Health and Disease in Frail Older Individuals: Assessment and Management in Clinical Practice

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 6360

Special Issue Editors

Department of Nursing, Faculty of Medicine, Linkoping University, Linkoping, Sweden
Interests: assessment and measurement of body temperature; fever; clinical desicion-making; fever phobia; elderly; evidence-based practice; EDIS; reference values
Special Issues, Collections and Topics in MDPI journals
Dr. Ewa Grodzinsky
E-Mail Website
Guest Editor
Department of Biomedicine and Clinical Science, Faculty of Medicine, Linköping University, Linkoping, Sweden
Interests: body temperature; fever; clinical desicion-making; elderly, immunology laboratory methods; celiac disease; food intolerance; reference value; assessment and measurement accuracy

Special Issue Information

Dear Colleagues,

Aging and frailty entail an increased risk of co-morbidity, diseases related to chronic inflammatory processes, and impaired physical and cognitive ability. Combined with the presentation of non-specific signs and symptoms, it is a challenge to detect deteriorating health in frail older people.

Precision medicine (also called individual-based, person-based or tailored medicine) aims to provide care and treatment according to individual conditions and needs, and aims to deliver the most effective treatment for a given patient and thus improve the quality of care. In clinical practice, decision support tools with reference values for vital parameters and biomarkers aim to facilitate the assessment of an individual’s health condition.  However, current reference values are interpreted at a group level and are mainly based on young, male, or healthy individuals aged 18–65 years. People with long-term medical conditions and receiving daily medication are excluded. Recent research has drawn attention to this commonly encountered range of values, and how the normal range/reference range can be misleading as the stated lower or upper limits do not match the individual's normal range. To enhance the efficacy of precision medicine and health it is necessary to interpret vital parameters and biomarkers based on individuals’ normal ranges. To detect changes in the health status of frail older people early on, there is an urgent need to clarify the ways in which vital parameters and biomarkers related to ageing and frailty might be interpreted. This Special Issue will focus on topics that are essential to improving the process of assessing the health condition of frail older people in clinical practice.

High-quality original research and review articles will be considered. In particular, we highlight clinical studies that demonstrate how interprofessional collaboration improves the clinical decision-making process. We hope you and your colleagues will be willing to submit your creative work to this exciting Special Issue of Geriatrics. We look forward to hearing from you.

Dr. Märta Sund Levander
Dr. Ewa Grodzinsky
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • biomarkers
  • clinical decision-making
  • frail olde people
  • infection
  • interprofessional collaboration
  • morbidity
  • mortality
  • low-grade chronic inflammation
  • vital parameters

Published Papers (5 papers)

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Research

11 pages, 1288 KiB  
Article
The Development and Evaluation of an Animated Video for Pre- and Postoperative Instructions for Patients with Osteoarthritis—A Design Science Research Approach
Geriatrics 2024, 9(1), 19; https://doi.org/10.3390/geriatrics9010019 - 08 Feb 2024
Viewed by 489
Abstract
Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video [...] Read more.
Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video for pre- and postoperative instructions for patients with osteoarthritis was designed. The design science research (DSR) approach was followed by creating a web-based animated video. The web-based animated video is used to support surgical departments with education for patients suffering from OA. In the web-based animated video, information about OA surgical treatment and its pre- and post-arrangements was included. The relevance, the rigor, and the design cycles were focused on, with some iterations of and improvements in the animations. Even after implementation, there was a feedback-loop with comments from the surgeons and their patients. Moreover, as more departments will use the web-based animated video, they want to make their special mark on it, so that further changes will be made. This paper presents the design and successful implementation of an animated video for pre- and postoperative instructions for patients with osteoarthritis, tightly linked to the patient journey and the workflow of healthcare professionals. The animated video serves not only as a tool to improve care but also as a basis for further scientific research studies. Full article
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9 pages, 500 KiB  
Article
The Contributions of Knee Extension Strength and Hand Grip Strength to Factors Relevant to Physical Frailty: The Tanno-Sobetsu Study
Geriatrics 2024, 9(1), 9; https://doi.org/10.3390/geriatrics9010009 - 10 Jan 2024
Viewed by 999
Abstract
Sarcopenia is the core factor of frailty. This study specifically focused on lower limb muscle strength and examined muscle indices that indicate the risk of frailty or pre-frailty in older adults. The study included 327 community-dwelling individuals aged ≥65 years (43.7% male) who [...] Read more.
Sarcopenia is the core factor of frailty. This study specifically focused on lower limb muscle strength and examined muscle indices that indicate the risk of frailty or pre-frailty in older adults. The study included 327 community-dwelling individuals aged ≥65 years (43.7% male) who participated in the cohort. Frailty was defined based on five symptoms: weight loss, low activity level, exhaustion, weakness and slowness. Participants were classified into frail (three or more applicable), pre-frail (one to two applicable) and non-frail groups. Muscle strength (knee extension strength, toe grip strength and hand grip strength) were assessed, and appendicular muscle mass was assessed via a bioelectrical impedance analysis. The adjusted odds ratio (OR) of muscle indices for with frailty (frail group vs. pre-frail group) or pre-frailty (pre-frail group vs. non-frail group) were calculated. The prevalence of frail and pre-frail was 7% and 40%, respectively. Adjusted for age, sex, albumin and medical history, knee extension strength was significantly associated with frailty (odds ratio 0.95, 95% CI 0.92–0.98), while hand grip strength was associated with pre-frailty (odds ratio 0.92, 95% CI 0.88–0.97) but not with other muscle indices. This study is significant for identifying knee extension strength as a factor relevant to frailty in older adults considered pre-frailty, emphasizing the importance of this specific muscle measure in predicting and managing frailty. Full article
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10 pages, 303 KiB  
Article
Translation and Psychometric Properties of the Portuguese Version of the Timed Instrumental Activities of Daily Living (TIADL)
Geriatrics 2023, 8(6), 124; https://doi.org/10.3390/geriatrics8060124 - 18 Dec 2023
Viewed by 1139
Abstract
(1) Background: to examine the psychometric properties of the Portuguese version of the Timed Instrumental Activities of Daily Living (TIADL) in nursing home residents. (2) Methods: Fifty-two participants (85.8 ± 4.2 years) were assessed on two occasions, 10–14 days apart. The same rater [...] Read more.
(1) Background: to examine the psychometric properties of the Portuguese version of the Timed Instrumental Activities of Daily Living (TIADL) in nursing home residents. (2) Methods: Fifty-two participants (85.8 ± 4.2 years) were assessed on two occasions, 10–14 days apart. The same rater administered all assessments. Internal consistency was analysed through Cronbach’s α. The reliability was estimated using the intraclass correlation coefficients (ICCs), and the standard error of the mean (SEM) was used to estimate the minimal detectable change (MDC). Construct validity was determined by Spearman’s correlation coefficients. (3) Results: For internal consistency, Cronbach’s α (0.81) revealed high internal reliability. All of the subtests demonstrated good or excellent reliability and also presented acceptable measurement precision, considering the criterion SEM < SD/2. According to Spearman’s rho, correlations with the Portuguese version of the TIADL, the Useful Field of View test, and semantic and phonemic fluency tests were significant, with moderate positive and negative correlations (0.4 < rs < 0.69). (4) Conclusions: The Portuguese version of the TIADL had good to excellent test–retest reliability (ICC > 0.90) and acceptable measurement precision. This test could be a valuable clinical tool for assessing actual performance in instrumental activities of daily living in nursing home residents. Full article
14 pages, 1548 KiB  
Article
Development of a Machine Learning-Based Model to Predict Timed-Up-and-Go Test in Older Adults
Geriatrics 2023, 8(5), 99; https://doi.org/10.3390/geriatrics8050099 - 07 Oct 2023
Viewed by 1315
Abstract
Introduction: The measurement of physical frailty in elderly patients with orthopedic impairments remains a challenge due to its subjectivity, unreliability, time-consuming nature, and limited applicability to uninjured individuals. Our study aims to address this gap by developing objective, multifactorial machine models that do [...] Read more.
Introduction: The measurement of physical frailty in elderly patients with orthopedic impairments remains a challenge due to its subjectivity, unreliability, time-consuming nature, and limited applicability to uninjured individuals. Our study aims to address this gap by developing objective, multifactorial machine models that do not rely on mobility data and subsequently validating their predictive capacity concerning the Timed-up-and-Go test (TUG test) in orthogeriatric patients. Methods: We utilized 67 multifactorial non-mobility parameters in a pre-processing phase, employing six feature selection algorithms. Subsequently, these parameters were used to train four distinct machine learning algorithms, including a generalized linear model, a support vector machine, a random forest algorithm, and an extreme gradient boost algorithm. The primary goal was to predict the time required for the TUG test without relying on mobility data. Results: The random forest algorithm yielded the most accurate estimations of the TUG test time. The best-performing algorithm demonstrated a mean absolute error of 2.7 s, while the worst-performing algorithm exhibited an error of 7.8 s. The methodology used for variable selection appeared to exert minimal influence on the overall performance. It is essential to highlight that all the employed algorithms tended to overestimate the time for quick patients and underestimate it for slower patients. Conclusion: Our findings demonstrate the feasibility of predicting the TUG test time using a machine learning model that does not depend on mobility data. This establishes a basis for identifying patients at risk automatically and objectively assessing the physical capacity of currently immobilized patients. Such advancements could significantly contribute to enhancing patient care and treatment planning in orthogeriatric settings. Full article
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16 pages, 869 KiB  
Article
The Prevalence of Xerostomia in Older Thai Individuals with Type II Diabetes Mellitus and Its Association with Type of Toothpaste and Oral Functions: A Cross-Sectional Study Using Questionnaires
Geriatrics 2023, 8(4), 76; https://doi.org/10.3390/geriatrics8040076 - 15 Jul 2023
Viewed by 1773
Abstract
Aim: To investigate the prevalence of xerostomia in older people with diabetes mellitus and its impacts on oral functions, as well as to determine potential risk factors for xerostomia. Methods: An analytical cross-sectional study was conducted on 623 older type 2 diabetes mellitus [...] Read more.
Aim: To investigate the prevalence of xerostomia in older people with diabetes mellitus and its impacts on oral functions, as well as to determine potential risk factors for xerostomia. Methods: An analytical cross-sectional study was conducted on 623 older type 2 diabetes mellitus (T2DM) Thai people using valid structural questionnaires. Patients were interviewed, and data were recorded. Xerostomia was assessed using subjective symptom questionnaires. Risk factors for xerostomia were analyzed using bivariate and multiple logistic regression analyses. Results: Among the study participants, 38.4% of the older T2DM people had xerostomia, which is associated with sex, age, type of toothpaste, years of diabetes, hemoglobin A1c level, other systemic diseases, medication, smoking, alcohol consumption, and denture wearing. It was significant that xerostomia was associated with toothpaste containing spicy herbal extracts (OR: 9.32 [3.46 to 15.25]), while toothpaste containing artificial sweeteners tended to lower the risk of xerostomia. In addition, older T2DM adults with xerostomia had greater impaired oral functions, which include difficulties in speaking (OR: 3.31 [1.11 to 9.80]), tasting (OR: 5.12 [3.26 to 8.06]), swallowing (OR: 3.59 [2.32 to 5.53]), and chewing (OR: 3.34 [1.15 to 5.82]). Conclusions: Xerostomia is prevalent in older Thai people with T2DM. The results suggest that toothpaste containing spicy herbal extracts might increase the risk of xerostomia, resulting in various oral function problems. Therefore, greater awareness of xerostomia in this group should be raised to monitor dental health, and professionals should work in parallel with other aspects of oral health promotion. Full article
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