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Blog and Commentary

The Geriatric Surgery Program at Johns Hopkins

June 29, 2021
Susan Gearhart, MD
Susan Gearhart, MD

Associate Professor of Surgery
Johns Hopkins University School of Medicine
Faculty Profile

Johns Hopkins Bayview Medical Center (JHBMC) annually performs surgical procedures on more than 600 patients over the age of 65, with nearly one-third of these patients identified as frail and at high-risk for adverse outcomes.  It is currently the goal of JHBMC to be the national leader in discovering how to bring our older patients through surgery safely, preserve quality of life, and return them to their loved ones as soon as possible. The first step in mitigating the impact of frailty on surgical outcomes is being able to recognize who is vulnerable. JHBMC has been a leader in the affirmation and implementation of best practice guidelines put forth by the American College of Surgeons and the American Geriatric Society for the care of the older surgical patient. JHBMC participated in a national survey to examine what resources were most needed for the care of the older frail surgical patient.... Continue Reading

 

Understanding the etiology underlying frailty: Making frail older adults less frail 

May 14, 2021
Karen Bandeen-Roche, PhD
Karen Bandeen-Roche, PhD

Frank Hurley and Catharine Dorrier Chair of Biostatistics
Johns Hopkins Bloomberg School of Public Health
Co-Director, Johns Hopkins Older Americans Independence Center
Faculty Profile

Why do older adults grow frail?  Because they grow old--but not only this. We all know, or we recognize as researchers, that some octogenarians thrive, while others ten years younger are highly vulnerable.  Our field of gerontology often asks a different question: How should an older adult's frailty influence the care we provide them? That's important. So also, though, is to treat the frailty itself: truly treat, and not just ameliorate symptoms. This is what any one of us would wish if we were frail—to not be as frail anymore.  Continue Reading

 

Frailty and Cognitive Impairment: Time to Acknowledge and Embrace Heterogeneity

January 19, 2021
Qian-Li Xue, PhD
Qian-Li Xue, PhD

Associate Professor of Geriatric Medicine
Johns Hopkins University School of Medicine
Faculty Profile

Frailty and cognitive impairment, two common geriatric conditions, are known to be associated with late-life vulnerability in older adults. An estimated 15% of non-nursing home older adults in the United States aged 65 and over are frail, and about 22% and 9% have mild cognitive impairment and dementia. Physical frailty and cognitive impairment often co-exist in older adults. However, there are sizeable subgroups who have one but not the other. Continue Reading

 

World AIDS Day 2020 Reflection--Frailty, Resilience, and Impact.

December 01, 2020
Todd T. Brown, MD, PhD
Todd T. Brown, MD, PhD

Professor of Medicine, Division of Endocrinology, Diabetes, & Metabolism
Johns Hopkins University School of Medicine
Faculty Profile

On December 1st 1988, the first World AIDS Day was observed to support people living with HIV (PLWH) and remember those who died during the initial phase of the AIDS epidemic.  Now, 32 years later, HIV has been transformed into a chronic disease with the widespread use of effective combination antiretroviral therapy. The goal of ending the HIV epidemic, while aspirational, is increasingly achievable with the widespread test and treat efforts and very effective prevention strategies. Continue Reading

 

Safer Holiday Plans for Older and Vulnerable People

November 23, 2020
Anthony L. Teano, MLA
Anthony L. Teano, MLA

Communications Specialist
Johns Hopkins University School of Medicine

It should come as no surprise that observing the holidays will be different this year.  Here we outline important considerations about holiday gatherings during COVID-19 times, with special consideration to the health of older and more vulnerable relatives and friends. Continue Reading

 

Double Jeopardy for Older Adults of Color: An Urgent Call to Address Frailty Disparities in the United States

November 18, 2020
Karen Bandeen-Roche, PhD
Karen Bandeen-Roche, PhD

Frank Hurley and Catharine Dorrier Chair of Biostatistics
Johns Hopkins Bloomberg School of Public Health
Co-Director, Johns Hopkins Older Americans Independence Center
Faculty Profile

 Sarah L. Szanton, PhD, MSN, RN
Sarah L. Szanton, PhD, MSN, RN

FAAN, ANP
Professor
Endowed Professor for Health Equity and Social Justice
Director, Center for Innovative Care in Aging
Faculty Profile

Roland J. Thorpe, Jr., PhD
Roland J. Thorpe, Jr., PhD

Co-Director DrPH Concentration in Health, Equity, and Social Justice
Professor
Faculty Profile

Racial inequality that has been embedded in US structures and institutions has been exposed by twin catastrophes of 2020. In the height of the early novel coronavirus pandemic, Black, Latinx, and Native Americans were roughly 5 times as likely to be hospitalized for COVID-19 than their white peers, and Black Americans were twice as likely to die as whites (CDC COVID-19 Hospitalization by Race/Ethnicity, accessed 11/18/20). The killing of George Floyd, Ahmaud Arbery, Breonna Taylor, and others highlight the fact that people of color in the US continue to disproportionately experience police and vigilante violence along with other forms of inequality, including substandard housing, under-resourced schools, and restricted access to living-wage employment. Continue Reading


 

Overcoming the stress of selecting a frailty assessment instrument: guidance and considerations.

November 13, 2020
Brian Buta 2020
Brian Buta, MHS

Project Administrator, Geriatric Medicine
Johns Hopkins University School of Medicine
Faculty Profile

Research on frailty has exploded over the past two decades. A quick PubMed search of the term shows an exponential increase in the number of frailty-related publications since the early 2000s. But the concept of frailty can be diverse in its underlying theory and measurement... So how do we move past these challenges? Continue Reading


 

Healthy Voting is a Sacred Right

October 15, 2020
Anthony L. Teano, MLA
Anthony L. Teano, MLA

Communications Specialist
Johns Hopkins University School of Medicine

Everyone in our clinician and researcher community is invited to share vote-by-mail information with their patients and families.  This blog offers a summary of ways to help older people get out their votes as safely as possible in 2020, and it provides a voter’s personal experience on the ease of using a vote-by-mail ballot at a community-based official election ballot drop box. Continue Reading


 

Self-Efficacy as a Tool for Older Adults to Cope with Coronavirus

September 17, 2020
Melissa deCardi Hladek, PhD, CRNP, FNP-BC
Melissa deCardi Hladek, PhD, CRNP, FNP-BC

Assistant Professor, Department of Nursing Faculty
Johns Hopkins School of Nursing
Faculty Profile

JS is a 72 year-old caregiver to her 75 year-old husband with advanced heart failure.  She usually brings him in to clinic every 3 months.  In April, she was able to conduct a telemedicine visit with the heart failure clinic. She said her grand-daughter had face-timed with her from out of state and talked her through using the computer to connect to the electronic record, but she had to search for her glasses to read the weight chart to the provider, as she could not scan and upload it. And she got flustered manipulating the camera to show his degree of edema. She requested refills but, she expressed a sincere fear of going to the pharmacy to pick-up the medications, where there may be sick people.  JS is not alone in the adaptations she is making or the stress she feels from having to do so.  Even formerly routine activities of daily living like grocery shopping feel oddly intense, full of new rules and routines. This is not normal time; this is pandemic time, and the impacts on health are likely to be significant even in those who never get COVID-19.  Continue Reading