Dataset Information

Unintentional Weight Loss in Older Adults: A Geriatric Interprofessional Simulation Case Series for Health Care Providers.

ABSTRACT:

Introduction

Interprofessional teams can provide better care and management of complex geriatric patients. Unintentional weight loss in older patients can lead to significant morbidity and mortality and functional decline. This simulation curriculum focuses on teaching learners from all health care professions how to use the Carolina Geriatrics Workforce Enhancement Program unintentional weight loss tool and flowchart (T&F) to identify, diagnose, and create a plan of care for weight loss in geriatric patients.

Methods

A presentation on use of the T&F and two standardized patient cases utilizing the T&F in an interprofessional team are included. Case 1 presents a 71-year-old male with dementia who has lost 20 pounds, with weight loss secondary to cognitive impairment, denture problems, oral candidiasis, and polypharmacy. Case 2 presents a 67-year-old female with a history of depression and breast cancer who has lost 15 pounds, likely related to alcohol dependence, social isolation, oral cancer, and food insecurity. Pre- and posttests measure knowledge gained through the course.

Results

Overall knowledge of unintentional weight loss improved in the 14 learners who participated in two pilot sessions. Test scores improved an average of 1.2 points from pre- to posttest. Participants felt that interprofessional teams increased the quality of care provided to patients and job satisfaction.

Discussion

This tool can be utilized by practitioners from multiple disciplines. By completing the curriculum, learners gain knowledge of how to identify geriatric patients with significant weight loss, determine next steps in diagnosis and workup, and work in an interprofessional group.

SUBMITTER: Mulligan R

PROVIDER: S-EPMC6338256 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

Unintentional Weight Loss in Older Adults: A Geriatric Interprofessional Simulation Case Series for Health Care Providers.

Mulligan Rebekah R Gilmer-Scott Melissa M Kouchel Dana D Nickelson Davia D Safavi Atousa A Drickamer Margaret M Roberts Ellen E

MedEdPORTAL : the journal of teaching and learning resources 20170920

<h4>Introduction</h4>Interprofessional teams can provide better care and management of complex geriatric patients. Unintentional weight loss in older patients can lead to significant morbidity and mortality and functional decline. This simulation curriculum focuses on teaching learners from all health care professions how to use the Carolina Geriatrics Workforce Enhancement Program unintentional weight loss tool and flowchart (T&F) to identify, diagnose, and create a plan of care for weight loss ...[more]

PMID: 30800832

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Project description:BackgroundUnintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital.MethodsA case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records.ResultsThe mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37-4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62-9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32-4.63; P = 0.005) were factors significantly associated with UWL.ConclusionsFactors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.

Project description:BackgroundObesity exacerbates the age-related decline in physical function and causes frailty in older adults; however, the appropriate treatment for obese older adults is controversial.MethodsIn this 1-year, randomized, controlled trial, we evaluated the independent and combined effects of weight loss and exercise in 107 adults who were 65 years of age or older and obese. Participants were randomly assigned to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. The primary outcome was the change in score on the modified Physical Performance Test. Secondary outcomes included other measures of frailty, body composition, bone mineral density, specific physical functions, and quality of life.ResultsA total of 93 participants (87%) completed the study. In the intention-to-treat analysis, the score on the Physical Performance Test, in which higher scores indicate better physical status, increased more in the diet-exercise group than in the diet group or the exercise group (increases from baseline of 21% vs. 12% and 15%, respectively); the scores in all three of those groups increased more than the scores in the control group (in which the score increased by 1%) (P<0.001 for the between-group differences). Moreover, the peak oxygen consumption improved more in the diet-exercise group than in the diet group or the exercise group (increases of 17% vs. 10% and 8%, respectively; P<0.001); the score on the Functional Status Questionnaire, in which higher scores indicate better physical function, increased more in the diet-exercise group than in the diet group (increase of 10% vs. 4%, P<0.001). Body weight decreased by 10% in the diet group and by 9% in the diet-exercise group, but did not decrease in the exercise group or the control group (P<0.001). Lean body mass and bone mineral density at the hip decreased less in the diet-exercise group than in the diet group (reductions of 3% and 1%, respectively, in the diet-exercise group vs. reductions of 5% and 3%, respectively, in the diet group; P<0.05 for both comparisons). Strength, balance, and gait improved consistently in the diet-exercise group (P<0.05 for all comparisons). Adverse events included a small number of exercise-associated musculoskeletal injuries.ConclusionsThese findings suggest that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT00146107.).

Dataset Information

Unintentional Weight Loss in Older Adults: A Geriatric Interprofessional Simulation Case Series for Health Care Providers.

Introduction

Methods

Results

Discussion

Publications

Unintentional Weight Loss in Older Adults: A Geriatric Interprofessional Simulation Case Series for Health Care Providers.

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