Table Of ContentLee Ann Lindquist
Editor
New Directions in
Geriatric Medicine
Concepts, Trends, and
Evidence-Based Practice
123
New Directions in Geriatric Medicine
Lee Ann Lindquist
Editor
New Directions
in Geriatric Medicine
Concepts, Trends,
and Evidence-Based Practice
Editor
Lee Ann Lindquist
Division of General Internal Medicine
and Geriatrics
Northwestern University Feinberg School
of Medicine
Chicago, IL, USA
ISBN 978-3-319-28135-3 ISBN 978-3-319-28137-7 (eBook)
DOI 10.1007/978-3-319-28137-7
Library of Congress Control Number: 2016934408
© Springer International Publishing Switzerland 2016
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Contents
1 Can Dementia Be Delayed? What You Need to Know
to Counsel Your Older Patients ............................................................. 1
Emily Morgan, Bobby Heagerty, and Elizabeth Eckstrom
2 Targeting Enhanced Services Toward High-Cost,
High-Need Medicare Patients ................................................................ 13
Melissa Dattalo, Stephanie Nothelle, and Elizabeth N. Chapman
3 Challenges to Diagnosis and Management of Infections
in Older Adults ........................................................................................ 31
Theresa Rowe and Geetha Iyer
4 Urinary Incontinence Among Older Adults ......................................... 49
Amy Hsu, Anne M. Suskind, and Alison J. Huang
5 To Fall Is Human: Falls, Gait, and Balance in Older Adults .............. 71
Patricia Harris and Maristela Baruiz Garcia
6 Should Your Older Adult Patient Be Driving? ..................................... 91
Quratulain Syed and Ned Wilson Holland Jr.
7 Making House Calls: Treating Older Adults at Home ........................ 105
Linda V. DeCherrie, Melissa Dattalo, Ming Jang,
and Rachel K. Miller
8 Aging in Place: Selecting and Supporting Caregivers
of the Older Adult ................................................................................... 115
Jennifer Fernandez, Jennifer Reckrey, and Lee Ann Lindquist
9 Skilled Nursing Facilities and Post- hospitalization Options
for Older Adults ...................................................................................... 127
Jill Huded and Fernanda Heitor
10 Utilizing Geriatric Assessments to Fulfill the Medicare
Annual Wellness Visits ............................................................................ 147
Ming Jang, Rachel K. Miller, and Lee A. Lindquist
Index ................................................................................................................. 155
v
Contributors
Elizabeth N. Chapman Geriatric Research Education and Clinical Center
(GRECC), University of Wisconsin-Madison School of Medicine and Public
Health, Madison, WI, USA
Melissa Dattalo Geriatric Research Education and Clinical Center (GRECC),
William S. Middleton Memorial VA Hospital, University of Wisconsin-Madison
School of Medicine and Public Health, Madison, WI, USA
Linda V. DeCherrie Department of Geriatrics and Palliative Medicine, Mount
Sinai Medical Center, New York, NY, USA
Elizabeth Eckstrom Division of General Internal Medicine and Geriatrics, Oregon
Health and Science University, Portland, OR, USA
Jennifer Fernandez Division of General Internal Medicine and Geriatrics,
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Maristela Baruiz Garcia Division of Geriatrics, Department of Medicine, David
Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Patricia Harris Division of Geriatrics, Department of Medicine, David Geffen
School of Medicine at UCLA, Los Angeles, CA, USA
Bobby Heagerty OHSU Brain Institute, Oregon Health and Science University,
Portland, OR, USA
Fernanda Heitor Division of General Internal Medicine and Geriatrics,
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Ned Wilson Holland Jr. Division of General Medicine and Geriatrics, Department
of Medicine, Emory University School of Medicine, Atlanta Veterans Affairs
Medical Center, Decatur, GA, USA
Amy Hsu Division of Geriatrics, Department of Medicine, San Francisco Veterans
Affairs Medical Center; University of California, San Francisco, San Francisco,
CA, USA
vii
viii Contributors
Alison J. Huang Department of Medicine, University of California, San Francisco,
San Francisco, CA, USA
Jill Huded Department of Medicine, Louis Stokes Cleveland Veterans Affairs
Medical Center, Case Western Reserve University School of Medicine, Cleveland,
OH, USA
Geetha Iyer Department of Epidemiology, Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD, USA
Ming Jang Division of Geriatrics, Perelman School of Medicine, Hospital of the
University of Pennsylvania, Philadelphia, PA, USA
Lee Ann Lindquist Division of General Internal Medicine and Geriatrics,
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Rachel K. Miller Division of Geriatrics, Perelman School of Medicine, Hospital
of the University of Pennsylvania, Philadelphia, PA, USA
Emily Morgan Division of General Internal Medicine and Geriatrics, Oregon
Health and Science University, Portland, OR, USA
Stephanie Nothelle Department of Medicine, Johns Hopkins Bayview Medical
Center, Baltimore, MD, USA
Jennifer Reckrey Departments of Medicine and Geriatrics and Palliative Medicine,
Icahn School of Medicine at Mount Sinai, New York, NY, USA
Theresa Rowe Division of General Internal Medicine and Geriatrics, Northwestern
University Feinberg School of Medicine, Chicago, IL, USA
Anne M. Suskind Department of Urology, University of California, San Francisco,
San Francisco, CA, USA
Quratulain Syed Division of General Medicine and Geriatrics, Department of
Medicine, Grady Memorial Hospital, Emory University School of Medicine,
Atlanta, GA, USA
1
Can Dementia Be Delayed? What
You Need to Know to Counsel Your
Older Patients
Emily Morgan , Bobby Heagerty , and Elizabeth Eckstrom
Patient Scenario
Dr. H is a retired chemist who moved with his wife to the west coast to be closer to
his family. When I met him several years ago at age 83, he was vibrant, witty, and a
loving husband, father, and grandfather. He and his wife quickly learned to fi nd their
way around their new community and settled comfor t ably into a new life of spending
time with family. However, it wasn’t long before subtle changes started to occur.
Mrs. H noticed that Dr. H was choosing not to go on walks with her. She was
interested in getting to know neighbors and attend cultural events in their commu-
nity, but he preferred to stay home. Within a year or two of meeting Dr. H, it was
clear that he had mild cognitive impairment , and now at 88, he is in the early stages
of Alzheimer’s disease.
Any primary care physician who cares for older adults will recognize this as an
all-too-common scenario and has probably agonized over her seeming inability to
do anything to prevent it. Nonsteroidal anti-infl ammatory drugs, aspirin, estrogen,
gingko, and many other drugs have been studied and found to have no impact on
cognitive health. We know that medical conditions such as diabetes and stroke pre-
dispose to the development of cognitive decline [1 ] and that cognitive decline
comes in all shapes and sizes—from gradually progressive Alzheimer’s disease
E. Morgan (cid:129) E. Eckstrom (*)
Division of General Internal Medicine and Geriatrics , Oregon Health and Science University ,
3181 SW Sam Jackson Park Rd L475 , Portland , OR 97239 , USA
e-mail: [email protected]
B. Heagerty
OHSU Brain Institute, Oregon Health and Science University ,
3181 SW Sam Jackson Park Rd , Portland , OR 97239 , USA
© Springer International Publishing Switzerland 2016 1
L.A. Lindquist (ed.), New Directions in Geriatric Medicine,
DOI 10.1007/978-3-319-28137-7_1
