Impacts Of Common Geriatric Syndromes And Their Interaction With Chronic Diseases On Health

Geriatric syndromes can lead to age-related decline in well-being among elderly adults. The signs and symptoms encompassed by geriatric syndromes span multiple physiological systems related to functional dependency. A number of syndromes identified by longitudinal studies are associated with reduced function and quality of life and increased risk of institutionalization and mortality. However, variations in syndrome definitions make systematic discussion of their effects difficult. Routine clinical practice includes assessment of age-related chronic diseases based on accepted diagnostic criteria. In contrast, comprehensive geriatric assessment goes beyond examination for chronic diseases and focuses on functional independence in daily activities and optimal interventions to improve functional status and quality of life. Indeed, comprehensive geriatric assessment emphasizes functional status as a major quality of life factor for older adults. Quality of life improvements for older adults require addressing geriatric syndromes in addition to managing chronic disease. A geriatric syndrome's definition, along with its combination with any chronic disease, affects the syndrome's association with patient-centered outcomes, including quality of life, institutionalization, and mortality. Certain factors are long known to affect patient-centered outcomes. For example, the persistently strong association between self-assessed health status and patient-centered outcomes remains a marvel. Similarly, dependency, defined as deficiencies in activities of daily living (ADLs), also associates strongly with patient-centered outcomes. Systematic reviews have yet to examine other syndromes, such as cognitive impairment, frailty, poor nutrition status, or chronic inflammation for prevalence or association with institutionalization and mortality. This review examines what is known about common geriatric syndromes and their effect on the clinical course of older patients. Our analysis examines the extent to which varying definitions of each syndrome can affect determination of its prevalence and its association with patient-centered outcomes. In general, we anticipate a reciprocal relationship; the more inclusive the definition, the higher the prevalence. More encompassing definitions or those with lower thresholds will inevitably raise prevalence estimates and be less precise in their predictive power than more stringent definitions with higher cut scores. For example, Manton applied ADL- and instrumental activities of daily living (IADL)-related measures for disability to describe a pattern of decline in prevalence over two decades. This review synthesizes the evidence for the following research questions. Key Question 1. What is the definition and prevalence of common syndromes/conditions in older adults? Key Question 2. What is the prevalence of common syndromes/conditions in older adults in sex, age, race, ethnicity, and other subgroups? Key Question 3. What is the association between these common syndromes/conditions and mortality, institutionalization, hospitalization, and activities of daily living? Key Question 4. What statistical and decisionmaking models report mortality based on these common geriatric syndromes/conditions?

Over the past two decades there has been a marked change in global age demographics, with the number of over-60s increasing by 82% and the number of centenarians by 715%. This new-found longevity is testament to the success of recent advances in medicine, but poses significant challenges to multiple areas of health care concerning older patients. Building upon its predecessor's reputation as the definitive resource on the subject, this new edition of the Oxford Textbook of Geriatric Medicine offers a comprehensive and multinational examination of the field. Fully revised to reflect the current state of geriatric medicine, it examines the medical and scientific basis of clinical issues, as well as the ethical, legal, and socio-economic concerns for healthcare policy and systems. Over 170 chapters are broken up into 16 key sections, covering topics ranging from policy and key concepts through to infection, cancer, palliative medicine, and healthy ageing. New material includes focus on the evolving concepts of malnutrition, sarcopenia, frailty, and related geriatric syndromes and integration of geriatric principles from public health, primary and specialized care, and transitional stages from home to emergency, medicine and surgery, rehabilitation, and long term care. The Oxford Textbook of Geriatric Medicine brings together specialists from across the globe to provide every physician involved in the care of older patients with a comprehensive resource on all the clinical problems they are likely to encounter, as well as on related psychological, philosophical, and social issues.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Rehabilitation of the geriatric patient poses a unique set of challenges and conditions often not seen in younger patients, but which are common among older adults. This quick, practical resource helps physiatrists and other members of the rehabilitation team overcome these challenges, covering the wide range of topics necessary to provide the highest level of care to this rapidly increasing population. Presents practical guidance on arthritis and joint replacement, polypharmacy and mobility, swallowing dysfunction, nutritional recommendations, psychiatric and cognitive disorders, assistive technology, and more. Covers the physiologic changes and epidemiology of aging, osteoporosis and fragility fractures, fall prevention and intervention, and prevention of hospital-acquired deconditioning. Consolidates today’s available information on geriatric rehabilitation into one convenient resource.

This book provides the first comprehensive overview of a new scientific discipline termed Geroscience. Geroscience examines the molecular and cellular mechanisms that might explain why aging is the main risk factor for most chronic diseases affecting the elderly population. Over the past few decades, researchers have made impressive progress in understanding the genetics, biology and physiology of aging. This book presents vital research that can help readers to better understand how aging is a critical malleable risk factor in most chronic diseases, which, in turn, could lead to interventions that can help increase a healthy lifespan, or ‘healthspan.’ The book begins with an analysis of the Geroscience hypothesis, as well as the epidemiological underpinnings that define aging as a candidate main risk factor for most chronic diseases. Next, each chapter focuses on one particular disease, or group of diseases, with an emphasis on how basic molecular and cellular biology might explain why aging is a major risk factor for it. Coverage in the book includes: cancer, cardiovascular disease, dementias, stroke, Parkinson's and Alzheimer’s diseases, osteoporosis, arthritis, diabetes asthma, emphysema, kidney disease, vision impairment, and AIDS/HIV. It finishes with a chapter on pain in the elderly and an overview of future steps needed to bring the newly acquired knowledge into the clinic and the public at large.

The most convenient, authoritative overview of family medicine and primary care -- completely updated and expanded! A Doody's Core Title ESSENTIAL PURCHASE! Praise for an earlier edition--"This portable, 700 page paperback is an excellent reference for practitioners caring for patients in ongoing settings. Information is complete, yet readily accessible. Information is prioritized well, making it easy to locate information rapidly. It will be a cost-effective addition to the shelves of thousands of hardworking family doctors. 5 STARS!"--Doody's Review Service Great for USMLE Step 3 review, board certification, and maintenance or recertification Concise, evidence-based coverage of the diseases and syndromes most commonly seen in clinical practice Organized according to the developmental lifespan, beginning with childhood and adolescence, focusing on the reproductive years, and progressing through adulthood and senior years -- includes end-of-life issues Complementary and alternative treatments included where appropriate Recommendations for both immediate and ongoing management strategies Numerous algorithms, charts, and tables encapsulate important information Conservative and pharmacologic therapies Patient education information Sections on Therapeutics, Genetics, and Prevention; Psychosocial Disorders; and Physician-Patient Issues NEW chapter patient-centered medicine