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Geriatric dizziness
(Family Physicians Inquiries Network, 2010)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of dizziness in the elderly.
Which anticoagulant is safest for frail elderly patients with nonvalvular A-fib?
(Family Physicians Inquiries Network, 2022-11)
Consider apixaban, which demonstrated a lower adverse event (AE) rate than warfarin regardless of frailty status, for anticoagulation treatment of older patients with nonvalvular atrial fibrillation (AF); by comparison, ...
Visual impairment in the elderly
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of visual impairment in the elderly.
Do standing orders help with chronic disease care and health maintenance in ambulatory practice?
(Family Physicians Inquiries Network, 2010)
Studies of standing orders tend to examine their effect on compliance with preventive interventions for chronic disease rather than disease outcomes. In the ambulatory setting, they improve rates of influenza vaccination ...
Which drugs are best when aggressive Alzheimer's patients need medication?
(Family Physicians Inquiries Network, 2010)
controlled trials [RCTs]). However, evidence of drug-related deaths in patients taking these drugs mandates weighing the benefits against the risks. SSRIs may be a safer, effective alternative (SOR: B, limited studies). Evidence for the efficacy...
Should we use appetite stimulants for malnourished elderly patients?
(Family Physicians Inquiries Network, 2007)
Only 1 appetite stimulate, megestrol acetate oral suspension (Megace) at 400 mg or 800 mg daily, has been studied in this population. The data show only limited benefit, mixed outcomes, and potential harm (strength of recommendation: B, based...
What could be behind your elderly patient's subjective memory complaints?
(Family Physicians Inquiries Network, 2008)
Depression, anxiety, and dementia, as well as older age, female gender, lower education level, and decreased physical activity, have all been associated with memory loss reported by patients or family members (strength of ...
Which late-stage Alzheimer's patients should be referred for hospice care?
(Family Physicians Inquiries Network, 2005)
Medicare guidelines are used to determine eligibility for hospice care (strength of recommendation [SOR]: C, based on expert opinion), but they correlate with 6-month mortality no better than an experienced clinician's judgment (SOR: B, based on 1...
How do we decide when a patient with nonmalignant disease is eligible for hospice care?
(Family Physicians Inquiries Network, 2006)
Each hospice has its own policy, but Medicare requires 6 months or less life expectancy for certification of eligibility and reimbursement. Other important criteria include patient and family understanding and wishes. Evidence-based guidelines...
Are antibiotics effective in preventing pneumonia for nursing home patients?
(Family Physicians Inquiries Network, 2004)
. Three measures effectively prevent pneumonia in nursing home patients: influenza vaccination of residents (strength of recommendation [SOR]: B, based on systematic review of homogenous cohort observational studies); influenza vaccination of caregivers...
Care for life? : The failing system of nursing home care in the United States
(University of Missouri, The Campus Writing Program, 2014)
The phrase "respect your elders" is ingrained in most minds at a young age. This phrase, however, has been lost somewhere. A lack of respect for the elderly is especially present in the quality of health care they receive. Not only are the elderly...
Pain scales for assessing pain intensity in the elderly
(Family Physicians Inquiries Network, 2010)
This issue of eMedRef provides information to clinicians on using pain scales to assess pain in the elderly.
Hospitalist update : why does team-based care matter to hospitalists?
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2011-07)
Quality of Life in Older Persons with Dementia Living in Nursing Homes
(Family Physicians Inquiries Network, 2008)
with assisted living/residential care facilities. However, evidence suggests a gradual decline in average functioning in persons with dementia, regardless of living situation. (Strength of Recommendation: B; based on cohort studies)....
What is angular cheilitis and how is it treated?
(Family Physicians Inquiries Network, 2005)
Cheilitis is a broad term that describes inflammation of the lip surface characterized by dry scaling and fissuring. Specific types are atopic, angular, granulomatous, and actinic. Angular cheilitis is commonly seen in primary care settings...
Monitoring Therapy for Patients with Alzheimer's Disease
(Family Physicians Inquiries Network, 2007)
Patients with Alzheimer's disease who undergo treatment of any kind should be monitored eight weeks after initiation of therapy and at least every six months thereafter. (Strength of Recommendation: C, based on expert opinion and extrapolation from...
Advanced hospital medicine Fellowship program
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-01)
The hospitalist field was founded on the premise that inpatient generalists could improve the care of hospitalized patients and systems of inpatient care. In the early years, the challenge was to determine whether the field was indispensable....
Should we identify and treat hyperlipidemia in the advanced elderly?
(Family Physicians Inquiries Network, 2006)
of CAD, should be treated irrespective of age; however, evidence is limited to support lowering lipids for advanced elderly patients with and without known CAD (strength of recommendation: C, based on expert and consensus guidelines)....
What is the best hypnotic for use in the elderly?
(Family Physicians Inquiries Network, 2003)
, based on extrapolations of randomized controlled trials). Zolpidem and zaleplon have a quick onset and short duration of action, making them less likely to cause residual sedation, cognitive changes, and falls than benzodiazepines. More comparative...
Should we treat elevated cholesterol in elderly patients?
(Family Physicians Inquiries Network, 2002)
HMG-CoA reductase inhibitors, or statins, have been shown to decrease all-cause mortality in individuals aged 65 and older with known coronary heart disease (CHD) and elevated cholesterol levels. (Grade of recommendation: A, based on randomized...