Geriatrics & gerontology international
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Geriatr Gerontol Int · Sep 2016
ReviewAlgorithm of medication review in frail older people: Focus on minimizing the use of high-risk medications.
Frail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing and avoiding use of high-risk medications might prevent adverse events. The present study aimed to develop a pragmatic, easily applied algorithm for medication review to help clinicians identify and discontinue potentially inappropriate high-risk medications. ⋯ The algorithm captures a range of different clinical scenarios in relation to potentially inappropriate medications, and offers an evidence-based approach to identifying and, if appropriate, discontinuing such medications. Studies are required to evaluate algorithm effects on prescribing decisions and patient outcomes. Geriatr Gerontol Int 2016; 16: 1002-1013.
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Geriatr Gerontol Int · Sep 2016
Comparative StudyEvaluating attention in delirium: A comparison of bedside tests of attention.
Impaired attention is a core diagnostic feature for delirium. The present study examined the discriminating properties for patients with delirium versus those with dementia and/or no neurocognitive disorder of four objective tests of attention: digit span, vigilance "A" test, serial 7s subtraction and months of the year backwards together with global clinical subjective rating of attention. ⋯ Objective tests are useful for prediction of non-delirium, but lack specificity for a delirium diagnosis. Global attentional deficits were more indicative of delirium than deficits of specific domains of attention. Geriatr Gerontol Int 2016; 16: 1028-1035.
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Geriatr Gerontol Int · Sep 2016
Observational StudyComprehensive Geriatric Assessment is a useful predictive tool for postoperative delirium after gastrointestinal surgery in old-old adults.
To determine whether carrying out the Comprehensive Geriatric Assessment before operations would be useful for predicting complications, particularly postoperative delirium (POD), in old-old patients. ⋯ The Comprehensive Geriatric Assessment before gastrointestinal surgery can be a useful tool for predicting the development of POD in old-old patients. Geriatr Gerontol Int 2016; 16: 1036-1042.