Search results for "Frail"
showing 10 items of 320 documents
Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart…
2018
Frailty is an age-associated clinical syndrome characterized by a decrease in physiological reserve in situations of stress, constituting a state of vulnerability that involves a higher risk of adverse events. Its prevalence in Spain is high, especially in elderly individuals with comorbidity and chronic diseases. In cardiovascular disease, frailty is associated worse clinical outcomes and higher morbidity and mortality in all scenarios, in both acute and chronic settings, and could consequently influence diagnosis and treatment. However, frailty is often not addressed or included when planning the management of elderly patients with heart disease. In this article, we review the available s…
Postural Adjustments and Kinematic Index Finger Features in Frail Older Adults under Different Equilibrium Constraints
2021
Background: Anticipatory postural adjustments (APAs) are significantly affected by age and may represent restrictions on functional independence. Previous studies in young adults have already highlighted that changing postural stability (i.e., seated vs. upright posture) affects the motor planning and APAs. In frail older adults (FOAs), the effect of these different conditions of postural stability have not yet been established, and the present study aimed to disentangle this issue. Methods: Participants executed an arm-pointing task to reach a diode immediately after it turned on, under different conditions of stability (seated with and without foot support and in an upright posture). A ki…
Evaluating the effectiveness and risks of oral anticoagulant treatments in multimorbid frail older subjects with atrial fibrillation using the multid…
2018
Background: Previous studies suggested that a different risk of mortality may influence the oral anticoagulant prescription in older patients with atrial fibrillation (AF). Recently, the Multidimensional Prognostic Index (MPI) demonstrated a high grade of accuracy, calibration and feasibility to predict mortality in hospitalized and community-dwelling older people. Prognostic information, as calculated by the MPI, however, is not included in the decision algorithm of treatments in older patients with AF Purpose: The aim of this international multicenter prospective observational study was to evaluate whether a different prognostic profile, as determined by the MPI, is associated with differ…
Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study
2019
Background: A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65 years. Methods: Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivar…
Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis
2021
Background There is emerging evidence that frail individuals present a decreased physiological reserve, decreased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has become increasingly recognized as a valuable measure in oncological surgical patients, including those with head and neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be used by an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysis was to evaluate the relationship between frailty and the risk of major postoperative complications in frail individuals submitted to head and n…
Invasive Versus Conservative Strategy in Frail Patients With NSTEMI: The MOSCA-FRAIL Clinical Trial Study Design
2019
Abstract Introduction and objectives Although clinical guidelines recommend invasive management in non–ST-segment elevation myocardial infarction (NSTEMI), this strategy is underused in frail elderly patients in the real world. Furthermore, these patients are underrepresented in clinical trials and therefore the evidence is scarce. Our hypothesis is that an invasive strategy will improve prognosis in elderly frail patients with NSTEMI . Methods This will be a prospective, multicenter, randomized trial, in which the conservative and invasive strategies will be compared in patients meeting all of the following inclusion criteria: NSTEMI diagnosis, age ≥ 70 years, and frailty defined by a cate…
Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population
2020
Platelet aggregation inhibitors (PAI) have widely proven their efficiency for the prevention of ischemic cardiovascular events. We aimed to describe PAI prescription in an elderly multimorbid population and to determine the factors that influence their prescription, including the impact of age, comorbidities and frailty, evaluated through a comprehensive geriatric assessment. This cross-sectional study included all patients admitted to the acute geriatric department of a university hospital from November 2016 to January 2017. We included 304 consecutive hospitalized patients aged 88.7 ±
Effects of Home-Based Physical Exercise on Days at Home and Cost-Effectiveness in Pre-Frail and Frail Persons: Randomized Controlled Trial.
2021
Objectives: Frailty increases the risks of hospitalization, institutionalization, and death. Our objective was to study the effects of home-based physical exercise on the number of days spent at home among pre frail and frail persons, versus usual care. In addition, utilization and costs of health care and social services, cost-effectiveness, and health-related quality-of-life (HRQoL) were explored. Design: Randomized controlled trial, with year-long supervised exercise for 60 minutes twice a week versus usual care. Follow-up for 24 months after randomization. Setting and Participants: A sample of 299 home-dwelling persons in South Karelia, Finland. Main inclusion criteria: >65 years, meeti…
Implementación de un modelo de atención integral a residencias
2019
Introduction: La incidencia y la prevalencia de patologias cronicas son un reto para los sistemas de salud cuya progresion se preve que aumentara de forma simultanea al envejecimiento poblacional. Short description of practice change implemented: Se presenta un Modelo de Atencion Integral a Residencias en el que, ademas de los niveles asistenciales convencionales (residencias, atencion primaria y hospitalaria) se incorpora el soporte de la Unidad Domiciliaria de Atencion Integral a Residencias (UDAIR), como elemento clave para la continuidad de cuidados y la atencion integrada. Aim and theory of change: Los objetivos principales son mejorar la atencion de las personas que residen en insti…
Residential mobility as a cause and consequence of vulnerability among the elderly in Reunion Island
2021
Sur la base d’une revue de la littérature et d’un corpus de quatorze entretiens semi-directifs, l’objet de cet article est de mettre en relation les facteurs de vulnérabilité du territoire réunionnais, ceux des personnes âgées de ce département français d’outre-mer ainsi que ceux éventuellement issus d’une mobilité résidentielle. Pour cela, une analyse macroscopique et une analyse individuelle sont proposées autour des facteurs de vulnérabilité dans les registres économiques, sanitaires, sociaux et environnementaux. Ces deux niveaux d’analyse indiquent la nécessité d’une approche territoriale fine pour mieux comprendre la vulnérabilité des personnes âgées et ses liens avec la mobilité résid…