Article
Geriatrics & Gerontology
Katharina Tabea Jungo, Sven Streit, Julie C. Lauffenburger
Summary: This study investigated measurable patient factors associated with new outpatient prescribing of potentially inappropriate medications in older multimorbid adults. It found that factors such as gender, age, number of ambulatory visits, number of prescribing orders, and heart failure were independently associated with being newly prescribed a potentially inappropriate medication.
Article
Geriatrics & Gerontology
Marco Vincenzo Lenti, Alice Silvia Brera, Alessia Ballesio, Gabriele Croce, Lucia Padovini, Giampiera Bertolino, Antonio Di Sabatino, Catherine Klersy, Gino Roberto Corazza
Summary: This study aimed to explore the relationship between resilience and frailty, as well as other clinical and sociodemographic characteristics in an internal medicine setting. The findings showed that frailty, age, dependency, clinical and cognitive impairment, and low educational status were significantly associated with lower resilience. Additionally, frail patients differed significantly from non-frail patients in terms of age, disease burden, dependency, cognitive impairment, and educational level. Age and dependency were found to have negative effects on resilience in different age groups.
Article
Geriatrics & Gerontology
Fiammetta Monacelli, Alessio Signori, Alessandra Marengoni, Simona Di Santo, Emanuela Rossi, Maria Grazia Valsecchi, Alessandro Morandi, Giuseppe Bellelli
Summary: The study aimed to investigate the potential association of multimorbidity with delirium in a large cohort of older patients hospitalized for acute medical or surgical conditions. Results showed neurosensorial multimorbidity as the most prevalent, indicating a vulnerability to in-hospital delirium. The findings support the importance of routine screening for sensory impairments and cognitive status to prevent delirium in older patients.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Pharmacology & Pharmacy
Caroline McCarthy, Michelle Flood, Barbara Clyne, Susan M. Smith, Emma Wallace, Fiona Boland, Frank Moriarty
Summary: This study evaluated changes in prescribing, potentially inappropriate prescriptions, and prescribing of low-value medicines in older people with multimorbidity and significant polypharmacy. The results showed reductions in the prescription of most drug groups, with the largest reduction observed in antiplatelet prescriptions. The median number of medication changes per person was five, highlighting the complexity of prescribing for patients with polypharmacy. Frequent medication changes could have important implications for patients in terms of adherence and medication safety.
INTERNATIONAL JOURNAL OF CLINICAL PHARMACY
(2023)
Article
Health Care Sciences & Services
Siddharth Jain, Paul R. Rosenbaum, Joseph G. Reiter, Omar Ramadan, Alexander S. Hill, Sean Hashemi, Rebecca T. Brown, Rachel R. Kelz, Lee A. Fleisher, Jeffrey H. Silber
Summary: The conventional definition of multimorbidity, which identifies patients with >= 2 comorbidities, labels almost all older patients as multimorbid, making it less useful. This study developed new medical condition-specific definitions, called Qualifying Comorbidity Sets (QCSs), for acute myocardial infarction (AMI), heart failure (HF), and pneumonia patients, which resulted in fewer patients being labeled as multimorbid but with a higher risk of death compared to the conventional definition.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Medicine, General & Internal
David R. Axon, Megan Grieser
Summary: This study investigates the variables associated with multimorbidity status among older US adults with self-reported pain and opioid use. The study finds that individuals aged 50-64, Hispanic, employed, and those who exercise frequently have lower odds of having multimorbidity.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Geriatrics & Gerontology
Teck Yong Gabriel Ding, Jacqueline Giovanna De Roza, Cheuk Ying Chan, Poay Sian Sabrina Lee, Sin Kee Ong, Kaiwei Jeremy Lew, Hui Li Koh, Eng Sing Lee
Summary: Singapore is dealing with an ageing population, with a particular need for care among frail older adults with multimorbidity. This study aimed to assess the burden on primary family caregivers of these individuals and identified factors associated with this burden. The findings showed that being a Chinese primary family caregiver and spending more time caregiving per week were positively associated with caregiver burden.
Article
Oncology
Henrik Egeland Gaudernack, Martine Mathia Hareide, Christine Miaskowski, Christine Ritchie, Borghild L. Loyland, Ellen Karine Grov, Steven M. Paul, Ann Helen Torstveit, Inger Utne
Summary: The study found that multimorbidity is associated with higher symptom occurrence, severity, and distress in older oncology patients, with the high multimorbidity group showing more symptoms and more severe symptoms compared to the low multimorbidity group.
EUROPEAN JOURNAL OF ONCOLOGY NURSING
(2021)
Article
Medicine, General & Internal
Maria Teresa Chiarelli, Stefania Antoniazzi, Laura Cortesi, Luca Pasina, Alessio Novella, Francesca Venturini, Alessandro Nobili, Pier Mannuccio Mannucci
Summary: Collaboration between hospital pharmacists and clinicians in identifying and resolving medication-related problems in multimorbid older patients can effectively reduce inappropriate prescriptions and harmful drug interactions. The study highlights the feasibility and mutual acceptance of a trajectory of recognition and reconciliation in medication optimization for older patients admitted to medical wards.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Geriatrics & Gerontology
Yong Zhao, Jianchun Wang, Xiaojuan Zhu, Xiyu Zhang, Yahui Zhang, Wen Zhang, Yan Dong
Summary: This study investigated the prevalence of multimorbidity and polypharmacy in hospitalized older patients. It found that multimorbidity was highly prevalent and polypharmacy was common. Factors such as older age, polypharmacy, and prolonged hospitalization were associated with more morbidities. Age, number of morbidities, and hospitalization duration were potential risk factors for all-cause death. However, the number of medications and polypharmacy were associated with a decreased risk of mortality.
Article
Cardiac & Cardiovascular Systems
Daniel E. Forman, George A. Kuchel, John C. Newman, James L. Kirkland, Elena Volpi, George E. Taffet, Nir Barzilai, Ambarish Pandey, Dalane W. Kitzman, Peter Libby, Luigi Ferrucci
Summary: Geroscience posits that CVD and other chronic diseases are caused by the progressive erosion of homeostatic mechanisms that counter age-related molecular damage. Gerotherapeutics enhance resilience mechanisms to prevent chronic diseases, frailty, and disability, thereby extending healthspan.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Xueyuan Guo, Mengmeng Li, Xin Du, Chenxi Jiang, Songnan Li, Ribo Tang, Caihua Sang, Ronghui Yu, Deyong Long, Jianzeng Dong, Changsheng Ma
Summary: Multimorbidity and polypharmacy are highly prevalent among elderly patients with atrial fibrillation in China, leading to a high rate of inappropriate prescribing. Greater attention should be given to addressing these serious health issues in the elderly population.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Johnny Huynh, Sahil A. Alim, David C. Chan, David M. Studdert
Summary: Comparing the rates of inappropriate prescribing between nurse practitioners and primary care physicians, it was found that they were virtually identical. Although nurse practitioners were overrepresented among clinicians with the highest and lowest rates of inappropriate prescribing, discrepancies in rates tended to be larger across states rather than between these practitioners within states.
ANNALS OF INTERNAL MEDICINE
(2023)
Article
Geriatrics & Gerontology
Claudia Salm, Julia Sauer, Nadine Binder, Aline Pfefferle, Mario Sofroniou, Gloria Metzner, Erik Farin-Glattacker, Sebastian Voigt-Radloff, Andy Maun
Summary: This study examines the association between inappropriate prescribing, including Potentially Inappropriate Medications (PIMs) and Potential Prescribing Omissions (PPOs), and functional disability in older patients. The results indicate a relationship between inappropriate prescribing and functional disability.
Article
Geriatrics & Gerontology
Oliver Baretella, Heba Alwan, Martin Feller, Carole E. Aubert, Cinzia Del Giovane, Dimitrios Papazoglou, Antoine Christiaens, Arend-Jan Meinders, Stephen Byrne, Patricia M. Kearney, Denis O'Mahony, Wilma Knol, Benoit Boland, Baris Gencer, Drahomir Aujesky, Nicolas Rodondi
Summary: In multimorbid older patients with type 2 diabetes mellitus (T2DM), more than one third were overtreated, highlighting the high prevalence of this problem. Careful balancing of benefits and risks in the choice of glucose-lowering medication (GLM) may improve patient care, especially in the context of comorbidities such as severe renal impairment, and frequent non-GP healthcare contacts.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Neuroimaging
Bihong T. Chen, Zikuan Chen, Sunita K. Patel, Russell C. Rockne, Chi Wah Wong, James C. Root, Andrew J. Saykin, Tim A. Ahles, Andrei Holodny, Can-Lan Sun, Mina S. Sedrak, Heeyoung Kim, Ashley Celis, Vani Katheria, William Dale
Summary: Chemotherapy in older women with breast cancer can lead to alterations in the connectivity of the default mode network, with a pattern of stronger anterior connectivity and weaker posterior connectivity observed post-chemotherapy. These changes may serve as potential neuroimaging biomarkers for cancer-related cognitive impairment and accelerated aging.
BRAIN IMAGING AND BEHAVIOR
(2022)
Article
Oncology
Daneng Li, Can-Lan Sun, Rebecca Allen, Christiana J. Crook, Abrahm Levi, Richard Ballena, Heidi D. Klepin, Rawad Elias, Supriya G. Mohile, William P. Tew, Cynthia Owusu, Hyman B. Muss, Stuart M. Lichtman, Cary P. Gross, Andrew E. Chapman, Ajeet Gajra, Harvey J. Cohen, Vani Katheria, Arti Hurria, William Dale
Summary: This study aimed to identify risk factors for hospitalization in older adults with GI cancers receiving chemotherapy. The findings suggest that cardiac comorbidity may be a risk factor for hospitalization in this population.
Article
Oncology
Amara Naseer, Anthea Cree, Richard Simcock, Stefan Starup Jeppesen, Lucinda Morris, Cindy Kenis, Amira Hashmi, William Dale, Anita O'Donovan
Summary: The current study explored the implementation of geriatric assessment (GA) in radiation oncology. The findings revealed low awareness of GA guidelines and a lack of utilization of validated tools and processes. The integration of GA principles into radiation oncology seems to be ad hoc and in its early stages. There is a clear need for increased interdisciplinary education and collaboration between radiation oncology and geriatric medicine.
JOURNAL OF GERIATRIC ONCOLOGY
(2022)
Article
Neuroimaging
Ebenezer Daniel, Frank Deng, Sunita K. Patel, Mina S. Sedrak, Heeyoung Kim, Marianne Razavi, Can-Lan Sun, James C. Root, Tim A. Ahles, William Dale, Bihong T. Chen
Summary: This study aimed to evaluate alterations in cortical thickness and cognition in older long-term survivors of breast cancer who had been treated with chemotherapy. The results showed that long-term chemotherapy could lead to cortical thinning and cognitive decline in older cancer survivors.
BRAIN IMAGING AND BEHAVIOR
(2023)
Review
Oncology
Laura Ashley, Claire Surr, Rachael Kelley, Mollie Price, Alys Wyn Griffiths, Nicole R. Fowler, Dana E. Giza, Richard D. Neal, Charlene Martin, Jane B. Hopkinson, Anita O'Donovan, William Dale, Bogda Koczwara, Katie Spencer, Lynda Wyld
Summary: With the aging population, cancer patients are getting older and more likely to have preexisting comorbidities, such as dementia. People with dementia are vulnerable to health disparities, which can complicate cancer care and outcomes.
CA-A CANCER JOURNAL FOR CLINICIANS
(2023)
Article
Oncology
Eva Culakova, Supriya G. Mohile, Luke Peppone, Erika Ramsdale, Mostafa Mohamed, Huiwen Xu, Megan Wells, Rachael Tylock, Jim Java, Kah Poh Loh, Allison Magnuson, Leah Jamieson, Victor Vogel, Paul R. Duberstein, Benjamin P. Chapman, William Dale, Marie Anne Flannery
Summary: Providing a geriatric assessment summary with management recommendations to oncologists reduces clinician-rated toxicity in older patients with advanced cancer receiving treatment. A GA intervention for older patients with advanced cancer reduces patient-reported symptomatic toxicity in the presence of a high baseline symptom burden.
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Oncology
Mina S. Sedrak, Can-Lan Sun, Jingran Ji, Harvey J. Cohen, Cary P. Gross, William P. Tew, Heidi D. Klepin, Tanya M. Wildes, Efrat Dotan, Rachel A. Freedman, Tracey O'Connor, Selina Chow, Mary Ann Fenton, Beverly Moy, Andrew E. Chapman, William Dale, Vani Katheria, Nicole M. Kuderer, Gary H. Lyman, Allison Magnuson, Hyman B. Muss
Summary: Older women with high-risk early breast cancer often suffer from toxic side effects during adjuvant chemotherapy, leading to dose reductions and delays. Identifying women at risk of receiving suboptimal dose intensity may improve treatment discussions and guide early supportive care interventions.
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Oncology
Marianne Razavi, Cristiane Decat Bergerot, Errol J. Philip, William Dale
Summary: This study investigated the factors influencing adherence to breast and prostate cancer screening intervals in older adults. Age, income, and insurance status were found to have a significant impact on the timing of screenings. Participants aged 60-79, African American women, and physically active men were more likely to undergo screenings earlier. These findings highlight the importance of socioeconomic and lifestyle factors in screening timing.
JOURNAL OF GERIATRIC ONCOLOGY
(2023)
Article
Oncology
Marissa LoCastro, Chandrika Sanapala, Ying Wang, Marielle Jensen-Battaglia, Marsha Wittink, Sally Norton, Heidi D. Klepin, Daniel R. Richardson, Jason H. Mendler, Jane Liesveld, Eric Huselton, Kristen O'Dwyer, Ashley-Marie Cortes, Chrystina Rodriguez, William Dale, Kah Poh Loh
Summary: This study assessed the feasibility and usefulness of a patient-centered communication tool (UR-GOAL tool) for treatment decision making between older patients with AML, their caregivers, and oncologists. The results showed that the UR-GOAL tool helped patients understand their diagnosis and treatment options, improve communication with oncologists, and make more informed decisions.
Article
Oncology
Cristiane Decat Bergerot, Paulo Gustavo Bergerot, Marianne Razavi, Errol J. Philip, Sabri Lakhdari, Marcos Vinicius da Silva Franca, Lorena Nascimento Manrique Molina, Alici Natalia de Sousa Freitas, Mariane Cunha Taveira, Andressa Cardoso de Azeredo, William Hiromi Fuzita, Cristiano Menezes Fernandes, Raquel Batista Pio, Romildo de Araujo, Milena Macedo Couto, Vitor Fiorin de Vasconcellos, Maria Fernanda Nonino, David Lee, Joao Nunes de Matos Neto, Marco Murilo Buso, Enrique Soto-Perez-de-Celis, William Dale
Summary: This study aimed to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The program showed high feasibility and acceptability among older adults with cancer receiving treatment, and significant improvement in health-related quality of life (HR-QOL) outcomes was observed. The GAIN program could also guide early detection of chemotherapy toxicity and improve patient-reported outcomes in low-resource environments.
Article
Health Care Sciences & Services
Elizabeth T. Loggers, Amy A. Case, Marcin Chwistek, William Dale, Marvin O. Delgado Guay, Stephen B. Edge, Steven R. Grossman, Jillian Gustin, Judith Nelson, Sahana Rajasekhara, Akhila Reddy, James A. Tulsky, Finly Zachariah, Kristen McNiff Landrum
Summary: The Alliance of Dedicated Cancer Centers (ADCC) initiated the Improving Goal Concordant Care Initiative (IGCC) to address the lack of formal communication training and institutional support among oncologists. IGCC requires four core components for participation, aiming to improve patient outcomes and promote care that aligns with patient preferences.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2023)
Article
Oncology
Janet V. Mokhnatkin, Marie Bae, William Dale, Abhay Tiwari, Jasmine Patanapirom, Mina S. Sedrak
Summary: This study examines the perceived facilitators and barriers to cancer trial enrollment from the perspective of older patients with breast cancer and their family caregivers. The findings suggest that while there is agreement on the clinical benefit of trials and physician recommendation, there is divergence in terms of patient motivation and the perceived influence of the caregiver on enrollment.
JCO ONCOLOGY PRACTICE
(2023)
Article
Oncology
William Dale, Heidi D. Klepin, Grant R. Williams, Shabbir M. H. Alibhai, Cristiane Bergerot, Karlynn Brintzenhofeszoc, Judith O. Hopkins, Minaxi P. Jhawer, Vani Katheria, Kah Poh Loh, Lisa M. Lowenstein, June M. Mckoy, Vanita Noronha, Tanyanika Phillips, Ashley E. Rosko, Tracy Ruegg, Melody K. Schiaffino, John F. Simmons, Ishwaria Subbiah, William P. Tew, Tracy L. Webb, Mary Whitehead, Mark R. Somerfield, Supriya G. Mohile
Summary: The purpose of this article is to update the ASCO guideline on the practical assessment and management of age-associated vulnerabilities in older patients undergoing systemic cancer therapy. The panel recommends the use of geriatric assessments to identify vulnerabilities or impairments in older adults with cancer and to guide their care plan. The Practical Geriatric Assessment is one option for this purpose.
JOURNAL OF CLINICAL ONCOLOGY
(2023)
Article
Oncology
Daneng Li, Can-Lan Sun, Heeyoung Kim, Christiana Crook, Ya-Han Zhang, Rebecca Allen, Richard Ballena, Shadman Hyder, Marianna Koczywas, Vincent Chung, Dean Lim, Vani Katheria, William Dale, Gagandeep Singh
Summary: This study investigated treatment goals and health outcome preferences of patients with neuroendocrine tumors (NETs) and found that patients prioritize quality of life and independence over survival. Improved communication between patients and physicians is needed to ensure patient preferences are taken into consideration.
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
(2022)
Letter
Oncology
Li Daneng, Mina S. Sedrak, William Dale