scholarly journals Treatment of Older Adult Patients with Glioblastoma: Moving towards the Inclusion of a Comprehensive Geriatric Assessment for Guiding Management

2022 ◽  
Vol 29 (1) ◽  
pp. 360-376
Author(s):  
Manik Chahal ◽  
Brian Thiessen ◽  
Caroline Mariano
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Adult Population ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Assessment Tools ◽  
Combined Modality Treatment ◽  
General Adult Population ◽  
Predictive Role

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, and over half of patients with newly diagnosed GBM are over the age of 65. Management of glioblastoma in older patients includes maximal safe resection followed by either radiation, chemotherapy, or combined modality treatment. Despite recent advances in the treatment of older patients with GBM, survival is still only approximately 9 months compared to approximately 15 months for the general adult population, suggesting that further research is required to optimize management in the older population. The Comprehensive Geriatric Assessment (CGA) has been shown to have a prognostic and predictive role in the management of older patients with other cancers, and domains of the CGA have demonstrated an association with outcomes in GBM in retrospective studies. Furthermore, the CGA and other geriatric assessment tools are now starting to be prospectively investigated in older GBM populations. This review aims to outline current treatment strategies for older patients with GBM, explore the rationale for inclusion of geriatric assessment in GBM management, and highlight recent data investigating its implementation into practice.

scholarly journals Feminist approach to geriatric care: comprehensive geriatric assessment, diversity and intersectionality

2021 ◽  
Author(s):  
Merle Weßel
Keyword(s):  
Standardized Testing ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Geriatric Medicine ◽  
Assessment Tools ◽  
Assessment Process ◽  
Social Category ◽  
Social Categories ◽  
The Social

AbstractDespite being a collection of holistic assessment tools, the comprehensive geriatric assessment primarily focuses on the social category of age during the assessment and disregards for example gender. This article critically reviews the standardized testing process of the comprehensive geriatric assessment in regard to diversity-sensitivity. I show that the focus on age as social category during the assessment process might potentially hinder positive outcomes for people with diverse backgrounds of older patients in relation to other social categories, such as race, gender or socio-economic background and their influence on the health of the patient as well as the assessment and its outcomes. I suggest that the feminist perspective of intersectionality with its multicategorical approach can enhance the diversity-sensitivity of the comprehensive geriatric assessment, and thus improve the treatment of older patients and their quality of life. By suggesting an intersectional-based approach, this article contributes to debates about justice and diversity in medical philosophy and advocates for the normative value of diversity in geriatric medicine.

scholarly journals Geriatric Assessment in Multicultural Immigrant Populations

Geriatrics ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 40 ◽  
Author(s):  
Katherine T. Ward ◽  
Mailee Hess ◽  
Shirley Wu
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Adult Population ◽  
The United States ◽  
Assessment Tools ◽  
Screening Tests ◽  
Foreign Born ◽  
Immigrant Populations ◽  
Current Assessment

While the traditional comprehensive geriatric assessment provides valuable information essential to caring for older adults, it often falls short in multicultural immigrant populations. The number of foreign-born older adults is growing, and in some regions of the United States of America (U.S.), they encompass a significant portion of the older adult population. To ensure we are caring for this culturally diverse population adequately, we need to develop a more culturally competent comprehensive geriatric assessment. In this review, we explore ways in which to do this, address areas unique to multicultural immigrant populations, and identify limitations of the current assessment tools when applied to these populations. In order to be more culturally sensitive, we should incorporate the concepts of ethnogeriatrics into a comprehensive geriatric assessment, by addressing topics like healthcare disparities, language barriers, health literacy, acculturation level, and culturally defined beliefs. Additionally, we must be sensitive to the limitations of our current assessment tools and consider how we can expand our assessment toolkit to address these limitations. We discuss the limitations in cognitive screening tests, delirium assessments, functional and mental health assessments, advance care planning, and elder abuse.

scholarly journals Comprehensive Geriatric Assessment in the Management of Older Patients With Cardiovascular Disease

2020 ◽  
Vol 95 (6) ◽  
pp. 1231-1252 ◽  
Author(s):  
Mandeep Singh ◽  
John A. Spertus ◽  
Shahyar M. Gharacholou ◽  
Rakesh C. Arora ◽  
Robert J. Widmer ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients

What you need to know about malnutrition in older adults

2020 ◽  
Vol 81 (9) ◽  
pp. 1-8
Author(s):  
Kerry Cheah ◽  
Amy Illsley
Keyword(s):  
Older Patients ◽  
Nutritional Assessment ◽  
Adult Population ◽  
Management Strategies ◽  
Community Dwelling ◽  
Nursing Home Care ◽  
Assessment Tools ◽  
Ageing Population ◽  
Age Related ◽  
Older Adult Population

Malnutrition is the disturbance of normal form or function, arising from the deficiency of one or more nutrients, and is a significant issue in the older adult population. Despite their reduced energy requirements, older patients need the same protein intake and micronutrients as younger patients, but age-related changes may impact the ability to meet these requirements. The cause of malnutrition in individuals is likely to be multifactorial and can therefore be complex to manage. Adequate nutrition is important for both community dwelling patients and inpatients, as malnutrition increases the risk of complications and the likelihood of needing residential or nursing home care on discharge. This article discusses the risk factors for the development of malnutrition in older patients and the different nutritional assessment tools available. Management strategies for optimising nutrition can be divided into systems and supplementation. With an ageing population, most doctors will inevitably become increasingly involved with treating older patients and this article highlights the need to consider a patient's nutritional status. Nutrition should be considered during every ward round and the multidisciplinary team as a whole should maintain an awareness and responsibility for managing malnutrition.

scholarly journals Evaluation of comprehensive geriatric assessment in older patients undergoing pacemaker implantation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas W. Schoenenberger ◽  
Ian Russi ◽  
Benjamin Berte ◽  
Vanessa Weberndörfer ◽  
Renate Schoenenberger-Berzins ◽  
...  
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Pacemaker Implantation

Comprehensive Geriatric Assessment for Older Patients With Cancer

2007 ◽  
Vol 25 (14) ◽  
pp. 1824-1831 ◽  
Author(s):  
Martine Extermann ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Cancer Care ◽  
Older Patients ◽  
Morbidity And Mortality ◽  
Psychological State ◽  
Future Research ◽  
Oncology Patient ◽  
Patients With Cancer

Purpose During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Accumulating data show the benefits of incorporating a CGA in the evaluation of older patients with cancer. Prospective trials evaluating the utility of a CGA to guide interventions to improve the quality of cancer care in older adults are justified. Conclusion Growing evidence demonstrates that the variables examined in a CGA can predict morbidity and mortality in older patients with cancer, and uncover problems relevant to cancer care that would otherwise go unrecognized.

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