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Choosing Wisely? Measuring the Burden of Medications in Older Adults near the End of Life: Nationwide, Longitudinal Cohort Study

The burden of medications near the end of life has recently come under scrutiny, because several studies suggested that people with life-limiting illness receive potentially futile treatments. Methods We identified 511,843 older adults (>65 years) who died in Sweden between 2007 and 2013 and reconstructed their drug prescription history for each of the last 12 […]

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Joseph S. Alpert, MD

Polypharmacy in Elderly Patients: The March Goes On and On

Polypharmacy is a major public health problem in the United States and abroad. Although there is no standard definition of polypharmacy, I see and recognize it every day in the outpatient and inpatient environment. A typical example that I saw yesterday was an 84-year-old man admitted to our internal medicine service for worsening heart failure. […]

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Predicting Falls in People Aged 65 Years and Older from Insurance Claims

Accidental falls among people aged 65 years and older caused approximately 2,700,000 injuries, 27,000 deaths, and cost more than 34 billion dollars in the US annually in recent years. Here, we derive and validate a predictive model for falls based on a retrospective cohort of those 65 years and older. Methods Insurance claims from a […]

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Training Geriatric Cardiologists for an Aging Population: Time to Get Going

Our society is aging—20% of the US population will be aged more than 65 years by 2030, and the number of the “oldest old,” those aged more than 85 years, will triple by 2050. Cardiovascular disease prevalence increases exponentially with age, and direct costs for cardiovascular care in the United States will exceed $800 billion […]

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Restoring Balance: Paraneoplastic Cerebellar Degeneration

A 63-year-old woman was evaluated for 3 months of gradually worsening tremors in her legs. The tremors were worse in the right leg, increased in amplitude on standing or walking, and were absent at rest. She also had a milder tremor of her head. She had no headache, confusion, weakness, numbness, or dyscoordination. Her medical […]

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