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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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Mortality in Elderly Patients with Acute Venous Thromboembolism

  Long-term predictors and causes of death are understudied in elderly patients with acute venous thromboembolism. Methods We prospectively followed up 991 patients aged ≥65 years with acute venous thromboembolism in a multicenter Swiss cohort study. The primary outcome was overall mortality. We explored the association between patient baseline characteristics and mortality, adjusting for other […]

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