Health Status Of Elderly Patients Research Articles

Influence of initial check, information exchange, final accuracy check, reaction information nursing on the psychology of elderly with lung cancer.

As one of the fatal diseases with high incidence, lung cancer has seriously endangered public health and safety. Elderly patients usually have poor self-care and are more likely to show a series of psychological problems. To investigate the effectiveness of the initial check, information exchange, final accuracy check, reaction (IIFAR) information care model on the mental health status of elderly patients with lung cancer. This study is a single-centre study. We randomly recruited 60 elderly patients with lung cancer who attended our hospital from January 2021 to January 2022. These elderly patients with lung cancer were randomly divided into two groups, with the control group taking the conventional propaganda and education and the observation group taking the IIFAR information care model based on the conventional care protocol. The differences in psychological distress, anxiety and depression, life quality, fatigue, and the locus of control in psychology were compared between these two groups, and the causes of psychological distress were analyzed. After the intervention, Distress Thermometer, Hospital Anxiety and Depression Scale (HADS) for anxiety and the HADS for depression, Revised Piper's Fatigue Scale, and Chance Health Locus of Control scores were lower in the observation group compared to the pre-intervention period in the same group and were significantly lower in the observation group compared to those of the control group (P < 0.05). After the intervention, Quality of Life Questionnaire Core 30 (QLQ-C30), Internal Health Locus of Control, and Powerful Others Health Locus of Control scores were significantly higher in the observation and the control groups compared to the pre-intervention period in their same group, and QLQ-C30 scores were significantly higher in the observation group compared to those of the control group (P < 0.05). The IIFAR information care model can help elderly patients with lung cancer by reducing their anxiety and depression, psychological distress, and fatigue, improving their tendencies on the locus of control in psychology, and enhancing their life qualities.

Determinants of self-rated health among elderly patients with hypertension: a cross-sectional analysis based on the Chinese longitudinal healthy longevity survey

ABSTRACT Background The total number of elderly patients with hypertension in China has been increasing year by year, it is necessary to adopt simple and valid measures to evaluate the health status of elderly patients with hypertension to reduce the heavy burden faced by this group. Method This study is a cross-sectional analysis. Participants aged at least 65 years were included. Self-Rated Health (SRH) assessment of respondents was classified into two groups: participants who responded as “very good” and “good” were considered as having good SRH, and participants who answered as “average,” “poor,” and “very poor” were considered as having poor SRH. Chi-square tests were used to determine differences in patient characteristics between the two groups. Binary logistic regression models were used to identify factors associated with SRH. Results The results of the logistic regression analysis indicated that having a spouse, better economic status, exercise, eating fruits and vegetables, nighttime sleep of 7 to 9 hours, good living environment, interaction with friends, and hypertension with comorbidity such as diabetes mellitus, heart disease, stroke or hyperlipidemia were influencing factors of SRH (P < .05). Another finding was that alcohol use significantly affected SRH (P < .05). Depression, anxiety, and community nursing services did not figure as determinants of health in this group. Conclusion The findings of this study provide evidence for the need to develop effective health promotion programs for the well-being of hypertensive patients.

The Importance of Periodic Dental Control in the Oral Health Status of Elderly Patients

The aim of the present study was to evaluate the status of the elderly patient with oral pathology, comparing two groups of elderly patients, from the point of view of presentation for periodic dental control (regular and irregular). In carrying out the study, the following parameters were analyzed: the epidemiological profile of the group of patients; associated chronic diseases; dental hygiene; the accessibility of, and attendance at, dental health services; quality of life; and dental clinical diagnosis. Of the 120 elderly patients included in the study, only 25% present regularly for dental checkups. Increasing age leads to a reduction in the share of patients who regularly present themselves for dental checkups, and patients with higher education and those with higher incomes regularly visit the dentist. Associated chronic diseases are found in both groups; patients with regular checkups have a statistically significantly lower drug consumption for dental pain in the last month compared to those who present irregularly for checkups. A better achievement of dental hygiene is observed in patients who regularly see the dentist. It is alarming that we find patients (10% among those who do not visit the dentist regularly) who do not use a toothbrush and toothpaste, and approximately 40% of the patients enrolled in the study do not know which toothpaste they use. Approximately 40% of the interviewed patients indicate a lack of money as the main reason for attending the dentist only when necessary. Difficult access is mentioned by 10% of the group of patients who regularly visit the dentist and who come from rural areas. The reasons for visiting the dentist are different in the two groups: patients who regularly visit the dentist request caries treatment or prosthetic work, or they present with dental bleeding; patients with irregular checkups especially request emergency services such as toothache treatment, assistance with denture problems, and tooth extractions. When undergoing odontal and endodontic examination, 60% of the respondents who go to the dentist as required suffer from periodontal disease, and 50% of them suffer from class I and II edentation. The results of the study demonstrated that elderly patients who regularly attend periodic dental checkups have better self-reported and dentist-confirmed oral health status.

Effect of Educational Video on Family Caregiver's Burden and Health Status of Elderly Patients with Parkinson's disease

Effect of Educational Video on Family Caregiver's Burden and Health Status of Elderly Patients with Parkinson's disease

The Association Between Communication Skills and the Mental Health of Elderly Patients’ Hospitalization in the South of Iran Hospitals in 2020

Background: Aging is considered a critical period of life, and paying attention to the needs of this stage is a social necessity. Objectives: This study aimed to investigate the association between communication skills and mental health of elderly patients who were hospitalized in the south of Iran hospitals in 2020. Methods: The present study is a descriptive-analytical study conducted on 386 elderly patients. The data of the present study were collected through a three-section questionnaire consists of demographic information, interpersonal communication skills, and mental health. The data were analyzed by descriptive and inferential statistical methods, Pearson correlation coefficient, t-test, ANOVA, and multiple linear regression tests in SPSS software version 23 and at a significance level of α = 0.05. Results: Elderly patients’ communication skills were assessed at a low level (67.01 ± 7.36). The mean score of total mental health among elderly patients indicated mild symptoms of mental disorders among them (177.84 ± 9.21). A significant association was also found between communication skills and mental health disorders among elderly patients (P &lt; 0.001, r = -0.631). The results of multiple linear regression revealed that the components of understanding the message (P &lt; 0.001), emotional control (P = 0.001), listening (P = 0.001), assertiveness (P = 0.005), and insight (P = 0.006) had a positive and significant impact on the mental health of elderly patients. Conclusions: Owing to the correlation between communication skills and mental health, it is recommended to develop and use supportive programs in the form of elderly health programs in medical centers to improve the mental health status of elderly patients.

Dietary Intake and Health Status of Elderly Patients With Type 2 Diabetes Mellitus: Cross-sectional Study Using a Mobile App in Primary Care

BackgroundHealthy dietary intake reduces the risk of complications of diabetes mellitus. Using assessment methods helps to understand these circumstances, and an electronic application may optimize this practice.ObjectiveIn this study, we aimed to (1) assess the dietary intake and health status of elderly patients with type 2 diabetes mellitus (T2DM) in primary care, (2) use a mobile app as a tool for data collection and analysis in the context of primary care, and (3) verify the perceptions of multidisciplinary health professionals regarding app use.MethodsFirst, we developed a mobile app comprised of the questions of the Food and Nutrition Surveillance System (SISVAN) of Brazil, which includes a food frequency questionnaire of food categories with a recall of the previous 7 days. Thereafter, we used the app to collect data on the health status and dietary intake of 154 participants, aged 60-96 years, diagnosed with T2DM, and under treatment in primary care centers in the northern region of Rio Grande do Sul, Brazil. We also collected participants’ demographic, anthropometric, biochemical, and lifestyle variables. The associations between dietary intake and other variables were tested using chi-square tests with a 5% significance level. Regarding the app, we assessed usability and acceptance with 20 health professionals.ResultsBetween August 2018 and December 2018, participants had an intake in line with recommended guidelines for raw salads (57.1%), fruits (76.6%), milk products (68.2%), fried foods (72.7%), savory biscuits (60.4%), cookies or sweets (72.1%), and sugary drinks (92.9%) Meanwhile, the consumption of beans (59.7%), pulses and cooked vegetables (73.4%), and processed meat products (59.7%) was not in line with the guidelines. There were statistically significant differences in meeting the recommended guidelines among participants of different genders (P=.006 and P=.035 for the intake of fried foods and sugary drinks, respectively), place of residence (P=.034 for the intake of cookies and sweets), family history of diabetes (P<.001 for the intake of beans), physical activity engagement (P=.003 for the intake fresh fruits), history of smoking (P=.001 for the intake of raw salads), and presence of coronary disease (P=.050 for the intake of pulses and cooked vegetables). The assessment of usability resulted in a mean score of 71.75 points. Similarly, the assessment of the 15 acceptance questions revealed high scores, and the qualitative questions revealed positive perceptions.ConclusionsWe identified that most participants complied with recommended intake guidelines for 7 of 10 categories in the SISVAN guidelines. However, most participants were overweight and had nutritional and clinical disorders, which justifies further investigations in this population. The app was well-rated by health professionals and considered a useful and promising tool for collecting and analyzing data in primary care settings.

Does Economic Support Have an Impact on the Health Status of Elderly Patients With Chronic Diseases in China? - Based on CHARLS (2018) Data Research.

Objective: The economic support of elderly patients with chronic diseases may affect their health status. This study assessed the impact of economic support on the health status of elderly patients with chronic diseases in China and explored the relationship between regional economic differences and the impact of economic support on health status.Methods: This study used the data of 3,416 elderly patients with chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. Logit model and stepwise regression method were used to analyze and compare the influence of economic support on self-rated health, mental health, and activities of daily living (ADL) of elderly patients with chronic diseases. Sub-regional comparison was used for the research of regional differences in the impact of economic support on health.Results: we find that economic support has a positive effect on the health status of elderly patients with chronic diseases in China. Socioeconomic support has a positive effect on self-rated health and mental health of elderly patients with chronic diseases, and the effect on activities of daily living (ADL) is no longer significant after the gradual inclusion of control variables. Family economic support has no significant impact on the health dimensions of elderly patients with chronic diseases. With respect to regional differences, socioeconomic support can improve mental health in central China and improve self-rated health in western China, while it can improve overall health status in eastern China. The influence of family economic support on different health dimensions in different regions is still insignificant.Conclusions: The health status of elderly patients with chronic diseases is affected by socioeconomic support in China. In order to improve the health of elderly patients with chronic diseases, it is necessary to increase socioeconomic support. Meanwhile, it is also essential to pay attention to the differences in economic support between different regions and increase the socioeconomic support for elderly patients with chronic diseases in undeveloped regions so as to improve their health status.

The Future of the Elderly Population Health Status: Filling a Knowledge Gap

The ageing process in OECD countries calls for a better understanding of the future disease prevalence, life expectancy and patterns of inequalities in health outcomes. In this paper we present the results obtained from several dynamic microsimulation models of the Future Elderly Model (FEM) family for thirteen OECD countries, with the aim of reproducing for the first time comparable longterm trends in individual health status across OECD. The FEM is a multi-risk multi-morbidity dynamic microsimulation model to project health status and health demand. Given the dynamic structure of the model, we allow individual health status to evolve over time according to individual characteristics. Our model provides forecasts of the evolution of life expectancy and prevalences of major chronic conditions and disabilities, overall, by gender and by education. We find a catch-up of the considered European countries main chronic conditions prevalence with the US and a relevant and persistent educational gradient in the health status of elderly patients. Our findings represent a valid contribution to support policy makers in designing and implementing effective interventions in the healthcare sector.

Impact of polypharmacy on oral health status in elderly patients admitted to the recovery and rehabilitation ward.

The oral health status of elderly adults has implications for general health problems. Polypharmacy for elderly adults is associated with an increased risk of potentially inappropriate medicines and many adverse drug events; however, no report has shown that polypharmacy itself is associated with complex oral problems. This study aimed to determine the association between polypharmacy and oral health status in patients admitted to the recovery and rehabilitation ward. This cross-sectional study included 471 patients (age: 81.9 ± 7.7 years, women: n = 346). Oral health status was measured using the Oral Health Assessment Tool and poor oral health status was defined as a score of ≥3. Cases of patients taking six or more medications were defined as polypharmacy. Logistic regression analysis was performed to examine the relationship between polypharmacy and oral health status. Age, sex, body mass index, number of comorbidities, cognitive and motor functions, and potentially inappropriate medicines were set as confounding factors. Using the Oral Health Assessment Tool, 51.0% (n = 240) of patients scored ≥3. The prevalence of patients with polypharmacy was 56.9% (n = 268). Polypharmacy was significantly associated with poor oral health status (odds ratio = 1.65, 95% confidence interval = 1.14-2.39, P = 0.007; adjusted odds ratio = 1.65, 95% confidence interval = 1.12-2.43, P = 0.011). This study showed that polypharmacy was associated with poor oral health status. Focusing on the number of medications may be helpful in detecting oral problems. Geriatr Gerontol Int 2021; 21: 66-70.

Important differences between quality of life and health status in elderly patients suffering from critical limb ischemia.

IntroductionCritical limb ischemia (CLI) patients are often of advanced age with reduced health status (HS) and quality of life (QoL) at baseline. Physical health is considered as the most affected domain due to reduced mobility and ischemic pain. QoL and HS are often used interchangeably in the current literature. HS refers to objectively perceived physical, psychological, and social functioning and in assessing QoL, change is measured subjectively and can only be determined by the individual since it concerns patients’ evaluation of their functioning. It is important to distinguish between QoL and HS, especially in the concept of shared decision-making when the opinion of the patient is key. Goal of this study was to examine and compare QoL and HS in elderly CLI patients in relation to the used therapy, with a special interest in conservatively treated patients.MethodsPatients suffering from CLI and ≥70 years old were included in a prospective study with a follow-up period of 1 year. Patients were divided into three groups; endovascular revascularization, surgical revascularization, and conservative therapy. The WHOQoL-Bref was used to determine QoL, and the 12-Item Short Form Health Survey was used to evaluate HS at baseline, 5–7 days, 6 weeks, 6 months, and 1 year.ResultsPhysical QoL of endovascularly and surgically treated patients showed immediate significant improvement during follow-up in contrast to delayed increased physical HS at 6 weeks and 6 months (P<0.001). Conservatively treated patients showed significantly improved physical QoL at 6 and 12 months (P=0.02) in contrast to no significant improvement in physical HS.ConclusionThis study demonstrates that QoL and HS are indeed not identical concepts and that differentiating between these two concepts could influence the choice of treatment in elderly CLI patients. Discriminating between QoL and HS is, therefore, of major importance for clinical practice, especially to achieve shared decision-making.

Neurosurgery for strokes in elderly people

While neurosurgery plays a marginal role in the treatment of ischemic strokes, and while the development of endovascular techniques has reduced its contribution to the treatment of subarachnoid haemorrhages resulting from an aneurysm, it still has a role to play in the event of a compressive haematoma. The overall improvement of the health status of elderly patients and the progress made in different medical fields have resulted in a more aggressive surgical approach in patients in the third, or even fourth age.

Screening Hipertensi pada Lansia Di Wilayah Puskesmas Banyumas

Abstract Hypertension in the elderly is abnormally high blood pressure where the systolic pressure is above ≥140 mmHg and diastolic pressure above ≥90 mmHg is measured at least on three different occasions. Hypertension is a chronic disease that can not be cured but can be controlled. Hypertension in elderly increases with age and degenerative proceses. This study aims to determine the description of Hypertension Screening in Elderly. The design used of this research was descriptive analytic research using crossectional approach, sampling technique using cluster sampling with random. Data collection instrument used a questionnaire screening the risk of hypertension and measurement of blood pressure used sphygnomanometer. The analysis used Chi Square statistical test with significance level <0,05. The results showed that respondents who risked suffering from hypertension as much as 107 (52.2%) did not have hypertension and 98 (47.8) were at risk of hypertension. There was no relationship between age, sex, marital status and risk of hypertension with consecutive values of 0.530, 0.434 and 0.508. Screening of Hypertension can be done as early detection to determine the health status of elderly patients.

Effect of self-management program on health status of elderly patients with heart failure: a single-blind, randomized clinical trial

Objective: To determine the effect of self-management program on the health status of elderly patients with heart failure. Methods: The present study was a single-blind, randomized clinical trial, and conducted on 90 patients with heart failure of stages II-III at one teaching hospital in eastern Iran in 2017. The participants were randomly assigned into two groups: the intervention group and the control groups, with 45 patients in each group. Self-management programs including awareness and recognition, problem-solving process, diet, exercise, and stress management were carried out. The participants were trained for six weeks and were followed for two months. Data of the health status were collected before, after and eight weeks after intervention by Kansas City Cardiomyopathy Questionnaire. Data analysis by chi-square, independent t-test, Fisher, ANOVA with repeated measures was conducted. Results: Patients in both groups were matched in terms of demographic characteristics before the intervention. There was no significant difference in the mean scores of health status between the two groups (P=0.1) before the intervention. However, the second measurement after intervention showed a significant difference in the mean scores between the two groups (P=0.001). Conclusions: Self-management program can improve the different dimensions of health (except in the subscale of sign and symptoms). Therefore, this supportive method can be used to improve the health of patients and manage problems caused by heart failure.

Depressive Symptoms, Co-Morbidities, and Glycemic Control in Hong Kong Chinese Elderly Patients With Type 2 Diabetes Mellitus.

Undiagnosed depression is an important comorbidity in type 2 diabetes (T2D) which can be detected using the Geriatric Depression Scale (GDS-15) questionnaire. In this cross-sectional study, we examined the associations of depression using GDS score with control of cardiometabolic risk factors and health status in elderly patients with T2D. Between February and December 2013, patients aged ≥65 years who underwent structured comprehensive assessment as a quality improvement program at the Diabetes Center of a teaching hospital were invited to complete the GDS-15 questionnaire. Depression was defined as a GDS score ≥7. Demographic data, prior history of co-morbidities, frequency of self-reported hypoglycemia, and attainment of treatment targets defined as HbA1c, <7%, blood pressure <130/80 mmHg, and LDL-C <2.6 mmol/L were documented. Among 325 participants (65% male, median [interquartile range] age: 69 [8] years), 42 (13%) had depression. Patients with depression had longer disease durations (mean ± SD: 15.1 ± 9.1 vs. 11.6 ± 8.1 years, P = 0.02), more frequent self-reported hypoglycemic events (17 vs. 6%, P = 0.03) and were less likely to attain all three treatment targets (0 vs. 16%, P = 0.004) than those without depression. On multivariable analysis, patients with depression had an odds ratio of 2.84 (95% confidence intervals: 1.35-6.00, P = 0.006) of reporting prior history of co-morbidities. In elderly patients with T2D, depression was not uncommon especially in those with poor control of risk factors, hypoglycemia, and co-morbidities. Inclusion of GDS-15 questionnaire during structured assessment for complications and risk factors can identify these high-risk patients for more holistic management of their physical and mental health.

Epidemiology of chronic noncommunicable diseases and evaluation of life quality in elderly.

Chronic noncommunicable diseases (NCDs) are the leading cause of death, accounting for 70% of global deaths. Also referred to as chronic diseases, NCDs mainly include cardiovascular disease (such as heart disease and stroke), cancer, chronic respiratory disease (such as chronic obstructive pulmonary disease and asthma), and diabetes. The incidence of NCDs is rising over time, becoming one of the most important threats to human health. As a measurement of quality of life, scales can reflect the entire health status of patients. But there are still many disadvantages in the multidimensional health status of elderly patients with chronic diseases, so it is of great significance to develop a simple and practical multidimensional health scale of good reliability and validity for chronic diseases in the elderly.

Oral health and chemotherapy act as cofactors in malnutrition in the elderly withother cancers than head and neck malignancies.

This study explores whether the chemotherapy regimen has a role in inducing oral health problems and malnutrition in elderly patients with other cancers than head and neck malignancies. An observational cross-sectional study was designed to compare the relationships between oral health and nutritional status between four groups of elderly differing in cancer or chemotherapy regimen. Data were collected using a questionnaire including the Mini-Nutritional Assessment (MNA), the Geriatric Oral Health Assessment Index (GOHAI) and questions about perception of xerostomia. The oral examinations recorded the number of functional dental units (PFU) and the presence of oral lesions. The sample comprised 46 patients receiving chemotherapy, 48 patients on a non-chemotherapy regimen, 45 persons in complete remission not under treatment and 53 non-cancer patients. Oral health perception was significantly worse in chemotherapy patients. They reported limiting the kinds of food they consumed, the discomfort felt when eating and took medications for oral pain. Oral lesions were frequent in chemotherapy participants. Nutritional status was related to the cancer treatment regimen (OR = 4.17; p value = 0.017), the presence of oral lesions (OR = 4.51; p value = 0.003), perception of xerostomia (OR = 3.54; p value = 0.012), the number of PFU (OR = 2.51; p value = 0.046) and GOHAI score (OR = 1.617; p value = 0.019). The presence of oral lesions and the chemotherapeutic regimen were highly associated with nutritional status in older patients with cancer. Dental professionals should be asked to intervene preventively and per-therapy to optimise oral health status in elderly patients with other cancers than head and neck malignancies.

Sustained 3-Year Benefits in Quality of Life After Percutaneous Coronary Interventions in the Elderly: A Prospective Cohort Study

BackgroundImpact of percutaneous coronary interventions (PCI) on health-related quality of life (HRQOL) is important but under-reported in elderly patients. ObjectivesTo evaluate long-term health status in elderly patients who underwent PCI. MethodsConsecutive patients who underwent PCI at a university-affiliated hospital from September 2009 to June 2012 were prospectively enrolled with HRQOL assessment at baseline (up to 2 weeks before PCI) and at 6-, 12-, and 36-month follow-up using the EuroQol five-dimensional questionnaire descriptive profile and visual analogue scale (VAS). Minimally important benefit (MIB) in HRQOL was defined as greater than half an SD improvement in the baseline VAS score. ResultsOf 1957 patients, 49.9%, 29.1%, and 21.0% were aged younger than 65 years, 65 to 74 years, and 75 years and older, respectively. Mean VAS scores at baseline (50.1 ± 20.5 vs. 51.6 ± 20.5 vs. 52.6 ± 21.8; P = 0.09) and at 36 months (72.9 ± 14.0 vs. 72.8 ± 16.1 vs. 72.0 ± 14.8; P = 0.77) were similar between the three age groups, respectively. MIB at 36 months was observed in 65.7%, 61.9%, and 61.2% of patients in each age group, respectively. Proportion of patients aged 75 years and older reporting problems in pain/discomfort and self-care reduced from 91.2% and 24.8% at baseline to 41.4% and 10.1% at 36 months, respectively (both P < 0.01). Independent predictors of MIB in HRQOL at 36 months in patients 75 years and older included poor baseline HRQOL, MIB at 6 months, and presentation with myocardial infarction (all P < 0.01). ConclusionsElderly patients experienced sustained long-term improvement in quality of life comparable with younger patients after PCI. Our findings suggest that age per se should not deter against revascularization because of sustained benefit in HRQOL.

Effect of Reflexology Training forFamily Caregivers on Health Status of Elderly Patients with Colorectal Cancer

Patients with colorectal cancer experience physical, psychological and social challenges and family caregivers are usually not prepared for these new challenges. Foot reflexology is one of the most frequently used complementary therapies and has been shown to be effective for cancer patients. The aim: Determine the effect of reflexology training for family caregiver son health status of elderly patients with colorectal cancer. Design: Quasi -experimental design was used in this study. Setting: This study was carried out at Mansoura University hospital (Oncology Center). Subjects: A purposive sample of 50 elderly patients diagnosed with colorectal cancer and their family caregivers attending in the above mentioned settings within a period of six months. Tools: Six tools was utilized in this study; socio demographic and clinical data structured interview schedule, the short form (36) health survey, hospital anxiety & depression scale, memorial symptom assessment scale, foot reflexology knowledge structured interview schedule and foot reflexology training observational checklist. Results: Family caregivers' reflexology training has a significant positive effect on their knowledge and practices and on elderly patients' health status, anxiety & depression and symptoms management. Conclusion: This study concluded that, the implementation of foot reflexology training for family caregivers was successful in improving their knowledge and practice regarding foot reflexology and in improving the health status of elderly patients with colorectal cancer.

Advances in caring for the older cancer patient: a report from the 2015 conference of the International Society of Geriatric Oncology

A paradox in cancer research is that the majority of patients enrolled in clinical trials are relatively young and fit while typical patients in daily practice are elderly and have comorbidities and impaired organ function. Given these differences, many major studies provide an imperfect guide to optimizing the treatment of the majority of patients. Since cancer incidence is highly correlated with age, and since the world's population is rapidly ageing, this problem can only increase. For this reason, oncologists and geriatricians need to collaborate in developing tools to systematically assess the health status of elderly patients and their fitness to receive cancer therapies of various intensity. Tailoring anti-cancer treatments and supportive care to individual needs should be seen as part of the move towards personalized medicine. Achieving this goal is as much of a challenge to developing and middle-income countries as it is to western nations. The 2015 annual conference of the International Society of Geriatric Oncology (SIOG) held in Prague, Czech Republic, November 2015 and had a global focus on advancing the science of geriatric oncology and supportive care. Central to this approach is the systematic assessment of life expectancy, independent functioning, and the physical and psychological health of older cancer patients. The assumption behind comprehensive geriatric assessment is that elderly cancer patients have complex needs. The implication is that effective intervention will require a multidisciplinary team. Examples of effective geriatric assessment, multidisciplinary working and supportive care were presented at the SIOG conference.

Treatment of Newly Diagnosed Elderly Multiple Myeloma.

Multiple myeloma (MM) is a disease of the elderly, with a median age at diagnosis of approximately 70years old, and more than 30% of patients aged >75years. This latter and very elderly population is going to significantly rise in the near future given the increase in life expectancy in Western countries, and, most importantly, global health status of elderly patients is improving, justifying appropriate treatments. Changes in treatment paradigm from the old melphalan-prednisone regimen used since the 1970s to its use as a backbone in a nontransplant setting since the late 1990s have highlighted different subgroups in elderly MM. Some "elderly" patients could be treated like transplant eligible patients, more likely those aged between 65 and the early 70; while a second group would rather be referred to current approved treatment regimens for the non-transplant setting. A dose-intensity approach seems reasonable for this group, aiming for the best response, eventually the complete response (CR) or even minimal residual disease (MRD). The advent of novel agents such as thalidomide, bortezomib, and most recently lenalidomide have allowed a major improvement in outcome as compared to historical combinations, and soon the novel class of monoclonal antibodies should help to further improve these patients' survival. Nonetheless, elderly patients are more susceptible to side effects and are often unable to tolerate full drug doses, and thus require lower dose intensity regimens, or novel drugs or combinations with more favourable safety profile. Recent developments in MM have focused on identifying these vulnerable patients through geriatric assessment and novel myeloma scoring system, including the notions of frailty, disability and comorbidities. Eventually, we have reached an era in which we should be able to provide individualized treatment strategies and drug doses-"tailored therapy"-to improve tolerability and optimize efficacy and ultimately survival for most elderly MM patients.