Edith Haage, PT, GCS NewCourtland Senior Services 10/26/2016. NEWCOURTLAND.org

Size: px
Start display at page:

Download "Edith Haage, PT, GCS NewCourtland Senior Services 10/26/2016. NEWCOURTLAND.org"

Transcription

1 Edith Haage, PT, GCS NewCourtland Senior Services 10/26/2016 NEWCOURTLAND.org

2 Edith Haage has disclosed she has no financial relationships.

3 1. Define frailty in geriatric clientele, including classification profiles, physiological changes, and biological basis. 2. Explain clinical assessment strategies and factors for consideration during evaluations for frailty. 3. Discuss interdisciplinary implications of frailty, including the risks, consequences, and costs of frailty. 4. Identify evidence-based practice interventions for pre-frail and frail participants.

4 Alas, the frailty is to blame, not we. For such as we are made of, such we be. William Shakespeare

5

6 According to the U.S Department of Health and Human Services, persons 65 years or older numbered 46.2 million in 2014 (the latest year for which data is available). Represented 14.5% of the U.S. population, about one in every seven Americans. By 2060, there will be about 98 million older persons, more than twice their number in People 65+ represented 14.5% of the population in the year 2014 but are expected to grow to be 21.7% of the population by 2040.

7 Focused on a subset of leading chronic diseases: heart disease, stroke, and diabetes. In 2006, this subset of diseases incurred estimated economic losses of $20 million in the United States. Short-term projections (to 2015) indicate that losses will nearly double The potential estimated loss in economic output for 23 nations surveyed as a whole between 2006 and 2015 totaled US$84 billion. NIH.gov

8 Average cost per hospital stay in US in 2014 was > $5,200 (Statistica.com) Average cost per SNF day in US in 2015 was > $230 (longtermcare.gov)

9 A B

10 1. Progressive physiologic decline in multiple body systems 2. Loss of function 3. Loss of physiologic reserve 4. Increased vulnerability to disease and death

11 Vulnerable to poor health outcomes Social isolation Disability Repeated hospitalization Institutionalization

12 Mobility Strength Endurance Nutrition Physical activity Some include cognitive impairment and depression

13 Studenski et al: Examined gait speed, ability to rise from a chair, and balance skills Predicted decline in function, hospitalization, and global decline in health in older patients seen in primary care Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc 2003; 51:

14 5 conditions: slow walking speed, poor hand grip, exhaustion, weight loss, and low energy expenditure Statistically higher risk for falls, disability, hospitalization, and death Findings persisted after adjusting for health status, socioeconomic status, and disability at baseline Incidence of these outcomes increased in stepwise fashion from non-frail (no factors) to intermediate (one or two factors) to frail people (three or more factors)

15 Frailty index based on impairments in cognitive status, mood, motivation, communication, mobility, balance, bowel and bladder function, activities of daily living, instrumental activities of daily living, nutrition, and social resources, as well as a number of comorbidities. This index was found to be highly predictive of death or institutionalization. Originally 92 deficits, simplified to 30 items; still complex for PACE environment Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. Lancet 1999; 353:

16 Frailty was defined as a clinical syndrome in which three or more of the following criteria were present: Unintentional weight loss (10# past year) Self-reported exhaustion Weakness (grip strength) Slow walking speed Low physical activity

17 Intermediate frailty status, or Prefrail Indicated by the presence of one or two criteria, showed intermediate risk of these outcomes as well as increased risk of becoming frail over 3 4 years of follow-up Stay tuned: Progression vs regression

18 Frailty has been associated with being African American or Hispanic Having lower education and income Having poorer health Higher rates of comorbid chronic diseases and disability. Diabetes Depression Cognitive Decline

19

20 Robust Stable Temporal difficulties Pre-Frail Signs of dysfunction when stressed Frail At risk for poor outcomes Vulnerable to decline Poor tolerance to stressors

21 IDT Management of the Frail Participant

22 Frailty Screening: Need criteria to identify frail and pre-fail participants Comprehensive Geriatric Assessment and Treatment IDT intensive assessment to determine baselines and at risk areas Developing interventions is a critical next step in decreasing adverse health outcomes in frail older adults

23 PT OT RT CHIROPRACTIC RN RD PCP PARTICIPANT SW

24 Benefits include enhanced mobility and activities of daily living, improved gait, decreased incidence of falls, increased bone mineral density, and improvements in general well-being Exercise is likely to benefit even the frailest of older adults. Even low levels increase muscle strength.

25 NIH: 2008: minimum 150 min/week mod intensity aerobic Resistance training 2 x /week Multifactorial exercise program; mm performance, gait, endurance and power (force with speed) Gait Speed associated with survival in all studies 1.0 m/s benchmark

26 Lifestyle Modifications thedesigninspiration.com/ category/photos Thediabetesworld.com Ihealthyinfo.com

27 Proof is in the pudding Boult et al: randomized controlled intervention trial with geriatric evaluation & targeted management Intervention results: Decreased health care utilization, improved depressive symptoms, & slowed rate of functional decline. Critical importance of ensuring IDT specific recommendations are implemented.

28 Poor implementation of recommendations from the comprehensive team is the main reason management is less effective. Patient adherence to treatment plans also determines the effectiveness of comprehensive geriatric assessment. Physicians are more likely to implement the plan and patients are more likely to adhere to it if the patient and primary care physician share a collaborative relationship

29 Robust Cancer Screening / Diagnostic Testing Lifestyle Modification Smoking Cessation Strengthening Exercise Pre-frail Lifestyle Modification Comprehensive Assessment and IDT intervention Physical and Occupational Therapy for individualized dynamic program Diagnostic testing only as needed to determine interventions FRAIL Aggressive screening and diagnostics can be detrimental Modified exercise for strengthening, mobility and balance as tolerated Eventual palliative / supportive care

30 PACE: Although it is not yet clear that the PACE model offers clear monetary or health outcome advantages over traditional care, the model provides interdisciplinary team care that has proven effective in other health care models for older adults. Frailty in older adults: Insights and interventions. Espinoza, Sara; Walston, Jeremy D. Cleveland Clinic Journal of Medicine, Vol. 72, No. 12, , p

31

32 1. Espinoza, Sara; Walston, Jeremy D. Cleveland Clinic. Frailty in older adults: Insights and interventions. Journal of Medicine, Vol. 72, No. 12, , p Lally, Frank and Crome, Peter. Understanding Frailty. Postgraduate Medical Journal Jan; 83(975): Dennis T. Villareal, M.D., Suresh Chode, M.D., Nehu Parimi, M.D., David R. Sinacore, P.T., Ph.D., Tiffany Hilton, P.T., Ph.D., Reina Armamento-Villareal, M.D., Nicola Napoli, M.D., Ph.D., Clifford Qualls, Ph.D., and Krupa Shah, M.D., M.P.H. Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults. N Engl J Med 2011; 364: March 31, Fried, Linda P, Tangen, Catherine M, Walston, Jeremy, Newman, Anne B, Hirsch, Calvin, Gottdiener, J, Seeman, Teresa, Kop, Willem, Burke, Gregory and McBurnie, Mary Ann. Frailty in Older Adults: Evidence for a Phenotype. Journal of Gerontol A Biol Sci Med Sci(2001) 56 (3): M Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc 2003; 51:

33 6. Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. Lancet 1999; 353: Espinoza, Sara; Hazuda, Helen. Frailty Prevalence and Neighborhood Residence in Older Mexican Americans: The San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society, Vol. 63, No. 1, , Boult C, Boult LB, Morishita L, Dowd B, Kane RL, Urdangarin CF. A randomized clinical trial of outpatient geriatric evaluation and management. J Am Geriatr Soc 2001; 49: Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993; 342: Shah PN, Maly RC, Frank JC, Hirsch SH, Reuben DB. J Managing geriatric syndromes: what geriatric assessment teams recommend, what primary care physicians implement, what patients adhere to. Am Geriatr Soc 1997; 45: Miller ME, Rejeski WJ, Reboussin BA, Ten Have TR, Ettinger WH. Physical activity, functional limitations, and disability in older adults. J Am Geriatr Soc 2000; 48:

34 The power to question is the basis of all human progress. Indira Ghandi Edith Haage, PT, GCS

FRAILTY SYNDROME. dr. Rose Dinda Martini, Sp.PD, K-Ger

FRAILTY SYNDROME. dr. Rose Dinda Martini, Sp.PD, K-Ger FRAILTY SYNDROME dr. Rose Dinda Martini, Sp.PD, K-Ger Geriatric Division, Internal Medicine Department M. Djamil Hospital Padang Faculty of Medicine, Andalas University, 2018 Medical syndrome Multiple

More information

What is frailty and why it is important

What is frailty and why it is important What is frailty and why it is important Tony Moran North West Knowledge and Intelligence Team Cancer Outcomes Conference 2013 Contents Definitions of frail and frailty Prevalence and measurement Use in

More information

Frailty in Older Mexican Americans

Frailty in Older Mexican Americans Frailty in Older Mexican Americans Kenneth J. Ottenbacher Sealy Center on Aging & PAHO/WHO Collaborating Center on Aging and Health University of Texas Medical Branch Where is Galveston, TX? Galveston,

More information

Pre- Cardiac intervention. Dr. Victor Sim 26 th Sept 2014

Pre- Cardiac intervention. Dr. Victor Sim 26 th Sept 2014 Pre- Cardiac intervention Frailty assessment Dr. Victor Sim 26 th Sept 2014 Defining frailty Lacks consensus (Rockwood CMAJ 2005;173(5):489-95 Introduction) Some consider symptoms, signs, diseases and

More information

Geriatric Assessment & Intervention. The Goal 5/9/2017. Current events. Student Conclave 2017 Fresno State goo.gl/slides/m5d6wm.

Geriatric Assessment & Intervention. The Goal 5/9/2017. Current events. Student Conclave 2017 Fresno State goo.gl/slides/m5d6wm. Geriatric Assessment & Student Conclave 2017 Fresno State goo.gl/slides/m5d6wm Intervention The Goal Active Aging Current events Betty White s 95th birthday (Jan, 2017) Queen Elizabeth II s 91st birthday

More information

Frailty: Challenges and Possible Solutions

Frailty: Challenges and Possible Solutions Frailty: Challenges and Possible Solutions EMA Workshop: Ensuring safe and effective medicines for an ageing population Niccolò Marchionni Professor of Geriatrics University of Florence, Italy 22-23 March

More information

public health crisis! Understanding frailty at population level!

public health crisis! Understanding frailty at population level! Frailty as an emerging public health crisis! Understanding frailty at population level! Dr Rónán O Caoimh, MB, MRCPI, MSc, PhD Senior Lecturer in Geriatric Medicine 08/03/2017 A brief history of frailty...

More information

The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly

The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly ORIGINAL ARTICLE Korean J Intern Med 2016;31:594-600 The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly Hee-Won Jung 1,2, Hyun-Jung

More information

Frailty: from Academic Definition to Clinical Applicability

Frailty: from Academic Definition to Clinical Applicability Frailty: from Academic Definition to Clinical Applicability Associate Professor Ruth E. Hubbard October 26 th 2018 Objectives 1. Describe the development of frailty as a concept 2. Provide an overview

More information

Ageing and frailty Facts and myths. Finn Rønholt MD. Ph.d. MPA.

Ageing and frailty Facts and myths. Finn Rønholt MD. Ph.d. MPA. Ageing and frailty Facts and myths Finn Rønholt MD. Ph.d. MPA. Ageing and frailty Facts and myths Ageing Ageing and disease Ageing and frailty Risk scores Physical activity and rehabilitation Most common

More information

Modulate the prevention stategy according to the level of frailty. Prof Leocadio Rodríguez Mañas Hospital Universitario de Getafe

Modulate the prevention stategy according to the level of frailty. Prof Leocadio Rodríguez Mañas Hospital Universitario de Getafe Modulate the prevention stategy according to the level of frailty Prof Leocadio Rodríguez Mañas Hospital Universitario de Getafe CONFLICT OF INTEREST DISCLOSURE I have no potential conflict of interest

More information

March 13, :00 11:00 a.m. CST. Jane F. Potter, MD

March 13, :00 11:00 a.m. CST. Jane F. Potter, MD University of Nebraska Medical Center CAPTURE Collaboration and Proactive Teamwork Used to Reduce Falls March 13, 2012 10:00 11:00 a.m. CST Jane F. Potter, MD Harris Professor of Geriatric Medicine Chief,

More information

Pre-operative Assessment of the Frail Elderly Person at Addenbrookes Hospital. Dr Fay J Gilder Consultant Anaesthetist

Pre-operative Assessment of the Frail Elderly Person at Addenbrookes Hospital. Dr Fay J Gilder Consultant Anaesthetist Pre-operative Assessment of the Frail Elderly Person at Addenbrookes Hospital Dr Fay J Gilder Consultant Anaesthetist Frailty Models A multidimensional state of increased vulnerability Phenotype model

More information

Getting Fit for Transplant. Thuy Koll, MD Assistant Professor Division of Geriatrics Department of Internal Medicine

Getting Fit for Transplant. Thuy Koll, MD Assistant Professor Division of Geriatrics Department of Internal Medicine Getting Fit for Transplant Thuy Koll, MD Assistant Professor Division of Geriatrics Department of Internal Medicine No Disclosures. Objectives Describe frailty in transplant Discuss the role of physical

More information

Pre- Cardiac intervention. Dr. Victor Sim 16 th Oct 2014

Pre- Cardiac intervention. Dr. Victor Sim 16 th Oct 2014 Pre- Cardiac intervention Frailty assessment Dr. Victor Sim 16 th Oct 2014 Topics to cover Defining frailty Pathophysiology of frailty Are current pre-cardiac surgery assessment tools adequate? Why do

More information

Frailty in Older Adults. Farshad Sharifi, MD, MPH Elderly Health Research Center

Frailty in Older Adults. Farshad Sharifi, MD, MPH Elderly Health Research Center Frailty in Older Adults Farshad Sharifi, MD, MPH Elderly Health Research Center 1 Outlines Definition of frailty Significance of frailty Conceptual Frailty Models Pathogenesis of frailty Management of

More information

Frailty Assessment of Urban Homeless Adults

Frailty Assessment of Urban Homeless Adults Frailty Assessment of Urban Homeless Adults Creighton University College of Nursing Lori Rusch PhD RN, Cindy Hadenfeldt EdD RN, Kathy Flecky OTR/OTD, Alex Hall MA, Jenna Woster PhD RN, Pat Nilsson MSN

More information

Screening and treatment of hypertension in older adults: less is more?

Screening and treatment of hypertension in older adults: less is more? WENNBERG INTERNATIONAL COLLABORATIVE SPRING POLICY MEETING 2018 Zürich, April 12th Screening and treatment of hypertension in older adults: less is more? Daniela Anker (1), Brigitte Santos-Eggimann (2),

More information

Ageing Well. Avoiding falls in older people. Prof Martin Vernon NCD Older People. Find Recognise Assess Intervene Long-term.

Ageing Well. Avoiding falls in older people. Prof Martin Vernon NCD Older People. Find Recognise Assess Intervene Long-term. Ageing Well Avoiding falls in older people Prof Martin Vernon NCD Older People 21 October 2016 1 Its not how old we are, but how we are old 2 Key points 1. Demography 2. Frailty & falls 3. Routine frailty

More information

Identifying and Understanding Frailty

Identifying and Understanding Frailty Identifying and Understanding Frailty Dr Dawn Moody Associate National Clinical Director for Older People and Integrated Person-Centred Care, NHS England GPSI Care of Older People, Derbyshire The North

More information

Frailty Assessment: Simplifying the Complex

Frailty Assessment: Simplifying the Complex Frailty Assessment: Simplifying the Complex Natalie Sanders, DO Internal Medicine, Geriatrics Rocky Mountain Geriatrics Conference 2017 U N I V E R S I T Y O F U T A H H E A L T H, 2 0 1 7 OBJECTIVES Define

More information

Frailty in Older Adults

Frailty in Older Adults Frailty in Older Adults John Puxty puxtyj@providencecare Geriatrics 20/20: Bringing Current Issues into Perspective Session Overview Definition of Frailty Strategies for identifying frail older adults

More information

Geriatrics and Cancer Care

Geriatrics and Cancer Care Geriatrics and Cancer Care Roger Wong, BMSc, MD, FRCPC, FACP Postgraduate Dean of Medical Education Clinical Professor, Division of Geriatric Medicine UBC Faculty of Medicine Disclosure No competing interests

More information

Elderly patients with advanced frailty in the community: a qualitative study on their needs and experiences

Elderly patients with advanced frailty in the community: a qualitative study on their needs and experiences 13 th EAPC World Congress Palliative Care the right way forward Prague, May 30 June 2, 2013 Elderly patients with advanced frailty in the community: a qualitative study on their needs and experiences Gabriele

More information

Services for Frailty or Services for Dementia? Dr Gill Turner Lymington New Forest

Services for Frailty or Services for Dementia? Dr Gill Turner Lymington New Forest Services for Frailty or Services for Dementia? Dr Gill Turner Lymington New Forest Hospital gill.turner1@nhs.net @turner_gill Do we have to decide? How Common are they? Frailty up to 25% of those over

More information

Frailty conundrums: dilemmas and unsolved conceptual issues.

Frailty conundrums: dilemmas and unsolved conceptual issues. Roger A. Fielding, PhD Director and Senior Scientist Professor of Nutrition and Medicine Nutrition, Exercise Physiology, and Sarcopenia Laboratory Frailty conundrums: dilemmas and unsolved conceptual issues.

More information

4/26/2012. Laura Grooms, MD Assistant Professor Geriatric Medicine Department of Family and Geriatric Medicine University of Louisville April 20, 2012

4/26/2012. Laura Grooms, MD Assistant Professor Geriatric Medicine Department of Family and Geriatric Medicine University of Louisville April 20, 2012 Laura Grooms, MD Assistant Professor Geriatric Medicine Department of Family and Geriatric Medicine University of Louisville April 20, 2012 Laura Grooms, MD Assistant Professor Geriatric Medicine Department

More information

Frailty. Nicholas Butler MD, MBA Department of Family Medicine University of Iowa

Frailty. Nicholas Butler MD, MBA Department of Family Medicine University of Iowa Frailty Nicholas Butler MD, MBA Department of Family Medicine University of Iowa Doris 84 yo female who comes into your clinic with her daughter. She complains of feeling increasingly fatigued and just

More information

INVITED REVIEW ARTICLE PROCESS OF PHYSICAL DISABILITY AMONG OLDER ADULTS CONTRIBUTION OF FRAILTY IN THE SUPER-AGED SOCIETY

INVITED REVIEW ARTICLE PROCESS OF PHYSICAL DISABILITY AMONG OLDER ADULTS CONTRIBUTION OF FRAILTY IN THE SUPER-AGED SOCIETY Nagoya J. Med. Sci. 74. 31 ~ 37, 2012 INVITED REVIEW ARTICLE PROCESS OF PHYSICAL DISABILITY AMONG OLDER ADULTS CONTRIBUTION OF FRAILTY IN THE SUPER-AGED SOCIETY MASAFUMI KUZUYA Department of Community

More information

Economics of Frailty. Eamon O Shea

Economics of Frailty. Eamon O Shea Economics of Frailty Eamon O Shea Patient Complexity Framework Demography Mutimorbidity Mental health Frailty Social capital Resource utilisation WHO and Frailty Progressive age-related decline in physiological

More information

Frailty Ascertainment: Beginning of the pathway to treatment

Frailty Ascertainment: Beginning of the pathway to treatment Frailty Ascertainment: Beginning of the pathway to treatment Karen Bandeen-Roche, Ph.D. Johns Hopkins Older Americans Independence Center Introduction Whither frailty ascertainment? Geronmetrics a.k.a.:

More information

Overview of epidemiology studies on frailty. Leocadio Rodriguez Mañas Sº de Geriatría

Overview of epidemiology studies on frailty. Leocadio Rodriguez Mañas Sº de Geriatría Overview of epidemiology studies on frailty Leocadio Rodriguez Mañas Sº de Geriatría 1. FRAILTY PREVALENCE a) HIGH INCOME COUNTRIES (HIC) b) LOW AND MEDIUM INCOME COUNTRIES (LAMIC) 2. POTENTIAL EXPLANATIONS

More information

Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease

Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease Prospective Evaluation of the Eyeball Test for Assessing Frailty in Elderly Patients with Valvular Heart Disease Background Frailty is a common occurrence in elderly patients Approximately half of the

More information

Beyond the Next Breath: Controlling Costs and Maximizing COPD Outcomes

Beyond the Next Breath: Controlling Costs and Maximizing COPD Outcomes Beyond the Next Breath: Controlling Costs and Maximizing COPD Outcomes Edith Haage, PT, GCS NewCourtland Senior Services 10/21/2015 NEWCOURTLAND.org 1-888-530-4913 http://www.poliosurvivorsnetwork.org.uk/archive/lincolnshire/library/australia/paleop/ima

More information

The Deconditioned Elderly Patient: Have We Been Getting it Wrong? By: Ernest Roy PT, DPT

The Deconditioned Elderly Patient: Have We Been Getting it Wrong? By: Ernest Roy PT, DPT The Deconditioned Elderly Patient: Have We Been Getting it Wrong? By: Ernest Roy PT, DPT The Debilitated Patient A review of outcomes for > 84,000 patients over 65 y/o revealed: Rate of functional recovery

More information

Comprehensive Assessment of the Frail Older Patient

Comprehensive Assessment of the Frail Older Patient Comprehensive Assessment of the Frail Older Patient Executive Summary Comprehensive geriatric assessment (CGA) is a multidimensional and usually interdisciplinary diagnostic process designed to determine

More information

Biological theory for the construct of intrinsic capacity to be used in clinical settings Matteo Cesari, MD, PhD

Biological theory for the construct of intrinsic capacity to be used in clinical settings Matteo Cesari, MD, PhD Biological theory for the construct of intrinsic capacity to be used in clinical settings Matteo Cesari, MD, PhD World Health Organization Geneva (Switzerland) December 1, 2016 World Health Organization.

More information

Nutritional Assessment in frail elderly. M. Secher, G.Abellan Van Kan, B.Vellas 1st December 2010 Firenze

Nutritional Assessment in frail elderly. M. Secher, G.Abellan Van Kan, B.Vellas 1st December 2010 Firenze Nutritional Assessment in frail elderly M. Secher, G.Abellan Van Kan, B.Vellas 1st December 2010 Firenze Frailty definition Undernutrition as part of the frailty syndrome Nutritional assessment in frail

More information

What is Frailty? National Background and Local Pathways

What is Frailty? National Background and Local Pathways What is Frailty? National Background and Local Pathways Learning Outcomes At the end of the session you will be able to :Know where to go to look at key national resources on frailty. Define frailty. Screen

More information

Care of the Older ED Patient: Triage, Systems, and Accreditation. Don Melady November 30, 2017 Champlain LHIN Senior Friendly Hospital Symposium

Care of the Older ED Patient: Triage, Systems, and Accreditation. Don Melady November 30, 2017 Champlain LHIN Senior Friendly Hospital Symposium Care of the Older ED Patient: Triage, Systems, and Accreditation Don Melady November 30, 2017 Champlain LHIN Senior Friendly Hospital Symposium Disclosure I have no financial or other conflicts of interest

More information

Older people are living longer than before, but are they living healthier?

Older people are living longer than before, but are they living healthier? Older people are living longer than before, but are they living healthier? Trajectories of Frailty among Chinese Older People in Hong Kong between 2001 and 2012: An Age-period-cohort Analysis Ruby Yu,

More information

Frailty and Sarcopenia

Frailty and Sarcopenia Frailty and Sarcopenia Hans Hobbelen Professor in Healthy lifestyle, Ageing and Health Care Hanze University of Applied Sciences Groningen Lotte Kunst Master Geriatric physical therapist Careyn Utrecht

More information

Integrating Geriatrics into Oncology Care

Integrating Geriatrics into Oncology Care Integrating Geriatrics into Oncology Care William Dale, MD, PhD Chief, Geriatrics & Palliative Medicine Director, Specialized Oncology Care & Research in the Elderly (SOCARE) Clinic University of Chicago

More information

Frailty and Aging Managing from a Community Perspective. Dr. John Puxty

Frailty and Aging Managing from a Community Perspective. Dr. John Puxty Frailty and Aging Managing from a Community Perspective Dr. John Puxty puxtyj@providencecare.ca Presenter Disclosure No commercial support received or potential conflicts Learning Objectives The participant

More information

Evaluation of fragility and factors influencing falls in nursing homes. Dr Marie-Laure Seux Geriatrics Broca Hospital May 2013

Evaluation of fragility and factors influencing falls in nursing homes. Dr Marie-Laure Seux Geriatrics Broca Hospital May 2013 Evaluation of fragility and factors influencing falls in nursing homes Dr Marie-Laure Seux Geriatrics Broca Hospital May 2013 Epidemiological data Among the over 65s: 1/3 present at least one fall per

More information

Falls and Mobility. Katherine Berg, PhD, PT and Arielle Berger, MD. Presented by: Ontario s Geriatric Steering Committee

Falls and Mobility. Katherine Berg, PhD, PT and Arielle Berger, MD. Presented by: Ontario s Geriatric Steering Committee Falls and Mobility Katherine Berg, PhD, PT and Arielle Berger, MD Key Learnings Arielle Berger, MD Key Learnings Learn approaches to falls assessment Understand inter-relationship between promoting safe

More information

University of Groningen. Towards tailored elderly care Peters, Lilian L. DOI: /j.jpsychores

University of Groningen. Towards tailored elderly care Peters, Lilian L. DOI: /j.jpsychores University of Groningen Towards tailored elderly care Peters, Lilian L. DOI: 10.1016/j.jpsychores.2013.02.003 IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you

More information

Understanding and Assessing for Frailty

Understanding and Assessing for Frailty Understanding and Assessing for Frailty Dr Gloria Yu Clinical Head of Bexley Integrated Care Consultant Physician in Elderly, General and Stroke Medicine 8 July 2015 Learning objectives What is frailty?

More information

Challenge: the elderly patient with cancer The physical therapists perspective

Challenge: the elderly patient with cancer The physical therapists perspective Challenge: the elderly patient with cancer The physical therapists perspective Aniek Heldens, MSc, PT Christel van Beijsterveld, MSc, PT Department physical therapy, MUMC+ Rehabilitation and functioning,

More information

Chairs: John Lainchbury & Andrew Aitken. Elderly/Frailty

Chairs: John Lainchbury & Andrew Aitken. Elderly/Frailty Frailty Elderly/Frailty Ralph Stewart Chairs: John Lainchbury & Andrew Aitken Elderly/Frailty Ralph Stewart Green Lane Cardiovascular Service and Cardiovascular Research Unit Auckland City Hospital 1 What

More information

A Study of relationship between frailty and physical performance in elderly women

A Study of relationship between frailty and physical performance in elderly women Original Article Journal of Exercise Rehabilitation 2015;11(4):215-219 A Study of relationship between frailty and physical performance in elderly women Bog Ja Jeoung 1, *, Yang Chool Lee 2 1 Department

More information

Quality Care for the Hospitalized Older Adult

Quality Care for the Hospitalized Older Adult Quality Care for the Hospitalized Older Adult Quality Care for the Hospitalized Older Adult Shelley R McDonald, DO, PhD May 19 th, 2018 Objectives To define why the hospital is a dangerous place for older

More information

HIV, Multimorbidity, and Frailty: what s going on? (with apologies to Marvin Gaye)

HIV, Multimorbidity, and Frailty: what s going on? (with apologies to Marvin Gaye) HIV, Multimorbidity, and Frailty: what s going on? (with apologies to Marvin Gaye) Julian Falutz MD, FRCPC Director Comprehensive HIV Aging Initiative Chronic Viral Illness Service Senior Physician, Division

More information

INTEGRATED GERIATRIC AND PRIMARY CARE MANAGEMENT OF FRAIL OLDER ADULTS IN THE COMMUNITY

INTEGRATED GERIATRIC AND PRIMARY CARE MANAGEMENT OF FRAIL OLDER ADULTS IN THE COMMUNITY INTEGRATED GERIATRIC AND PRIMARY CARE MANAGEMENT OF FRAIL OLDER ADULTS IN THE COMMUNITY LM Pérez (1), P Burbano (1), M Hernandez (1), N Gual (1,2), G Liesa (1), E Martin (3), L Tobella (3), MB Enfedaque

More information

Breast cancer in the elderly - is there a role for the geriatrician?

Breast cancer in the elderly - is there a role for the geriatrician? Breast cancer in the elderly - is there a role for the geriatrician? Workshop in Breast Cancer Surgery Aarhus 18 May 2016 Lone Winther Lietzen MD, PhD Department of Geriatrics, Geriatricians? Internal

More information

FRAILTY SCREENING & EMERGENCY DEPARTMENT: Update

FRAILTY SCREENING & EMERGENCY DEPARTMENT: Update FRAILTY SCREENING & EMERGENCY DEPARTMENT: CYRILLE LAUNAY, MD, PHD DEPARTMENT OF MEDICINE UNIVERSITY HOSPITAL OF LAUSANNE MONTREAL, 2018/21/04 CONFLICTS OF INTEREST No potential conflicts of interest HOSPITAL

More information

Improving the Survivorship of Older Adults with Cancer Using Geriatric Assessment

Improving the Survivorship of Older Adults with Cancer Using Geriatric Assessment Improving the Survivorship of Older Adults with Cancer Using Geriatric Assessment Deborah Bacon, RN,BSN Geriatric Oncology Clinical Nurse Coordinator James P Wilmot Cancer Institute Outline Geriatric assessment

More information

Nutrition to prevent and treat sarcopenia in older people

Nutrition to prevent and treat sarcopenia in older people 1 Nutrition to prevent and treat sarcopenia in older people Alfonso J. Cruz-Jentoft Hospital Universitario Ramón y Cajal Madrid, Spain Roma, 17 dicembre 2014 + The objective of Gerontology is not to increase

More information

Recent studies suggest that exercise-training interventions

Recent studies suggest that exercise-training interventions Langlois, F., Vu, T.T.M., Chassé, K., Dupuis, G., Kergoat, M.J., & Bherer, L., (2012). Benefits of physical exercise training on cognition and quality of life in frail older adults. Journals of Gerontology

More information

THE IMPACT OF FRAILTY IN THE OUTCOMES OF HIP FRACTURE SURGERY IN THE ELDERLY PATIENTS. Health Sciences, Lagankhel, Laitpur, Nepal

THE IMPACT OF FRAILTY IN THE OUTCOMES OF HIP FRACTURE SURGERY IN THE ELDERLY PATIENTS. Health Sciences, Lagankhel, Laitpur, Nepal International Journal of Medicine and Pharmaceutical Science (IJMPS) ISSN (P): 2250-0049; ISSN (E): 2321-0095 Vol. 7, Issue 5, Oct 2017, 15-20 TJPRC Pvt. Ltd. THE IMPACT OF FRAILTY IN THE OUTCOMES OF HIP

More information

Interprofessional Care for Elders through 48/5

Interprofessional Care for Elders through 48/5 Interprofessional Care for Elders through 48/5 Janet E. McElhaney, MD, FRCPC, FACP HSN Volunteer Association Chair in Geriatric Research Professor of Medicine, Northern Ontario School of Medicine Health

More information

On Bridging the Theory and Measurement of Frailty

On Bridging the Theory and Measurement of Frailty On Bridging the Theory and Measurement of Frailty K. Bandeen-Roche 1, Ph.D., Q.-L. Xue 2, Ph.D., L. Ferrucci 3, MD, Ph.D., J. Walston 2, MD, J. M. Guralnik 4, MD, Ph.D., P. Chaves 2, MD, Ph.D., S. L. Zeger

More information

The Industry s Views on Older Old Patients

The Industry s Views on Older Old Patients The Industry s Views on Older Old Patients Susanna Del Signore and Philippe Guillet Global Regulatory Policy and Ageing Therapeutic Strategic Unit SANOFI R&D 1 Outline Introduction EFPIA Survey: Overview

More information

Geriatr Gerontol Int 2016; 16: ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH

Geriatr Gerontol Int 2016; 16: ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH bs_bs_banner Geriatr Gerontol Int 2016; 16: 1324 1331 ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH Lower body function as a predictor of mortality over 13 years of follow up: Findings from

More information

Assessing the utility of simple measures of frailty in older hospital-based cardiology patients. by Yong Yong Tew (medical student)

Assessing the utility of simple measures of frailty in older hospital-based cardiology patients. by Yong Yong Tew (medical student) Assessing the utility of simple measures of frailty in older hospital-based cardiology patients by Yong Yong Tew (medical student) Declaration No conflict of interest. Ethical considerations Reviewed and

More information

An Ounce of Prevention: Using Resistance training to optimize function in (pre-)frailty

An Ounce of Prevention: Using Resistance training to optimize function in (pre-)frailty An Ounce of Prevention: Using Resistance training to optimize function in (pre-)frailty CHRISTINA PREVETT (NOWAK) MSCPT, CSCS, PHD(C) REGISTERED PHYSIOTHERAPIST/ CO-OWNER STAVE OFF Objectives Aging as

More information

Frailty Predicts Recurrent but Not Single Falls 10 Years Later in HIV+ and HIV- Women

Frailty Predicts Recurrent but Not Single Falls 10 Years Later in HIV+ and HIV- Women Frailty Predicts Recurrent but Not Single Falls 10 Years Later in HIV+ and HIV- Women Anjali Sharma, Deborah Gustafson, Donald R Hoover, Qiuhu Shi, Michael W Plankey, Phyllis C Tien, Kathleen Weber, Michael

More information

Frailty, Sarcopenia and Outcomes after Emergency Surgery Admissions Across Wessex

Frailty, Sarcopenia and Outcomes after Emergency Surgery Admissions Across Wessex Frailty, Sarcopenia and Outcomes after Emergency Surgery Admissions Across Wessex Wessex Surgical Trainee Research Collaborative Malcolm A West MD MRCS PhD NIHR Clinical Lecturer in Surgery ST6 Colorectal

More information

Outcomes in GEM models of geriatric care: How do we measure success? Disclosure. Objectives. Geriatric Grand Rounds

Outcomes in GEM models of geriatric care: How do we measure success? Disclosure. Objectives. Geriatric Grand Rounds Geriatric Grand Rounds Tuesday, October 7, 2008 12:00 noon Dr. Bill Black Auditorium Glenrose Rehabilitation Hospital Outcomes in GEM models of geriatric care: How do we measure success? In keeping with

More information

[Rescuing the Frail Elderly

[Rescuing the Frail Elderly [Rescuing the Frail Elderly & Failure to Rescue] Chris Subbe Conflicts of Interest Populations Mrs LLewelyn Frail elderly patient & RRS Defining Frailty Impact on Outcomes in Critical Illness Operationalising

More information

When asked to define frailty, the image of a thin,

When asked to define frailty, the image of a thin, PROGRESS IN GERIATRICS The Identification of Frailty: A Systematic Literature Review Shelley A. Sternberg, MD, MSCE, * Andrea Wershof Schwartz, MD, MPH, Sathya Karunananthan, MSc, Howard Bergman, MD, and

More information

Connie W. Bales, PhD, RD: Written Testimony before the. United States Senate Special Committee on Aging. July 12, 2107

Connie W. Bales, PhD, RD: Written Testimony before the. United States Senate Special Committee on Aging. July 12, 2107 Connie W. Bales, PhD, RD: Written Testimony before the United States Senate Special Committee on Aging July 12, 2107 Good morning Chairman Collins, Ranking Member Casey, and members of the Aging Committee.

More information

Frailty assessment in solid organ transplantation

Frailty assessment in solid organ transplantation Frailty assessment in solid organ transplantation Kenneth Rockwood MD, FRCPC, FRCP Division of Geriatric Medicine Dalhousie University & Capital District Health Authority Halifax, Nova Scotia, Canada Read

More information

The Frail and At-Risk Critically Ill: Screening and Outcomes

The Frail and At-Risk Critically Ill: Screening and Outcomes The Frail and At-Risk Critically Ill: Screening and Outcomes Sean M Bagshaw, MD, MSc Department of Critical Care Medicine, University of Alberta, Edmonton, Canada CCCF, Toronto, Canada October 2, 2017

More information

FRAILTY AND COGNITION IN THE ASSESSMENT OF VASCULAR SUGERY PATIENTS WHY WHY DISCLOSURES. INDIVIDUAL None. INSTITUTIONAL Cook, Inc

FRAILTY AND COGNITION IN THE ASSESSMENT OF VASCULAR SUGERY PATIENTS WHY WHY DISCLOSURES. INDIVIDUAL None. INSTITUTIONAL Cook, Inc DISCLOSURES FRAILTY AND COGNITION IN THE ASSESSMENT OF VASCULAR SUGERY PATIENTS INDIVIDUAL None INSTITUTIONAL Cook, Inc Not discussing off-label use of anything WHY WHY Frailty increases with age Frailty

More information

Factors Associated with Limitations in Daily Activity Among Older HIV+ Adults

Factors Associated with Limitations in Daily Activity Among Older HIV+ Adults Factors Associated with Limitations in Daily Activity Among Older HIV+ Adults KM Erlandson, K Wu, R Kalayjian, S Koletar, B Taiwo, FJ Palella Jr, K Tassiopoulos and the A5322 Team Background Growing burden

More information

William C Miller, PhD, FCAOT Professor Occupational Science & Occupational Therapy University of British Columbia Vancouver, BC, Canada

William C Miller, PhD, FCAOT Professor Occupational Science & Occupational Therapy University of British Columbia Vancouver, BC, Canada William C Miller, PhD, FCAOT Professor Occupational Science & Occupational Therapy University of British Columbia Vancouver, BC, Canada THE L TEST MANUAL Version: November 2014 Table of Contents Introduction...

More information

The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-Year Follow-up

The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-Year Follow-up Journal of Gerontology: MEDICAL SCIENCES The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. cite journal as: J Gerontol A Biol Sci Med Sci All rights

More information

Ageing Well. The challenge of our ageing population. Martin Vernon NCD Older People. Find Recognise Assess Intervene Long-term.

Ageing Well. The challenge of our ageing population. Martin Vernon NCD Older People. Find Recognise Assess Intervene Long-term. Ageing Well The challenge of our ageing population Martin Vernon NCD Older People 7 th June 2017 1 Projected UK age structure Foresight, 2016 2 Ageing impacts 15 million live with a long term condition

More information

Frailty as deficit accumulation

Frailty as deficit accumulation Frailty as deficit accumulation Kenneth Rockwood MD, FRCPC, FRCP Division of Geriatric Medicine Dalhousie University & Capital District Health Authority Halifax, Canada Read it as: Rockwood K, Mitnitski

More information

Living well with frailty. JOHN YOUNG National Clinical Director for the Frail Elderly & Integration, NHS England

Living well with frailty. JOHN YOUNG National Clinical Director for the Frail Elderly & Integration, NHS England Living well with frailty JOHN YOUNG National Clinical Director for the Frail Elderly & Integration, NHS England A LTC rarely travels alone Kent Whole Population Dataset: Interim Report 2014 The burden

More information

36-Item Short Form Survey (SF-36) Versus Gait Speed as a Predictor of Preclinical Mobility Disability in Older Women

36-Item Short Form Survey (SF-36) Versus Gait Speed as a Predictor of Preclinical Mobility Disability in Older Women 36-Item Short Form Survey (SF-36) Versus Gait Speed as a Predictor of Preclinical Mobility Disability in Older Women May 2018 WHI Investigator Meeting MS 2744 J Am Geriatr Soc. 2018 Feb 10. doi: 10.1111/jgs.15273.

More information

Measures of Physical Performance and Risk for Progressive and Catastrophic Disability: Results From the Women s Health and Aging Study

Measures of Physical Performance and Risk for Progressive and Catastrophic Disability: Results From the Women s Health and Aging Study Journal of Gerontology: MEDICAL SCIENCES 2005, Vol. 60A, No. 1, 74 79 Copyright 2005 by The Gerontological Society of America Measures of Physical Performance and Risk for Progressive and Catastrophic

More information

Geriatric screening tools in older patients with cancer

Geriatric screening tools in older patients with cancer Geriatric screening tools in older patients with cancer Pr. Elena Paillaud Henri Mondor hospital, Créteil, France University Paris-Est Créteil CONFLICT OF INTEREST DISCLOSURE I have the following potential

More information

Changing care systems for people with frailty. John Young

Changing care systems for people with frailty. John Young Changing care systems for people with frailty John Young Geriatrician, Bradford Hospitals Trust, UK National Clinical Director for Integration & the Frail Elderly, NHS England (john.young@bthft.nhs.uk)

More information

Community Programs & Minimising Frailty in Older People

Community Programs & Minimising Frailty in Older People VITALITY CLUB Community Programs & Minimising Frailty in Older People Presented by Theeban Rubasingham & Ahilan St George Vitality Club Directors & Co-Founders Outline of talk: 1. The Founders 2. The Vitality

More information

Physical Function & Frailty in HIV

Physical Function & Frailty in HIV Physical Function & Frailty in HIV Kristine M. Erlandson, MD Assistant Professor University of Colorado Divisions of Infectious Diseases & Geriatric Medicine Research funding through the National Institutes

More information

Healthy Ageing with HIV

Healthy Ageing with HIV Healthy Ageing with HIV (It s More than Just Laboratory Values) Barcelona October 19 th 2014 Margarita Robau Gassiot mrobau@clinic.ub.es Hospital Clínic Barcelona Outline/ Agenda 1. What is Ageing? 2.

More information

Old age, polymorbidity and stroke, a new epidemy?

Old age, polymorbidity and stroke, a new epidemy? Old age, polymorbidity and stroke, a new epidemy? Professor Gary Ford Chief Executive Officer, Oxford Academic Health Science Network Consultant Stroke Physician, Oxford University Hospitals Visiting Professor

More information

New York City Development of the Geriatric Collaborative

New York City Development of the Geriatric Collaborative New York City - 2014 Development of the Geriatric Collaborative The Clinical Problem More than 50% persons age 65 years will have some surgical procedure in the remainder of his or her lifetime Outcome

More information

9/19/2018. Common Medical Issues and Management in the Geriatric Trauma Patient. Disclosures. Objectives. I have no financial disclosures

9/19/2018. Common Medical Issues and Management in the Geriatric Trauma Patient. Disclosures. Objectives. I have no financial disclosures Common Medical Issues and Management in the Geriatric Trauma Patient 2018 UW Medicine EMS & Trauma Conference September 17, 2018 Joe C. Huang, M.D. Clinical Instructor Medical Director, Geriatrics-Palliative

More information

Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults

Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults T h e n e w e ngl a nd j o u r na l o f m e dic i n e original article Weight Loss,, or Both and Physical Function in Obese Older Adults Dennis T. Villareal, M.D., Suresh Chode, M.D., Nehu Parimi, M.D.,

More information

Frailty as deficit accumulation

Frailty as deficit accumulation Frailty as deficit accumulation Kenneth Rockwood MD, FRCPC, FRCP Division of Geriatric Medicine Dalhousie University & Capital District Health Authority Halifax, Canada Read it as: Rockwood K, Mitnitski

More information

The Elusive Frailty Formula: Shining the geriatric light on the 1-5% Dr John Puxty

The Elusive Frailty Formula: Shining the geriatric light on the 1-5% Dr John Puxty The Elusive Frailty Formula: Shining the geriatric light on the 1-5% Dr John Puxty puxtyj@providencecare.ca Health Care use is not uniform by Seniors How common is Frailty? Approximately10% of all individuals

More information

Research Report. The Effects of a Home-Based Exercise Program on Physical Function in Frail Older Adults

Research Report. The Effects of a Home-Based Exercise Program on Physical Function in Frail Older Adults The Effects of a Home-Based Exercise Program on Physical Function in Frail Older Adults Patricia Noritake Matsuda, PT, DPT; Anne Shumway-Cook, PT, PhD, FAPTA; Marcia A. Ciol, PhD ABSTRACT Background and

More information

Evaluating Functional Status in Hospitalized Geriatric Patients. UCLA-Santa Monica Geriatric Medicine Didactic Lecture Series

Evaluating Functional Status in Hospitalized Geriatric Patients. UCLA-Santa Monica Geriatric Medicine Didactic Lecture Series Evaluating Functional Status in Hospitalized Geriatric Patients UCLA-Santa Monica Geriatric Medicine Didactic Lecture Series Case 88 y.o. woman was admitted for a fall onto her hip. She is having trouble

More information

11/2/2017. Individualized Seating and Wheeled Mobility for the Older Adult

11/2/2017. Individualized Seating and Wheeled Mobility for the Older Adult 1 2 3 4 for the Older Adult Course Objectives Upon completion of this course the participant will be able to: Recognize the need for individualized seating and wheeled mobility Understand seating as it

More information

2004, Editrice Kurtis

2004, Editrice Kurtis Aging Clinical and Experimental Research Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study Ingvild Saltvedt 1,2, Turi Saltnes 2, Ellen-Sofie

More information

SARCOPENIA FRAILTY AND PROTEINS

SARCOPENIA FRAILTY AND PROTEINS SARCOPENIA FRAILTY AND PROTEINS ALFONSO J. CRUZ-JENTOFT SERVICIO DE GERIATRÍA HOSPITAL UNIVERSITARIO RAMÓN Y CAJAL (IRICYS) UNIVERSIDAD EUROPEA DE MADRID MADRID, SPAIN THERE IS NO UNIVERSALLY AGREED DEFINITION

More information

The geriatric syndrome of frailty is a syndrome of physical

The geriatric syndrome of frailty is a syndrome of physical CLINICAL INVESTIGATIONS The Association Between Obesity and the Frailty Syndrome in Older Women: The Women s Health and Aging Studies Caroline S. Blaum, MD, MS, w Qian Li Xue, PhD, z Elisabete Michelon,

More information