Geriatrics

  • Deprescribing: When trying for less is more
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 179-180; DOI: https://doi.org/10.3949/ccjm.85b.03018

    We should periodically revisit the goals and rationale for all prescribed medications.

  • Hypertension in older adults: What is the target blood pressure?
    Anu Garg, MD and Barbara J. Messinger-Rapport, MD, PhD
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 193-195; DOI: https://doi.org/10.3949/ccjm.85a.17064

    Goal: systolic pressure below 130 mm Hg if the patient can take multiple medications and be followed closely.

  • Alzheimer dementia: Starting, stopping drug therapy
    Luke D. Kim, MD, FACP, CMD and Ronan M. Factora, MD, FACP, AGSF
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 209-214; DOI: https://doi.org/10.3949/ccjm.85a.16080

    It is reasonable to consider discontinuing therapy when a patient has progressed to advanced dementia.

  • Medication management in older adults
    Luke D. Kim, MD, FACP, CMD, Kenneth Koncilja, MD and Craig Nielsen, MD, FACP
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 129-135; DOI: https://doi.org/10.3949/ccjm.85a.16109

    Some drugs may become unnecessary or even dangerous as the patient ages. Periodic medication review is needed.

  • Finding balance: Optimizing medication prescribing in older patients
    Kelly C. Sponsler, MD and Amanda S. Mixon, MD, MS, MSPH, FHM
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 136-137; DOI: https://doi.org/10.3949/ccjm.85a.17087

    More than one-third of older adults in the United States take 5 or more medications. Consider deprescribing.

  • Transient neurologic syndromes: A diagnostic approach
    Justin R. Abbatemarco, MD and Alexander D. Rae-Grant, MD
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 155-163; DOI: https://doi.org/10.3949/ccjm.85a.17022

    Diagnosing TIA, migraine, partial seizures, hypoglycemia, hyperventilation, transient global amnesia, and others.

  • Hypothermia and severe first-degree heart block
    Kevin Bryan Uy Lo, MD and Alison Nelson, MD
    Cleveland Clinic Journal of Medicine January 2018, 85 (1) 10-11; DOI: https://doi.org/10.3949/ccjm.85a.17003

    A 96-year-old woman with hypertension, diabetes, and dementia was found unresponsive and was transferred to the hospital.

  • Preventing cardiovascular disease in older adults: One size does not fit all
    Ariela R. Orkaby, MD, MPH, Oyere Onuma, MD, MSc, Saadia Qazi, DO, MPH, J. Michael Gaziano, MD, MPH and Jane A. Driver, MD, MPH
    Cleveland Clinic Journal of Medicine January 2018, 85 (1) 55-64; DOI: https://doi.org/10.3949/ccjm.85a.16119

    The balance of risk and benefit may differ considerably for 2 patients of the same age if one is fi t and the other is frail.

  • Frailty and cardiovascular disease: A two-way street?
    Emer Joyce, MD, PhD
    Cleveland Clinic Journal of Medicine January 2018, 85 (1) 65-68; DOI: https://doi.org/10.3949/ccjm.85a.17075

    Frailty may be both a cause and a consequence of cardiovascular disease.

  • 2017 Update in perioperative medicine: 6 questions answered
    Ryan Munyon, MD, Steven L. Cohn, MD, FACP, SFHM, Barbara Slawski, MD, MS, SFHM, Gerald W. Smetana, MD, MACP and Kurt Pfeifer, MD, FACP, SFHM
    Cleveland Clinic Journal of Medicine November 2017, 84 (11) 863-872; DOI: https://doi.org/10.3949/ccjm.84a.17068

    Topics: cardiac risk assessment, surgery after percutaneous intervention, statins, sleep apnea, bridging anticoagulation, and frailty.

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