BOOK
Screening and Prevention in Geriatric Medicine, An Issue of Clinics in Geriatric Medicine, E-Book
Danelle Cayea | Samuel C. Durso
(2017)
Additional Information
Book Details
Abstract
This issue of Clinics in Geriatric Medicine, Guest Edtied by Drs. Danelle Cayea and Samuel C. Durso, is devoted to Screening and Prevention in Geriatric Medicine. Articles in this issue include: The Medicare Annual Wellness Visit; Individualized Cancer Screening; Frailty; Medication Appropriateness; Geriatric Syndromes; Mental Health; Cardiovascular Screening; Preoperative Screening; Safety; Substance Use Disorders; Sexuality; Vaccines; and Excercise.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Screening and Prevention in Geriatric Medicine\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Screening and Prevention in the Modern Era | vii | ||
| The Medicare Annual Wellness Visit | vii | ||
| Individualized Approach to Cancer Screening in Older Adults | vii | ||
| Frailty Screening and Interventions: Considerations for Clinical Practice | vii | ||
| Screening for Medication Appropriateness in Older Adults | vii | ||
| Screening for Geriatric Syndromes: Falls, Urinary/Fecal Incontinence, and Osteoporosis | viii | ||
| Screening Older Adults for Mental Disorders | viii | ||
| Cardiovascular Screening and Primary Prevention in Older Adults | viii | ||
| Preoperative Screening | viii | ||
| Driving Dilemmas: A Guide to Driving Assessment in Primary Care | ix | ||
| Prevention and Screening of Unhealthy Substance Use by Older Adults | ix | ||
| Vaccinations in Older Adults | ix | ||
| Exercise and Older Adults | ix | ||
| CLINICS IN GERIATRIC MEDICINE\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| May 2018 | xi | ||
| August 2018 | xi | ||
| November 2018 | xi | ||
| RECENT ISSUES | xi | ||
| November 2017 | xi | ||
| August 2017 | xi | ||
| May 2017 | xi | ||
| Preface:\rScreening and Prevention in the Modern Era | xiii | ||
| REFERENCES | xvi | ||
| The Medicare Annual Wellness Visit | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| ELEMENTS OF THE ANNUAL WELLNESS VISIT | 2 | ||
| GERIATRIC ASSESSMENT IN THE ANNUAL WELLNESS VISIT | 3 | ||
| Cognitive Screening | 3 | ||
| Functional Assessment | 4 | ||
| Fall Risk Screening | 5 | ||
| Depression Screening | 5 | ||
| Preventive Health Care | 6 | ||
| Advance Directive Documentation | 6 | ||
| STRATEGIES FOR INCORPORATING THE ANNUAL WELLNESS VISIT INTO CLINIC | 6 | ||
| Pharmacist-Led Visit | 6 | ||
| Nurse-Led Visit | 7 | ||
| Shared Appointment | 7 | ||
| Interprofessional Team Visit | 7 | ||
| SUMMARY | 7 | ||
| REFERENCES | 8 | ||
| Individualized Approach to Cancer Screening in Older Adults | 11 | ||
| Key points | 11 | ||
| INTRODUCTION | 11 | ||
| WHAT TO CONSIDER IN AN INDIVIDUALIZED APPROACH TO CANCER SCREENING | 12 | ||
| Magnitude of Benefit and Time Horizon to Benefit | 12 | ||
| Potential Harms and Burdens of Screening | 13 | ||
| Informed Patient Preference | 14 | ||
| WHAT DO THE GUIDELINES SAY REGARDING INDIVIDUALIZED CANCER SCREENING? | 15 | ||
| Breast Cancer Screening | 15 | ||
| Colorectal Cancer Screening | 15 | ||
| Prostate Cancer Screening | 17 | ||
| Common Theme | 17 | ||
| TOOLS THAT FACILITATE INDIVIDUALIZED APPROACH TO CANCER SCREENING | 17 | ||
| Tools to Estimate Risk of Cancer | 17 | ||
| Tools to Estimate Life Expectancy | 18 | ||
| Frameworks for Individualizing Cancer Screening Decisions | 18 | ||
| CHALLENGES AROUND INDIVIDUALIZED CANCER SCREENING | 19 | ||
| SUMMARY | 20 | ||
| REFERENCES | 20 | ||
| Frailty Screening and Interventions | 25 | ||
| Key points | 25 | ||
| INTRODUCTION TO FRAILTY | 25 | ||
| Frailty Screening Instruments | 26 | ||
| SCREENING FOR FRAILTY IN THE CLINICAL SETTING | 27 | ||
| Screening for Frailty in General Clinical Practice | 27 | ||
| Screening for Frailty in Subspecialty Populations | 27 | ||
| Challenges and Emerging Areas in Screening for Frailty | 32 | ||
| INTERVENTIONS FOR FRAILTY AND PREVENTING THE DEVELOPMENT OF FRAILTY | 32 | ||
| Frailty Interventions | 32 | ||
| Preventing the Development of Frailty | 34 | ||
| SUMMARY | 34 | ||
| REFERENCES | 34 | ||
| Screening for Medication Appropriateness in Older Adults | 39 | ||
| Key points | 39 | ||
| INTRODUCTION | 39 | ||
| IMPACT OF MEDICATION INAPPROPRIATENESS ON HEALTH OUTCOMES | 41 | ||
| RATIONALE FOR SCREENING FOR MEDICATION APPROPRIATENESS | 42 | ||
| HOW TO SCREEN FOR MEDICATION APPROPRIATENESS | 42 | ||
| Overview | 42 | ||
| Targeted Reviews | 42 | ||
| Dashboards, Reports, and Electronic Medical Records | 42 | ||
| Online Resources to Screen for Medication Appropriateness | 43 | ||
| Utilization of Pharmacists | 43 | ||
| Challenges and Considerations | 48 | ||
| General | 48 | ||
| Community | 48 | ||
| Hospital | 48 | ||
| Nursing home | 48 | ||
| FUTURE DIRECTIONS TO IMPROVE SCREENING FOR MEDICATION APPROPRIATENESS | 49 | ||
| Semiautomation for Faster Medication Appropriateness Screening | 49 | ||
| National Efforts | 50 | ||
| STRATEGIES FOR IMPROVING SCREENING FOR MEDICATION APPROPRIATENESS | 51 | ||
| SUMMARY | 52 | ||
| REFERENCES | 52 | ||
| Screening for Geriatric Syndromes | 55 | ||
| Key points | 55 | ||
| INTRODUCTION | 55 | ||
| SCREENING FOR FALLS | 56 | ||
| SCREENING FOR URINARY AND FECAL INCONTINENCE | 59 | ||
| Screening for Urinary Incontinence | 59 | ||
| Screening for Fecal Incontinence | 60 | ||
| SCREENING FOR OSTEOPOROSIS | 61 | ||
| SUMMARY | 64 | ||
| REFERENCES | 64 | ||
| Screening Older Adults for Mental Disorders | 69 | ||
| Key points | 69 | ||
| INTRODUCTION | 69 | ||
| Incentives | 70 | ||
| DEPRESSION | 70 | ||
| Instruments | 70 | ||
| ANXIETY | 70 | ||
| Instruments | 72 | ||
| COGNITIVE IMPAIRMENT | 72 | ||
| Instruments | 74 | ||
| SUMMARY | 76 | ||
| REFERENCES | 77 | ||
| Cardiovascular Screening and Primary Prevention in Older Adults | 81 | ||
| Key points | 81 | ||
| EPIDEMIOLOGY OF CARDIOVASCULAR DISEASE AND AGING | 82 | ||
| SCREENING FOR CARDIOVASCULAR DISEASE | 83 | ||
| ESTIMATING RISK OF CARDIOVASCULAR DISEASE | 83 | ||
| PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE | 83 | ||
| MODIFIABLE RISK FACTORS | 84 | ||
| LIFESTYLE | 84 | ||
| Smoking | 84 | ||
| Exercise | 84 | ||
| Diet | 85 | ||
| RISK FACTORS | 85 | ||
| Hypertension | 85 | ||
| Hypercholesterolemia | 86 | ||
| Diabetes Mellitus | 87 | ||
| Frailty | 88 | ||
| PHARMACOLOGIC INTERVENTIONS | 88 | ||
| Aspirin | 88 | ||
| Angiotensin-Converting Enzyme Inhibitors/Angiotensin II Receptor Blockers | 88 | ||
| RECOMMENDATIONS | 89 | ||
| SUMMARY | 90 | ||
| REFERENCES | 90 | ||
| Preoperative Screening | 95 | ||
| Key points | 95 | ||
| INTRODUCTION | 95 | ||
| GERIATRIC-FOCUSED PREOPERATIVE ASSESSMENT | 95 | ||
| Functional Status and Frailty | 95 | ||
| Cognition | 96 | ||
| Sensory | 97 | ||
| Mental Health | 97 | ||
| Medication Management | 97 | ||
| Pain Management | 97 | ||
| Cardiovascular Risk Stratification | 98 | ||
| Pulmonary Risk Assessment | 99 | ||
| Obstructive Sleep Apnea | 99 | ||
| DISCUSSION: RISK ASSESSMENT AND SHARED DECISION MAKING | 101 | ||
| SUMMARY | 102 | ||
| REFERENCES | 102 | ||
| Driving Dilemmas | 107 | ||
| Key points | 107 | ||
| INTRODUCTION | 107 | ||
| WHEN TO ASSESS FOR DRIVING FITNESS | 108 | ||
| DRIVER ASSESSMENT | 110 | ||
| VISION ASSESSMENT | 110 | ||
| COGNITIVE ASSESSMENT | 110 | ||
| NEUROMUSCULAR FUNCTION | 111 | ||
| WHAT TO DO WHEN AN OLDER ADULT IS DEEMED TO BE AN AT-RISK DRIVER | 111 | ||
| DRIVING LAWS | 113 | ||
| SUMMARY | 113 | ||
| REFERENCES | 113 | ||
| Prevention and Screening of Unhealthy Substance Use by Older Adults | 117 | ||
| Key points | 117 | ||
| INTRODUCTION | 117 | ||
| PREVALENCE OF USE AND HEALTH-RELATED RISKS OF ALCOHOL, TOBACCO, AND OTHER DRUGS | 118 | ||
| Alcohol Use | 118 | ||
| Tobacco Use | 120 | ||
| Illegal Drug Use | 121 | ||
| Prescription Drug Misuse | 121 | ||
| PREVENTION AND SCREENING | 122 | ||
| Prevention | 122 | ||
| Screening | 122 | ||
| Approach to screening | 122 | ||
| Screening tools | 123 | ||
| SELECTED SCREENING INSTRUMENTS | 124 | ||
| The CAGE and CAGE-AID | 124 | ||
| The Michigan Alcohol Screening Test—Geriatric Version | 124 | ||
| The Alcohol Use Disorders Identification Test | 124 | ||
| The Alcohol, Smoking, and Substance Involvement Screening Test | 124 | ||
| The Comorbidity—Alcohol Risk Evaluation Tool | 124 | ||
| ASSESSMENT, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT | 124 | ||
| SUMMARY | 125 | ||
| REFERENCES | 125 | ||
| Vaccinations in Older Adults | 131 | ||
| Key points | 131 | ||
| INTRODUCTION | 131 | ||
| INFLUENZA VACCINATION | 132 | ||
| High-Dose Influenza Vaccination | 132 | ||
| PNEUMOCOCCUS VACCINE | 133 | ||
| Pneumococcal Polysaccharide Vaccine | 133 | ||
| Pneumococcal Conjugate Vaccine | 134 | ||
| VARICELLA-ZOSTER VIRUS VACCINE | 135 | ||
| Inactivated Subunit Herpes Zoster Vaccine | 135 | ||
| Live Attenuated Herpes Zoster Vaccine | 135 | ||
| Herpes Zoster Vaccine Administration | 136 | ||
| TETANUS, DIPHTHERIA, PERTUSSIS VACCINATION | 136 | ||
| Tetanus and Diphtheria | 136 | ||
| Pertussis | 136 | ||
| Recommended Vaccination Schedule | 136 | ||
| HEPATITIS VACCINATIONS | 137 | ||
| Hepatitis A | 137 | ||
| Hepatitis B | 137 | ||
| BARRIERS TO VACCINATION IN OLDER ADULTS | 137 | ||
| Cost of Vaccinations | 137 | ||
| Racial and Ethnic Barriers | 139 | ||
| Misconceptions | 139 | ||
| SUMMARY | 140 | ||
| REFERENCES | 140 | ||
| Exercise and Older Adults | 145 | ||
| Key points | 145 | ||
| INTRODUCTION | 145 | ||
| Physical Inactivity Among Older Adults | 145 | ||
| Prevalence of physical inactivity | 145 | ||
| Chronic disease and physical inactivity | 146 | ||
| Effects of physical inactivity | 146 | ||
| Interventions to Increase Physical Activity Among Older Adults | 146 | ||
| The role of primary care | 146 | ||
| Social determinants of health and physical activity | 146 | ||
| CURRENT EXERCISE RECOMMENDATIONS FOR OLDER ADULTS | 146 | ||
| Physical Activity Guidelines | 146 | ||
| Key Recommendations for Exercise Beyond Regular Amount of Daily Activities | 146 | ||
| EXERCISE AND MEDICATIONS | 148 | ||
| EXERCISE AND NUTRITION IN OLDER ADULTS | 149 | ||
| Dehydration | 149 | ||
| EXERCISE AND INJURIES IN OLDER ADULTS | 149 | ||
| EXERCISE AFTER HIP AND KNEE ARTHROPLASTY | 149 | ||
| BENEFITS OF EXERCISE | 151 | ||
| Physiologic Benefits of Exercise and Primary Prevention | 151 | ||
| Social Benefits of Exercise for Older Adults | 151 | ||
| EXERCISE AND COMMON CHRONIC CONDITIONS | 152 | ||
| EXERCISE ASSESSMENT, PRESCRIPTION, AND COUNSELING | 152 | ||
| SUMMARY | 156 | ||
| ACKNOWLEDGMENTS | 156 | ||
| REFERENCES | 156 |