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 793 records · Page 44Linked to original sources
PubMed1998

Geriatric psychiatry subspecialization in Canada: past, present, and future.

OBJECTIVE: To describe the development, future challenges, and directions of geriatric psychiatry in Canada. METHOD: This review and description of geriatric psychiatry was developed in the context of the criteria established by the Royal College of Physicians and Surgeons of Canada for subspecialization applications. Information from key informants, both nationally and internationally, was combined with a review of relevant literature in the field. RESULTS AND CONCLUSIONS: Canada has provided important contributions to the field of geriatric psychiatry in Canada and abroad. The increased needs of older persons with severe mental illness and their families, combined with a significant body of knowledge and therapeutic options, provide an important foundation for further development. Subspecialization in geriatric psychiatry as part of the overall development of psychiatry in Canada is proposed as critical to meeting the challenges of our aging population.

Age Distribution↗
PubMed1997

Characteristics of persons utilizing a geriatric psychiatry outpatient clinic.

Mental-health service utilization among elderly people has been shown to be low relative to younger age groups. This study was done to determine the current proportion of elderly persons served in a university-affiliated psychiatry outpatient clinic, and to better characterize elderly patients who receive specialized mental-health care in this setting. The proportion of visits from elderly patients (aged 60 and over) was found to be 16%. Demographic and clinical characteristics of a sample of 140 consecutive geriatric patients evaluated at the clinic were obtained. The data revealed that the patients had a mean age of 74.7+/-7.5 (SD) years, and were mostly female (72.1%) and white (78.6%). Surprisingly, the age distribution was found to be bell shaped, with a small upper tail. The three most prevalent psychiatric diagnoses were depression (56.4%), dementia (35.7%), and substance use disorder (20%). Overall, 59.3% of geriatric patients had a history of prior psychiatric treatment. Females were significantly more likely than males to have a psychiatric history (69.3% vs. 33.3%, P = .0001). Among patients with a psychiatric history, females were more likely to have a current diagnosis of major depression (P = .0006), while males were more likely to have a current substance use disorder (P = .03). The prevalence of dementia increased with each successive decade above 60, while the occurrence of bipolar and adjustment disorders was confined to younger geriatric patients. Elderly patients receiving psychiatric treatment in the clinic thus formed a heterogeneous group. Gender, age, and presence of a psychiatric history were all associated with differences in prevalence and distribution of various mental disorders in this geriatric psychiatry outpatient clinic.

Age Distribution↗
PubMed1983

Pharmacists' perceptions of geriatric pharmacy practice.

Four hundred thirty-two pharmacists from two separate pharmacy organizations associated with geriatric practice were surveyed to determine their perceptions of 51 content areas in terms of their importance for inclusion in pharmacy curricula. The population surveyed was also asked to respond to the question: What do you believe is the most difficult aspect of geriatric pharmacy practice? Demographic and descriptive information was collected for each respondent, for statistical purposes. The most important content areas for inclusion in pharmacy curricula were the pharmacist's responsibility in long-term care, patient compliance, drug interactions, adverse drug reactions, and psychotropic medication use. The most difficult aspects of geriatric pharmacy practice identified included inadequate geriatric knowledge, patient compliance, physician overprescribing, communication with the elderly, and lack of professional and/or financial recognition.

Attitude of Health Personnel↗
PubMed1999

Predictors of outcome of rehabilitation of elderly stroke patients in a geriatric ward.

PURPOSE: To identify predictors of outcome after 12 months in elderly stroke patients rehabilitated in a geriatric ward. DESIGN: Prospective with evaluation in the subacute phase and after 12 months. SETTING: Geriatric ward and outpatient clinic. SUBJECTS: All stroke patients admitted from the acute unit to a geriatric ward for rehabilitation during a 16-month period (n = 171). MAIN OUTCOME MEASURES: Place of living, mortality and social functioning (Frenchay Activities Index) 12 months following stroke. RESULTS: Age, urinary incontinence and cognitive function were significantly associated with place of living (home versus nursing home) 12 months post stroke in bivariate analyses. However, using multivariate logistic regression analyses, only age (p = 0.005) and urinary incontinence at baseline (p = 0.028) remained independent predictors of place of living. Mortality during the first year was significantly predicted by urinary incontinence and gender (men doing worse), whereas the Barthel Activities of Daily Living (ADL) Index sumscore was the only significant independent predictor of social activities. CONCLUSION: Urinary incontinence at baseline seems to be a most important predictor of outcome 12 months post stroke in geriatric patients. However, with regard to social activities (Frenchay Activities Index), functional impairment in the initial phase as reflected by the Barthel ADL Index supersedes other predictors.

Activities of Daily Living↗
PubMed2006

Geriatric syndromes in elderly patients admitted to an oncology-acute care for elders unit.

PURPOSE: The goal of this study was to characterize an elderly population admitted to a novel Oncology-Acute Care for Elders (OACE) unit, determine the prevalence of functional dependencies and geriatric syndromes, and examine their suitability for an interdisciplinary model of care. PATIENTS AND METHODS: We conducted a retrospective review of 119 patients age 65 years or older who had a primary oncologic or hematologic diagnosis and were admitted to the OACE Unit. Standard geriatric screens were administered to assess mood, functional, and cognitive status. Demographic and medical data were compiled by review of patients' medical records. RESULTS: The mean age of the patients was 74.1 years (standard deviation, 5.9 years). The sample was predominantly white, of equal sex, had limitations in instrumental and basic activities of daily living, and a mean length of stay of 6 days. Geriatric syndromes detected by the OACE interdisciplinary team included cognitive impairment (dementia and/or delirium), depression, weight loss, and use of high-risk medications. Adverse events such as falls, restraint use, and pressure sores were rare. CONCLUSION: In this descriptive study, many older cancer patients were found to have geriatric syndromes by the OACE team and these patients were considered appropriate for an interdisciplinary model of care. Additional studies are needed to compare the outcomes of hospitalized older oncology patients receiving an OACE intervention with those patients receiving usual care.

Activities of Daily Living↗
PubMed2006

Comorbidity, disability, and geriatric syndromes in elderly cancer patients receiving home health care.

PURPOSE: To assess the prevalence of comorbidity, disability, and geriatric syndromes, or a combination thereof, in elders with cancer receiving home health care (HHC). PATIENTS AND METHODS: Using the Ohio Cancer Incidence Surveillance System, we identified Ohio residents 65 years of age or older who were diagnosed with incident breast (n = 952), prostate (n = 324), or colorectal cancer (n = 1,276) during the 28-month study period, August 1999 through November 2001. We used the Outcome and Assessment Information Set, a database compiling comprehensive assessment forms completed for all HHC patients, to group individuals in independent and overlapping categories of comorbidity, disability, and geriatric syndromes on the basis of the patients' clinical condition 14 days before the date of the assessment. RESULTS: The proportion with no comorbidity, disability, or geriatric syndromes was 26.4% in breast cancer patients, 12.0% in prostate cancer patients, and 14.0% in colorectal cancer patients. The proportion of patients presenting all three entities at once was 11.7%, 24.7%, and 15.7%, respectively, in three cancer sites. As expected, the proportion of patients with no comorbidity, disability, or geriatric syndromes declined gradually with increasing age, and that of patients with all three entities was highest among patients 85 years or older. CONCLUSION: The proposed taxonomy will help us gain a more nuanced understanding of older cancer patients' clinical presentation and may lead to a more accurate identification of older patients who might benefit from standard cancer treatment, and those who might experience adverse outcomes.

Age Factors↗
PubMed2001

Interdisciplinary education in a community-based geriatric evaluation clinic.

BACKGROUND: Demographic predictions are challenging schools of medicine to emphasize geriatrics. This article describes a geriatric evaluation (GET) clinic and explores the opportunity for residents to attain core geriatric competencies. DESCRIPTION: The GET clinic is located in a small Midwestern city associated with a community-based medical school. It is staffed by an interdisciplinary team consisting of a geriatrician, a gerontological nurse specialist, and a social worker. Residents, medical students, and nursing students are frequent participants. EVALUATION: Descriptive data indicate that the clinic experience addresses the core competencies set forth by the American Geriatric Society. The clinical outcomes indicate that the clinic is effective in maintaining the functional status of patients and has a positive effect on family caregivers. Residents and students rate their experience as excellent. CONCLUSIONS: The GET clinic provides a unique interdisciplinary educational opportunity. Further investigation is needed to determine if residents who participate do attain core competencies.

Aged↗
PubMed2001

Geriatric assessment in primary care: formulating best practice.

Comprehensive geriatric assessment (CGA) is a structured approach to measuring physical, mental and social functioning of older people to identify needs and to plan care. Meta-analysis of trials of CGA suggest that it is cost-effective, but there is no agreed approach to its implementation in primary care. Our aim was to develop a best-practice model for geriatric assessment in primary care. We took an iterative approach to development, combining expert and local stakeholder opinion, and using semi-structured interviews to assess patient and practitioner experience in nine general practices in Sheffield. Patients were aged 75 and over, living at home. The best-practice model was the use of a standardized instrument (EASY-Care) to unselected patients aged 75 years and over living at home or in residential care, administered by a practice nurse in the context of an over-75s health check. There was high patient and practitioner acceptability, and significant cost savings were noted. Key beneficial features were the assessment of mental health and sources of support; goal-setting; generation of a disability score; and high patient satisfaction from contact with nursing staff. We conclude that geriatric assessment in primary care is feasible, economical and beneficial to patients and practitioners. Nursing staff are central to successful implementation of geriatric assessment in primary care.

Aged↗
PubMedDate not supplied

Geriatric day care in theory and practice.

Geriatric day care is currently receiving considerable attention as an alternative to institutionalization for a certain segment of our nation's chronically ill and impaired elderly. There are, however, few clear descriptions of day care and even fewer programmatic guidelines. In an effort to clear up some of the issues, this paper (a) defines geriatric day care and describes various types of geriatric day care centers, (b) discusses the place of day care in the long-term care continuum, and (c) describes the Levindale Adult Day Treatment Center as one model of geriatric day care.

Activities of Daily Living↗
PubMed1993

Alcohol use disorders in cognitively impaired patients referred for geriatric assessment.

Alcohol Use Disorders are thought to be underdiagnosed in the geriatric population. A retrospective medical record review was performed on 383 patients who presented for outpatient geriatric assessment from 1985-1990. The record review included data on the alcohol consumption history, age, sex, presence of alcoholic beverages in the home, geriatric psychiatry evaluation, and alcohol-related diagnoses. Alcohol Use Disorders were recognized as contributing to medical problems in 10% of patients having a mean age of 78 years. All except one patient were found to be cognitively impaired. In addition, 9% of patients consumed alcohol on a regular basis and this consumption was not considered in the diagnosis, despite the presence of cognitive impairment. Twenty-five percent of cognitively impaired patients were consuming alcohol at the time of evaluation. These results indicate that alcohol consumption and AUD are common in cognitively impaired patients presenting for geriatric assessment. Recognition of Alcohol Use Disorders is essential, as chronic alcohol toxicity represents one cause of potentially reversible dementia. Because there are no validated instruments for alcoholism screening in cognitively impaired elderly patients, evaluation should include a past and present consumption history, a search for alcoholic beverages at the home visit, and possible psychiatric referral.

Aged↗
PubMed2007

Using collaboration to maximize outcomes for a John A. Hartford Foundation geriatric enrichment project.

Two institutions representing two BSW and one MSW program and a geriatric education center collaborated in a John A. Hartford geriatric enrichment project. Sharing the risks and benefits of a collaborative model, 75 percent of faculty participated in mini faculty fellowships, and bi-monthly dinner meetings with colleagues from each of the three programs, and actively engaged in the curricula revisions. Faculty report pervasive geriatric enrichment in each program's foundation content areas, and increases in students placed in geriatric enriched field practicum settings, from pre-project levels of 8.1 percent to a high of 24 percent. The features of the collaborative project include: respecting each program's autonomy while actively sharing ideas, resources and partnering with community's aging experts; and strengthening mutually reciprocal relationships among faculty and the gerontologic practice community. This model of shared risks and benefits also provides opportunities for innovation, diverse thinking, and shared decision making.

Aged↗
PubMed1998

Risperidone: treatment response in adult and geriatric patients.

OBJECTIVE: To compare the efficacy and side effects of risperidone in younger adult and geriatric patients. METHODS: Open retrospective study of 102 consecutive intakes, prescribed risperidone, by a mental health team. All patients were non-hospitalized community residents. Prior to initiation of risperidone, and at termination of study period, Clinical Global Impression (CGI) scores were used to track progress. Variables monitored were: concurrent use of other antipsychotics, compliance, side effects, and maintenance dosage. RESULTS: The most common DSM-IV diagnoses were schizophrenia in the younger adult group and late onset delusional disorders in the geriatric group. Compliance was good for both groups. The geriatric group demonstrated a greater treatment response which was reached at a significantly lower dosage. There was no statistically significant difference in the occurrence of side effects. Examination of response by diagnostic category indicated that geriatric patients with late onset delusional disorder showed the best response while adults with either schizophrenia or affective syndromes also showed positive response. CONCLUSIONS: Risperidone, at lower than recommended doses, shows promise in the treatment of late onset delusional disorders and behavior syndrome of dementia. The side effect profile was benign, as was suggested by experience in treating schizophrenia. Scientifically more rigorous prospective studies for the indications and efficacy of risperidone in late onset psychotic disorders and psychoses and behavior syndromes associated with dementing illness are overdue.

Adult↗
PubMed1995

Cross-sectional psychometric assessment of the Functional Status Questionnaire: use with geriatric versus nongeriatric ambulatory medical patients.

OBJECTIVE: The Beth Israel/UCLA Functional Status Questionnaire (FSQ) is a multidimensional self-report instrument used for assessing the physical, social, and psychological status of children and adults. This study assessed the appropriateness of the FSQ for use with geriatric (at least 65 years of age) ambulatory medical patients. METHOD: Concurrent cohort convenience samples of forty geriatric and eighty-five nongeriatric ambulatory patients were drawn from a general internal medicine clinic. Patients completed the FSQ while waiting to see their physician. Analyses were conducted in order to: 1) address the magnitude and pattern of missing responses that are generated when the FSQ is administered to small groups; 2) assess whether, as was intended, each of the different FSQ subscales is unidimensional; 3) evaluate the magnitude and pattern of variances and covariances of items constituting FSQ subscales; 4) compare profiles of FSQ scores between geriatric versus nongeriatric samples; and 5) investigate whether FSQ subscales correlate with different self-report outcome measures in a convergent or divergent manner. RESULTS: For both samples, FSQ subscales were internally consistent and moderately variable. Cross-sectional comparisons revealed both convergent and divergent relationships between FSQ subscales and measures of social support and satisfaction with health. CONCLUSIONS: The FSQ appears to be appropriate for use with geriatric ambulatory medical patients. Findings highlighted the positive influence of intermediate activities of daily life--involving moderate levels of physical activity--on satisfaction with health, and the negative effect of depression on physical activity.

Activities of Daily Living↗
PubMed1991

The Geriatric Depression Scale and Hopelessness Index: longitudinal psychometric data on frail nursing home residents.

We administered the Geriatric Depression Scale and the Hopelessness Index 18 times over a 39-wk. period to an initial sample of 76 old, frail, multiply impaired, and depressed nursing home residents participating in a longitudinal quasi-experimental study on the effects of cognitive group interventions on cognition, depression , hopelessness, and life satisfaction. As no changes over time were observed on the outcome variables of geriatric depression and hopelessness, the stability of the instruments' internal consistency was examined longitudinally. For the Geriatric Depression Scale, Kuder-Richardson KR-20 coefficients ranged from .69 to .88, with a mean of .82 (SD = .05). Coefficients for the Hopelessness Index were between .72 and .86, with a mean of .80 (SD = .04). We conclude that both instruments give reliable measurements of geriatric depression and hopelessness in old, frail, and depressed nursing home residents.

Aged↗
PubMed2003

[A new strategy of aging and geriatric epidemiology in Japan].

Global trends of increases in the aging population will continue in the 21st century, and geriatric medicine will be a most important field of medicine. Increase in the aging population naturally causes increases in numbers of patients with geriatric disease. Geriatric diseases are often chronic, slowly progressive, and hard to cure. Medical care expenses for the patients will expand dramatically. Therefore, the most important key for future geriatric medicine is prevention. For prevention, detailed data on normal aging process are required. At the National Institute for Longevity Sciences (NILS), a comprehensive longitudinal study of aging, the NILS-Longitudinal Study of Aging (NILS-LSA) started in November 1997. The subjects of this study were about 2,300 residents aged 40 to 79 years who were stratified random samples selected from the neighborhood area of the NILS. They are examined every two years at the NILS-LSA Examination Center. The third wave of examinations started in 2002. Examined variables were over 1,000, including clinical evaluations, medical examinations, anthropometry, body composition, physical functions, physical activities, psychological assessments, nutritional analysis and molecular epidemiology.

Adult↗
PubMed2005

[Relationship of the community in National Center for Geriatrics and Gerontology].

Acute hospital has to have a good community relationship because of looking for a services and settings after discharge for elderly patients. In particular, physicians should have good relations with other physicians, visiting nurses, and care managers, because elderly patients had to go to facilities or nursing homes instead of their own homes. We must obtain information concerning care services and build networks between hospitals and the community in order to provide good services. To enable this we established a good discharge support team. We also have to educate the staff and care managers to take good care of patients. A comprehensive geriatrics and team approach is important for geriatric medicine in the community through care conference. So geriatricians must take part in care conferences and take a leadership role in networks for people with care needs. Finally our national center for geriatrics and gerontology has to take a role of the future achievement in geriatric field and provide information related research and clinical activity for the elderly.

Aged↗
PubMed1994

Case management models. Geriatric nursing prototypes for growth.

1. Geriatric nursing case management is an advocacy system and administrative service that guides clients/families through the health care system and maintains elders in a safe and nonrestrictive environment. 2. Geriatric nursing case managers can function in hospital-based geriatric assessment programs, public health departments or home health care agencies, social health maintenance organizations, or privately owned case management businesses. 3. Specific nursing interventions related to geriatric nursing case management include liaison activities to appropriately integrate clients into the health care system, health promotion and counseling, disease prevention, health education and screening, and community resource linkage. 4. Nursing case management is evolving into its own specialty because a specialized knowledge base is required to navigate our health care system and procure appropriate services for clients.

Aged↗
PubMed2001

Evaluation of a geriatrics course emphasizing interdisciplinary issues for chiropractic students.

In 1998, the Iowa Geriatric Education Center (IGEC) was funded by the U.S. Health Resources and Services Administration Bureau of Health Professions. The role of the chiropractic institution participating as a partner in the IGEC was to develop and evaluate a model geriatrics course for chiropractic students emphasizing experiential learning and interdisciplinary issues. The evaluation assessed changes in the students' knowledge of geriatrics and their attitudes toward older adults and toward interdisciplinary issues. There were 197 students in the class. The alternate course was offered to 20 volunteers for the pilot test. Score changes from baseline to post-intervention were evaluated using the Wilcoxon signed-ranks test. Instruments were Facts on Aging Quiz (FAQ), Aging Semantics Differential (ASD), and Interdisciplinary Education Perception Scale (IEPS). Median scores improved by 12 percentage points on FAQ (p = 0.002), 18 points on the ASD (p = 0.007), and decreased by 15 points on the IEPS (p = 0.064). Integration of the course into the curriculum is being planned, and the evaluation scheme appears appropriate for other health professions, such as nursing, to use for evaluating interdisciplinary geriatrics courses for their students.

Adult↗