Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “GERIATRICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed2004

Research agenda-setting program for geriatric ophthalmology.

The healthcare needs of an aging population of "baby boomers" (persons born between 1946 and 1964) will disproportionately affect ophthalmology. To meet this emerging need, the American Geriatrics Society and the John A. Hartford Foundation developed a research agenda-setting process for geriatric ophthalmology. A systematic literature search was performed using Medline from the years 1990 to 2000. The literature review (168 papers) was performed to determine the current state of information regarding selected issues in geriatric ophthalmology. A needs assessment for each of the identified topics was performed, gaps in the existing knowledge base were identified, and key questions for future research were proposed. A research agenda-setting process for geriatric ophthalmology might provide a structural framework for future research efforts in the field.

Accidental Falls↗
PubMed2004

An unfolding case with a linked Objective Structured Clinical Examination (OSCE): a curriculum in inpatient geriatric medicine.

As the percentage of time devoted to the care of older adults by internists continues to rise, the need for these physicians to be skilled at their care becomes even more critical. In fact, the Education Committee of the American Geriatrics Society has recommended the development of structured educational curricula to teach the principles of geriatric care. This article describes a comprehensive, evidence-based curriculum for internal medicine house staff in inpatient geriatric medicine. The intervention encompasses a novel instructional method, defined skill and behavioral goals, and a competency-based effectiveness evaluation. Moreover, the principles in this curricular model are those that may affect any hospitalized older adult and so will be important for all house staff taking care of inpatient geriatric patients, regardless of their future subspecialty choice.

Curriculum↗
PubMed2005

Geriatric content in medical school curricula: results of a national survey.

Despite recent gains in establishing academic sections, divisions, and departments of geriatrics in medical schools, much remains to be done to meet the medical needs of an aging population. To better understand how medical schools are educating students in geriatric-related topics, all U.S. allopathic and osteopathic medical schools were surveyed in two waves, in 1999 and 2000, using a questionnaire based on recommendations from the Education Committee of the American Geriatrics Society. Responding schools were more likely to address diseases and conditions of aging, psychosocial issues, and ethical issues and less likely to cover anatomic changes, nutrition, knowledge of healthcare financing, outcome measurement, and cultural aspects of aging. Although limited, the results indicate that medical schools have increased coverage of aging-related material, although further expansion of geriatric content will be necessary to meet the needs of an aging society.

Aged↗
PubMed2005

Creating a teaching geriatric service: ten important lessons.

The restructuring of The Medical Service at the Weill/Cornell campus of the New York Presbyterian Hospital, coupled with funding from the Donald W. Reynolds Foundation to strengthen physicians' training in geriatrics, enabled the creation of a geriatrics inpatient team and a 17-bed Acute Care for Elders unit. It has also allowed a program to be designed that exposes residents to the fundamental principles of geriatric care, offers them opportunities to follow older patients in multiple venues, and provides a chance to enhance their skills and gain experience in interdisciplinary care. In creating the service, a number of mistakes were made, but a few lessons were also learned in the process. After a brief description of the program, 10 lessons that highlight the pitfalls and potential of an inpatient geriatrics teaching service are shared.

Aged↗
PubMed2005

Multidimensional attitudes of medical residents and geriatrics fellows toward older people.

OBJECTIVES: To examine dimensions of a validated instrument measuring geriatric attitudes of primary care residents and performances on these dimensions between residents and fellows. DESIGN: Cross-sectional and longitudinal studies. SETTING: An academic medical center. PARTICIPANTS: Two hundred thirty-eight primary care residents (n=177) and geriatrics fellows (n=61) participated in the study from 1995 to 2000. MEASUREMENTS: A 14-item, 5-point Likert scale previously validated for measuring primary care residents' attitudes toward older people and geriatric patient care was used. RESULTS: Factor analysis showed four dimensions of the scale, labeled Social Value, Medical Care (MC), Compassion (CP), and Resource Distribution, which demonstrated acceptable reliability. Both groups of subjects showed significantly (P<.001) positive (mean>3) attitudes across the dimensions and times, except for residents, who had near-neutral (mean=3) attitudes on MC. Residents' mean attitude scores on the overall scale and the MC and CP subscales were significantly (P<.001) lower than those of fellows over time. Residents and fellows showed different change patterns in attitudes over time. Residents' attitudes generally improved during the first 2 years of training, whereas fellows' attitudes declined slightly. Personal experience was a strong predictor of residents' attitudes toward older patients. Ethnicity, academic specialty, professional experience, and career interest in geriatrics were also associated with residents' attitude scores. CONCLUSION: The multidimensional analysis of the scale contributes to better understanding of medical trainees' attitudes and sheds light on educational interventions.

Attitude of Health Personnel↗
PubMed2005

Geriatrics in Brazil: a big country with big opportunities.

Brazil has approximately 180 million inhabitants, of whom 15.2 million are aged 60 and older and 1.9 million are aged 80 and older. By 2025, the Brazilian elderly population is expected to grow to more than 32 million. Brazil has many problems related to its geographic and population size. Great distances between major cities, marked cultural and racial heterogeneity between the various geographic regions, high poverty levels, and decreasing family size all combine to put pressure on the medical and social services that can be made available to the elder population. Less than 500 Brazilian physicians are certified as geriatricians, translating into one geriatrician for every 37,000 elderly Brazilians. Beside 15 geriatric medicine residencies a larger number of fellowship programs exist, and these programs are in high demand, with more than 20 candidates per position, indicating new opportunities for growth in elder care. In addition, geriatric initiatives such as the annual elder vaccination program and the elder statute, recently approved by the Brazilian Congress, indicate that geriatric care in Brazil is entering a new era of growth and development. Although the challenges remain great, there are opportunities for Brazilian geriatrics and gerontology.

Aged↗
PubMed1998

Pulse oximetry as a fifth vital sign in emergency geriatric assessment.

OBJECTIVE: To determine the utility of pulse oximetry as a routine fifth vital sign in emergency geriatric assessment. METHODS: Prospective study using pulse oximetry to measure O2 saturation in geriatric patients presenting to ED triage. Saturation values were disclosed to clinicians only after they had completed medical evaluations and were ready to release or admit each patient. The authors measured changes in medical management and diagnoses initiated after the disclosure of pulse oximetry values. The study included 1,963 consecutive adults aged > or = 65 years presenting to triage at a university ED. Measurements included changes in select diagnostic tests: chest radiography, complete blood count (CBC), spirometry, arterial blood gases (ABGs), pulse oximetry, and ventilation-perfusion scans; treatments: antibiotics, beta-agonists, and supplemental O2; and hospital admission and final diagnoses that occurred after complete ED evaluation when physicians were informed of triage pulse oximetry values. RESULTS: 397 (20.2%) geriatric patients had triage pulse oximetry values <95%. Physicians ordered repeat oximetry for 51 patients, additional chest radiography for 23, CBC for 16, ABGs for 15, spirometry for 5, and ventilation-perfusion scans for none. Physicians ordered 49 new therapies for 44 patients, including antibiotics for 14, supplemental O2 for 29, and beta-agonists for 6. Nine patients initially scheduled for ED release were subsequently admitted to the hospital. Physicians changed or added diagnoses for 27 patients. CONCLUSIONS: Using pulse oximetry as a routine fifth vital sign resulted in important changes in the diagnoses and treatments of a small proportion of emergency geriatric patients.

Aged↗
PubMedDate not supplied

Training for the future: issues in geriatric dentistry.

The following report was presented during the October regional meeting of the American Society for Geriatric Dentistry in Washington, DC. The needs for dentists who specialize in geriatric dentistry and dental curriculum in geriatrics are discussed, together with issues that face dental educators in geriatric dentistry.

Curriculum↗
PubMed1997

[Coagulase typing of Staphylococcus aureus in the geriatric wards after introduction of preventive measures of hospital infection].

In the early 1980's methicillin-resistant Staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in our geriatric wards, including 190 beds, MRSA infection was prevalent. In the early 1980's in our geriatric wards minocycline was one of the most sensitive antibiotics to MRSA isolated in our wards and used frequently against MRSA pneumonias and bacteremia. In the late 1980's resistant strains of MRSA to minocycline rapidly increased because vancomycin was not allowed to introduced for treatment of MRSA before 1991 in Japan. At the same period the predominant coagulase type changed from type II to type VII. To decrease minocycline-resistant strains to MRSA after 1987, use of minocycline was limited. Moreover since Oct. 1991 to decrease nosocomial infections some active preventive measures against hospital infection, including limited use of 2nd and 3rd cephems, were taken. In this study changing patterns of coagulase type of Staphylococcus aureus were discussed. At least 4 years was needed to find out that the predominant coagulase type changed from type VII to type II again in 1991. In this study about 22 antimicrobial agents MICs of 313 strains of Staphylococcus aureus isolated between March 1992 and June 1993 were determined and compared with the data of MICs before introduction of preventive measures. The pattern of susceptibility to MINO was in part improved. Thus the some sensitive strains of S. aureus were observed again in our geriatric wards. Interestingly indeed it took approximately 5 years to find out the emergence of sensitive strains to MINO since limitation of use of MINO in 1987.

Bacterial Typing Techniques↗
PubMed2004

[Geriatric information in the hospital discharge reports of patients over 65 years of age admitted to an Internal Medicine Department].

CONTEXT: The hospital discharge report (HDR) is a document that serves as a link between the hospital clinician and the primary care team. Our objective has been to evaluate the level of geriatric information in the HDR developed in the Internal Medicine Department of an tertiary care university hospital. Besides, the possible changes along the last 5 years were also evaluated. METHODS: HDRs of 1,000 patients over 65 years (500 in 1996 and 500 in 2001) and cared in the Bellvitge University Hospital were evaluated. Data relative to social, functional (qualitative and quantitative), and cognitive (qualitative and quantitative) assessment were collected. RESULTS: In 269 patients (27%) there was some kind of geriatric information in the HDRs. In the 2001 HDRs a significant increase in the percentage of social, qualitative functional and qualitative cognitive information was observed compared to 1996 HDRs. There were no significant differences upon comparing the subgroup of 269 patients with geriatric data in their HDRs with the subgroup of 731 remaining patients. CONCLUSIONS: The level of geriatric information in the HDRs is low. Care of elderly patients admitted to the Internal Medicine Department requires an additional evaluation on the part of all the professionals involved in their assistance, carrying out a global assessment that let a better knowledge of the patient. These evaluations should be part of the HDR.

Aged↗
PubMed1980

Geriatric psychiatry training: a brief clinical rotation.

Burgeoning interest in geriatric psychiatry has created a challenge of optimally fitting geriatric content into already crowded psychiatric residency curricula. The authors review general considerations in geriatric psychiatry training and describe a brief clinical rotation for working with the elderly. The brief rotation is not presented as the ideal way of imparting geriatric psychiatry skills, but as an effective use of limited time to improve one's approach to the older patient. The clinical rotation enables the resident to learn more about psychiatric issues in later life, as well as to acquire a better perspective on other parts of the life cycle and on other aspects of psychiatry.

Aged↗
PubMedDate not supplied

End-of-life care: issues relevant to the geriatric psychiatrist.

Most deaths in the United States occur in the context of chronic diseases in later life and are too often accompanied by potentially remediable emotional or physical suffering. Geriatric psychiatrists and other mental health professionals can contribute meaningfully to the provision of optimal care during the final phases of life. This review provides an overview of end-of-life care, focusing on issues most relevant to the geriatric psychiatrist. The author examined palliative care textbooks and review papers to determine the topics to be included in this article, and searched computerized literature databases on these topics. Many of the recommendations provided herein stem from experts' clinical experience; however empirical evidence is also incorporated and critiqued. Topics covered include conversations with patients and families about end-of-life care; the evaluation and treatment of suffering, including pain, depression, suicidality, anxiety, and delirium; the role of individual and family therapies in caring for dying patients; capacity determination; advance care planning; withholding life-sustaining treatments; and "last resort" (and, in some cases, quite controversial) options, such as terminal sedation, assisted suicide, and euthanasia. The author also notes the relevance of such end-of-life-care considerations to patients with dementia. Geriatric psychiatrists' skills across these multiple domains are of particular usefulness. Through such clinical skills and the application of empirical research tools to the many unanswered questions in the care of dying patients, geriatric psychiatry can make increasingly valuable and visible contributions to improving quality of life for people suffering from life-threatening illnesses.

Affect↗
PubMed2003

Differentiation of geriatric major depression from Alzheimer's disease with CSF tau protein phosphorylated at threonine 231.

OBJECTIVE: Differentiation of geriatric major depression from Alzheimer's disease is hampered by overlapping symptoms. Increased CSF concentrations of tau protein phosphorylated at threonine 231 (p-tau(231)) have been suggested as a biomarker for Alzheimer's disease. The authors asked whether p-tau(231) levels improve the differential diagnosis between geriatric major depression and Alzheimer's disease. METHOD: Included were 34 depression subjects, 64 with probable Alzheimer's disease, 17 with possible Alzheimer's disease, and 21 healthy comparison subjects. P-tau(231) concentrations were measured with an enzyme-linked immunosorbent assay. RESULTS: P-tau(231) levels were significantly higher in Alzheimer's disease than in geriatric major depression patients and healthy comparison subjects. For differentiation of probable Alzheimer's disease from major depression, p-tau(231) correctly allocated 87% of subjects. When possible mild Alzheimer's disease was compared to major depression, p-tau(231) correctly allocated 78% of subjects. CONCLUSIONS: CSF p-tau(231) should be evaluated as a potential biological marker for differentiation of geriatric depression from Alzheimer's disease.

Aged↗
PubMed1994

Nutrition preparation and the geriatric nurse.

The purpose of this study was to determine whether or not geriatric nurses are prepared to implement nutrition interventions for high-risk elderly patients. Many factors can influence poor dietary intakes among the elderly, thus contributing to disease and impeding recovery from illness. The nurse, the main caregiver, must be prepared to care for this vulnerable population. Seventy-one geriatric nurses from randomly selected nursing homes and swing-bed facilities within a midwestern state were selected for participation in this descriptive-correlational study. The nurses were evaluated for nutrition knowledge as well as for demographic and educational correlates. This study supports a moderate correlation between the number and type of nutrition-related continuing education programs and nutrition knowledge levels of the geriatric nurses. Significant differences were found in geriatric nurses' nutrition knowledge scores in the following nutrition content areas: nutrient digestion, absorption, and metabolism; nutrition throughout the life cycle; diet and disease; cultural and regulatory considerations for food and nutrition; and nutrient quality.

Adult↗
PubMed2000

What factors contribute to senior psychiatry residents' interest in geriatric psychiatry? a Delphi study.

OBJECTIVE: To generate hypotheses regarding factors that influence senior psychiatric residents, to consider treating geriatric patients in their future practices. METHOD: Using the Delphi technique, designed to generate ideas and consensus, we asked psychiatry residents at the University of Toronto who had completed, or were completing, their geriatric rotation about the factors they thought might influence residents in devoting some of their practice to geriatric patients. Residents then rated the degree of influence of these factors which had been synthesized into a questionnaire. RESULTS: Twenty-six items were rated according to their degree of influence. The most influential item was positive clinical experiences with seniors. This was followed closely by supervisor characteristics such as enthusiasm, role modeling, competence, and mentoring. Interest in and comfort with the medical psychiatric and neuropsychiatric nature of the field were also felt to be influential. CONCLUSIONS: The factors that influence senior psychiatry resident interest in the practice of geriatric psychiatry are primarily educational and result from exposure to the field under optimal educational circumstances (positive clinical experiences and excellent supervisors). The medical and neuropsychiatric nature of the field also likely exerts a unique influence and should be considered in stimulating interest in this population.

Adult↗
PubMed2006

Corrected QT intervals in newly admitted geriatric psychiatric patients: an examination of risk factors.

OBJECTIVES: The primary objective of this study was to determine the incidence of prolonged corrected QT (QTc) intervals in a population of geriatric psychiatry inpatients. Our secondary objective was to examine the associations between prolonged QTc intervals and risk factors identified as determinants in prolonging the QTc interval. METHODS: We identified all geriatric patients (aged 60 years and older) who were admitted to the geriatric program of our facility between May 1, 2003, and December 31, 2003. Those patients with a heart rate QTc interval calculated on the electrocardiogram (ECG) were eligible for the study. We used Bazett's formula to calculate the QTc interval. We defined a priori that a prolonged QTc interval would be 450 ms and 460 ms for men and women, respectively. We collected data on demographic variables such as weight, sex, age, and Axis I and III diagnoses, as well as on recognized risk factors for prolonged QTc interval. We used Student's t tests to conduct parametric analysis on continuous variables, and chi-square to test categorical variables for independence. RESULTS: During the study period, 88 patients were admitted to the geriatric division of Riverview Hospital. Of these patients, 34 men and 42 women had calculated QTc intervals on their ECG and therefore made up the study population. Our data show that 29.4% of men and 21.4% of women had prolonged QTc intervals. However, neither diagnostic nor medicinal risk factors were found to be associated with an increased incidence of prolonged QTc interval in this patient population. CONCLUSION: The preliminary findings of this study suggest that in this patient population the QTc interval may not be influenced by recognized risk factors to the same extent as observed in the adult population. These results warrant confirmation by a larger, prospectively designed study.

Adverse Drug Reaction Reporting Systems↗
PubMed1986

Psychiatric residents' experience and career interest in geriatric psychiatry: implications for training programs.

A survey of residents' experience and career interest in geriatric psychiatry was carried out in Canadian training centres. Residents' exposure to specific training experiences in geriatric psychiatry has been steadily increasing, although a large proportion of residents continue to report insufficient amount of experience and supervision in this area. Residents viewed geriatric psychiatry as involving special skills and knowledge and half were in favour of a compulsory rotation in this area. Geriatric psychiatry was an infrequent career choice along with other areas of psychiatry that have had difficulty in recruiting. Alternative approaches to service provision and recommendations for meeting the manpower needs are discussed.

Attitude of Health Personnel↗
PubMed1992

Intensive early exposure to geriatric psychiatry in residency training: impact on career choice and practice.

The authors examined the impact of intensive early exposure to geriatric psychiatry on the career choice of trainees. All psychiatrists who had completed a six month inpatient rotation on a general hospital psychogeriatric unit as part of their first year of residency were interviewed three to 12 years later with a questionnaire designed to elicit practice patterns, prior interest in geriatrics, and the major influences of the rotation. Nine of 16 trainees had spent more than 50% of their time since graduation treating elderly patients. Those surveyed who were not practicing geriatrics spontaneously reported positive influences of the rotation on psychiatry training in general. The nature of geriatric psychiatry and the clinical issues, as well as the supervisors and educational activities were rated as the most important influences of the rotation. Early experience in psychogeriatrics seems valuable for subspecialty recruitment as well as general psychiatry training.

Attitude of Health Personnel↗