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Geriatrics, Volume 8, Issue 1 (February 2023) – 27 articles

Cover Story (view full-size image): Dysphagia poses a huge health issue in our aging population, impacting patients psychologically and leading to aspiration, malnutrition, and airway obstruction. This systematic review evaluates the use of carbonated liquids to provide sensory enhancement in the rehabilitation of dysphagia. The review highlights the limited research in this field and heterogeneity of study methodology, although there is some promise. Further longitudinal, large-scale studies are required to further investigate the potential of carbonated water in dysphagia rehabilitation before it can be embedded into routine clinical practice. View this paper
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12 pages, 1088 KiB  
Article
Predictors of Health Satisfaction in Spanish Physically Active Older Adults: A Cross-Sectional Observational Study
by Ana Isabel Agustí, Javier Guillem-Saiz, Jesús González-Moreno, María Cantero-García, Igor Cigarroa and María Antonia Parra-Rizo
Geriatrics 2023, 8(1), 27; https://doi.org/10.3390/geriatrics8010027 - 18 Feb 2023
Cited by 4 | Viewed by 1412
Abstract
Studies that analyze the predictors of satisfaction with the health of the elderly are scarce. That is the reason why the objective of this study is to analyze whether the physical-psychological state, sports practice, and the use of socio-health resources are factors that [...] Read more.
Studies that analyze the predictors of satisfaction with the health of the elderly are scarce. That is the reason why the objective of this study is to analyze whether the physical-psychological state, sports practice, and the use of socio-health resources are factors that predict satisfaction with health status in physically active elderly people. The Physical Activity and Quality of Life questionnaires were applied to a sample of 397 elderly people in this cross-sectional observational study. The data have been analyzed using Student’s t-test chi-square test, Cohen’s d, Phi Coefficient and Cramer’s V. The results have shown that the lack of physical illnesses (OR = 3.920; p < 0.001) and psychological problems (OR = 1.940; p = 0.032), practicing a high level of physical activity (OR = 2.049; p = 0.001), having high scores in functional skills (OR = 8.059; p < 0.001) and using little social and health services (OR = 2.595; p < 0.001) are all predictors of being highly satisfied with one’s health. In conclusion, predictors associated with high health satisfaction of active older people have been found, such as functional abilities, the existence of physical illness, psychological problems, level of physical activity, frequency of use of health and social services and satisfaction with health and social services; but it is not associated with gender or age of participants. Full article
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9 pages, 236 KiB  
Article
In Situ Simulation Training for Frailty
by Liam Dunnell, Anna Nicole Barnard, Katie Chu, Ania Barling, Jonathan Birns and Grace Walker
Geriatrics 2023, 8(1), 26; https://doi.org/10.3390/geriatrics8010026 - 17 Feb 2023
Cited by 1 | Viewed by 1472
Abstract
Background: People living with frailty account for a significant proportion of hospital inpatients and are at increased risk of adverse events during admission. The understanding of frailty remains variable among hospital staff, and there is a need for effective frailty training across multidisciplinary [...] Read more.
Background: People living with frailty account for a significant proportion of hospital inpatients and are at increased risk of adverse events during admission. The understanding of frailty remains variable among hospital staff, and there is a need for effective frailty training across multidisciplinary teams. Simulation is known to be advantageous for improving human factor skills in multidisciplinary teams. In situ simulation can increase accessibility and promote ward team learning, but its effectiveness with respect to frailty has not been explored. Method: A single-centre, multi-fidelity, inter-professional in situ frailty simulation programme was developed. One-hour sessions were delivered weekly using frailty-based clinical scenarios. Mixed-method evaluation was used, with data collected pre- and post-session for comparison. Results: In total, 86 multidisciplinary participants attended 19 sessions. There were significant improvements in self-efficacy rating across 10 of 12 human factor domains and in all frailty domains (p < 0.05). The common learning themes were situational awareness, communication and teamwork. Participants commented on the value of learning within ward teams and having the opportunity to debrief. Conclusion: In situ simulation can improve the self-efficacy of clinical and human factor skills related to frailty. The results are limited by the nature of self-reporting methods, and further studies assessing behavioural change and clinical outcomes are warranted. Full article
(This article belongs to the Collection Frailty in Older Adults)
10 pages, 521 KiB  
Article
Severe Periodontitis Increases the Risk of Oral Frailty: A Six-Year Follow-Up Study from Kashiwa Cohort Study
by Misa Nishimoto, Tomoki Tanaka, Hirohiko Hirano, Yutaka Watanabe, Yuki Ohara, Maki Shirobe and Katsuya Iijima
Geriatrics 2023, 8(1), 25; https://doi.org/10.3390/geriatrics8010025 - 13 Feb 2023
Cited by 1 | Viewed by 1913
Abstract
Oral frailty, overlapping a decline in multi-faceted oral functions and often seen in older adults, increases risks of adverse health outcomes, thereby necessitating earlier measures. Tooth loss, a major element of oral frailty, is mainly caused by periodontal disease and is an irreversible [...] Read more.
Oral frailty, overlapping a decline in multi-faceted oral functions and often seen in older adults, increases risks of adverse health outcomes, thereby necessitating earlier measures. Tooth loss, a major element of oral frailty, is mainly caused by periodontal disease and is an irreversible event. Therefore, this study aimed to clarify whether advanced periodontal disease increases the risks of “new-onset” oral frailty through a longitudinal analysis based on the 2012 baseline survey of the Kashiwa cohort and the follow-up assessments conducted in 2013, 2014, 2016, and 2018. The participants were disability-free, non-orally frail older adults living in Kashiwa City. Of the 1234 participants (72.2 ± 5.1 years old; 50.8% men) analyzed in this study, oral frailty occurred in 23.1% within the six-year period. The group with Community Periodontal Index (CPI) ≥ 3 at baseline had no significant difference in the risk of oral frailty compared with CPI ≤ 2; however, CPI4 at baseline was related to the increased risk of oral frailty compared with CPI ≤ 3 (an adjusted hazard ratio (95% confidence interval): 1.42 (1.12–1.81). Conclusively, severe periodontitis (CPI4) might be associated with new-onset oral frailty, suggesting that prevention of periodontal disease could contribute to oral frailty prevention. Full article
(This article belongs to the Collection Frailty in Older Adults)
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19 pages, 2521 KiB  
Systematic Review
Preoperative Risk Factors Associated with Increased Incidence of Postoperative Delirium: Systematic Review of Qualified Clinical Studies
by Vlasios Karageorgos, Lior Mevorach, Melissa Silvetti and Federico Bilotta
Geriatrics 2023, 8(1), 24; https://doi.org/10.3390/geriatrics8010024 - 07 Feb 2023
Cited by 2 | Viewed by 2850
Abstract
Postoperative delirium (POD) is an acute alteration of mental state, characterized by reduced awareness and attention, occurring up to five postoperative days after recovery from anesthesia. Several original studies and reviews have identified possible perioperative POD risk factors; however, there is no comprehensive [...] Read more.
Postoperative delirium (POD) is an acute alteration of mental state, characterized by reduced awareness and attention, occurring up to five postoperative days after recovery from anesthesia. Several original studies and reviews have identified possible perioperative POD risk factors; however, there is no comprehensive review of the preoperative risk factors in patients diagnosed with POD using only validated diagnostic scales. The aim of this systematic review was to report the preoperative risk factors associated with an increased incidence of POD in patients undergoing non-cardiac and non-brain surgery. The reviewed studies included original research papers that used at least one validated diagnostic scale to identify POD occurrence for more than 24 h. A total of 6475 references were retrieved from the database search, with only 260 of them being suitable for further review. Out of the 260 reviewed studies, only 165 that used a validated POD scale reported one or more preoperative risk factors. Forty-one risk factors were identified, with various levels of statistical significance. The extracted risk factors could serve as a preoperative POD risk assessment workup. Future studies dedicated to the further evaluation of the specific preoperative risk factors’ contributions to POD could help with the development of a weighted screening tool. Full article
(This article belongs to the Special Issue Advancing the Care of Delirium and Comorbid Dementia)
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12 pages, 246 KiB  
Article
Talking about Meaning and Loss with Relatives of Persons with Dementia: An Ethnographic Study in a Nursing Home
by Caroline Couprie and Jenny T. van der Steen
Geriatrics 2023, 8(1), 23; https://doi.org/10.3390/geriatrics8010023 - 03 Feb 2023
Cited by 1 | Viewed by 1307
Abstract
Advance care planning (ACP) can help prepare for future losses and decisions to be taken. However, relatives of persons with dementia may wait for healthcare professionals to initiate ACP conversations which may not adequately address their individual information needs. To evaluate inducing and [...] Read more.
Advance care planning (ACP) can help prepare for future losses and decisions to be taken. However, relatives of persons with dementia may wait for healthcare professionals to initiate ACP conversations which may not adequately address their individual information needs. To evaluate inducing and enhancing conversations about meaning and loss, we conducted an ethnographic study on nurse-led ACP conversations using a question prompt list (QPL) on six dementia wards of a nursing home in the Netherlands from January to September 2021. Staff received training in using the QPL, with information and sample questions to inspire relatives to ask their questions, in particular on meaning and loss. Thematic analysis was applied to transcribed interviews and memos of observations. Nursing staff in particular was concerned about having to be available to answer questions continuously. Relatives used the study as an opportunity to get in touch with professionals, and they saw the QPL as an acknowledgement of their needs. There was a mismatch in that staff wished to discuss care goals and complete a care plan, but the relatives wanted to (first) address practical matters. A QPL can be helpful to conversations about meaning and loss, but nursing staff need dedicated time and substantial training. Joint agenda setting before the conversation may help resolve a mismatch in the preferred topics and timing of conversations. Full article
15 pages, 288 KiB  
Review
Recognition of Delirium Superimposed on Dementia: Is There an Ideal Tool?
by Priyanka Shrestha and Donna M. Fick
Geriatrics 2023, 8(1), 22; https://doi.org/10.3390/geriatrics8010022 - 02 Feb 2023
Cited by 5 | Viewed by 2775
Abstract
Delirium in persons with dementia (DSD) is a common occurrence. Over the past three decades, several tools have been developed and validated to diagnose delirium, yet there is still a shortage of tools recommended in persons with dementia and there is a lack [...] Read more.
Delirium in persons with dementia (DSD) is a common occurrence. Over the past three decades, several tools have been developed and validated to diagnose delirium, yet there is still a shortage of tools recommended in persons with dementia and there is a lack of sufficient research on the accuracy of performance of such tools in this growing population. The purpose of this article is to (1) conduct a clinical review of the detection of DSD across settings of care by formal health care professionals and informal family members and care partners; (2) identify barriers and facilitators to detection and highlight delirium tools that have been tested in person with dementia; and (3) make recommendations for future research, practice, and policy. Given this review, an “ideal” tool for DSD would point to tools being brief, easy to integrate into the EMR, and accurate with at least 90% accuracy given the poor outcomes associated with delirium and DSD. Knowing the baseline and communication between family members and healthcare professionals should be a top priority for education, research, and health systems policy. More work is needed in better understanding DSD and optimizing and standardizing feature assessment, especially the acute change feature at the bedside for DSD. Full article
(This article belongs to the Special Issue Advancing the Care of Delirium and Comorbid Dementia)
13 pages, 440 KiB  
Article
How Well Did the Healthcare System Respond to the Healthcare Needs of Older People with and without Dementia during the COVID-19 Pandemic? The Perception of Healthcare Providers and Older People from the SI4CARE Project in the ADRION Region
by Stella Fragkiadaki, Dionysia Kontaxopoulou, Evangelia Stanitsa, Efthalia Angelopoulou, Dimosthenis Pavlou, Darja Šemrov, Simon Colnar, Mitja Lustrek, Bojan Blažica, Inga Vučica, Roberta Matković, Katarina Vukojevic, Ana Jelicic, Pietro Hiram Guzzi, Vlatka Martinović, Amina Pekmez Medina, Guido Piccoli, Margherita Menon, Srdjan Kozetinac, Miodrag Miljković, Chrysanthi Kiskini, Themis Kokorotsikos, Vasiliki Zilidou, Ivan Radević, John Papatriantafyllou, Eleftherios Thireos, Agis Tsouros, Vlado Dimovski and Sokratis G. Papageorgiouadd Show full author list remove Hide full author list
Geriatrics 2023, 8(1), 21; https://doi.org/10.3390/geriatrics8010021 - 01 Feb 2023
Cited by 5 | Viewed by 1969
Abstract
One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the [...] Read more.
One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the older people with or without cognitive impairment and their caregivers in the Adrion/Ionian region. Data were collected through e-questionnaires regarding the adequacy of the healthcare system and were anonymously administered to older individuals and stakeholder providers in the following countries: Slovenia, Italy (Calabria), Croatia, Bosnia and Herzegovina, Greece, Montenegro, and Serbia. Overall, 722 older people and 267 healthcare stakeholders participated in the study. During the COVID-19 pandemic, both healthcare stakeholders and the older population claimed that the healthcare needs of the older people and their caregivers increased dramatically in all countries, especially in Italy (Calabria), Croatia and BiH. According to our results, countries from the Adrion/Ionian regions faced significant challenges to adjust to the special needs of the older people during the COVID-19 pandemic, which was possibly due to limited accessibility opportunities to healthcare facilities. These results highlight the need for the development of alternative ways of providing medical assistance and supervision when in-person care is not possible. Full article
(This article belongs to the Collection Ageism, the Black Sheep of the Decade of Healthy Ageing)
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8 pages, 236 KiB  
Communication
Integration of Oral Health into General Health Services for Older Adults
by Alice Kit Ying Chan, Yiu Cheung Tsang, Chloe Meng Jiang, Katherine Chiu Man Leung, Edward Chin Man Lo and Chun Hung Chu
Geriatrics 2023, 8(1), 20; https://doi.org/10.3390/geriatrics8010020 - 30 Jan 2023
Cited by 4 | Viewed by 2056
Abstract
The prevalence of oral diseases in the older adult population remains high worldwide and is expected to surge in the coming decade. The World Health Organization (WHO) has listed the oral health of older adults as one of its pivotal concerns. Oral health [...] Read more.
The prevalence of oral diseases in the older adult population remains high worldwide and is expected to surge in the coming decade. The World Health Organization (WHO) has listed the oral health of older adults as one of its pivotal concerns. Oral health affects general health, and oral diseases increase mortality and morbidity in older adults. Integrating oral health into the general health service with a patient-centred approach can be an effective way to improve oral and systemic health for older adults simultaneously. This integration tackles the shared risk factors of both oral and noncommunicable diseases, aids in the early detection of systemic disease, strengthens health surveillance, enhances efficient data sharing, and allows for the better allocation of resources and the workforce in the healthcare system. However, the oral healthcare sector operates as an isolated field, with an emphasis on intervention rather than prevention, which presents a key challenge to the success of integration. Therefore, refocusing oral healthcare service on prevention is paramount. In addition, approaches taken in clinical practice implementation, interprofessional education and training, technology and innovation, research and evaluation, advocacy by national professional oral healthcare organizations, and policy making will ensure the efficient, effective, and long-term integration of oral and general health services. Integrating these services would foster the accessibility and affordability of oral healthcare services for older adults to improve their oral health and overall well-being in the coming decade. This review aims to discuss the merits and outline the challenges of integrating oral health into general health services for older adults and to propose the approaches that could be taken. Full article
12 pages, 954 KiB  
Article
A Molecular and Epidemiological Investigation of a Large SARS-CoV-2 Outbreak in a Long-Term Care Facility in Luxembourg, 2021
by Corinna Ernst, Yolanda Pires-Afonso, Dritan Bejko, Conny Huberty, Thomas G. Dentzer, Anke Wienecke-Baldacchino, Eric Hugoson, Daniel Alvarez, Murielle Weydert, Anne Vergison and Joël Mossong
Geriatrics 2023, 8(1), 19; https://doi.org/10.3390/geriatrics8010019 - 26 Jan 2023
Cited by 1 | Viewed by 1531
Abstract
In spring 2021, a long-term care facility (LTCF) of 154 residents in Luxembourg experienced a large severe, acute respiratory-syndrome coronavirus 2 (SARS-CoV-2) outbreak a few days after a vaccination campaign. We conducted an outbreak investigation and a serosurvey two months after the outbreak, [...] Read more.
In spring 2021, a long-term care facility (LTCF) of 154 residents in Luxembourg experienced a large severe, acute respiratory-syndrome coronavirus 2 (SARS-CoV-2) outbreak a few days after a vaccination campaign. We conducted an outbreak investigation and a serosurvey two months after the outbreak, compared attack rates (AR) among residents and staff, and calculated hospitalization and case-fatality rates (CFR). Whole genome sequencing (WGS) was performed to detect variants in available samples and results were compared to genomes published on GISAID. Eighty-four (55%) residents and forty-five (26%) staff members tested positive for SARS-CoV-2; eighteen (21%) residents and one (2.2%) staff member were hospitalized, and twenty-three (CFR: 27%) residents died. Twenty-seven (21% of cases) experienced a reinfection. Sequencing identified seventy-seven cases (97% of sequenced cases) with B.1.1.420 and two cases among staff with B.1.351. The outbreak strain B.1.1.420 formed a separate cluster from cases from other European countries. Convalescent and vaccinated residents had higher anti-SARS-CoV-2 IgG antibody concentrations than vaccinated residents without infection (98% vs. 52%, respectively, with >120 RU/mL, p < 0.001). We documented an extensive outbreak of SARS-CoV-2 in an LTCF due to the presence of a specific variant leading to high CFR. Infection in vaccinated residents increased antibody responses. A single vaccine dose was insufficient to mitigate the outbreak. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in Older People)
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8 pages, 667 KiB  
Editorial
Practical Implementation of the Comprehensive Geriatric Assessment to Optimise Care for Older Adults with Cancer
by Laura Tack, Patricia Schofield, Tom Boterberg, Rebecca Chandler, Christopher N. Parris and Philip R. Debruyne
Geriatrics 2023, 8(1), 18; https://doi.org/10.3390/geriatrics8010018 - 23 Jan 2023
Cited by 1 | Viewed by 2480
Abstract
Whilst cancer remains a very serious health problem at any stage, cancer combined with increasing age creates an even more challenging situation for health care providers [...] Full article
(This article belongs to the Section Geriatric Oncology)
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13 pages, 305 KiB  
Article
Attitudes toward COVID-19 Vaccine Uptake: A Qualitative Study of Mostly Immigrant Racial/Ethnic Minority Older Adults
by Carla Valero-Martínez, Christopher Martínez-Rivera, Jenny Zhen-Duan, Marie Fukuda and Margarita Alegría
Geriatrics 2023, 8(1), 17; https://doi.org/10.3390/geriatrics8010017 - 20 Jan 2023
Cited by 2 | Viewed by 1574
Abstract
(1) Background: Few qualitative studies address diverse older adults’ perceptions of COVID-19 vaccination in the United States, including non-English speakers and immigrant populations. This study aims to understand the attitudes of diverse, primarily immigrant older adults in the U.S. toward the COVID-19 vaccine [...] Read more.
(1) Background: Few qualitative studies address diverse older adults’ perceptions of COVID-19 vaccination in the United States, including non-English speakers and immigrant populations. This study aims to understand the attitudes of diverse, primarily immigrant older adults in the U.S. toward the COVID-19 vaccine and its influences on their vaccination decision-making. (2) Methods: The research team conducted semi-structured interviews (N = 100) in 2021 focused on understanding ethnically/racially diverse older adults’ perceptions of the COVID-19 vaccine. Interviews were recorded, coded, and analyzed using a thematic analysis approach. (3) Results: Thematic analyses identified three themes. (1) Older adults showed mixed attitudes toward the COVID-19 vaccine associated with information consumed and trust in healthcare systems; (2) health concerns and underlying medical conditions were the most influential factors of vaccine uptake; and (3) systemic barriers and trusted figures impacted vaccination decision-making of older adults. (4) Conclusions: Accessible information in diverse languages tailored to the community’s fears is needed to combat vaccine mistrust. Vaccine rollout programs need to tackle the fear of vaccine side effects. Attitudes of religious leaders, family members, and physicians considerably influenced vaccine uptake, suggesting their role as trusted members for vaccine messaging for older, primarily immigrant adults. Systemic barriers, namely lack of transportation and inaccessible vaccination sites, contributed to vaccine deterrence. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in Older People)
4 pages, 170 KiB  
Editorial
Acknowledgment to the Reviewers of Geriatrics in 2022
by Geriatrics Editorial Office
Geriatrics 2023, 8(1), 16; https://doi.org/10.3390/geriatrics8010016 - 18 Jan 2023
Viewed by 913
Abstract
High-quality academic publishing is built on rigorous peer review [...] Full article
11 pages, 1440 KiB  
Article
Prevalence, Risk Factors and Outcomes Associated with Physical Restraint in Acute Medical Inpatients over 4 Years—A Retrospective Cohort Study
by Umberto Spennato, Nathalie Lerjen, Jennifer Siegwart, Beat Mueller, Philipp Schuetz, Daniel Koch and Tristan Struja
Geriatrics 2023, 8(1), 15; https://doi.org/10.3390/geriatrics8010015 - 17 Jan 2023
Cited by 2 | Viewed by 2738
Abstract
Background: Physical restraints are frequently used in acute care hospitals. Their application is associated with negative outcomes, while their intended preventive effect is debated. Objectives: To determine the prevalence of physical restraints and associated outcomes on medical wards in a tertiary care hospital. [...] Read more.
Background: Physical restraints are frequently used in acute care hospitals. Their application is associated with negative outcomes, while their intended preventive effect is debated. Objectives: To determine the prevalence of physical restraints and associated outcomes on medical wards in a tertiary care hospital. Methods: Retrospective cohort study (January 2018 to December 2021). We included all adult medical in-patients and excluded patients with admission to the intensive care unit, short stays (length of stay (LOS) < 48 h), and patients declining informed consent. Results: Of 11,979 admissions, the prevalence of patients with at least one restraint was 6.4% (n = 772). Sensor mats were used most frequently (73.0%, n = 666), followed by blanket restrictions (14.5%, n = 132), bedrails (8.8%, n = 80) and belts (3.7%, n = 34). On average, restraints were applied 19 h (standard deviation (SD) ± 161) before a fall. Average restraint duration was 42 h (SD ± 57). Patients with a restraint had longer LOS 8 days (IQR 5–14) vs. 5 days (IQR 3–9). Median nurses’ time expenditure was 309 h (IQR 242–402) vs. 182 h (IQR 136–243) for non-restrained patients. Patients with restraints fell more often (22.5% vs. 2.7%) and were more likely to die (13.3% vs. 5.1%). These differences persisted after adjusting a regression model for important clinical confounders. We saw a decline in the duration of restraints over the years, but no variation between wards. Conclusion: Approximately 6% of medical patients, mostly older and severely ill, were affected by restraint use. For the first time, we report data over 4 years up to ward-level granularity. Full article
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12 pages, 654 KiB  
Article
Ageism and the Pandemic: Risk and Protective Factors of Well-Being in Older People
by Anna Rosa Donizzetti and Vincenza Capone
Geriatrics 2023, 8(1), 14; https://doi.org/10.3390/geriatrics8010014 - 16 Jan 2023
Cited by 4 | Viewed by 1999
Abstract
The COVID-19 pandemic has particularly affected the older population both in terms of the high number of victims and the psychological impact. Moreover, the pandemic has made older people more vulnerable to isolation and loneliness, and victims of ageism. The aim of the [...] Read more.
The COVID-19 pandemic has particularly affected the older population both in terms of the high number of victims and the psychological impact. Moreover, the pandemic has made older people more vulnerable to isolation and loneliness, and victims of ageism. The aim of the present study was to investigate the risk and protective factors for the well-being of older people during the pandemic. The role of positive affect, confidence in the future, current physical health, social isolation, loneliness, and ageism were analysed. A self-report questionnaire was administered to 1301 participants (mean age: 77.3 years, DS: 5.46), almost equally distributed by gender (56.1% female). Descriptive and correlational analyses were performed, together with SEM. The results showed that perceived age discrimination positively predicts loneliness and negatively and indirectly predicts well-being. Furthermore, positive affect, confidence in the future, and current physical health are protective factors, while loneliness, social isolation, and ageism are risk factors. Future emergency policies must take into account the impact of such actions on the well-being of this segment of the population. Full article
(This article belongs to the Collection Ageism, the Black Sheep of the Decade of Healthy Ageing)
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14 pages, 2558 KiB  
Article
Cross-Sectional Analysis of Fall-Related Factors with a Focus on Fall Prevention Self-Efficacy and Self-Cognition of Physical Performance among Community-Dwelling Older Adults
by Shintaro Hayashi, Yuka Misu, Toshimasa Sakamoto and Taisei Yamamoto
Geriatrics 2023, 8(1), 13; https://doi.org/10.3390/geriatrics8010013 - 14 Jan 2023
Cited by 3 | Viewed by 1474
Abstract
This study aimed to determine how fall prevention self-efficacy and degree of deviation in self-cognition of physical performance, which have recently received attention for their potential to explain falls in combination with a wide variety of fall-related factors, as well as affect falls. [...] Read more.
This study aimed to determine how fall prevention self-efficacy and degree of deviation in self-cognition of physical performance, which have recently received attention for their potential to explain falls in combination with a wide variety of fall-related factors, as well as affect falls. Older adults using day-care services (n = 27 with six men, mean age: 81.41 ± 7.43 years) were included in this study. Fall history in the past year, the modified fall efficacy scale (MFES), and physical performance and cognition errors were examined by evaluating the functional reach test (FRT), the stepping over test, and the timed up and go test (TUG), along with a questionnaire. In the fall (n = 14) and non-fall (n = 13) groups, logistic regression analysis using Bayesian statistical methods was used to identify factors associated with falls. The odds ratios for the MFES ranged from 0.97 to 1.0, while those of cognition-error items ranged from 3.1 to 170.72. These findings suggested that deviation in self-cognition of physical performance, particularly overestimation of timed cognitive ability, was a factor with more explanatory power for fall history. Future studies should analyze differences by disease and age group, which were not clarified in this study, to identify more detailed fall risk factors. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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10 pages, 1349 KiB  
Article
Mini-Mental State Examination: Optimal Cut-Off Levels for Mild and Severe Cognitive Impairment
by Francesco Salis, Diego Costaggiu and Antonella Mandas
Geriatrics 2023, 8(1), 12; https://doi.org/10.3390/geriatrics8010012 - 12 Jan 2023
Cited by 14 | Viewed by 4902
Abstract
Considering the need to intercept neurocognitive damage as soon as possible, it would be useful to extend cognitive test screening throughout the population. Here, we propose differential cut-off levels that can be used to identify mild and severe cognitive impairment with a simple [...] Read more.
Considering the need to intercept neurocognitive damage as soon as possible, it would be useful to extend cognitive test screening throughout the population. Here, we propose differential cut-off levels that can be used to identify mild and severe cognitive impairment with a simple and widely used first-level neurocognitive screening test: the Mini-Mental State Examination (MMSE). We studied a population of 262 patients referred for cognitive impairment testing using the MMSE and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a neuropsychological battery. The sample consisted of 262 participants with mean age 73.8 years (60–87), of whom 154 (58.8%) women. No significant gender-related differences in cognitive ability were identified. The two tests (MMSE and RBANS) showed a moderate correlation in identifying cognitive deficit. We used RBANS as a categorial variable to identify different degrees of cognitive impairment. Youden’s J indexes were used to consider the better sensitivity/specificity balance in the 24-point cut-off score for severe cognitive deficit, 29.7-point score for mild cognitive deficit, and 26.1-point score for both mild and severe cognitive deficit. The study shows that the MMSE does not identify early cognitive impairment. Though different cut-offs are needed to discriminate different impairment degrees, the 26.1-point score seems to be preferable to the others. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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11 pages, 747 KiB  
Article
Occurrence of Postoperative Delirium and the Use of Different Assessment Tools
by Andrea Kirfel, Diane Jossen, Jan Menzenbach, Andreas Mayr and Maria Wittmann
Geriatrics 2023, 8(1), 11; https://doi.org/10.3390/geriatrics8010011 - 11 Jan 2023
Viewed by 2131
Abstract
(1) Background: Postoperative delirium (POD) poses a high risk of worsening outcomes for patients and is also a burden for hospitals. The leading guidelines recommend standardized POD assessment and prevention. The aim of this subgroup analysis of the PRe-Operative Prediction of Postoperative DElirium [...] Read more.
(1) Background: Postoperative delirium (POD) poses a high risk of worsening outcomes for patients and is also a burden for hospitals. The leading guidelines recommend standardized POD assessment and prevention. The aim of this subgroup analysis of the PRe-Operative Prediction of Postoperative DElirium by Appropriate SCreening (PROPDESC) trial was to compare different delirium assessments and to analyse the frequency of POD on five postoperative days. (2) Methods: This prospective observational trial enrolled 1097 patients in a university hospital from 2018 until 2019. The following POD assessment tools were used for five consecutive days: Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method for normal ward (CAM), 4 A’s Test (4AT) and Delirium Observation Screening (DOS) scale. (3) Results: In a 5-day visit interval, most new POD developments occurred on the first and second postoperative day. A clear recommendation for a specific POD assessment tool based on our results cannot be given. (4) Conclusions: According to guidelines, a POD assessment should take place on the first five postoperative days, but of these, the first two are those of highest POD occurrence. The POD assessment tool used should at best include direct patient questioning and aspects of patient observation. Full article
(This article belongs to the Special Issue Advancing the Care of Delirium and Comorbid Dementia)
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9 pages, 950 KiB  
Article
Determinants of 1-Year Adverse Event Requiring Re-Hospitalization in COVID-19 Oldest Old Survivors
by Chukwuma Okoye, Riccardo Franchi, Alessia Maria Calabrese, Virginia Morelli, Umberto Peta, Tessa Mazzarone, Igino Maria Pompilii, Giulia Coppini, Sara Rogani, Valeria Calsolaro and Fabio Monzani
Geriatrics 2023, 8(1), 10; https://doi.org/10.3390/geriatrics8010010 - 10 Jan 2023
Viewed by 1640
Abstract
The incidence of “Long COVID” syndrome appears to be increasing, particularly in the geriatric population. At present, there are few data regarding the relationship between long COVID and the risk of re-hospitalization in the oldest old survivors. Patients older than 80 years consecutively [...] Read more.
The incidence of “Long COVID” syndrome appears to be increasing, particularly in the geriatric population. At present, there are few data regarding the relationship between long COVID and the risk of re-hospitalization in the oldest old survivors. Patients older than 80 years consecutively hospitalized for COVID-19 in our tertiary care hospital were enrolled and followed after discharge in a 12-month ambulatory program. A comprehensive geriatric assessment (CGA), including functional capabilities and physical and cognitive performances, was performed at 6-month follow-up. Frailty degree was assessed using a 30-item frailty index. The re-hospitalization rate was assessed at 12-month follow-up through a computerized archive and phone interviews. Out of 100 patients discharged after hospitalization for COVID-19 (mean [SD] age 85 [4.0] years), 24 reported serious adverse events requiring re-hospitalization within 12 months. The most frequent causes of re-hospitalization were acute heart failure (HF), pneumonia and bone fracture (15.3% each). By multivariate logistic analysis, after adjustment for potential confounders, history of chronic HF [aOR: 3.00 (CI 95%: 1.10–8.16), p = 0.031] or chronic renal failure [aOR: 3.83 (CI 95%: 1.09–13.43), p = 0.036], the burden of comorbidity [(CIRSc) aOR: 1.95 (CI 95%: 1.28–2.97), p = 0.002] and frailty [aOR: 7.77 (CI 95%: 2.13–28.27), p = 0.002] resulted as independent predictors of re-hospitalization. One-fourth of the oldest old patients previously hospitalized for COVID-19 suffered from adverse events requiring re-hospitalization, two-thirds of them within three months after discharge. Frailty, the burden of comorbidity, history of chronic HF or chronic renal failure, but not COVID-19 disease severity, independently predicted re-hospitalization. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in Older People)
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11 pages, 438 KiB  
Article
Outpatient Service Use in Korean Older Adult Women with Degenerative Arthritis Based on Andersen’s Model
by Soyoung Jang and Eunyoung E. Suh
Geriatrics 2023, 8(1), 9; https://doi.org/10.3390/geriatrics8010009 - 06 Jan 2023
Viewed by 1029
Abstract
To ensure that older adults (aged 65 years or older) can experience a healthy life, they should use medical services that are appropriate, both quantitatively and qualitatively. This study aimed to identify the factors affecting outpatient service use by older adult women with [...] Read more.
To ensure that older adults (aged 65 years or older) can experience a healthy life, they should use medical services that are appropriate, both quantitatively and qualitatively. This study aimed to identify the factors affecting outpatient service use by older adult women with degenerative arthritis using Andersen’s model. A survey was conducted among 232 older adult women with degenerative arthritis in two university hospitals in Seoul. The Korean Activities of Daily Living, Korean Instrumental Activities of Daily Living, and the Geriatric Depression Scale Short Form were used. Data were analyzed using descriptive statistics, χ2-test, t-test, and multiple logistic regression analysis. Among the participants, 69.8% used outpatient services and 30.2% did not. In the univariate analyses, age, marital status, residency, household income, chronic diseases, subjective health status, and disability were significant. Age (odds ratio [OR] = 5.53, p < 0.001), annual household income (OR = 5.64, p < 0.001), chronic diseases (OR = 11.06, p < 0.001), and disability (OR = 3.56, p = 0.016) significantly affected outpatient service use. The results suggest that health promotion interventions for Korean older adult women should focus on predicting outpatient service use according to the patient’s characteristics. Full article
(This article belongs to the Special Issue Women in Geriatrics)
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8 pages, 4759 KiB  
Case Report
Nutritional Management in a 101-Year-Old Woman with Physical Inactivity and General Weakness: A Case Report
by Ryoko Mineyama, Fumie Tezuka, Nobuko Takagi, Shoichiro Kokabu and Masahiko Okubo
Geriatrics 2023, 8(1), 8; https://doi.org/10.3390/geriatrics8010008 - 06 Jan 2023
Cited by 1 | Viewed by 1822
Abstract
Japan has the world’s highest life longevity, and centenarian patients are no longer rare. However, sufficient information related to centenarians is not available. Herein, we report the case of a 101-year-old centenarian woman who recovered from extreme inactivity and general weakness, mainly through [...] Read more.
Japan has the world’s highest life longevity, and centenarian patients are no longer rare. However, sufficient information related to centenarians is not available. Herein, we report the case of a 101-year-old centenarian woman who recovered from extreme inactivity and general weakness, mainly through nutritional management at home, to understand instances of nutritional management in centenarians. The patient developed lethargy, with a rapid decline in activity levels and food intake. She was diagnosed with senility by a primary doctor. We concluded that she had no problems with feeding and swallowing and predicted that her motivation to eat had decreased. We planned an intervention that lasted three months. To reduce the risk of aspiration, we paid attention to her posture while eating. To stimulate her appetite, we increased the variety and color of food items. To consider both the texture of food and safety, we changed the form of foods from paste (IDDSI Level 4)-like to solid food of regular size as much as possible. We recommended that the patient consume her favorite sweet between meals to enjoy eating. Two and half months after the initial intervention, the patient’s inactivity and general weakness improved dramatically, which was recognized by her willingness to eat, laugh loudly, and hum, although she could not speak clearly. The patient finally was able to have dinner with her family. Full article
(This article belongs to the Section Geriatric Nutrition)
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10 pages, 415 KiB  
Article
Decline in Other Instrumental Activities of Daily Living as Indicators of Driving Risk in Older Adults at an Academic Memory Clinic
by Frank Knoefel, Shehreen Hossain and Amy T. Hsu
Geriatrics 2023, 8(1), 7; https://doi.org/10.3390/geriatrics8010007 - 05 Jan 2023
Viewed by 1600
Abstract
Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving [...] Read more.
Background: Decisions around driving retirement are difficult for older persons living with cognitive decline and their caregivers. In many jurisdictions, physicians are responsible for notifying authorities of driving risks. However, there are no standardized guidelines for this assessment. Having access to a driving risk assessment tool could help older adults and their caregivers prepare for discussions around driving retirement. This study compares the clinical profiles of older adult drivers assessed in an academic memory clinic who were referred to the driving authority to older drivers who were not with a focus on instrumental activities of daily living (iADLs). Methods: Data on referred (R) and not-referred (NR) drivers were extracted from medical records. Elements from the medical history, cognitive history, functional abilities, Modified Mini-Mental State (3MS) examination, Trails A/B, and clock drawing were included in the analysis. Four risk factors of interest were examined in separate logistic regression analyses, adjusted for demographic variables. Results: 50 participants were identified in each group. The R group was older on average than the NR. As expected, R were more likely to have Trails B scores over 3 min and have significantly abnormal clock drawing tests. R also showed lower 3MS scores and a higher average number of functional impairments (including managing appointments, medications, bills, or the television). Conclusion: Beyond standard cognitive tests, impairment in iADLs may help general practitioners identify at-risk drivers in the absence of standardized guidelines and tools. This finding can also inform the design of a risk assessment tool for driving and could help with approaches for drivers with otherwise borderline test results. Full article
(This article belongs to the Special Issue Ageing and Driving)
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9 pages, 602 KiB  
Systematic Review
Are Bubbles the Future of Dysphagia Rehabilitation: A Systematic Review Analysing Evidence on the Use of Carbonated Liquids in Dysphagia Rehabilitation
by Kathryn Price, Grace Isbister, Susannah Long, John Mirams and David Smithard
Geriatrics 2023, 8(1), 6; https://doi.org/10.3390/geriatrics8010006 - 01 Jan 2023
Cited by 2 | Viewed by 2757
Abstract
Background: Dysphagia poses a huge health issue in our ageing population, impacting patients psychologically and through risk of aspiration, malnutrition and airway obstruction. The use of carbonated liquids to provide sensory enhancement as a tool to stimulate neuromuscular activity in dysphagia rehabilitation remains [...] Read more.
Background: Dysphagia poses a huge health issue in our ageing population, impacting patients psychologically and through risk of aspiration, malnutrition and airway obstruction. The use of carbonated liquids to provide sensory enhancement as a tool to stimulate neuromuscular activity in dysphagia rehabilitation remains an area with limited research. This article reviews current evidence. Method: A data search of PubMed, CINAHL, EMBASE and Cochrane was undertaken with set search terms. Abstracts were reviewed and selected by two clinicians according to inclusion criteria and papers were assessed using PRISMA methodology. Results: Selected publications (1992–2022) involved a median of 23 participants with predominantly neurogenic dysphagia. Despite the differences in study designs all used videofluroscopy (VF) to assess outcome measures except Morishita et al. who used fiberoptic endoscopic evaluation of swallow (FEES). The studies were small scale but showed encouraging results. However, there was heterogeneity between results of specific outcome measures. One study surveyed taste which was overall positively received. Conclusions: There continues to remain limited evidence to direct the use of carbonated liquids in rehabilitation of dysphagia, however its role shows some promise. The heterogeneity of not just study designs but also study participants seems to be a primary barrier. Whilst evidence is encouraging, further prospective studies standardising patient cohorts, methodologies and quantitative outcome measures must be carried out. Longitudinal studies to look at the role of carbonated liquids in secretion management is another area of potential interest. In conclusion the use of carbonated liquid in dysphagia rehabilitation may have a potential role but without firm evidence-based research, successful use in clinical practice cannot be implemented. Full article
(This article belongs to the Section Dysphagia)
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6 pages, 200 KiB  
Editorial
Telemedicine: Issues in the Analysis of Its Use in Elderly People and in People with Disabilities, According to the Perspective of the Clinical Psychology of Disability
by Donatella Rita Petretto, Luca Gaviano, Gian Pietro Carrogu, Roberta Berti, Martina Pinna and Roberto Pili
Geriatrics 2023, 8(1), 5; https://doi.org/10.3390/geriatrics8010005 - 30 Dec 2022
Cited by 4 | Viewed by 1581
Abstract
The recent COVID-19 pandemic has led to a sudden increase in the speed of the digitization process, which has affected several areas of life (public administration, schools, universities, and healthcare, and extending to so-called “digital citizenship”) [...] Full article
16 pages, 452 KiB  
Review
Multi-Component Interventions in Older Adults Having Subjective Cognitive Decline (SCD)—A Review Article
by Madhuchhanda Mohanty and Prakash Kumar
Geriatrics 2023, 8(1), 4; https://doi.org/10.3390/geriatrics8010004 - 27 Dec 2022
Cited by 1 | Viewed by 2322
Abstract
Subjective cognitive decline (SCD) is one of those significant concerns faced by older individuals. Though it is predominantly self-reported, it is not an event that should be overlooked, considering its significant association with cognitive disorders like Alzheimer’s disease, mild cognitive impairment, and so [...] Read more.
Subjective cognitive decline (SCD) is one of those significant concerns faced by older individuals. Though it is predominantly self-reported, it is not an event that should be overlooked, considering its significant association with cognitive disorders like Alzheimer’s disease, mild cognitive impairment, and so on. This makes it imperative to find ways to manage the event to enhance the cognitive performance of older adults and/or suppress the rate at which cognitive decline results in impairment. While multiple interventions have been used for SCD, multi-component non-pharmacological interventions are beginning to gain more attention among researchers. This is due to how such interventions have effectively contributed to improved cognitive performance across different outcome domains. Against this backdrop, this literature review has been conducted to explore the different multi-component non-pharmacological interventions utilized in managing SCD. Papers from databases such as PubMed, Scopus, and EBSCO were retrieved, with relevant data being extracted on the subject matter to address the objective of this review. Full article
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19 pages, 846 KiB  
Article
Communication Ecology Model of Successful Aging in Indonesian Context
by Irwansyah Irwansyah
Geriatrics 2023, 8(1), 3; https://doi.org/10.3390/geriatrics8010003 - 26 Dec 2022
Viewed by 2088
Abstract
The communication ecology model of successful aging (CEMSA) as a part of aging studies from a communication perspective was replicated in the Indonesian context. The CEMSA provided a specific perspective from communication scholars about the successful aging process. The study of CEMSA has [...] Read more.
The communication ecology model of successful aging (CEMSA) as a part of aging studies from a communication perspective was replicated in the Indonesian context. The CEMSA provided a specific perspective from communication scholars about the successful aging process. The study of CEMSA has grown significantly to demonstrate the importance of the interactive-communication process to propagate and enhance aging studies. However, there has been no specific aging study from a communication perspective, especially from communication scholars in the Indonesian context. This study applied all concepts, variables, measurements, and analyses from the replicated study. The result showed that seven domains of communication about aging may be relevant to predict successful aging from a negative effect and positive effect, and efficacy toward aging. The model showed that the uncertainty and combination of a negative and positive effect in seven domains of communication about aging could construct the efficacy and success of the aging process. The model with seven domains of communication about aging could be proved while the data were gathered not by self-report. Full article
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8 pages, 423 KiB  
Article
Sway and Acceleration Changes of the Center of Mass during Walking Stance Phase before and after Total Knee Arthroplasty
by Takashi Fukaya, Hirotaka Mutsuzaki and Koichi Mori
Geriatrics 2023, 8(1), 2; https://doi.org/10.3390/geriatrics8010002 - 24 Dec 2022
Viewed by 1234
Abstract
Elucidating the sway and changes in the acceleration of center of mass (COM) during walking is important for effective gait training and rehabilitation. The objective of this study was to verify the improvement in gait before and after total knee arthroplasty (TKA) from [...] Read more.
Elucidating the sway and changes in the acceleration of center of mass (COM) during walking is important for effective gait training and rehabilitation. The objective of this study was to verify the improvement in gait before and after total knee arthroplasty (TKA) from COM sway and the changes in the acceleration of COM during the stance phase of walking. This study included 13 patients (1 male and 12 females) with medial knee osteoarthritis who were hospitalized for TKA. The COM sway during the stance phase of walking was evaluated using root mean square (RMS) normalized by walking speed, and the changes in acceleration were further verified. Lateral and vertical RMS showed significant differences between preoperative and postoperative states and demonstrated low values after TKA. The lateral acceleration at the latter part of the early stance phase demonstrated a significant difference between preoperative and postoperative states. A significant difference was also observed in the lateral acceleration in the late stance phase between the two groups. Improvement in pain and alignment after TKA reduced the lateral sway of COM and the changes in acceleration during the gait stance phase, which is speculated to lead to improvement in gait and prevention of falls. Full article
(This article belongs to the Collection Joint Arthroplasty in the Oldest People)
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12 pages, 291 KiB  
Article
APOE Allele Frequency in Southern Greece: Exploring the Role of Geographical Gradient in the Greek Population
by Vasiliki Papastefanopoulou, Evangelia Stanitsa, Christos Koros, Aimilios Simoudis, Chryseis Florou-Hatziyiannidou, Ion Beratis, Roubina Antonelou, Nikolaos Andronas, Panagiota Voskou, Efthalia Angelopoulou, John D. Papatriantafyllou, Leonidas Stefanis, Christos Kroupis and Sokratis G. Papageorgiou
Geriatrics 2023, 8(1), 1; https://doi.org/10.3390/geriatrics8010001 - 20 Dec 2022
Cited by 1 | Viewed by 1757
Abstract
Background: the apolipoprotein e4 allele (APOE4) constitutes an established genetic risk factor for Alzheimer’s Disease Dementia (ADD). We aimed to explore the frequency of the APOE isoforms in the Greek population of Southern Greece. Methods: peripheral blood from 175 Greek AD [...] Read more.
Background: the apolipoprotein e4 allele (APOE4) constitutes an established genetic risk factor for Alzheimer’s Disease Dementia (ADD). We aimed to explore the frequency of the APOE isoforms in the Greek population of Southern Greece. Methods: peripheral blood from 175 Greek AD patients, 113 with mild cognitive impairment (MCI), and 75 healthy individuals. DNA isolation was performed with a High Pure PCR Template Kit (Roche), followed by amplification with a real-time qPCR kit (TIB MolBiol) in Roche’s Light Cycler PCR platform. Results: APOE4 allele frequency was 20.57% in the ADD group, 17.69% in the MCI group, and 6.67% in the control group. APOE3/3 homozygosity was the most common genotype, while the frequency of APOE4/4 homozygosity was higher in the AD group (8.60%). APOE4 carrier status was associated with higher odds for ADD and MCI (OR: 4.49, 95% CI: [1.90–10.61] and OR: 3.82, 95% CI: [1.59–9.17], respectively). Conclusion: this study examines the APOE isoforms and is the first to report a higher APOE frequency in MCI compared with healthy controls in southern Greece. Importantly, we report the occurrence of the APOE4 allele, related to ADD, as amongst the lowest globally reported, even within the nation, thus enhancing the theory of ethnicity and latitude contribution. Full article
(This article belongs to the Section Basic Science)
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