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Frailty as an Effect Modifier in Randomized Controlled Trials: A Systematic Review.

BackgroundThe effect of clinical interventions may vary by patients' frailty status. Understanding treatment effect heterogeneity by frailty could lead to frailty-guided treatment strategies and reduce overtreatment and undertreatment. This systematic review aimed to examine the effect modification by frailty in randomized controlled trials (RCTs) that evaluate pharmacological, non-pharmacological, and multicomponent interventions.MethodsWe searched PubMed, Web of Science, EMBASE, and ClinicalTrial.gov, from their inception to 8 December 2023. Two reviewers independently extracted trial data a

Integration of geriatric assessment-guided care plan modifications and interventions into clinical paths of older adults with cancer (GORILLA): a feasibility approach.

PurposeA comprehensive geriatric assessment (CGA) followed by geriatric assessment-guided interventions was demonstrated to reduce treatment-related toxicities CTCAE III°-V° in older adults with cancer undergoing systemic cancer treatments, but implementation remains insufficient. Thus, we aimed to evaluate the feasibility of implementing CGA into routine care and multidisciplinary tumor boards (MDTs) in Germany within a bicentric feasibility trial (DRKS00035569; 19.12.2024).MethodsPatients ≥ 65 years with positive geriatric screening (G8 Results75 patients received CGA (62.5% females). Of tho

Compassionate Communication and Advance Care Planning to improve End-of-life Care in Treatment of Haematological Disease 'ACT': Study Protocol for a Cluster-randomized trial.

IntroductionTo support the implementation of advance care planning and serious illness conversations in haematology, a previously developed conversation intervention titled 'Advance Consultations Concerning your Life and Treatment' (ACT) was found feasible. This study aims to investigate the effect of ACT on the quality of end-of-life care in patients with haematological malignancy and their informal caregivers.Methods and analysisThe study is a nationwide 2-arm cluster randomised trial randomising 40 physician-nurse clusters across seven haematological departments in Denmark to provide standa

Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions.

With the rapidly aging population, frailty, characterized by an increased risk of adverse outcomes, has become a major public health problem globally. Several frailty guidelines or consensuses recommend screening for frailty, especially in primary care settings. However, most of the frailty assessment tools are based on questionnaires or physical examinations, adding to the clinical workload, which is the major obstacle to converting frailty research into clinical practice. Medical data naturally generated by routine clinical work containing frailty indicators are stored in electronic health r

Nutritional Issues and Self-care Measures Adopted by Cancer Patients Attending a University Hospital in Turkey.

ObjectiveThis study aimed to assess the nutritional status of cancer patients and the self-care measures they adopted as a response to nutritional problems.MethodsThis descriptive study included seventy cancer patients staying in the oncology and internal disease clinics of a university hospital in Turkey. Data were collected using a questionnaire with 29 questions.ResultsThe mean age of participants was 40.2 ± 1.82 years. Approximately, 62.9% of the patients ate only half of the meals offered to them, 65.7% experienced weight loss, and 45.7% had difficulty eating their meals on their own. Mor

Association of Deviation From Glycated Hemoglobin (HbA1c) Target in the Guidelines for the Treatment of Diabetes in Older Patients With Place of Care and Interval Between HbA1c Tests Among Older Patients Receiving Home Medical Care.

AimWe examined the association of deviation from the glycated hemoglobin (HbA1c) target proposed in the Guidelines for the Treatment of Diabetes in Older Patients in Japan 2016 with the place of care and interval between HbA1c tests among older patients with diabetes.MethodsWe included patients aged > 65 years receiving biweekly home medical care by physicians from four clinics in Tokyo and Kanagawa Prefecture for > 2 months with ≥ 2 HbA1c tests between November 14, 2016 and November 13, 2021. Among patients meeting the glycemic target according to the above guidelines at the beginning of the

Patient-reported symptoms and performance status before palliative radiotherapy in geriatric cancer patients (octogenarians).

PurposeTo evaluate differences in baseline parameters including performance status and self-reported symptom burden between geriatric and non-geriatric cancer patients, and to assess the hypothesis that these factors might predispose older patients to incomplete radiotherapy and short survival.Patients and methodsRetrospective comparison of geriatric and non-geriatric patients treated with palliative radiotherapy (age ⩾80 years and ResultsMost patients received radiotherapy for bone metastases, commonly 5-10 fractions. Geriatric patients had significantly less pain at rest and depression. No s

Protocol of the optimal study: Optimization of polypharmacy in geriatric oncology - A randomized controlled trial.

BackgroundPolypharmacy is very common in older cancer patients and these patients are particularly vulnerable to drug-drug interactions and adverse drug reactions because they often receive chemotherapy and symptom-relieving agents.MethodsThe primary aim of the randomized, controlled Optimization of Polypharmacy in Geriatric Oncology (OPTIMAL) trial is to test whether an advisory letter with the results of a comprehensive medication review conducted with the Fit fOR The Aged (FORTA) list to the caring physician in rehabilitation clinics improves the quality of life (QoL) of older cancer patien

CHARM is prognostic of geriatric morbidity and toxicity after allogeneic transplant for older adults: BMT CTN 1704 study.

AbstractDespite concerns about the toxicity of allogeneic hematopoietic cell transplantation (alloHCT) in older patients, prospective data characterizing prevalence or risk stratification for geriatric morbidity such as disability or frailty are limited. We prospectively assessed the prognostic impact of the novel composite health assessment risk model (CHARM), a score established to predict 1-year nonrelapse mortality (NRM), among 1105 patients aged ≥60 years enrolled on the Bone Marrow Transplant Clinical Trials Network Study 1704. Secondary end points were assessed post-alloHCT at day 100 (

Factors Influencing Global Health Related Quality of Life in Elderly Cancer Patients: Results of a Secondary Data Analysis.

Cancer treatment for elderly patients is often complicated by poor physical condition, impaired functioning and comorbidities. Patient reported health related quality of life (HRQOL) can contribute to decisions about treatment goals and supportive therapy. Knowledge about factors influencing HRQOL is therefore needed for the development of supportive measures and care pathways. An exploratory secondary data analysis on 518 assessments of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30) and the elderly module (EORTC QLQ-ELD14) was perform

Сопоставление эффективности различных методов тренировки для взрослых МСИ: сетевой мета-анализ.

Небольшие когнитивные расстройства (MCI) считаются доклинической или продромальной стадией болезни Альцгеймера (AD). Пациенты MCI имеют годовую вероятность развития к слабоумию 10%-15%, намного выше, чем нормальные престарелые1%-2%). Мы провели сетевой метаанализ (NMA) относительно эффективности различных способов упражнений для взрослых, охваченных MCI. Компьютерный поиск MethodsA был проведен в Эмбасе, Пубмеде, Кокранской библиотеке и Сети наук для RCT о последствиях тренировок для пациентов MCI с момента их создания по февраль. 22, 2025. Two Эксперты, проводящие обзор, несут независимую отв

Leading Causes of In-Hospital Death of Older Patients of Different Age Groups in Shanghai

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… In the study of Goldberg et al, they studied the causes of the death of older patients in geriatric nursing homes in the United States and found the diseases leading to the death of older patients in geriatric nursing homes are Alzheimer’s/dementia, cardiac/cerebrovascular and pulmonary. 6 This research … result is different from ours since the geriatric nursing home in the United States is not a formal general hospital. …

Individualized Hospital to Home, Exercise-Nutrition Self-Managed Intervention for Pre-Frail and Frail Hospitalized Older Adults: The INDEPENDENCE Randomized Controlled Pilot Trial.

PurposePre-frailty and frailty in older adults are associated with poor health outcomes and increase health-care costs, and further worsening during hospitalization. This study aimed to examine the effect of an individualized hospital to home, exercise-nutrition self-managed intervention for pre-frail and frail hospitalized older adults.Patients and methodsOlder adults admitted to an acute medical unit of a tertiary hospital in South Australia who were pre-frail or frail were recruited from September 2020 to June 2021, randomized to either control or intervention group and followed up at 3 and

Secondary fracture prevention in primary care: a narrative review.

The global burden of osteoporosis continues to rise with an ageing population. Untreated osteoporotic fractures not only heighten the risk of subsequent fractures but are associated with excess mortality. Although primary care guidelines consistently stress the importance of secondary fracture prevention, fewer than 20% of patients are appropriately treated for osteoporosis following an initial osteoporotic fracture. This worldwide phenomenon is known as the osteoporosis care gap. This literature review examines the barriers to secondary fracture prevention in primary care and evaluates the ef

Treatment-related Decisional Conflict, Quality of Life, and Comorbidity in Older Adults with Cancer.

ObjectiveThe present study aims to examine the relationships between and among cancer treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer.MethodsA convenience sample of 200 older adults was recruited from outpatient medical oncology and radiation oncology practices in the northeastern United States. A cross-sectional, descriptive, correlational study design was used employing a survey method. Survey instruments included the Decisional Conflict scale (DCS) (with five subscales, including informed, values clarity, support, uncertainty, and effectiv

Randomized controlled trial of geriatric consultation versus standard care in older adults with hematologic malignancies.

We conducted a randomized controlled trial in older adults with hematologic malignancies to determine the impact of geriatrician consultation embedded in our oncology clinic alongside standard care. From February 2015 to May 2018, transplant-ineligible patients aged ≥75 years who presented for initial consultation for lymphoma, leukemia, or multiple myeloma at Dana-Farber Cancer Institute (Boston, MA, USA) were eligible. Pre-frail and frail patients, classified based on phenotypic and deficit-accumulation approaches, were randomized to receive either standard oncologic care with or without con

HCT Frailty Scale (HCT-FS) for assessing frailty in adult candidates for allogeneic haematopoietic cell transplantation: an international prospective, observational cohort study.

BackgroundFrailty assessment has emerged as a key component of pre-transplant evaluation. We aimed to validate, across international cohorts, the Hematopoietic Cell Transplantation Frailty Scale (HCT-FS) for the assessment of frailty in adult candidates for allogenic hematopoietic cell transplantation (allo-HCT). HCT-FS is designed for integration into routine workflows using existing resources.MethodsIn this prospective, observational cohort study, we evaluated the performance of HCT-FS, a frailty scale that categorises patients as fit, pre-frail, or frail based on a cumulative weighted score

Умственные меры по охране психического здоровья взрослых работников: обзор.

Справочная информация: Цель этого аналитического обзора заключалась в выявлении и обобщении данных о мерах, принимаемых на основе сознательности и направленных на достижение результатов в области психического здоровья работающих взрослых. Методы: Был проведен всеобъемлющий поиск four электронные базы данных (PubMed, Scopus, Web of Science и OT проситель) до октября 2025. Обзор проводился в соответствии с руководящими принципами ПРИСМА-СКР. Методологическое качество оценивалось с использованием классификации Оксфордского центра научно обоснованной медицины (OCEBM). Протокол был в перспективе за

Интракорпоральное состояние как фактор риска для дисфагии в небольничных пожилых людях: обновленный систематический обзор.

В соответствии с руководящими принципами PRISMA был проведен систематический поиск по базам данных PubMed, Scopus и Cochrane для проведения первоначальных исследований, опубликованных в период с 2015 по 2025 год. В рамках критериев интеграции основное внимание уделялось исследованиям по предметам в возрасте 65 лет и старше, в ходе которых изучалась взаимосвязь между состоянием перорального здоровья и УВ. Методологическое качество оценивалось с использованием контрольного перечня критических оценок ЯБК. Методы анализа и критерии включения были задокументированы в протоколе, опубликованном в Пер

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices