos residenciales.
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Scooped by
Sergio Ariño Blasco
February 1, 3:12 PM
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Is anyone listening to the World Bank's Chief Economist? Many countries, says IndermitGill, are “on a path to crisis”. The poorest countries are “stuck in a trap” that threatens to “obstruct progress on many global priorities”. “Without a major course correction, the 2020s will go down as a decade of wasted opportunity.” Gill's main concern, as outlined in a series of World Bank reports, is the paralysing amount ofdebt, exacerbated by soaring interest rates, faced by many low-income and middle-income countries (LMICs).
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Scooped by
Sergio Ariño Blasco
July 1, 7:07 AM
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Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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Scooped by
Sergio Ariño Blasco
July 1, 6:51 AM
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Journal of the American Geriatrics Society (JAGS) is the go-to geriatrics journal for clinical aging research including education, clinical practice and public policy.
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Scooped by
Sergio Ariño Blasco
April 25, 2:58 AM
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This article summarizes a 2022 clinical practice guideline on falls prevention and management in older adults from the World Falls Guidelines Initiative.
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Scooped by
Sergio Ariño Blasco
April 25, 2:53 AM
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Hearing progressively declines with age, manifesting initially as difficulty understanding speech in background noise and detrimentally affecting social functioning. Strategies and technologie
In their article, Ganguli and colleagues characterized a new measure of health care utilization—“health care contact days.” The editorialists find the measure a promising new way to understand ho
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Scooped by
Sergio Ariño Blasco
April 5, 2:49 AM
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The intervention most likely to sustain independence is individualised care planning including medicines optimisation and regular follow-up reviews resulting in multifactorial action. Homecare recipients may particularly benefit from this intervention. Unexpectedly, some combinations may reduce independence. Further research is needed to investigate which combinations of interventions work best for different participants and contexts.
Comprehensive geriatric assessment (CGA) is the cornerstone of modern geriatric medicine and the framework around which conventional and new models of care for older people are developed. Whilst there are a substantial number of reviews synthesising the evidence on patient and service outcomes from CGA, as an intervention it remains poorly described. There is a lack of detail on how a CGA plan is coordinated, delivered and followed up, especially outside of acute care. This commentary reflects on the authors’ experience of extracting data from 57 published studies on CGA. The CGA knowledge-do gap persists with a need to draw from complex system theory and implementation science frameworks to better describe the intervention and understand the influence of the organisation and health service within which CGA is operationalised. Equally, the voice of older people, families and staff is critical in the conduct and evaluation of CGA, and how it evolves as a model to meet the growing needs of ageing populations.
Comprehensive Geriatric Assessment (CGA) is a multidimensional interdisciplinary diagnostic process focused on determining an older person's medical, psychological and functional capability in order to develop a co‐ordinated and integrated care plan. CGA is not limited simply to assessment, but also directs a holistic management plan for older people, which leads to tangible interventions. While there is established evidence that CGA reduces the likelihood of death and disability in acutely unwell older people, the effectiveness of CGA for community‐dwelling, frail, older people at risk of poor health outcomes is less clear. CGA had no impact on death or nursing home admission. There is low‐certainty evidence that community‐dwelling, frail, older people who undergo CGA may have a reduced risk of unplanned hospital admission. Further studies examining the effect of CGA on emergency department visits and change in function and quality of life using standardised assessments are required.
To describe the evolution of a Hospital at Home (HAH) based on comprehensive geriatric assessment (CGA), including its adaptability to changing case-mixes and pathways during the COVID-19 pandemic.
This systematic review and meta-analysis suggest that FI-Labs, made of diverse deficits, predict mortality and other adverse health outcomes in a variety of populations. FI-Lab scores did not show a consistent difference between sexes. This does not align with what is found with clinical FIs, which typically find females to be frailer [56]. Future research utilising an FI-Lab may benefit from investigating the relationship between frailty in younger populations and the subsequent health status changes. Additionally, there is emerging evidence that a more granular approach to health variable categorisation (i.e. a non-binary quantile approach) using an FI-Lab improves the model’s accuracy [46] relative to dichotomizing variables. Both avenues deserve further attention.
eFI is the best-performing VEFM; however, based on our analysis of an average UK GP practice, it would return a high number of false-positive results. In conclusion, existing electronic frailty tools may not be appropriate for primary care-based population screening.
Wearable Technologies in Cardiovascular Medicine This article reviews the use of digital wearable technologies for monitoring of three common cardiovascular conditions: hypertension, hear
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Telemonitorización dirigida a personas confinados al hogar, sin acceso a transporte, problemas de movilidad, ubicacion geográfica remota...
Las recomendaciones del The Collaborative for Telehealth and Aging (C4TA) constituido por proveedores, expertos en geriatria, telemedicina y organizaciones defensoras de ancianos; se orienta a una atención centrada en el paciente, equitativas, accesibles, integradas y coordinadas entre personas y sistemas. .