Geriatric Medicine

Especially in the era of novel AD biomarkers (blood-based, CSF, PET scans), AD treatments, and new definitions of Alzheimer's (Alz Association 2025) -...

2 Answers available

How do you counsel older adults regarding the use of melatonin (dose and timing) for sleep-related problems?

2 Answers available

How soon after a fracture would it be safe to start anti-resorptive therapy?

3 Answers available

Would you continue or stop anticoagulation for a DVT/PE in a patient with active cancer who has completed 6 months of therapy?

Mahé et al., PMID 40162636

3 Answers available

What patient factors are most important when considering who needs a broader workup for osteoporosis prior to starting therapy?

Do you routinely rule out secondary causes of osteoporosis (i.e., TSH) in all patients prior to starting therapy? If you work up all patients, what la...

1 Answer available

What are your thoughts about lion's mane supplementation to slow the decline or improve cognitive capacity for those at risk of dementia?

1 Answer available

What is your preferred approach to obtaining an objective measure of frailty on physical exam in a primary care practice setting?

For example, do you use Timed Up and Go? Chair stands? Other measures?

1 Answer available

Do you recommend starting a statin in patients above 75 years old with diabetes but no known ASCVD?

3 Answers available

How do you counsel older adults regarding the use, dosing, and safety of CBD-containing products for insomnia?

1 Answer available

How do you decide between anticoagulation and observation for an incidentally detected subsegmental pulmonary embolism in elderly patients with a history of gastrointestinal bleeding?

7 Answers available

How do you approach the management of extremely low LDL levels in older adult patients receiving statin therapy for primary prevention of cardiovascular disease?

1 Answer available

How do you choose among SSRIs and dosing strategies for the management of behavioral and psychological symptoms of dementia?

What factors might drive decisions for different SSRIs and/or doses?

1 Answer available

Do you routinely adjust your interpretation of SLUMS and/or MOCA tests in patients depending on their level of education?

2 Answers available

What is your approach to deprescribing cholinesterase inhibitors and/or memantine in advancing stages of dementia?

2 Answers available

What is your approach to bisphosphonate use in patients with advanced chronic kidney disease and osteoporosis?

3 Answers available

What are some practical tips in distinguishing between metabolic bone disease due to chronic kidney disease and osteoporosis?

1 Answer available

What is your approach to initiation of mirtazapine for appetite stimulation and depression in older adults, both in terms of starting dose and titration?

2 Answers available

What is your approach to the use of GLP-1 agonists in older adults with diabetes with or at risk of sarcopenia?

3 Answers available

Would you recommend a GLP-1 agonist as an option to reduce the risk of dementia in patients with a strong family history?

As studied in Tang H, Donahoo WT, DeKosky ST, et al. GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related De...

1 Answer available

For patients over 70 with elevated ASCVD risk but no prior cardiovascular events, do you ever recommend continuing or initiating low-dose aspirin?

Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication

1 Answer available

What is your systolic blood pressure target for patients over 80 with frailty and multiple comorbidities?

1 Answer available

How can we approach tapering or discontinuing biologic DMARDs in patient in their 80s with well controlled rheumatoid arthritis?

3 Answers available

How do you approach balancing the treatment of urinary incontinence with anticholinergic medications with the use of cholinesterase inhibitors in dementia?

1 Answer available

How do you approach individualizing A1c goals in patients with dementia?

2 Answers available

What suggestions for environmental modifications do you find most helpful to reduce the risk of falls in the geriatric population?

Are there certain modifications to the home or aid devices that you commonly recommend? Some that are more cost-effective?

1 Answer available

Do you consider using buspirone for the management of anxiety in older patients?

4 Answers available

Do you routinely prescribe vitamin D to reduce the risk of fall-related fractures in elderly patients regardless of their serum levels?

1 Answer available

When stopping denosumab and transitioning to PO bisphosphonate, do you wait for 6 months after the last denosumab injection to start PO bisphosphonate?

2 Answers available

What is the next best osteoporosis treatment option for patients who completed 2 years of teriparatide, but has contraindication to bisphosphosnate therapy (e.g. history of atypical femur fracture)?

1 Answer available

Would you use a parathyroid hormone analog for treatment of osteoporosis in a patient with mildly elevated AlkPhos of unclear etiology?

1 Answer available

Would you start romosozumab in an active smoker?

1 Answer available

During treatment of severe osteoporosis with PTH analogs (abaloparatide), would a rise in alkaline phosphatase level >200 (in the setting of normal GGT) warrant discontinuation of medication?

There is concern for elevation in alkaline phosphatase as a precursor for bone pathology, such as an increase in risk of bone malignancy, potentially ...

1 Answer available

How do you recommend counseling patients on the prognosis of advanced cancer as a generalist who is not highly specialized in cancer literature or cancer-directed therapies?

2 Answers available

How do you counsel non-diabetic patients who wish to start metformin to reduce the risk of developing dementia?

2 Answers available

Papers discussed in this category

Lancet (London, England), 2015 Mar 12

A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial.

Journal of palliative medicine, 2012-02

Systematic review of cancer presentations with a median survival of six months or less.

Journal of the American Medical Directors Association, 2022 Mar 23

Post-Acute Care Outcomes and Functional Status Changes of Adults with New Cancer Discharged to Skilled Nursing Facilities.

Palliative medicine, 2022 Jul

The utility of the surprise question: A useful tool for identifying patients nearing the last phase of life? A systematic review and meta-analysis.

JAMA, 2021 Apr 13

Screening for Vitamin D Deficiency in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Journal of the American Geriatrics Society, 2025 Jan 29

Updating STEADI for Primary Care: Recommendations From the American Geriatrics Society Workgroup.

The journals of gerontology. Series A, Biological sciences and medical sciences, 2023 Jun 16

Nutritional Interventions: Dietary Protein Needs and Influences on Skeletal Muscle of Older Adults.

Mayo Clinic proceedings, 2000 Jan

The biology of aging.

Journal of the American Geriatrics Society, 2000 Jun

Epidemiology of sarcopenia.

The New England journal of medicine, 2025 Mar 29

Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2021 Feb 08

Safety of Oral Bisphosphonates in Moderate-to-Severe Chronic Kidney Disease: A Binational Cohort Analysis.

Current opinion in nephrology and hypertension, 2022 Jun 10

Clinical utility of bone turnover markers in patients with chronic kidney disease.

The Journal of clinical endocrinology and metabolism, 2022 Dec 17

Inpatient Zoledronic Acid and Integrated Orthopedic and Fracture Liaison Services Improve Osteoporosis Treatment Rates.

J Bone Miner Res, 2024 Aug 21

Zoledronic acid for hip fracture during initial hospitalization.

J Clin Endocrinol Metab, 2023 Oct 18

Safety of Inpatient Zoledronic Acid in the Immediate Postfracture Setting.

Arthritis Rheumatol, 2021 Jul

2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Rheumatology (Oxford, England), 2023 Oct 19

A real-world 2-year prospective study of medication tapering in patients with well-controlled rheumatoid arthritis within the rheumatoid arthritis medication tapering (RHEUMTAP) cohort.

Arthritis research & therapy, 2015 Aug 03

Sustained biologic-free and drug-free remission in rheumatoid arthritis, where are we now?

Arthritis and rheumatism, 2009 Aug

Prevalence of and predictive factors for sustained disease-modifying antirheumatic drug-free remission in rheumatoid arthritis: results from two large early arthritis cohorts.

Journal of pain and symptom management, 2002-05

An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms.

The Cochrane database of systematic reviews, 2006-07-19

Azapirones for generalized anxiety disorder.

Psychiatry and clinical neurosciences, 2010 Feb 01

Randomized, single-blind, trial of sertraline and buspirone for treatment of elderly patients with generalized anxiety disorder.

Basic & clinical pharmacology & toxicology, 2023 Jun 20

Serotonin syndrome-A focused review.

Ochsner journal, 2013 Winter

Serotonin syndrome.

The American journal of psychiatry, 2016-05-01

Heterogeneity of Treatment Response to Citalopram for Patients With Alzheimer's Disease With Aggression or Agitation: The CitAD Randomized Clinical Trial.

The American journal of psychiatry, 2016-05-01

Effects of Citalopram on Neuropsychiatric Symptoms in Alzheimer's Dementia: Evidence From the CitAD Study.

JAMA, 2014 Feb 19

Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial.

Frontiers in aging neuroscience, 2023 Mar 03

Comparative efficacy and safety of antidepressant therapy for the agitation of dementia: A systematic review and network meta-analysis.

Journal of Alzheimer's disease : JAD, 2020

The Efficacy of Sertraline, Escitalopram, and Nicergoline in the Treatment of Depression and Apathy in Alzheimer's Disease: The Okayama Depression and Apathy Project (ODAP).

Journal of the American Geriatrics Society, 2025 Apr 28

Treatment of Inappropriate Sexual Behavior in Persons With Dementia: A Systematic Review.

JAMA, 2025 Dec 02

Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis.

Diabetes research and clinical practice, 2021 Mar 08

GLP-1 receptor agonists and SGLT2 inhibitors for older people with type 2 diabetes: A systematic review and meta-analysis.

Journal of diabetes, 2025 Jun

Monitoring Sarcopenia With Incretin Receptor Activator Treatment.

Annals of internal medicine, 2021 Nov 23

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation : A Multicenter Prospective Cohort Study.

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2025 Mar 09

Denosumab discontinuation in the clinic: implications of rebound bone turnover and emerging strategies to prevent bone loss and fractures.

JAMA, 2011-09-28

Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis.

Psychiatry research, 2020 Dec 13

The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An update on management of behavioral and psychological symptoms in dementia.

Drugs & aging, 2001

Hypertension in the Very Elderly Trial (HYVET): protocol for the main trial.

Circulation research, 2019 Mar 29

Hypertension Management in Older and Frail Older Patients.

JAMA internal medicine, 2022 Jan 01

Time to Benefit of Bisphosphonate Therapy for the Prevention of Fractures Among Postmenopausal Women With Osteoporosis: A Meta-analysis of Randomized Clinical Trials.

Annals of internal medicine, 2023 Jan 03

Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians.

Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023 Sep 30

Study design and methods: U.S. study to protect brain health through lifestyle intervention to reduce risk (U.S. POINTER).

JAMA, 2025 Aug 26

Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial.

BMC geriatrics, 2019 Feb 04

The scientific evidence for a potential link between confusion and urinary tract infection in the elderly is still confusing - a systematic literature review.

Nutrition (Burbank, Los Angeles County, Calif.), 2001-04

Japanese fermented soybean food as the major determinant of the large geographic difference in circulating levels of vitamin K2: possible implications for hip-fracture risk.

International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 2022 Aug 30

Role of vitamin K2 in bone-vascular crosstalk.

Frontiers in endocrinology, 2025 Nov 05

The effect of vitamin K2 supplementation on bone turnover biochemical markers in postmenopausal osteoporosis patients: a systematic review and meta-analysis.

Frontiers in public health, 2022 Aug 11

Efficacy of vitamin K2 in the prevention and treatment of postmenopausal osteoporosis: A systematic review and meta-analysis of randomized controlled trials.

Circulation, 2024 Sep 24

2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Journal of clinical anesthesia, 2023 Jul 11

Diagnostic and prognostic value of cardiac stress testing before major noncardiac surgery-A cohort study.

Hypertension (Dallas, Tex. : 1979), 2005 Jun 06

Effect of compensated renal dysfunction on approved heart failure markers: direct comparison of brain natriuretic peptide (BNP) and N-terminal pro-BNP.

European journal of heart failure, 2022 Aug 08