Pancreatic Adenocarcinoma in the Older Adult

2010 ◽  
Vol 06 ◽  
pp. 53
Author(s):  
Arlene A Gayle ◽  
Noelle K LoConte ◽  
◽  
Keyword(s):  
Older Adults ◽  
Clinical Research ◽  
Effective Treatment ◽  
Pancreatic Adenocarcinoma ◽  
Older Adult ◽  
Treatment Options ◽  
Medical Conditions ◽  
Future Directions ◽  
Large Numbers

Pancreatic adenocarcinoma is common among older adults, who may be more frail or have comorbid medical conditions that make treatment more challenging. Pancreatic adenocarcinoma is a lethal malignancy with relatively few effective treatment options. To date, most clinical research has not enrolled large numbers of older adults, despite this being the demographic predominantly affected by this illness. In this article, etiology and treatments for pancreatic adenocarcinoma are reviewed with a particular emphasis on studies that have examined matters relating to treating older adults; future directions for research are also explored.

Immunotherapy in Older Adults: A Checkpoint to Palliation?

2019 ◽  
pp. e110-e120 ◽  
Author(s):  
Rawad Elias ◽  
Oreofe Odejide
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Advanced Disease ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Limited Life Expectancy ◽  
Goals Of Care ◽  
Limited Life ◽  
Checkpoint Inhibitor Therapy

The excitement about immunotherapy is justified. Patients with advanced disease and limited life expectancy before immune checkpoint inhibitors are now having prolonged and sometimes complete responses to treatment; however, most patients do not respond to checkpoint inhibitors. The hope for a meaningful response with only a limited risk of high-grade toxicity generated a prognostic dilemma for patients with advanced cancers and their treating oncologists. Older adults with advanced cancers are at the intersection of multiple biologic and clinical factors that can influence the efficacy of immunotherapy. Treating physicians should take all of these elements into account when considering treatment options for an older adult with advanced disease. Oncologists should have an honest conversation with their patients regarding the uncertainty around the clinical profile of checkpoint inhibitors. Early high-quality goals of care discussions can help manage expectations of older adults with advanced cancer treated with immunotherapy. We review in this paper select clinical characteristics that are important to consider when evaluating an older adult for checkpoint inhibitor therapy. In addition, we discuss strategies to optimize goals of care discussion given the increasing complexity of prognostication in the immunotherapy era.

scholarly journals Older Adult User Feedback on Design and Functionality of EngAGE, a Voice-Activated Exercise Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 267-267
Author(s):  
Yadira Montoya ◽  
Saira Shervani ◽  
Chelsea Smith ◽  
Louise Hawkley ◽  
Megan Huisingh-Scheetz ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Feasibility Study ◽  
Real World ◽  
Exercise Program ◽  
User Feedback ◽  
Future Directions ◽  
Socially Motivated ◽  
Supporting Materials ◽  
Adult Caregiver

Abstract The EngAGE Alexa app is a socially motivated exercise program targeting older adult-caregiver dyads to promote mobility independence. EngAGE provides exercise routines that older adults can perform in the home in conjunction with a messaging component to facilitate motivation from caregivers and a tracking component to monitor progress. This presentation will describe the qualitative results that have informed the app’s design and evaluation of its feasibility and functionality following a 14-week feasibility study in 10 dyads of older adult exercisers and their caregivers. The presentation will cover the perceived benefits of EngAGE’s older adult users (including “real world” clinically relevant improvements, the comprehensiveness of the exercises, and exercise knowledge gained), as well as likes and dislikes that contributed to our assessment of the app’s functionality. Finally, we will discuss how the feedback contributes to future directions in the development of the app’s features, supporting materials, design and content.

Impulse Control Disorders and Older Adults

2012 ◽  
Author(s):  
Rani A. Desai
Keyword(s):  
Older Adults ◽  
Mental Health Treatment ◽  
Impulse Control ◽  
Treatment Options ◽  
The Elderly ◽  
Impulse Control Disorders ◽  
Future Directions ◽  
Social Community ◽  
Excessive Gambling ◽  
Assessment And Treatment

Impulse control disorders (ICDs) are not well studied in the elderly, as the development of ICDs tend to decrease with age. Although less prevalent than younger patients, older adults with ICDs—psychological gambling in particular—may have unique assessment and treatment challenges as a result of their age, elaborate social community, comorbid medical conditions, and attitudes about mental health treatment. This chapter discusses the phenomenology of excessive gambling and other ICDs in elders, unique risk factors for this older population, and some potential treatment options. The chapter concludes with some thoughts on the future directions for research in this field.

scholarly journals Effects of Age, Mental Health, and Comorbidity on the Perceived Likelihood of Hiring a Healthcare Advocate

2016 ◽  
Vol 14 (3) ◽  
pp. 45-57 ◽  
Author(s):  
Symone A. McKinnon ◽  
Breanna M. Holloway ◽  
Maya S. Santoro ◽  
April C. May ◽  
Terry A. Cronan
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Chronically Ill ◽  
Cognitive Disorder ◽  
Medical Conditions ◽  
Care Services ◽  
System Method

Background and Purpose: The projected increase in chronically ill older adults may overburden the healthcare system and compromise the receipt of quality and coordinated health care services. Healthcare advocates (HCAs) may help to alleviate the burden associated with seeking and receiving appropriate health care. We examined whether having dementia or depression, along with hypertension and arthritis, or having no comorbid medical conditions, and being an older adult, affected the perceived likelihood of hiring an HCA to navigate the health care system. Method: Participants (N = 1,134), age 18 or older, read a vignette and imagined themselves as an older adult with either a mood or cognitive disorder, and comorbid medical conditions or as otherwise being physically healthy. They were then asked to complete a questionnaire assessing their perceived likelihood of hiring an HCA. Results: Participants who imagined themselves as having dementia reported a greater likelihood of hiring an HCA than participants who imagined themselves as having depression (p < .001). Conclusion: It is imperative that health care professionals attend to the growing and ongoing needs of older adults living with chronic conditions, and HCAs could play an important role in meeting those needs.

scholarly journals Depression in the older adult: What should be considered?

2016 ◽  
Vol 6 (5) ◽  
pp. 222-228 ◽  
Author(s):  
Bridget Bradley ◽  
Danielle Backus ◽  
Emily Gray
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Home Health Care ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Screening Tools ◽  
Comorbid Condition ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Treatment Of Depression

Abstract Introduction: The updated American Geriatrics Society (AGS) 2015 Beers Criteria include the following antidepressant classes as potentially inappropriate medications to be used with caution in older adults: selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and mirtazapine. Methods: A search of the medical literature using PubMed and references included in the AGS 2015 Beers Criteria. Results: The treatment of depression in the older adult can additionally be complicated by comorbid conditions, as 80% of older adults have at least 1 comorbid condition and 50% have at least 2. These considerations limit the pharmacologic treatment options for depression in older adults. However, the treatment of major depression should not be overlooked, as it is quite common, with estimates of up to 5% of older adults in the community and up to 13.5% in older adults who receive home health care. Discussion: This article reviews treatment considerations of depression in the older adult, including both available screening tools and a discussion balancing the need for treatment of depression in this population with the concerns addressed in the 2015 Beers Criteria.

Caring for the Older Population With Advanced Lung Cancer

2017 ◽  
pp. 587-596 ◽  
Author(s):  
Carolyn J. Presley ◽  
Craig H. Reynolds ◽  
Corey J. Langer
Keyword(s):  
Lung Cancer ◽  
Older Adults ◽  
Functional Status ◽  
Older Adult ◽  
Treatment Options ◽  
The Elderly ◽  
Advanced Lung Cancer ◽  
Multiple Chronic Conditions ◽  
Patient Reported ◽  
Key Issues

The management of advanced lung cancer is changing rapidly, with new drug approvals occurring almost monthly. The average age of a newly diagnosed patient with advanced lung cancer remains around age 70. Caring for the older adult with advanced cancer differs from the care of younger adults. Chronologic age often does not accurately reflect the physiologic and functional status of older adults. Selecting treatment based on age alone results in undertreatment and overtreatment of many older adults. Addressing issues such as multiple chronic conditions, polypharmacy, geriatric syndromes, and heterogeneity in functional status among an expanding menu of treatment options for advanced disease is increasingly difficult, particularly among older adults historically underrepresented in clinical trials. In this article, we highlight key issues in caring for the older adult with advanced non–small cell lung cancer and the continued need for data supporting current and emerging treatment options. Key issues include the unique challenges of managing advanced lung cancer and a summary of the current treatment evidence as they apply to the elderly lung cancer population including supportive care strategies, risk stratification, and patient-reported outcomes.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

Prescription of Exercise in Older Adults, Physiotherapeutic Approach

2017 ◽  
Vol 2 (5) ◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Exercise Prescription

• Identify the changes related to aging that must be taken into account for the prescription of the exercise • Define the appropriate functional assessmentsforthe prescription of the exercise in the older adult • Recognize the factors that influence the adherence to exercise by older adults • Describe according to the objectives the correct exercise prescription for older adults.

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