Showing papers in "Clinics in Geriatric Medicine in 2009"

TL;DR: An overview of the epidemiology of CVD in older adults is provided, including an assessment of the impact of CVC on mortality, morbidity, and health care costs.

TL;DR: The evidence on the relationship between obesity and mortality in the elderly, the definition of obesity in the ageing population, and the need for its treatment in this population is examined.

TL;DR: Antimicrobial treatment regimens in the elderly are similar to other populations, and chronic indwelling catheters are associated with increased morbidity from urinary tract infection.

TL;DR: The aging kidney undergoes several important anatomic and physiologic changes that increase the risk of acute kidney injury (formerly acute renal failure) in the elderly, with special focus given to older adults.

TL;DR: VA HBPC is a model to emulate for the care of persons with complex, chronic disabling conditions, improving quality without added cost, and maximizing their independence through comprehensive longitudinal interdisciplinary care delivered in their homes.

TL;DR: Effective transitional care processes, linked with strong home care programs can reduce re-hospitalization by a third in some less intensive models and by half or more in some more intensive models.

TL;DR: Aging is associated with a cascade of morphologic and physiologic changes that naturally predispose older adults to progressive weakening, functional decline, morbidity, disability, poor quality of life, and increased mortality, and physical activity moderates such insidious aging patterns.

TL;DR: Evidence that CR in nonhuman primates and people has a positive effect on risk factors for CVD is reviewed, showing that it is the only environmental or lifestyle intervention that repeatedly has been shown to increase maximum life span and to retard aging in laboratory rodents.

TL;DR: A thorough medication assessment for each patient is essential when determining pharmacotherapeutic options in the elderly.

TL;DR: Gaps in research on physical activity and cardiovascular health are discussed, with an emphasis on the need for research on how sedentary time affects risk of cardiovascular disease and other chronic illnesses.

TL;DR: The origin and evolution of house calls, what is uniquely gained from house calls for both patients and providers, key clinical issues managed at home, and changes in Medicare reimbursement, technology, and interdisciplinary team care that have influenced the delivery of home-based medical care are described.

TL;DR: Results from ongoing clinical trials will reveal whether the intriguing alternative of CR mimetics represents a safe and effective strategy to promote cardiovascular health and delay cardiac aging in humans.

TL;DR: Cumulative evidence implicates hypertension in the pathogenesis of Alzheimer disease and efforts directed at the treatment and control of hypertension can have significant public health impact.

TL;DR: The physiologic response to resistance training in older adults is reviewed and the impact of resistance exercise training on cardiovascular risk factors is discussed.

TL;DR: While reducing cardiovascular morbidity and mortality remains a primary objective of preventive cardiology in older adults with diabetes, the impact of these interventions on functional well-being, cognition, and other geriatric syndromes requires further study.

TL;DR: The author's review the different studies that look at arterial stiffness in the elderly, its impact on hypertension and cardiovascular outcome, and what is currently known on how to prevent vascular stiffness.

TL;DR: Primary care providers must proceed with caution when prescribing drugs for elderly patients with kidney disease, as Epidemiologic studies suggest that older patients are at a greater risk for renal failure if the kidney experiences insults from ischemia or exposure to pharmacologic and diagnostic nephrotoxins.

TL;DR: A model of coordinated home-based medical care, called Independence at Home (IAH), which operates on a limited basis in many US communities and in the Veterans Affairs system is described, which can lower total costs by 25 percent or more while improving patient satisfaction and outcomes.

TL;DR: The history and pathophysiology of hypertension, hypertension population studies, and hypertension treatment studies with a focus on the elderly are discussed, and the author's findings both justify and encourage antihypertensive treatment in all hypertensive adults.

TL;DR: Data favor HaH models that provide substantial physician inputs and are geared toward substituting for hospital care, provide service that is highly satisfying to patients and their caregivers, are associated with less iatrogenic complications, and are less expensive.

TL;DR: The concomitant intake of certain medications that counter the effects of antihypertensive drugs and the frequent occurrence of orthostatic hypotension complicate treatment in older patients and drive down blood pressure control rates.

TL;DR: Current data on lipid-lowering therapy in older adults and the management of hyperlipidemia in elderly patients are summarized.

TL;DR: Possible reasons for low physician and victim self-reporting are reviewed and involvement of health professionals in educating others in the community about elder abuse and neglect may allow isolated at-risk elders to be identified.

TL;DR: A wide variety of behavioral, pharmacologic, and surgical therapies are available to treat urinary incontinence, and these may be used alone or in combination.

TL;DR: The past history of home health agency care from its beginnings to the present day, evidence regarding the effect of recent changes in financing on these services, the state of skilled home health care in 2008, and a discussion of future directions are reviewed.

TL;DR: There is bona fide reason to hope that within a decade, kidney failure attributable to diabetes will be transformed into a preventable complication of a disease that has dominated and directed the authors' heritage.

TL;DR: Key findings from the past 2 decades of home care quality improvement research and public policy advances are reviewed, specific examples of local and regional programmatic approaches to quality improvement are described, and near-future trends in this vital arena of home health care are forecast.

TL;DR: A team approach is needed to ensure that devices are correctly prescribed, and the patient is taught how to use it effectively, to ensure successful outcomes.

TL;DR: Aging is a degenerative biologic process that affects the kidneys known to be associated with a decline in kidney function coincident with a progressive decrease in the number of functioning nephrons and with glomerular and tubulointerstitial scarring.

TL;DR: Key aspects of recruitment, training, and retention of home care workers are discussed, including those who provide basic support for activities of daily living as well as a variety of skilled professionals: therapists, nurses, pharmacists, and physicians.