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Lee L, Jones A, Patel T, Hillier LM, Heckman GA, Costa AP. Frailty prevalence and efficient screening in primary care-based memory clinics. Fam Pract 2023; 40:689-697. [PMID: 37002941 DOI: 10.1093/fampra/cmad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Little is known about the prevalence of frailty among patients with memory concerns attending a primary care-based memory clinic. OBJECTIVE This study aims to describe the prevalence of frailty among patients attending a primary care-based memory clinic and to determine if prevalence rates differ based on the screening tool that is used. METHODS We conducted a retrospective medical record review for all consecutive patients assessed in a primary care-based memory clinic over 8 months. Frailty was measured in 258 patients using the Fried frailty criteria, which relies on physical measures, and the Clinical Frailty Scale (CFS), which relies on functional status. Weighted kappa statistics were calculated to compare the Fried frailty and the CFS. RESULTS The prevalence of frailty was 16% by Fried criteria and 48% by the CFS. Agreement between Fried frailty and CFS was fair for CFS 5+ (kappa = 0.22; 95% confidence interval: 0.13, 0.32) and moderate for CFS 6+ (kappa = 0.47; 0.34, 0.61). Dual-trait measures of hand grip strength with gait speed were found to be a valid proxy for Fried frailty phenotype. CONCLUSIONS Among primary care patients with memory concerns, frailty prevalence rates differed based on the measure used. Screening for frailty in this population using measures relying on physical performance may be a more efficient approach for persons already at risk of further health instability from cognitive impairment. Our findings demonstrate how measure selection should be based on the objectives and context in which frailty screening occurs.
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Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, 10B Victoria Street South, Kitchener, ON N2G 1C5, Canada
- Department of Family Medicine, McMaster University, 100 Main Street West, Hamilton, ON L8P 1H6, Canada
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, 10A Victoria Street South, Kitchener, ON N2G 1C5, Canada
| | - Loretta M Hillier
- GERAS Centre for Aging Research, 88 Maplewood Ave, Hamilton, ON L8M 1W9, Canada
| | - George A Heckman
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada
- Faculty of Applied Health Sciences, School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON N2L 3G1, Canada
| | - Andrew P Costa
- Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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Cords CI, Spronk I, Mattace-Raso FUS, Verhofstad MHJ, van der Vlies CH, van Baar ME. The feasibility and reliability of frailty assessment tools applicable in acute in-hospital trauma patients: A systematic review. J Trauma Acute Care Surg 2022; 92:615-626. [PMID: 34789703 DOI: 10.1097/ta.0000000000003472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Assessing frailty in patients with an acute trauma can be challenging. To provide trustworthy results, tools should be feasible and reliable. This systematic review evaluated existing evidence on the feasibility and reliability of frailty assessment tools applied in acute in-hospital trauma patients. METHODS A systematic search was conducted in relevant databases until February 2020. Studies evaluating the feasibility and/or reliability of a multidimensional frailty assessment tool used to identify frail trauma patients were identified. The feasibility and reliability results and the risk of bias of included studies were assessed. This study was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in Prospective Register of Systematic Reviews (ID: CRD42020175003). RESULTS Nineteen studies evaluating 12 frailty assessment tools were included. The risk of bias of the included studies was fair to good. The most frequently evaluated tool was the Clinical Frailty Scale (CFS) (n = 5). All studies evaluated feasibility in terms of the percentage of patients for whom frailty could be assessed; feasibility was high (median, 97%; range, 49-100%). Other feasibility aspects, including time needed for completion, tool availability and costs, availability of instructions, and necessity of training for users, were hardly reported. Reliability was only assessed in three studies, all evaluating the CFS. The interrater reliability varied between 42% and >90% agreement, with a Krippendorff α of 0.27 to 0.41. CONCLUSION Feasibility of most instruments was generally high. Other aspects were hardly reported. Reliability was only evaluated for the CFS with results varying from poor to good. The reliability of frailty assessment tools for acute trauma patients needs further critical evaluation to conclude whether assessment leads to trustworthy results that are useful in clinical practice. LEVEL OF EVIDENCE Systematic review, Level II.
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Affiliation(s)
- Charlotte I Cords
- From the Association of Dutch Burn Centres (C.I.C., I.S., M.E.v.B.), Maasstad Hospital; Department of Public Health (I.S., M.E.v.B.), Section of Geriatric Medicine, Department of Internal Medicine (F.U.S.M.-R.), and Trauma Research Unit Department of Surgery (C.I.C., M.H.J.V., C.H.v.d.V.), Erasmus MC, University Medical Center; and Burn Center (C.H.v.d.V.), Maasstad Hospital, Rotterdam, the Netherlands
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Lee L, Jones A, Hillier LM, Costa A, Patel T, Parikh R. Frailty screening in older adults: is annual screening necessary in primary care? Fam Pract 2022; 39:12-18. [PMID: 34240132 DOI: 10.1093/fampra/cmab055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Case-finding for Complex Chronic Conditions in Adults 75+ (C5-75) involves annual frailty screening in primary care using dual-trait screening measures of handgrip strength and gait speed, with additional screening for co-existing conditions in those deemed frail. OBJECTIVE To identify low-risk individuals who could be screened for frailty every 2 years, rather than annually. METHODS This study examined a prospective cohort of patients who completed at least two annual C5-75 screenings between April 2014 and December 2018. Handgrip strength and gait speed on initial assessment were categorized based on proximity to frailty thresholds and were used to predict frailty risk on the second assessment. We used Fisher's exact test to assess differences in risk. Logistic regression models tested associations between independent variables of age, patient activity level, falls history, grip strength and gait speed on first assessment and dependent variable of frailty on subsequent assessment. RESULTS Analyses included 571 patients with two annual assessments. Frailty risk on the second assessment was significantly higher for patients who had gait speed or grip strength within 20% of the frailty threshold (5.7%), compared with the other categories (0.7%, 0.9%, 0%; P = 0.002); 60% of patients fell within these lower risk categories. Controlling for grip strength and gait speed, no other measures had significant associations with frailty risk. CONCLUSIONS Our results demonstrate that 60% patients are at low risk (<1%) of transitioning to frailty by the next annual assessment. Reducing screening frequency from annually to every 2 years may be appropriate for these patients.
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Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada.,Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
| | - Aaron Jones
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Andrew Costa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Tejal Patel
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada.,School of Pharmacy, University of Waterloo, Kitchener,Canada
| | - Ruchi Parikh
- Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
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Yoshioka T, Takayama A, Nakagawa H, Ozaka A, Takeshima T. Comment on: How physicians evaluate patients with dementia who present with shortness of breath. J Am Geriatr Soc 2021; 70:908-909. [PMID: 34773406 DOI: 10.1111/jgs.17557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/24/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takayama
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Nakagawa
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.,Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akihiro Ozaka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Taro Takeshima
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.,Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Shirakawa, Japan
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Kotsani M, Avgerinou C, Haidich AB, Smyrnakis E, Soulis G, Papageorgiou DI, Andreou M, Zeimbekis D, Kokkali S, Gavana M. Feasibility and impact of a short training course on frailty destined for primary health care professionals. Eur Geriatr Med 2021; 12:333-346. [PMID: 33646537 DOI: 10.1007/s41999-021-00467-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/04/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is an unmet need for training primary health care professionals on frailty, especially in countries where geriatrics is still emerging. PURPOSE We aimed to evaluate the feasibility and efficacy of a training course for primary health care professionals on the detection, assessment, and management of frailty. METHODS A single-day training course, developed and facilitated by three physicians trained in geriatrics abroad, was organized by the Aristotle University of Thessaloniki Primary Hearth Care Research Network. Primary health care professionals' attitudes, knowledge, and everyday practices regarding frailty were assessed by self-administered anonymous questionnaires (using Likert-type scales) at three time-points (before, upon completion of the training course, and 3 months afterward). RESULTS Out of 31 participants (17 physicians, 12 nurses, 2 health visitors; 87.1% women; mean age 46.4 years), 31(100%) filled in the first, 30(97%) the second, and 25(81%) the third questionnaire. Improvements were reported in familiarization with the frailty syndrome (p = 0.041) and in self-perception of knowledge and skills to detect (p < 0.001) and manage (p < 0.001) frailty, that were also sustained 3 months afterward (p = 0.001 and p = 0.003 respectively). Improvement was also observed in the attitude that frailty is an inevitable consequence of aging (p = 0.007) and in the frequency of application of screening (but not management) strategies, 3 months following the workshop compared to baseline (p = 0.014). Participants reported less disagreement with the statement that systematic screening for frailty was unfeasible in their daily practice at 3 months compared to baseline (p = 0.006), mainly due to time restrictions. CONCLUSION A short skill-oriented training course can significantly and sustainably improve primary health care professionals' attitudes and practices regarding frailty.
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Affiliation(s)
- Marina Kotsani
- Université de Lorraine, CHRU-Nancy, Pôle «Maladies du Vieillissement, Gérontologie et Soins Palliatifs», 54000, Nancy, France.
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London, UK
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Soulis
- Outpatient Geriatric Assessment Unit, Henry Dunant Hospital Center, Athens, Greece
| | - Dimitra Iosifina Papageorgiou
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Stamatia Kokkali
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Medical School, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Magda Gavana
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Merchant RA, Hui RJY, Kwek SC, Sundram M, Tay A, Jayasundram J, Chen MZ, Ng SE, Tan LF, Morley JE. Rapid Geriatric Assessment Using Mobile App in Primary Care: Prevalence of Geriatric Syndromes and Review of Its Feasibility. Front Med (Lausanne) 2020; 7:261. [PMID: 32733901 PMCID: PMC7360669 DOI: 10.3389/fmed.2020.00261] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
Abstract
With the aging population and consequent increase in associated prevalence of frailty, dementia, and multimorbidity, primary care physicians will be overwhelmed with the complexity of the psychosocial and clinical presentation. Geriatric syndromes including frailty, sarcopenia, cognitive impairment, and anorexia of aging (AA) either in isolation or in combination are associated with an increased risk of adverse outcomes and if recognized early, and appropriately managed, will lead to decreased disability. Primary care practices are often located in residential settings and are in an ideal position to incorporate preventive screening and geriatric assessment with personalized management. However, primary care physicians lack the time, multidisciplinary resources, or skills to conduct geriatric assessment, and the limited number of geriatricians worldwide further complicates the matter. There is no one effective strategy to implement geriatric assessment in primary care which is rapid, cost-effective, and do not require geriatricians. Rapid Geriatric Assessment (RGA) takes <5 min to complete. It screens for frailty, sarcopenia, AA, and cognition with assisted management pathway without the need of a geriatrician. We developed RGA iPad application for screening with assisted management in two primary care practices and explored the feasibility and overall prevalence of frailty, sarcopenia, and AA. The assessment was conducted by trained nurses and coordinators. Among 2,589 older patients ≥65 years old, the prevalence of frailty was 5.9%, pre-frail 31.2%, and robust 62.9%. Fatigue was present in 17.8%, and among them, the prevalence of undiagnosed depression as assessed by the Patient Health Questionnaire (PHQ)-9 was 76.4% and 13.5% of total. The prevalence of sarcopenia was 15.4%, and 13.9% experienced at least one fall in the past year. AA was prevalent in 10.9%. The time taken to do the assessment with defined algorithm was on average 5 min or less per patient, and 96% managed to complete the assessment prior to seeing their doctor in the same session. The RGA app is a rapid and feasible tool to be used by any healthcare professional in primary care for identification of geriatric syndrome with assisted management.
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Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Richard Jor Yeong Hui
- National University Polyclinics, National University Hospital System, Singapore, Singapore
| | - Sing Cheer Kwek
- National University Polyclinics, National University Hospital System, Singapore, Singapore
| | - Meena Sundram
- National University Polyclinics, National University Hospital System, Singapore, Singapore
| | - Arthur Tay
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
| | - Jerome Jayasundram
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Shu Ee Ng
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Li Feng Tan
- Healthy Ageing Program, Alexandra Hospital, National University Health System, Singapore, Singapore
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
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Abbasi M, Khera S, Dabravolskaj J, Garrison M, King S. Identification of Frailty in Primary Care: Feasibility and Acceptability of Recommended Case Finding Tools Within a Primary Care Integrated Seniors' Program. Gerontol Geriatr Med 2019; 5:2333721419848153. [PMID: 31192278 PMCID: PMC6540471 DOI: 10.1177/2333721419848153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/09/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Case finding for frailty is recommended as part of routine clinical practice. We aimed to test feasibility and acceptability of three recommended case finding tools in primary care as part of an integrated seniors’ program. Method: Program of Research to Integrate Services for the Maintenance of Autonomy-7 (PRISMA-7), 4-m walk test, and electronic frailty index (eFI) were used as frailty case finding tools for a target population of community-dwelling seniors ≥65 years of age enrolled in a seniors’ program within an academic primary care clinic in Alberta, Canada. Feasibility was measured by percent completion rate and requirements for training/equipment/space/time, and acceptability by health care providers was measured using focus groups. Results: Eighty-five patients underwent case finding and 16 health care providers participated in the focus groups. Completion rate for PRISMA-7, 4-m walk test, and eFI was 97.6%, 93%, and 100%, respectively. No special training or equipment was required for PRISMA-7; brief training, equipment, and space were required for 4-m walk test. Both tools took less than 5 min to complete. Despite eFI requiring 10 to 20 min/patient chart, providers found it less intrusive. Conclusion: Despite feasibility of the tests, acceptance was higher for tools with minimal clinic interruption, low requirements for resources, and those with added benefit.
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Fillion V, Sirois MJ, Gamache P, Guertin JR, Morin SN, Jean S. Frailty and health services use among Quebec seniors with non-hip fractures: a population-based study using adminsitrative databases. BMC Health Serv Res 2019; 19:70. [PMID: 30683094 PMCID: PMC6347825 DOI: 10.1186/s12913-019-3865-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/02/2019] [Indexed: 01/12/2023] Open
Abstract
Background The number of frail elderly will increase as the world population ageing accelerates. Since frail elders are at risk of falls, hospitalizations and disabilities, they will require more health care and services. To assess frailty prevalence using health administrative databases, to examine the association between frailty and the use of medical services and to measure the excess use of health services following a non-hip fracture across frailty levels among community-dwelling seniors. Methods A population-based cohort study was built from the Quebec Integrated Chronic Disease Surveillance System, including men and women ≥65 years old, non-institutionalized in the pre-fracture year. Frailty was measured using the Elders Risk Assessment (ERA) index. Multivariate Generalized Estimating Equation models were used to examine the relationship between frailty levels and health services while adjusting for covariates. The excess numbers of visits to Emergency Departments (ED) and to Primary Care Practitioners (PCP) as well as hospitalizations were also estimated. Results The cohort included 178,304 fractures. There were 13.6 and 5.2% frail and robust seniors, respectively. In the post-fracture year, the risks of ED visits, PCP visits and hospitalizations, were significantly higher in frail vs. non-frail seniors: adjusted relative risk (RR) = 2.69 [95% CI: 2.50–2.90] for ED visits, RR = 1.28 [95% CI: 1.23–1.32] for PCP visits and RR = 2.34 [95% CI: 2.14–2.55] for hospitalizations. Conclusion Our results suggest that it is possible to characterize seniors’ frailty status at a population level using health administrative databases. Furthermore, this study shows that non-institutionalized frail seniors require more health services after an incident fracture. Screening for frailty in seniors should be part of clinical management in order to identify those at a higher risk of needing health services. Electronic supplementary material The online version of this article (10.1186/s12913-019-3865-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vanessa Fillion
- Centre d'Excellence sur le Vieillissement de Québec (CEVQ), Québec, Canada. .,Centre de recherche du CHU de Québec, Québec, Canada. .,The Canadian Emergency Team Initiative (CETI), Québec, Canada. .,Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec (INSPQ), 945, avenue Wolfe, Québec, QC, G1V 5B3, Canada.
| | - Marie-Josée Sirois
- Centre d'Excellence sur le Vieillissement de Québec (CEVQ), Québec, Canada.,Centre de recherche du CHU de Québec, Québec, Canada.,The Canadian Emergency Team Initiative (CETI), Québec, Canada.,Université Laval, Québec, Canada.,Hôpital de l'Enfant-Jésus, 1401 18e rue, H-602, Québec, QC, G1J 1Z4, Canada
| | - Philippe Gamache
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec (INSPQ), 945, avenue Wolfe, Québec, QC, G1V 5B3, Canada
| | - Jason Robert Guertin
- Centre de recherche du CHU de Québec, Québec, Canada.,Université Laval, Québec, Canada.,Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Bureau J0-01, Québec, QC, G1S 4L8, Canada
| | - Suzanne N Morin
- Université McGill, Québec, Canada.,Montreal General Hospital, 1650 Cedar Avenue, Room B2.118, Montréal, QC, H3G 1A4, Canada
| | - Sonia Jean
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec (INSPQ), 945, avenue Wolfe, Québec, QC, G1V 5B3, Canada.,Université Laval, Québec, Canada
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RETRACTED ARTICLE: Rapid Screening for Frailty and Sarcopenia in Daily Clinical Practice. J Nutr Health Aging 2018. [DOI: 10.1007/s12603-018-1057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Fougère B, Lagourdette C, Abele P, Resnick B, Rantz M, Kam Yuk Lai C, Chen Q, Moyle W, Vellas B, Morley JE. Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries. J Nutr Health Aging 2018; 22:463-470. [PMID: 29582884 DOI: 10.1007/s12603-018-1008-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The increasing demand for healthcare services is placing great strain on healthcare systems throughout the world. Although the older population is increasing worldwide, there is a marked deficit in the number of persons trained in geriatrics. It is now recognized that early detection and treatment of geriatric conditions (e.g., frailty, sarcopenia, falls, anorexia of aging, and cognitive decline) will delay or avert the development of disability. At the same time, recent years have seen an increased interest and use of advanced practice nurses (APN). Models of best practices of supervision and collaboration have been promulgated by many organizations. APN's roles and scope of practice have been expanded in many countries and the quality and cost-effectiveness of healthcare systems have improved. Nevertheless, in older people, evidence of advanced practice roles remains scattered, and there is little synthesis of evidence, and therefore it is not easy to visualize the different practice models and their components. The aim of this paper is to explain the need for advanced practice nurses to manage geriatric conditions.
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Affiliation(s)
- B Fougère
- B. Fougère, Institut du Vieillissement, Gérontopôle, Université Toulouse III Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse, France, Tel: +33561145657 ; fax: +33561145640, E-mail:
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Fougère B, Cesari M, Arai H, Woo J, Merchant RA, Flicker L, Cherubini A, Bauer JM, Vellas B, Morley JE. Editorial: Involving Primary Care Health Professionals in Geriatric Assessment. J Nutr Health Aging 2018; 22:566-568. [PMID: 29717754 DOI: 10.1007/s12603-018-1001-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- B Fougère
- B. Fougère, Institut du Vieillissement, Gérontopôle, Université Toulouse III Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse, France, Tel: +33561145657 ; fax: +33561145640, E-mail:
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12
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Affiliation(s)
- B Vellas
- John E. Morley, MB,BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
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