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Geriatrics Evidence Alert
Current Issue & Archives


The Geriatrics Evidence Alert is an electronic newsletter developed by the Outpatient Clinical Informatics Consult Service (OCICS) at the Eskind Biomedical Library to provide a bimonthly update of selected evidence-based biomedical literature and recently published news and research to clinicians and other health professionals who provide clinical services for older adults at Vanderbilt University Medical Center and the Middle Tennessee area.
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Current Issue » June 2011

Issue Highlights
  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Efficacy and cost of contrast MRI of the brain for diagnosing acoustic neuroma in patients with asymmetric hearing loss
  2.  Clinical Practice Guidelines
    • American Academy of Neurology provides practice recommendations on driving risk in dementia patients
    • American Academy of Neurology releases practice guidelines for treatment of painful diabetic neuropathy
    • National Institute on Aging-Alzheimer's Association workgroup releases revised criteria for diagnosing Alzheimer's disease
  3.  Newly Published Research
    • Study shows higher likelihood of serious postoperative morbities and mortality in smokers
    • Longitudinal study finds association between obesity and functional decline in older Americans
    • Older African Americans less likely to utilize overnight hospital care
  4.  Recent News & Drug Safety Advisories
    • FDA recommends new dose limitations for simvastatin
    • FDA concludes no increased risk of cancer with ARBs
    • FDA Approves Solesta injectable gel for fecal incontinence
 
Past Issues
» September 2010

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Current evidence base weak for selecting nonpharmacologic strategies to manage agitation in older palliative care patients
    • More randomized trials needed to determine best management approach for delirium in hospitalized older adults without critical illness
    • Clinical indicators of frailty in the elderly: Clear definition needed before reliable indicators can be identified
    • Literature on Milk of Magnesia lacks strong evidence for/against its efficacy and safety
  2.  Clinical Practice Guidelines
    • American Academy of Neurology provides practice recommendations on driving risk in dementia patients
    • International Osteoporosis Foundation suggests supplemental vitamin D requirements for elderly patients
  3.  Newly Published Research
    • AHRQ review finds evidence insufficient to determine protective factors or risk for Alzheimer's disease and cognitive decline
    • Meta-analysis finds protective effect of oral vitamin D supplementation on preventing falls
    • Meta-analysis finds beneficial effect of multidisciplinary inpatient rehabilitation tailored for elderly
    • Trial finds higher rate of falls and fractures with single annual high-dose vitamin D compared to placebo in older women
    • Study compares diagnostic accuracy of bedside instruments for detecting delirium in hospitalized adults
  4.  Recent News & Safety Advisories
    • FDA approves new injectable osteoporosis drug
    • FDA launches safety review for possible increased risk of cancer with ARBs
    • Federal report released on key indicators of well-being in older Americans
    • CDC releases data on trends in office-based physician services and population aging
    • CDC publishes national hospitalization rates for older patients with septicemia or sepsis

» April 2010

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Evidence remains weak for guideline recommendations for or against endoscopic screening for Barrett's esophagus and dysplasia in adults 50 years or older
    • Need for stronger evidence to support risks with anticoagulant use in patients with age-related macular degeneration
    • Recommendations for treatment of osteoporosis in patients with end-stage renal disease on dialysis and the role of bisphosphonates
  2.  Clinical Practice Guidelines
    • AGS updates clinical practice guidelines for accidental falls in older adults
    • Dietetics position statement stresses improvements to food and nutrition programs for community-dwelling older adults
  3.  Newly Published Research
    • Randomized controlled trial finds significant effects of testosterone therapy in frail elderly men
    • Study finds association between oral health status and food avoidance in elderly, multiethnic rural population
    • Meta-analysis examines effectiveness of inpatient geriatric evaluation and management units
  4.  Recent News & Safety Advisories
    • FDA warns of increased risk of serious muscle injury with high doses of Zocor (simvastatin)
    • FDA adds black box warning to Plavix label due to decreased effects in poor metabolizers
    • MEPS brief highlights expenditures for top five therapeutic classes of outpatient prescription drugs

» September 2009

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Helpful components of a caregiver hot line
    • Benefits of providing respite care to caregivers
    • Bibliography: Measuring caregiver stress and using support programs to reduce caregiver burden
  2.  Clinical Practice Guidelines
    • American Geriatrics Society publishes recommendations on pharmacological management of persistent pain
    • USPSTF finds insufficient evidence for screening for impaired visual acuity in older adults
  3.  Newly Published Research
    • Randomized controlled trial shows mortality benefit and long term cost effectiveness of ultrasound screening for AAA in older adults
    • Randomized clinical trial finds response to high dose flu vaccine in older adults superior to low dose
  4.  CDC and FDA news
    • CDC releases second mental health and aging Issue brief: Evidence-based programs for depression in older adults
    • FDA approves new injectable form of ibuprofen to treat pain and fever
    • FDA approves Onglyza (saxagliptin) to treat type 2 diabetes
    • FDA approves new statin for lowering cholesterol levels

» February 2009

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Bibliography: Orthogeriatric services in the co-management of elderly patients with hip fractures
    • Bibliography: Carotid stenting for reducing cerebrovascular accident risk in older persons
    • Statistical data located for accidental falls for older females
  2.  Clinical Practice Guidelines
    • Infectious Disease Society of America updates guidelines on evaluation of fever and infection in older adult residents of long-term care facilities
  3.  Newly Published Research
    • Randomized placebo-controlled trial shows improvement in anxiety in older adults taking Lexapro®
    • Ginkgo biloba not effective in reducing overall incidence rates of dementia or Alzheimer’s
    • Positive effect found on weight and appetite with omega-3 fatty acid supplementation in older adults with mild to moderate Alzheimer’s Disease
  4.  CDC and FDA news
    • CDC publishes issue brief on the state of mental health and aging in America

» November 2008

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Evidence suggests mental exercises may maintain cognitive thinking skills for specific tasks by elderly patients
    • Evidence for adding low-dose aspirin to warfarin therapy in artificial heart valve patients
    • Consenting patients with cognitive impairment for surgical procedures
  2.  Clinical Practice Guidelines
    • USPSTF recommends against routine screening for colorectal cancer in patients older than 75 years
    • CDC releases new and expanded Hepatitis B testing recommendations
    • ACP recommends considering drug therapy for patients at risk for osteoporosis
  3.  Newly Published Research
    • Multicenter RCT shows no significant difference in time to death with rosuvastatin vs placebo in CHF patients
    • RCT shows conflicting results for daily high-dose vitamin KI on bone loss and fractures in postmenopausal women with osteopenia
    • Randomized trial shows no difference between episodic and continuous amiodarone therapy for major adverse events in ambulatory patients with recurrent persistent a-fib
    • Multicenter RCT shows no significant change in cognition with vitamin B regimen versus placebo in AD patients
  4.  FDA News & Safety Advisories
    • FDA receives additional data from manufacturer of Spiriva HandiHaler showing no increased risk of stroke
    • FDA postmarketing adverse event review finds no significant incidence or risk of ALS with statin use
    • FDA continues ongoing safety review of risk of atrial fibrillation in patients taking bisphosphonates

» September 2008

Issue Highlights

  1.  Clinical questions recently sent to the EBM Literature Request message basket in StarPanel
    • Limited evidence for management of recurrent infection with chronic indwelling urinary catheters
    • Conflicting evidence for efficacy and duration of benefit with Synvisc for elderly patients with osteoarthritis
    • Adding low-dose aspirin to anticoagulation therapy may aid patients with artificial heart valves
    • Literature lacks strong evidence for management of UTI in adults with chronic urinary calculi
  2.  Clinical Practice Guidelines
    • USPSTF concludes available evidence is insufficient regarding prostate cancer screening
    • USPSTF recommends screening asymptomatic adults for type 2 diabetes based on blood pressure level
    • ACIP Finalizes Zoster Vaccine Recommendations
  3.  Newly Published Research
    • Dimebon shows significant improvement in cognition for patients with mild-to-moderate Alzheimer’s
    • Randomized trial of fish oil supplementation does not show significant cognitive improvement in older adults
    • Problem-solving therapy as collaborative care within a primary care clinic compared to usual care effective for reducing late-life depression in older adults
    • Tibolone reduces fracture risk and breast cancer risk but increases stroke risk in older women with osteoporosis
  4.  FDA News & Safety Advisories
    • FDA warns of increased mortality risk in elderly patients treated with antipsychotics for dementia-related psychosis
    • CDC releases framework monograph for translating public health research on caregiving into practice
    • Medicare Improvements for Patients and Providers Act of 2008 Enacted