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Geriatrics, Volume 8, Issue 3 (June 2023) – 22 articles

Cover Story (view full-size image): Identifying reliable biomarkers for assessing ovarian function and predicting menopause has become a significant area of research in recent years. Anti-Müllerian hormone (AMH) has gained attention as a potential marker for evaluating ovarian senescence due to its close association with the ovarian follicle reserve. This study aimed to establish an appropriate cut-off value for AMH to detect ovarian senescence in a group of premenopausal Greek women. Additionally, the study sought to explore the potential relationship between AMH levels and the severity of climacteric symptoms during a 24-month follow-up period. The study included 180 premenopausal women. The participants’ AMH blood levels were measured, and their climacteric symptoms were assessed using the Greene scale, which provides a comprehensive evaluation of various menopausal symptoms. View this paper
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9 pages, 634 KiB  
Brief Report
Predictors of Nursing Home Entry within 36 Months after Hospitalization via the Emergency Department among Persons Aged 75 Years or Older
by Moustapha Dramé, Alison Volberg, Lukshe Kanagaratnam, Claire Coutureau and Lidvine Godaert
Geriatrics 2023, 8(3), 67; https://doi.org/10.3390/geriatrics8030067 - 15 Jun 2023
Viewed by 1004
Abstract
Objective: We aimed to identify risk factors for nursing home (NH) entry 36 months after hospitalization via the emergency department (ED) in a population of patients aged 75 years or older. Methods: This was a prospective multicentre cohort. Patients were recruited from the [...] Read more.
Objective: We aimed to identify risk factors for nursing home (NH) entry 36 months after hospitalization via the emergency department (ED) in a population of patients aged 75 years or older. Methods: This was a prospective multicentre cohort. Patients were recruited from the emergency departments (EDs) of nine hospitals. Subjects had been hospitalised in a medical ward in the same hospital as the ED to which they were initially admitted. Subjects who experienced NH entry prior to ED admission were excluded. NH entry has been defined as the incident admission either into an NH or other long-term care facility within the follow-up period. Variables from a comprehensive geriatric assessment of patients were entered into a Cox model with competing risks to predict NH entry during 3 years of follow-up. Results: Among 1306 patients included in the SAFES cohort, 218 (16.7%) who were already in an NH were excluded. The remaining 1088 patients included in the analysis were aged 84 ± 6 years on average. During 3 years of follow-up, 340 (31.3%) entered an NH. The independent risk factors for NH entry were that they: living alone (Hazard ratio (HR) 2.00, had a 95% confidence interval (CI) 1.59–2.54, p < 0.0001), could not independently perform activities of daily living (HR 1.81, 95% CI 1.24–2.64, p = 0.002), and had balance disorders (HR 1.37, 95% CI 1.09–1.73, p = 0.007), dementia syndrome (HR 1.80, 95% CI 1.42–2.29, p < 0.0001) and a risk of pressure ulcers (HR 1.42, 95% CI 1.10–1.82, p = 0.006). Conclusion: The majority of the risk factors for NH entry within 3 years after emergency hospitalization are amenable to intervention strategies. It is therefore reasonable to imagine that targeting these features of frailty could delay or prevent NH entry and improve the quality of life of these individuals before and after NH entry. Full article
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12 pages, 293 KiB  
Article
Morbidity and Mortality Analysis in the Treatment of Intertrochanteric Hip Fracture with Two Fixation Systems: Dynamic Hip Screw (DHS) or Trochanteric Fixation Nail Advance (TFNA)
by Alvaro López-Hualda, Elsa Arruti-Pérez, Fátima N. Bebea-Zamorano, María Dolores Sosa-Reina, Jorge Hugo Villafañe and Javier Martínez-Martin
Geriatrics 2023, 8(3), 66; https://doi.org/10.3390/geriatrics8030066 - 08 Jun 2023
Cited by 1 | Viewed by 1307
Abstract
Background: The aim of this study was to compare the clinical outcomes, complications, and mortality of patients with intertrochanteric hip fracture treated with dynamic hip screw (DHS) vs. trochanteric fixation nail advance (TFNA). Methods: We evaluated 152 patients with intertrochanteric fractures concerning age, [...] Read more.
Background: The aim of this study was to compare the clinical outcomes, complications, and mortality of patients with intertrochanteric hip fracture treated with dynamic hip screw (DHS) vs. trochanteric fixation nail advance (TFNA). Methods: We evaluated 152 patients with intertrochanteric fractures concerning age, sex, comorbidity, Charlson Index, preoperative gait, OTA/AO classification, time from fracture to surgery, blood loss, amount of blood replacement, changes in gait, full weight-bearing at hospital discharge, complications, and mortality. The final indicators encompassed the adverse effects linked to implants, postoperative complications, clinical healing or bone healing duration, and functional score. Results: The study included a total of 152 patients, out of which 78 (51%) received DHS treatment and 74 (49%) received TFNA treatment. The results of this study show that the TFNA group demonstrated superiority (p < 0.001). However, it should be noted that the TFNA group had a higher frequency of the most unstable fractures (AO 31 A3, p < 0.005). Full weight-bearing at discharge also decreased in patients with more unstable fractures (p = 0.005) and severe dementia (p = 0.027). Mortality was higher in the DHS group; however, a longer time from diagnosis to surgery was also observed in this group (p < 0.005). Conclusions: The TFNA group has shown a higher success rate in achieving full weight-bearing at hospital discharge when treating trochanteric hip fractures. This makes it the preferred choice for treating unstable fractures in this region of the hip. Additionally, it is important to note that a longer time to surgery is associated with increased mortality in patients with hip fractures. Full article
15 pages, 568 KiB  
Article
The Institutionalisation of Brazilian Older Abused Adults: A Qualitative Study among Victims and Formal Carers
by Dayane Ribeiro, Lígia Carreira, Maria Aparecida Salci, Francielle Renata Danielli Martins Marques, Adriana Gallo, Wanessa Baccon, Vanessa Baldissera and Carlos Laranjeira
Geriatrics 2023, 8(3), 65; https://doi.org/10.3390/geriatrics8030065 - 06 Jun 2023
Viewed by 1161
Abstract
Abuse against elders is acknowledged as a severe and pervasive problem in society. If support services are not tailored to the victims’ knowledge or perceived needs, the intervention is likely to be unsuccessful. This study aimed to explore the experience of institutionalisation of [...] Read more.
Abuse against elders is acknowledged as a severe and pervasive problem in society. If support services are not tailored to the victims’ knowledge or perceived needs, the intervention is likely to be unsuccessful. This study aimed to explore the experience of institutionalisation of abused older people from the perspective of the victims and their formal carers in a Brazilian social shelter. A qualitative descriptive study was performed with 18 participants, including formal carers and older abused persons admitted to a long-term care institution in the south of Brazil. Qualitative thematic analysis was used to analyse the transcripts of semi-structured qualitative interviews. Three themes were identified: (1) personal, relational, and social bonds: broken or weakened; (2) denial of the violence suffered; and (3) from imposed protection to compassionate care. Our findings provide insights for effective prevention and intervention measures in elder abuse. From a socio-ecological standpoint, vulnerability and abuse might be averted at the community and societal levels (e.g., education and awareness of elder abuse) by creating a minimum standard for the care of older individuals (e.g., law or economic incentives). Further study is needed to facilitate recognition and raise awareness among individuals in need and those offering assistance and support. Full article
(This article belongs to the Collection Ageism, the Black Sheep of the Decade of Healthy Ageing)
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11 pages, 387 KiB  
Article
Contribution of Different Brain Disorders and Multimorbidity to Delirium Superimposed Dementia (DSD)
by Tilman Wetterling and Klaus Junghanns
Geriatrics 2023, 8(3), 64; https://doi.org/10.3390/geriatrics8030064 - 02 Jun 2023
Viewed by 1137
Abstract
Delirium, an acute neuropsychiatric disorder characterized by a disturbance of attention and awareness, is often superimposed on dementia with its progressive cognitive decline. Despite the high frequency and clinical relevance of this condition, often called delirium-superimposed dementia (DSD), little is known about possible [...] Read more.
Delirium, an acute neuropsychiatric disorder characterized by a disturbance of attention and awareness, is often superimposed on dementia with its progressive cognitive decline. Despite the high frequency and clinical relevance of this condition, often called delirium-superimposed dementia (DSD), little is known about possible triggers. In this study using the GePsy-B databank, we investigated the impact of the underlying brain disorder and multimorbidity (MM) on DSD. MM was measured by CIRS and the number of ICD-10 diagnoses. Dementia was diagnosed by CDR, and delirium by DSM IV TR criteria. A total of 218 patients were diagnosed with DSD and these were compared to 105 patients with only dementia, 46 with only delirium, and 197 patients suffering from other psychiatric diseases, mainly depression. No significant differences between groups were found concerning CIRS scores. Based on CT scans, DSD cases were grouped into those with cerebral atrophy only (probably pure neurodegenerative), with brain infarction, or with white matter hyperintensities (WMH), but no between-group differences regarding the MM indices could be found. Regression analysis only revealed age and dementia stage as influencing factors. Conclusion: Our results suggest that neither MM nor morphologic changes in the brain are predisposing factors for DSD. Full article
(This article belongs to the Section Geriatric Neurology)
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8 pages, 493 KiB  
Commentary
The Value of Age-Friendly Public Health Systems in the Age-Friendly Ecosystem
by Megan Wolfe and J. Nadine Gracia
Geriatrics 2023, 8(3), 63; https://doi.org/10.3390/geriatrics8030063 - 02 Jun 2023
Viewed by 2125
Abstract
The United States population is living longer and healthier than ever. This enables our communities—and our society—to continue to benefit from our knowledge, experience, and energy as we age. The public health system is foundational for increasing life expectancy, and now it has [...] Read more.
The United States population is living longer and healthier than ever. This enables our communities—and our society—to continue to benefit from our knowledge, experience, and energy as we age. The public health system is foundational for increasing life expectancy, and now it has the opportunity to further support older adult health and well-being. Trust for America’s Health (TFAH), in partnership with The John A. Hartford Foundation, launched the age-friendly public health systems initiative in 2017 with the goal of raising awareness within the public health sector of its many potential roles in healthy aging. TFAH has worked with state and local departments of health to build capacity and expertise in older adult health and has provided guidance and technical assistance to expand this work across the U.S. TFAH now envisions a public health system that has healthy aging as a core function. This paper aims to describe why the public health sector should adopt healthy aging policies and practices, how this is being operationalized at the state and local levels, and the value of age-friendly public health systems within the age-friendly ecosystem. Full article
(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)
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13 pages, 2677 KiB  
Article
Impact of Medical Specialties on Diagnostic and Therapeutic Management of Elderly Cancer Patients
by Ludovic Lafaie, Anne-Françoise Chanelière-Sauvant, Nicolas Magné, Wafa Bouleftour, Fabien Tinquaut, Thomas Célarier and Laurent Bertoletti
Geriatrics 2023, 8(3), 62; https://doi.org/10.3390/geriatrics8030062 - 01 Jun 2023
Viewed by 1117
Abstract
The management (diagnostic and therapeutic) of cancer in the geriatric population involves a number of complex difficulties. The aim of this study was to assess the impact of a medical specialty on the diagnostic and therapeutic management of elderly cancer patients. Four clinical [...] Read more.
The management (diagnostic and therapeutic) of cancer in the geriatric population involves a number of complex difficulties. The aim of this study was to assess the impact of a medical specialty on the diagnostic and therapeutic management of elderly cancer patients. Four clinical scenarios of cancer in the geriatric population, with a dedicated survey to gather information regarding each clinical case’s diagnostic and therapeutic approaches, as well as the different criteria influencing physicians’ therapeutic decisions, were exposed to geriatricians, oncologists, and radiotherapists in Saint-Etienne. The surveys were filled out by 13 geriatricians, 11 oncologists, and 7 radiotherapists. There was a homogeneity of responses regarding the confirmation of cancer diagnostics in the elderly. There were strong disparities (inter- and intra-specialties) for several clinical situations regarding the therapeutic management of cancer. There were significant disparities in terms of surgical management, the implementation of a chemotherapy protocol, and the adaptation of the chemotherapy dosage. Contrary to oncologists, who primarily consider the G8 and the Karnofsky score, geriatric autonomy scores and frailty with cognitive assessment were the key factors determining diagnostic/therapeutic therapy for geriatricians. These results raise important ethical questions, requiring specific studies in geriatric populations to provide the homogenous management of elderly patients with cancer. Full article
(This article belongs to the Section Geriatric Oncology)
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15 pages, 936 KiB  
Article
Associations between Physical Activity and Health-Related Quality of Life among Community-Dwelling Older Adults: A Cross-Sectional Study in Urban Greece
by Anna Psarrou, Theodoula Adamakidou, Paraskevi Apostolara, Alexandra Koreli, Marianna Drakopoulou, Sotirios Plakas, Dimos Mastrogiannis, Alexandra Mantoudi, Stelios Parissopoulos, Afroditi Zartaloudi and Marianna Mantzorou
Geriatrics 2023, 8(3), 61; https://doi.org/10.3390/geriatrics8030061 - 01 Jun 2023
Cited by 2 | Viewed by 1673
Abstract
Physical activity is an important factor in achieving healthy aging, offering older persons multiple benefits in terms of maintaining and improving their health and wellbeing. The aim of this study was to investigate the effect of physical activity on the quality of life [...] Read more.
Physical activity is an important factor in achieving healthy aging, offering older persons multiple benefits in terms of maintaining and improving their health and wellbeing. The aim of this study was to investigate the effect of physical activity on the quality of life of older adults. A cross-sectional study was conducted from February to May 2022, using the Short-Form Health Survey (SF-36) and the International Physical Activity Questionnaire (IPAQ). A total of 124 people aged 65 and over participated in the survey. The average age of the participants was 71.6 years, and 62.1% were women. Participants showed a moderate quality of life with regard to the physical health dimension (mean score 52.4) and a higher quality of life with regard to the mental health dimension (mean score 63.1) compared to the expected values of the population. Low levels of physical activity were recorded among older adults, reaching a rate of 83.9%. A moderate or high level of physical activity has been found to contribute to a better physical functioning (p = 0.03), vitality (p = 0.02) and general health (p = 0.01). Finally, comorbidity had a negative impact on physical activity (p = 0.03) and quality of life regarding mental and physical health in older adults. The study showed very low levels of physical activity in older Greek adults. The management of this problem, which was intensified during the COVID-19 pandemic, should be a high priority in public health programs focusing on healthy aging, as physical activity affects and promotes many of the basic aspects of quality of life. Full article
(This article belongs to the Special Issue Physical and Cognitive Decline in Older Adults)
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10 pages, 410 KiB  
Article
Prediction of In-Hospital Falls Using NRS, PACD Score and FallRS: A Retrospective Cohort Study
by Jennifer Siegwart, Umberto Spennato, Nathalie Lerjen, Beat Mueller, Philipp Schuetz, Daniel Koch and Tristan Struja
Geriatrics 2023, 8(3), 60; https://doi.org/10.3390/geriatrics8030060 - 01 Jun 2023
Cited by 1 | Viewed by 1250
Abstract
Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute care discharge (PACD) score [...] Read more.
Background: Harmful in-hospital falls with subsequent injuries often cause longer stays and subsequently higher costs. Early identification of fall risk may help in establishing preventive strategies. Objective: To assess the predictive ability of different clinical scores including the Post-acute care discharge (PACD) score and nutritional risk screening score (NRS), and to develop a new fall risk score (FallRS). Methods: A retrospective cohort study of medical in-patients of a Swiss tertiary care hospital from January 2016 to March 2022. We tested the ability of the PACD score, NRS and FallRS to predict a fall by using the area under curve (AUC). Adult patients with a length of stay of ≥ 2 days were eligible. Results: We included 19,270 admissions (43% females; median age, 71) of which 528 admissions (2.74%) had at least one fall during the hospital stay. The AUC varied between 0.61 (95% confidence interval (CI), 0.55–0.66) for the NRS and 0.69 (95% CI, 0.64–0.75) for the PACD score. The combined FallRS score had a slightly better AUC of 0.70 (95% CI, 0.65–0.75) but was more laborious to compute than the two other scores. At a cutoff of 13 points, the FallRS had a specificity of 77% and a sensitivity of 49% in predicting falls. Conclusions: We found that the scores focusing on different aspects of clinical care predicted the risk of falls with fair accuracy. A reliable score with which to predict falls could help in establishing preventive strategies for reducing in-hospital falls. Whether or not the scores presented have better predictive ability than more specific fall scores do will need to be validated in a prospective study. Full article
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4 pages, 167 KiB  
Editorial
Intermediate Care in Italy: Addressing the Challenges and Opportunities for Person-Tailored Care
by Virginia Boccardi and Patrizia Mecocci
Geriatrics 2023, 8(3), 59; https://doi.org/10.3390/geriatrics8030059 - 30 May 2023
Viewed by 1153
Abstract
The concept of intermediate care is gaining increasing recognition in Italy as a critical strategy for improving quality of care and promoting the integration of healthcare services across different settings. This is driven by demographic changes and the growing prevalence of chronic conditions. [...] Read more.
The concept of intermediate care is gaining increasing recognition in Italy as a critical strategy for improving quality of care and promoting the integration of healthcare services across different settings. This is driven by demographic changes and the growing prevalence of chronic conditions. One of the key challenges in delivering intermediate care in Italy is ensuring that care is person-tailored, which requires a shift towards a more holistic approach that prioritizes individual preferences and values. This requires greater collaboration and communication across different healthcare settings and a coordinated approach to the delivery of care that promotes innovation and the use of technology to support remote monitoring and care delivery. Despite these challenges, intermediate care offers significant opportunities with which to enhance the quality of care, reduce healthcare costs, and promote social cohesion as well as community engagement. Overall, a coordinated and comprehensive approach is required to address the challenges and opportunities associated with intermediate care and to deliver person-tailored care that improves health outcomes as well as sustainability in Italy. Full article
16 pages, 1673 KiB  
Article
Awareness and Perceptions of “Age-Friendly”: Analyzing Survey Results from Voices in the United States
by Lauren Dunning, Diane Ty, Priyanka Shah and Mac McDermott
Geriatrics 2023, 8(3), 58; https://doi.org/10.3390/geriatrics8030058 - 28 May 2023
Cited by 1 | Viewed by 1885
Abstract
The term “age-friendly” is widely used to describe cities, communities, health systems, and other environments. However, little is known about how this is interpreted or what the term means to the public. To investigate the public’s familiarity with the term and gain insights [...] Read more.
The term “age-friendly” is widely used to describe cities, communities, health systems, and other environments. However, little is known about how this is interpreted or what the term means to the public. To investigate the public’s familiarity with the term and gain insights into its relevance to older adults, we utilized data generated by a survey of 1000+ adults aged 40 and above. We employed a 10-question survey, distributed online in the US from 8 to 17 March 2023 via a third-party vendor, that captured awareness and perceptions of age-friendly designations by exploring awareness of the term, contextual understanding, and influence on decision making. The resultant aggregate data was analyzed using Microsoft Excel and straightforward summary statistical analyses. The majority of respondents (81%) were aware of the term “age-friendly.” Older adults (ages 65+) lagged in the self-described extreme or moderate level of awareness compared to adults aged 40–64. In the surveyed population, the term “age-friendly” was most often understood to apply to communities (57%), followed by health systems (41%) and cities (25%). Most people believed “age-friendly” refers to all ages, even though age-friendly health systems are designed to meet the unique needs of older adults. These survey results provide the age-friendly ecosystem field with insights into the awareness and perceptions of the term “age-friendly,” highlighting opportunities to bolster understanding. Full article
(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)
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11 pages, 846 KiB  
Article
Antimüllerian Hormone as a Tool to Predict the Age at Menopause
by Efstathia Chatziandreou, Andreas Eustathiou, Areti Augoulea, Eleni Armeni, Nikoletta Mili, Ioannis Boutas, Nikolaos Tsoltos, Antigoni Kapetanaki and Sofia Kalantaridou
Geriatrics 2023, 8(3), 57; https://doi.org/10.3390/geriatrics8030057 - 19 May 2023
Cited by 1 | Viewed by 4397
Abstract
This study aimed to assess an eligible cut-off value of anti-Müllerian hormone (AMH) to detect ovarian senescence in a group of premenopausal Greek women to evaluate the possible link between AMH-values and the severity of climacteric symptoms during a follow-up of 24 months. [...] Read more.
This study aimed to assess an eligible cut-off value of anti-Müllerian hormone (AMH) to detect ovarian senescence in a group of premenopausal Greek women to evaluate the possible link between AMH-values and the severity of climacteric symptoms during a follow-up of 24 months. This study included 180 women (group A, 96 women of late reproductive stage/early perimenopause; group B, 84 women in late perimenopause). We measured AMH blood levels and assessed climacteric symptoms using the Greene scale. Log-AMH is inversely associated with postmenopausal status. The AMH cut-off of 0.012 ng/mL predicts the postmenopausal status with a sensitivity of 24.2% and specificity of 30.5%. The postmenopausal stage associated with age (OR = 1.320, 95%CI: 1.084–1.320) and AMH (values ≥ vs. <0.012 ng/mL, OR = 0.225, 95%CI: 0.098–0.529, p-value < 0.001). Moreover, the severity of vasomotor symptoms (VMS) was only associated inversely with AMH (b-coefficient = −0.272, p-value = 0.027). In conclusion, AMH levels measured in the late premenopausal period are inversely associated with the time to ovarian senescence. In contrast, AMH levels measured in the perimenopausal period are inversely associated only with the severity of VMS. Therefore, a cut-off of 0.012 ng/mL predicts menopause with low sensitivity and specificity, making it challenging to use in a clinical setting. Full article
(This article belongs to the Topic Women's Health and Aging)
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14 pages, 1359 KiB  
Article
Education Intervention Has the Potential to Improve Short-Term Dietary Pattern among Older Adults with Undernutrition
by Samantha Chandrika Vijewardane, Aindralal Balasuriya, Alexandra M. Johnstone and Phyo Kyaw Myint
Geriatrics 2023, 8(3), 56; https://doi.org/10.3390/geriatrics8030056 - 17 May 2023
Viewed by 1331
Abstract
Low-cost educational interventions to improve dietary pattern is a pragmatic solution to prevent undernutrition in low- and middle-income countries. A prospective nutritional education intervention was conducted among older adults aged 60 years or above with undernutrition with 60 people in each intervention and [...] Read more.
Low-cost educational interventions to improve dietary pattern is a pragmatic solution to prevent undernutrition in low- and middle-income countries. A prospective nutritional education intervention was conducted among older adults aged 60 years or above with undernutrition with 60 people in each intervention and control group. The objective was to develop and evaluate the efficacy of a community-based nutrition education intervention to improve the dietary pattern of older adults with undernutrition in Sri Lanka. The intervention consisted of two modules to improve the diversity, the variety of diet, and the serving sizes of food consumed. The primary outcome was the improvement of the Dietary Diversity Score (DDS) and the secondary outcomes were the Food Variety Score and Dietary Serving Score, which was assessed using the 24 h dietary recall. The mean difference in scores between the two groups was compared using the independent sample t-test at baseline, two weeks and three months post-intervention. Baseline characteristics were comparable. After two weeks, only the difference in DDS between the two groups was statistically significant (p = 0.002). However, this was not sustained at three months (p = 0.08). This study concludes that nutrition education interventions have the potential for short-term improvement in dietary patterns in older adults in a Sri Lanka setting. Full article
(This article belongs to the Section Geriatric Nutrition)
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12 pages, 1017 KiB  
Article
A Novel Approach to Assess Balneotherapy Effects on Musculoskeletal Diseases—An Open Interventional Trial Combining Physiological Indicators, Biomarkers, and Patients’ Health Perception
by Jani Silva, José Martins, Cristina Nicomédio, Catarina Gonçalves, Cátia Palito, Ramiro Gonçalves, Paula Odete Fernandes, Alcina Nunes and Maria José Alves
Geriatrics 2023, 8(3), 55; https://doi.org/10.3390/geriatrics8030055 - 16 May 2023
Cited by 4 | Viewed by 1737
Abstract
The present study aimed to evaluate whether a 14-day period of balneotherapy influences the inflammatory status, health-related quality of life (QoL) and quality of sleep, underlying overall health state, and clinically relevant benefits of patients with musculoskeletal diseases (MD). The health-related QoL was [...] Read more.
The present study aimed to evaluate whether a 14-day period of balneotherapy influences the inflammatory status, health-related quality of life (QoL) and quality of sleep, underlying overall health state, and clinically relevant benefits of patients with musculoskeletal diseases (MD). The health-related QoL was evaluated using the following instruments: 5Q-5D-5L, EQ-VAS, EUROHIS-QOL, B-IPQ, and HAQ-DI. The quality of sleep was evaluated by a BaSIQS instrument. Circulating levels of IL-6 and C-reactive protein (CRP) were measured by ELISA and chemiluminescent microparticle immunoassay, respectively. The smartband, Xiaomi MI Band 4, was used for real-time sensing of physical activity and sleep quality. MD patients improved the health-related QoL measured by 5Q-5D-5L (p < 0.001), EQ-VAS (p < 0.001), EUROHIS-QOL (p = 0.017), B-IPQ (p < 0.001), and HAQ-DI (p = 0.019) after balneotherapy; the sleep quality was also improved (BaSIQS, p = 0.019). Serum concentrations of IL-6 were markedly decreased after the 14-day balneotherapy (p < 0.001). No statistically significant differences were observed regarding the physical activity and sleep quality data recorded by the smartband. Balneotherapy may be an effective alternative treatment in managing the health status of MD patients, with a decrease in inflammatory states, along with positive effects on pain reduction, patient’s functionality, QoL, quality of sleep, and disability perception status. Full article
(This article belongs to the Special Issue Physical Activities, Antioxidants, Thalassotherapy, and Health)
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11 pages, 765 KiB  
Article
Practices of Self-Care in Healthy Old Age: A Field Study
by Estela González-González and Carmen Requena
Geriatrics 2023, 8(3), 54; https://doi.org/10.3390/geriatrics8030054 - 13 May 2023
Viewed by 1646
Abstract
Two competing psychological approaches for how to care for oneself to stay healthy in old age have coexisted and dominated the scientific literature. Objective: Identify the self-care practices of healthy older adults and establish the relationship between these practices and the cognitive processes [...] Read more.
Two competing psychological approaches for how to care for oneself to stay healthy in old age have coexisted and dominated the scientific literature. Objective: Identify the self-care practices of healthy older adults and establish the relationship between these practices and the cognitive processes involved. Method: 105 healthy older people (83.91% women) recorded their self-care practices using the Care Time Test and underwent a cognitive evaluation. Results: The frequency and variety of different activities that participants spent performing on a day of the week where they had the fewest obligations are as follows: nearly 7 h on seven survival activities, 4 h and 30 min on three maintenance of functional independence activities and 1 h on one activity that promoted personal development. Older people who carry out activities in a developmental approach showed better everyday memory (8.63 points) and attention levels (7.00 points) than older people who carry out activities using a conservative approach (memory: 7.43; attention level: 6.40). Conclusion: The results evidenced that the frequency and variety of activities that promote personal development are associated with better attention and memory performance. Full article
(This article belongs to the Section Healthy Aging)
8 pages, 400 KiB  
Communication
Adherence of Older Cardiac Patients to a Home-Based Cardiac Rehabilitation Program
by Dennis van Erck, Michel Terbraak, Christine D. Dolman, Peter J. M. Weijs, José P. Henriques, Ronak Delewi, Lotte Verweij, Patricia Jepma, Wilma J. M. Scholte op Reimer and Josje D. Schoufour
Geriatrics 2023, 8(3), 53; https://doi.org/10.3390/geriatrics8030053 - 13 May 2023
Cited by 1 | Viewed by 1283
Abstract
Referral to home-based cardiac rehabilitation (HBCR) is low among older and frailer patients due to low expectations regarding adherence by healthcare professionals. The aim of this study was to determine adherence to HBCR when old and frail patients are referred, and to explore [...] Read more.
Referral to home-based cardiac rehabilitation (HBCR) is low among older and frailer patients due to low expectations regarding adherence by healthcare professionals. The aim of this study was to determine adherence to HBCR when old and frail patients are referred, and to explore any differences in baseline characteristics between adherent and nonadherent patients. Data of the Cardiac Care Bridge were used (Dutch trial register NTR6316). The study included hospitalized cardiac patients ≥ 70 years old and at high risk of functional loss. Adherence to HBCR was confirmed when two-thirds of the intended nine sessions were followed. Of the 153 patients included (age: 82 ± 6 years, 54% female), 29% could not be referred due to death before referral, not returning home, or practical problems. Of the 109 patients who were referred, 67% adhered. Characteristics associated with non-adherence were older age (84 ± 6 vs. 82 ± 6, p = 0.05) and higher handgrip strength in men (33 ± 8 vs. 25 ± 11, p = 0.01). There was no difference in comorbidity, symptoms, or physical capacity. Based on these observations, most older cardiac patients who return home after hospital admission appear to adhere to HBCR after referral, suggesting that most older cardiac patients are motivated and capable of receiving HBCR. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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21 pages, 689 KiB  
Review
Enhancing Community Participation through Age-Friendly Ecosystems: A Rapid Realist Review
by Judith Sixsmith, Meiko Makita, Deborah Menezes, Marianne Cranwell, Isaac Chau, Mark Smith, Susan Levy, Pat Scrutton and Mei Lan Fang
Geriatrics 2023, 8(3), 52; https://doi.org/10.3390/geriatrics8030052 - 11 May 2023
Cited by 3 | Viewed by 2209
Abstract
This rapid realist review explored the key components of age-friendly ecosystems that promote community participation among older adults. The study (undertaken in 2021 and updated in 2023) synthesized evidence from 10 peer-reviewed and grey literature databases to identify the underlying mechanisms and contextual [...] Read more.
This rapid realist review explored the key components of age-friendly ecosystems that promote community participation among older adults. The study (undertaken in 2021 and updated in 2023) synthesized evidence from 10 peer-reviewed and grey literature databases to identify the underlying mechanisms and contextual factors that shape why, under what circumstances, and for whom an age-friendly ecosystems might be effective as well as the intervention outcomes. A total of 2823 records were initially identified after deduplication. Title and abstract screening produced a potential dataset of 126 articles, reducing to 14 articles after full text screening. Data extraction focused on the contexts, mechanisms, and outcomes of ecosystems for older adults’ community participation. Analysis suggested that age-friendly ecosystems that aim to promote community participation are characterized by the provision of accessible and inclusive physical environments, the availability of supportive social networks and services, and the creation of opportunities for meaningful engagement in community life. The review also highlighted the importance of recognizing the diverse needs and preferences of older adults and involving them in the design and implementation of age-friendly ecosystems. Overall, the study has provided valuable insights into the mechanisms and contextual factors that contribute to the success of age-friendly ecosystems. Ecosystem outcomes were not well discussed in the literature. The analysis has important implications for policy and practice, emphasizing the need to develop interventions that are tailored to the specific needs and contexts of older adults, and that promote community participation as a means of enhancing health, wellbeing, and quality of life in later life. Full article
(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)
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17 pages, 439 KiB  
Article
Colombian Stakeholder Perceptions and Recommendations Regarding Fall Detection Systems for Older Adults
by Edna Avella-Rodríguez, Lessby Gómez, Jose Ramirez-Scarpetta and Esteban Rosero
Geriatrics 2023, 8(3), 51; https://doi.org/10.3390/geriatrics8030051 - 08 May 2023
Viewed by 1304
Abstract
This study aimed to analyze perceptions and recommendations from stakeholders on the effectiveness of fall detection systems for older adults, aside from any additional technological solutions they may use within their activities of daily living (ADLs). This study performed a mixed-method approach to [...] Read more.
This study aimed to analyze perceptions and recommendations from stakeholders on the effectiveness of fall detection systems for older adults, aside from any additional technological solutions they may use within their activities of daily living (ADLs). This study performed a mixed-method approach to explore the views and recommendations of stakeholders concerning the implementation of wearable fall detection systems. Semi-structured online interviews and surveys were conducted on 25 Colombian adults classified into four stakeholder groups: older adults, informal caregivers, healthcare professionals, and researchers. A total of 25 individuals were interviewed or surveyed, comprising 12 females (48%) and 13 males (52%). The four groups cited the importance of wearable fall detection systems in ADLs monitoring of older adults. They did not consider them stigmatizing nor discriminatory but some raised potential privacy issues. The groups also communicated that the apparatus could be small, lightweight, and easy to handle with a help message sent to a relative or caregiver. All stakeholders interviewed perceived assistive technology as potentially useful for opportune healthcare, as well as for promoting independent living for the end user and their family members. For this reason, this study assessed the perceptions and recommendations received concerning fall detectors depending on the needs of stakeholders and the settings in which they are used. Full article
(This article belongs to the Special Issue Physical and Cognitive Decline in Older Adults)
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13 pages, 430 KiB  
Systematic Review
Efficacy of Health Promotion Interventions Aimed to Improve Health Gains in Middle-Aged Adults—A Systematic Review
by Eunice M. C. P. Santos, Ana M. G. D. S. Canhestro, Jorge M. O. A. Rosário, César J. V. Fonseca, Lara M. G. Pinho and Helena M. S. L. R. Arco
Geriatrics 2023, 8(3), 50; https://doi.org/10.3390/geriatrics8030050 - 30 Apr 2023
Cited by 2 | Viewed by 1764
Abstract
Population aging will be one of the major social transformations in the coming decades, with a very significant impact in all countries. The consequences of this will cause an overload of social and health services. It will be necessary to prepare for an [...] Read more.
Population aging will be one of the major social transformations in the coming decades, with a very significant impact in all countries. The consequences of this will cause an overload of social and health services. It will be necessary to prepare for an aging population. The promotion of healthy lifestyles is necessary to increase quality of life and well-being as people age. The aim of this study was to identify and synthesize interventions in middle-aged adults that promote healthy lifestyles and translate this knowledge into health gains. We performed a systematic review of the literature with research on the EBSCO Host—Research Databases platform. The methodology followed the PRISMA guidelines, and the protocol was registered with PROSPERO. A total of 10 articles out of 44 retrieved were included in this review, which identified interventions to promote healthy lifestyles with an impact on well-being, quality of life, and adherence to healthy behaviors. The synthesized evidence supports the efficacy of interventions that contributed to positive changes at the biopsychosocial level. Health promotion interventions were educational or motivational and related to physical exercise, healthy eating, and changes in habits and lifestyles related to harmful behaviors (tobacco use, excess carbohydrates in the diet, physical inactivity, and stress). The health gains found were increased mental health knowledge (self-actualization), adherence to physical exercise, improvement in physical condition, adherence to the consumption of fruits and vegetables, increased quality of life, and well-being. Health promotion interventions in middle-aged adults can significantly improve healthy lifestyles, protecting them from the negative effect of aging. For aging to be a successful experience, continuity of healthy lifestyles practiced in middle age is necessary. Full article
(This article belongs to the Section Healthy Aging)
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10 pages, 269 KiB  
Article
The Impact of Potentially Inappropriate Medications and Polypharmacy on 3-Month Hospital Readmission among Older Patients: A Retrospective Cohort Study from Malaysia
by Muhammad Eid Akkawi, Hani Hazirah Abd Aziz and Abdul Rahman Fata Nahas
Geriatrics 2023, 8(3), 49; https://doi.org/10.3390/geriatrics8030049 - 30 Apr 2023
Cited by 1 | Viewed by 1660
Abstract
Introduction: Potentially inappropriate medications (PIMs) use and polypharmacy are two issues that are commonly encountered among older people. They are associated with several negative outcomes including adverse drug reactions and medication-related hospitalization. There are insufficient studies regarding the impact of both PIMs and [...] Read more.
Introduction: Potentially inappropriate medications (PIMs) use and polypharmacy are two issues that are commonly encountered among older people. They are associated with several negative outcomes including adverse drug reactions and medication-related hospitalization. There are insufficient studies regarding the impact of both PIMs and polypharmacy on hospital readmission, especially in Malaysia. Aim: To investigate the possible association between polypharmacy and prescribing PIMs at discharge and 3-month hospital readmission among older patients. Materials and method: A retrospective cohort study involved 600 patients ≥60 years discharged from the general medical wards in a Malaysian teaching hospital. The patients were divided into two equal groups: patients with or without PIMs. The main outcome was any readmission during the 3-month follow-up. The discharged medications were assessed for polypharmacy (≥five medications) and PIMs (using 2019 Beers’ criteria). Chi-square test, Mann–Whitney test, and a multiple logistic regression were conducted to study the impact of PIMs/polypharmacy on 3-month hospital readmission. Results: The median number for discharge medications were six and five for PIMs and non-PIMs patients, respectively. The most frequently prescribed PIMs was aspirin as primary prevention of cardiovascular diseases (33.43%) followed by tramadol (13.25%). The number of medications at discharge and polypharmacy status were significantly associated with PIMs use. Overall, 152 (25.3%) patients were re-admitted. Polypharmacy and PIMs at discharge did not significantly impact the hospital readmission. After applying the logistic regression, only male gender was a predictor for 3-month hospital readmission (OR: 2.07, 95% CI: 1.022–4.225). Conclusion: About one-quarter of the patients were admitted again within three months of discharge. PIMs and polypharmacy were not significantly associated with 3-month hospital readmissions while male gender was found to be an independent risk factor for readmission. Full article
(This article belongs to the Section Geriatric Public Health)
12 pages, 298 KiB  
Article
Population Older than 69 Had Similar Fatality Rates Independently If They Were Admitted in Nursing Homes or Lived in the Community: A Retrospective Observational Study during COVID-19 First Wave
by Javier Martínez-Redondo, Carles Comas, Cristina García-Serrano, Montserrat Crespo-Pons, Pilar Biendicho Palau, Teresa Vila Parrot, Francisco Reventoz Martínez, Lídia Aran Solé, Neus Arola Serra, Eva Tarragona Tassies and Jesús Pujol Salud
Geriatrics 2023, 8(3), 48; https://doi.org/10.3390/geriatrics8030048 - 28 Apr 2023
Viewed by 1547
Abstract
The aim of this study is to assess the influence of living in nursing homes on COVID-19-related mortality, and to calculate the real specific mortality rate caused by COVID-19 among people older than 20 years of age in the Balaguer Primary Care Centre [...] Read more.
The aim of this study is to assess the influence of living in nursing homes on COVID-19-related mortality, and to calculate the real specific mortality rate caused by COVID-19 among people older than 20 years of age in the Balaguer Primary Care Centre Health Area during the first wave of the pandemic. We conducted an observational study based on a database generated between March and May 2020, analysing COVID-19-related mortality as a dependent variable, and including different independent variables, such as living in a nursing home or in the community (outside nursing homes), age, sex, symptoms, pre-existing conditions, and hospital admission. To evaluate the associations between the independent variables and mortality, we calculated the absolute and relative frequencies, and performed a chi-square test. To avoid the impact of the age variable on mortality and to assess the influence of the “living in a nursing home” variable, we established comparisons between infected population groups over 69 years of age (in nursing homes and outside nursing homes). Living in a nursing home was associated with a higher incidence of COVID-19 infection, but not with higher mortality in patients over 69 years of age (p = 0.614). The real specific mortality rate caused by COVID-19 was 2.270/00. In the study of the entire sample, all the comorbidities studied were associated with higher mortality; however, the comorbidities were not associated with higher mortality in the infected nursing home patients group, nor in the infected community patients over 69 years of age group (except for neoplasm history in this last group). Finally, hospital admission was not associated with lower mortality in nursing home patients, nor in community patients over 69 years of age. Full article
(This article belongs to the Collection Ageism, the Black Sheep of the Decade of Healthy Ageing)
14 pages, 1973 KiB  
Article
The Impact of Population Ageing on Rural Aged Care Needs in Australia: Identifying Projected Gaps in Service Provision by 2032
by Irene Blackberry and Nicholas Morris
Geriatrics 2023, 8(3), 47; https://doi.org/10.3390/geriatrics8030047 - 27 Apr 2023
Cited by 2 | Viewed by 2550
Abstract
This observational study examines and estimates the trends and impact of population ageing on rural aged care needs in Australia. With its universal health system and subsidised aged care system, Australia is among those countries with a long life expectancy. Being a geographically [...] Read more.
This observational study examines and estimates the trends and impact of population ageing on rural aged care needs in Australia. With its universal health system and subsidised aged care system, Australia is among those countries with a long life expectancy. Being a geographically large country with a relatively small and dispersed population presents challenges for equitable access to aged care service provision. While this is widely acknowledged, there is little empirical evidence to demonstrate the magnitude and location of the aged care service provision gaps in the next decade. We performed time series analyses on administrative data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare GEN databases. The Aged Care Planning Regions (ACPR) were classified according to geographical remoteness using the Modified Monash Model scale. There is currently a shortfall of 2000+ places in residential aged care in rural and remote areas of Australia based on 2021 data. By 2032, population ageing will mean that an additional 3390 residential care places and around 3000 home care packages will be required in rural and remote communities alone. Geographical disparities in aged care exist in Australia and continue to worsen, requiring immediate action. Full article
(This article belongs to the Section Geriatric Public Health)
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11 pages, 493 KiB  
Article
Age-Friendly Cities in Latin America: A Human Ecological Framework
by Jonathan R. Guillemot and Mildred E. Warner
Geriatrics 2023, 8(3), 46; https://doi.org/10.3390/geriatrics8030046 - 25 Apr 2023
Cited by 1 | Viewed by 2028
Abstract
Despite the demographic aging of Latin America, the uptake of the WHO’s Age-Friendly Cities Framework remains extremely low, with the notable exceptions of Chile, Mexico and Brazil. We argue for a broader human ecological framework, which focuses on the macro, meso and micro [...] Read more.
Despite the demographic aging of Latin America, the uptake of the WHO’s Age-Friendly Cities Framework remains extremely low, with the notable exceptions of Chile, Mexico and Brazil. We argue for a broader human ecological framework, which focuses on the macro, meso and micro levels, to better address the context, challenges and opportunities for age-friendly cities in the Latin American region. The WHO’s age-friendly city domains are primarily at the meso (community) scale, with a focus on built environment, services and participation. We call for more attention to be paid to the macro policy scale to address concerns regarding migration, demography and social policy context. More attention also should be given to the micro scale to recognize the critical role of family and informal care supports. It is possible that the WHO domains are the result of a design bias, with Global North settings in mind for their development. We find the domains of UNICEF’s Child-Friendly Cities Initiative, which give more attention to the realities of the Global South, helpful to broaden the WHO’s Age-Friendly Cities Framework. Full article
(This article belongs to the Special Issue Age-Friendly Ecosystems: Voices from around the World)
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