Aging and the ICU: Podcast with Lauren Ferrante and Julien Cobert
A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken\u2019s post is still one of the most searched and viewed posts on GeriPal.
This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today.\xa0 Julien Cobert just published a study in Chest finding that even after accounting for the rising age of patients admitted to the ICU, rates of pre-existing disability, frailty, and multimorbidity increased over about a ten year period. Rise in these conditions occurred over a decade - what happens over the next 10, 20, 30 years?\xa0\xa0
And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation.\xa0 In a separate study in Chest, Lauren found pre-ICU frailty was associated with post-ICU disability and new nursing home admission.\xa0 Lauren uses her magic wand to address the measurement issue: we\u2019re not measuring function, frailty, and cognition routinely in hospitalized older adults.\xa0 We wouldn\u2019t dream of not measuring oxygen saturation, yet function, which is highly predictive of outcomes older adults care about, many hospitals hardly measure.
Additional links:
- GeriPal podcast with Lauren Ferrante and Nathan Brummel on geriatricizing the ICU
- GeriPal podcast with Tom Gill on the Precipitating Events Study, distressing symptoms, disability, and hospice
- GeriPal podcast with Linda Fried on frailty
- Shunichi Nakagawa\u2019s Tweet that went viral on responding a patient request to drink ice water before death.
And a note- on the podcast you\u2019ll hear a drum track on the song (!).\xa0 I\u2019m taking lessons with an audio producer in LA who is helping me to learn some new Logic Pro post-production skills.\xa0 Bear with me!\xa0 I\u2019m having fun working on these songs from home during COVID.
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