Unrealistic Postsurgical Expectation of Independence Predicts Complex Hospital Discharge.

Background: Careful discharge planning for older surgical patients can reduce length of stay, readmission, and cost. We hypothesized that patients who overestimate their self-care ability before surgery are more likely to have complex postoperative discharge planning.

Materials And Methods: The Vulnerable Elders Surgical Pathways and Outcomes Assessment is a brief preoperative assessment that can identify older (age ≥70) patients with multidimensional geriatric risk, defined by all three of the following: (1) physical or cognitive impairment, (2) living alone, and (3) lack of handicap-accessible home.

A multidisciplinary intervention for reducing readmissions among older adults in a patient-centered medical home.

Objectives: To evaluate the effectiveness of a multidisciplinary practice model consisting of medical providers, clinical pharmacists, and social workers on reducing 30-day all-cause readmissions.

Study Design: Retrospective cohort study.

Methods: This study included adults 60 years or older discharged from a large academic medical center.

Analytic morphomics corresponds to functional status in older patients.

Background: Older patients account for nearly half of the United States surgical volume, and age alone is insufficient to predict surgical fitness. Various metrics exist for risk stratification, but little work has been done to describe the association between measures. We aimed to determine whether analytic morphomics, a novel objective risk assessment tool, correlates with functional measures currently recommended in the preoperative evaluation of older patients.

A vertically integrated geriatric curriculum improves medical student knowledge and clinical skills.

The objective of this study was to determine the effect of a vertically integrated curriculum intervention on the geriatric knowledge and performance in clinical skills of third-year medical students. This observational cohort study conducted at the University of Michigan Medical School evaluates the performance of 622 third-year medical students from the graduating class years of 2004 through 2007. An integrated curriculum intervention was developed and implemented for the class of 2006.

Development of a standardized patient instructor to teach functional assessment and communication skills to medical students and house officers.

Professional societies have called for increased geriatrics training for all medical students and physicians. A Geriatrics Standardized Patient Instructor (GSPI) was developed in which learners assess the functional status of a patient preparing for hospital discharge. Standardized patients (SPs) rate learners on functional assessment and communication skills, and provide feedback.

Diabetic neuropathy: inhibitory G protein dysfunction involves PKC-dependent phosphorylation of Goalpha.

We examined the hypothesis that decreased inhibitory G protein function in diabetic neuropathy is associated with increased protein kinase C (PKC)-dependent phosphorylation of the Goalpha subunit. Streptozotocin-induced diabetic rats were studied between 4 and 8 weeks after onset of diabetes and compared with aged-matched healthy animals as controls. Opioid-mediated inhibition of forskolin-stimulated cyclic AMP was significantly less in dorsal root ganglia (DRGs) from diabetic rats compared with controls.

Aging and neural control of the GI tract. II. Neural control of the aging gut: can an old dog learn new tricks?

There has been a dramatic increase in funding available for aging research, primarily due to the fact that answers to questions on aging are likely to have a major impact on the well-being and healthy aging of the world's population for decades to come. The incidence of certain gastrointestinal problems, such as dysphagia and constipation, increases dramatically with age. Changes in gastrointestinal neuromuscular function with aging have been demonstrated in both human and animal models of aging.