Geriatric oncology in Mexico.

Mexico is an upper-middle income country located in North America, with an increasing life expectancy and a growing population of older adults. Due to population ageing and lifestyle changes, the number of cancer cases amongst older individuals is expected to increase in the upcoming decades, representing a challenge to the healthcare system. The challenges for implementing geriatric oncology care in Mexico include a fragmented healthcare system, as well as the lack of geriatric training amongst healthcare professionals. In this mini-review, we present an overview of the epidemiology of cancer amongst older adults in Mexico, the Mexican healthcare system and ongoing initiatives for the development of geriatric oncology programmes in the country. In addition, we highlight the priorities for future developments in the field of cancer and ageing in Mexico, with a focus on the various stakeholders involved.

CLINICAL DECISION MAKING IN OLDER ADULTS WITH COVID-19 IN DEVELOPING COUNTRIES: LOOKING BEYOND CHRONOLOGICAL AGE.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Older adults have been found as a vulnerable group for developing severe forms of disease and increased mortality. OBJECTIVE: The objective of the study was to propose a pathway to assist the decision-making process for hospital resource allocation for older adults with COVID-19 using simple geriatric assessment-based tools. METHODS: We reviewed the available literature at this point of the COVID-19 outbreak, focusing in older adult care to extract key recommendations for those health-care professionals who will be treating older adults in the hospital emergency ward (HEW) in developing countries during the COVID-19 pandemic. RESULTS: We listed a series of easy recommendations for non-geriatrician doctors in the HEW and suggested simple tools for hospital resource allocation during critical care evaluation of older adults with COVID-19 in low- and middle-income countries. CONCLUSIONS: Age must not be used as the sole criterion for resource allocation among older adults with COVID-19. Simple and efficient tools are available to identify components of the comprehensive geriatric assessment, which could be useful to predict outcomes and provide high-quality care that would fit the particular needs of older adults in resource-limited settings amidst this global pandemic.

Clinical decision making in older adults with COVID-19 in developing countries: looking beyond chronological age

ABSTRACT Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Older adults have been found as a vulnerable group for developing severe forms of disease and increased mortality. Objective: The objective of the study was to propose a pathway to assist the decision-making process for hospital resource allocation for older adults with COVID-19 using simple geriatric assessment-based tools. Methods: We reviewed the available literature at this point of the COVID-19 outbreak, focusing in older adult care to extract key recommendations for those health-care professionals who will be treating older adults in the hospital emergency ward (HEW) in developing countries during the COVID-19 pandemic. Results: We listed a series of easy recommendations for non-geriatrician doctors in the HEW and suggested simple tools for hospital resource allocation during critical care evaluation of older adults with COVID-19 in low- and middle-income countries. Conclusions: Age must not be used as the sole criterion for resource allocation among older adults with COVID-19. Simple and efficient tools are available to identify components of the comprehensive geriatric assessment, which could be useful to predict outcomes and provide high-quality care that would fit the particular needs of older adults in resource-limited settings amidst this global pandemic.

Coronavirus, Ageism, and Twitter: An Evaluation of Tweets about Older Adults and COVID-19.

OBJECTIVES: In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic. High morbidity and mortality rates of COVID-19 have been observed among older adults and widely reported in both mainstream and social media. The objective of this study was to analyze tweets related to COVID-19 and older adults, and to identify ageist content. DESIGN: We obtained a representative sample of original tweets containing the keywords "elderly," "older," and/or "boomer" plus the hashtags "#COVID19" and/or "#coronavirus." SETTING: Tweets posted between March 12 and March 21, 2020. MEASUREMENTS: We identified the type of user and number of followers for each account. Tweets were classified by three raters as (1) informative, (2) personal accounts, (3) personal opinions, (4) advice seeking, (5) jokes, and (6) miscellaneous. Potentially offensive content, as well as that downplaying the severity of COVID-19 because it mostly affects older adults, was identified. RESULTS: A total of 18,128 tweets were obtained, of which a random sample of 351 was analyzed. Most accounts (91.7%) belonged to individuals. The most common types of tweets were personal opinions (31.9%), followed by informative tweets (29.6%), jokes/ridicule (14.3%), and personal accounts (13.4%). Overall, 72 tweets (21.9%) likely intended to ridicule or offend someone and 21.1% had content implying that the life of older adults was less valuable or downplayed the relevance of COVID-19. CONCLUSION: Most tweets related to COVID-19 and older adults contained personal opinions, personal accounts, and jokes. Almost one-quarter of analyzed tweets had ageist or potentially offensive content toward older adults. J Am Geriatr Soc 68:1661-1665, 2020.

Predicting Life Expectancy for Older Adults with Cancer in Clinical Practice: Implications for Shared Decision-making.

PURPOSE OF REVIEW: The calculation of noncancer-specific life expectancy can guide shared decision-making and avoid over- and undertreatment in older adults with cancer. Several factors determine life expectancy, including socio-demographic background, comorbidities, physical performance, and geriatric assessment variables. We present an overview of existing tools to estimate life expectancy, as well as practical examples of how to take into account the patient's noncancer-specific life expectancy when discussing screening decisions, initiation of treatment, and end-of-life care. RECENT FINDINGS: Life expectancy prognostication has been recently recommended by international societies as part of the initial assessment of all older adults with cancer. Additionally, online resources have been created in order to make life expectancy calculation tools accessible for clinicians. Understanding available methods to estimate life expectancy, as well as how to utilize them, is a fundamental part of geriatric oncology that should be integrated into everyday clinical practice.