Subjects -> MEDICAL SCIENCES (Total: 8196 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (205 journals)
    - ANAESTHESIOLOGY (105 journals)
    - CARDIOVASCULAR DISEASES (334 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (19 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (227 journals)
    - DENTISTRY (266 journals)
    - DERMATOLOGY AND VENEREOLOGY (162 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)
    - ENDOCRINOLOGY (149 journals)
    - FORENSIC SCIENCES (43 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (178 journals)
    - GERONTOLOGY AND GERIATRICS (125 journals)
    - HEMATOLOGY (160 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (177 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (90 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2241 journals)
    - NURSES AND NURSING (331 journals)
    - OBSTETRICS AND GYNECOLOGY (199 journals)
    - ONCOLOGY (355 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (135 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (150 journals)
    - OTORHINOLARYNGOLOGY (76 journals)
    - PATHOLOGY (96 journals)
    - PEDIATRICS (254 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (153 journals)
    - PSYCHIATRY AND NEUROLOGY (800 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (182 journals)
    - RESPIRATORY DISEASES (109 journals)
    - RHEUMATOLOGY (76 journals)
    - SPORTS MEDICINE (77 journals)
    - SURGERY (388 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)

GERONTOLOGY AND GERIATRICS (125 journals)                     

Showing 1 - 122 of 122 Journals sorted alphabetically
Activities, Adaptation & Aging     Hybrid Journal   (Followers: 6)
Advances in Alzheimer's Disease     Open Access   (Followers: 8)
Advances in Geriatrics     Open Access   (Followers: 4)
Advances in Gerontology     Partially Free   (Followers: 9)
Advances in Parkinson's Disease     Open Access   (Followers: 2)
Age and Ageing     Hybrid Journal   (Followers: 106)
Aging & Mental Health     Hybrid Journal   (Followers: 40)
Aging and Cancer     Open Access   (Followers: 2)
Aging and Health Research     Open Access   (Followers: 1)
Aging Clinical and Experimental Research     Hybrid Journal   (Followers: 3)
Aging Medicine     Open Access   (Followers: 1)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 41)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 50)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Journal of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 21)
American Journal of Geriatric Psychiatry     Hybrid Journal   (Followers: 19)
Anales en Gerontología     Open Access  
Angewandte GERONTOLOGIE Appliquée     Full-text available via subscription  
Annual Review of Gerontology and Geriatrics     Hybrid Journal   (Followers: 14)
Arthritis und Rheuma     Hybrid Journal  
Australasian Journal On Ageing     Hybrid Journal   (Followers: 12)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 5)
B&G Bewegungstherapie und Gesundheitssport     Hybrid Journal   (Followers: 2)
Biogerontology     Hybrid Journal   (Followers: 1)
BMC Geriatrics     Open Access   (Followers: 17)
Canadian Geriatrics Journal     Open Access   (Followers: 6)
Canadian Journal on Aging     Hybrid Journal   (Followers: 17)
Clinical Gerontologist     Hybrid Journal   (Followers: 3)
Clinics in Geriatric Medicine     Full-text available via subscription   (Followers: 6)
Current Geriatrics Reports     Hybrid Journal   (Followers: 1)
Current Gerontology and Geriatrics Research     Open Access   (Followers: 11)
Dementia and Geriatric Cognitive Disorders     Full-text available via subscription   (Followers: 36)
Dementia and Geriatric Cognitive Disorders Extra     Open Access   (Followers: 19)
Drugs & Aging     Full-text available via subscription   (Followers: 10)
European Geriatric Medicine     Full-text available via subscription   (Followers: 3)
European Journal of Ageing     Hybrid Journal   (Followers: 16)
European Review of Aging and Physical Activity     Open Access   (Followers: 11)
Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process     Hybrid Journal   (Followers: 2)
Experimental Gerontology     Hybrid Journal   (Followers: 5)
Frontiers in Aging Neuroscience     Open Access   (Followers: 22)
Gait & Posture     Hybrid Journal   (Followers: 17)
Generations     Full-text available via subscription   (Followers: 3)
Geriatric Care     Open Access   (Followers: 4)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Geriatric Orthopaedic Surgery Rehabilitation     Open Access   (Followers: 5)
Geriatrics     Open Access   (Followers: 3)
Geriatrics & Gerontology International     Hybrid Journal   (Followers: 12)
Geriatrie up2date     Hybrid Journal  
Geriatrie-Report : Forschung und Praxis in der Altersmedizin     Full-text available via subscription  
Gerodontology     Hybrid Journal   (Followers: 2)
Gerokomos     Open Access   (Followers: 1)
Geron     Full-text available via subscription  
Gerontologia     Open Access  
Gerontology     Full-text available via subscription   (Followers: 22)
Gerontology & Geriatrics Education     Hybrid Journal   (Followers: 8)
Gerontology and Geriatric Medicine     Open Access   (Followers: 5)
GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry     Hybrid Journal   (Followers: 5)
GeroScience : Official Journal of the American Aging Association (AGE)     Hybrid Journal   (Followers: 8)
Global Journal of Geriatrics Nursing     Open Access   (Followers: 4)
Hip International     Hybrid Journal  
I Advance Senior Care     Full-text available via subscription  
Immunity & Ageing     Open Access   (Followers: 9)
Innovation in Aging     Open Access   (Followers: 1)
International Journal of Ageing and Later Life     Open Access   (Followers: 1)
International Journal of Aging and Human Development     Full-text available via subscription   (Followers: 11)
International Journal of Alzheimer's Disease     Open Access   (Followers: 8)
JMIR Aging     Open Access  
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Adult Protection, The     Hybrid Journal   (Followers: 16)
Journal of Aging and Environment     Hybrid Journal   (Followers: 4)
Journal of Aging and Health     Hybrid Journal   (Followers: 28)
Journal of Angiogenesis Research     Open Access   (Followers: 2)
Journal of Applied Gerontology     Hybrid Journal   (Followers: 18)
Journal of Elder Abuse & Neglect     Hybrid Journal   (Followers: 6)
Journal of Frailty & Aging     Hybrid Journal  
Journal of Geriatric Cardiology     Open Access   (Followers: 3)
Journal of Geriatric Mental Health     Open Access   (Followers: 6)
Journal of Geriatric Oncology     Hybrid Journal   (Followers: 2)
Journal of Geriatric Physical Therapy     Hybrid Journal   (Followers: 14)
Journal of Geriatrics     Open Access   (Followers: 1)
Journal of Geriatrics and Palliative Care     Open Access   (Followers: 5)
Journal of Gerontological Social Work     Hybrid Journal   (Followers: 14)
Journal of Mid-life Health     Open Access  
Journal of Military and Veterans Health     Full-text available via subscription   (Followers: 7)
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Prevention of Alzheimer's Disease     Hybrid Journal   (Followers: 1)
Journal of Religion Spirituality & Aging     Hybrid Journal   (Followers: 7)
Journal of Social Work in End-of-Life & Palliative Care     Hybrid Journal   (Followers: 22)
Journal of the American Geriatrics Society     Hybrid Journal   (Followers: 68)
Journal of the Indian Academy of Geriatrics     Open Access   (Followers: 4)
Maturitas     Hybrid Journal   (Followers: 10)
Medycyna Wieku Podeszłego (Geriatric Medicine)     Open Access  
Mortality: Promoting the interdisciplinary study of death and dying     Hybrid Journal   (Followers: 9)
Neurodegenerative Diseases     Full-text available via subscription   (Followers: 1)
Neuroembryology and Aging     Full-text available via subscription   (Followers: 1)
NOVAcura     Hybrid Journal  
npj Aging and Mechanisms of Disease     Open Access   (Followers: 1)
npj Parkinson's Disease     Open Access   (Followers: 4)
Nursing Older People     Full-text available via subscription   (Followers: 9)
OA Elderly Medicine     Open Access  
Paediatrics & Child Health in General Practice     Full-text available via subscription   (Followers: 5)
Palliative Care & Social Practice     Open Access   (Followers: 3)
Parkinson's Disease     Open Access   (Followers: 12)
Pathobiology of Aging & Age-related Diseases     Open Access  
Physical & Occupational Therapy in Geriatrics     Hybrid Journal   (Followers: 56)
Quality in Ageing and Older Adults     Hybrid Journal   (Followers: 44)
Quality of Life Research     Hybrid Journal   (Followers: 20)
RASP - Research on Ageing and Social Policy     Open Access   (Followers: 4)
Revista Española de Geriatría y Gerontología     Full-text available via subscription  
Senex: Yaşlılık Çalışmaları Dergisi / Senex: Journal of Aging Studies     Open Access  
The Aging Male     Hybrid Journal   (Followers: 2)
The Gerontologist     Hybrid Journal   (Followers: 23)
The Journals of Gerontology : Series A     Hybrid Journal   (Followers: 22)
Topics in Geriatric Rehabilitation     Hybrid Journal   (Followers: 15)
Translational Medicine of Aging     Open Access  
Work, Aging and Retirement     Open Access   (Followers: 4)
Working with Older People     Hybrid Journal   (Followers: 40)
Zeitschrift fur Gerontologie und Geriatrie     Hybrid Journal   (Followers: 1)
Zeitschrift für Gerontopsychologie und -psychiatrie     Full-text available via subscription   (Followers: 1)
Zeitschrift für Palliativmedizin     Hybrid Journal  

           

Similar Journals
Journal Cover
Geriatrics
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2308-3417
Published by MDPI Homepage  [84 journals]
  • Geriatrics, Vol. 7, Pages 71: Sex Difference in Control of Low-Density
           Lipoprotein Cholesterol in Older Patients after Acute Coronary Syndrome

    • Authors: Tan Van Nguyen, Dieu Thi Thanh Tran, Trinh Thi Kim Ngo, Tu Ngoc Nguyen
      First page: 71
      Abstract: Objective. The main aim of this study is to examine the achievement of low-density lipoprotein cholesterol (LDL-C) targets in older patients after acute coronary syndrome (ACS), and the secondary aim is to examine sex difference in LDL-C target achievement. Methods. Patients aged ≥60 years with ACS admitted to a tertiary hospital in Vietnam were recruited from December 2019 to August 2020. LDL-C target achievement was defined as having an LDL-C goal of <1.8 mmol/L. Multivariate logistic regression was applied to investigate the predictive factors for LDL-C target achievement. Results. A total of 232 participants were included in this study (mean age 75.5 years, 40.1% were women). Participants had an average of three chronic conditions other than coronary heart disease. All participants were prescribed statin monotherapy at discharge (59.5% on high-intensity statins). After 3 months, 218 (94.0%) of the participants were on statin monotherapy, 14 (6.0%) were on statin combined with ezetimibe. The proportion of participants that achieved LDL-C target after 3 months was 56.5% (40.9% in women and 66.9% in men, p < 0.001). On univariate logistic regression, women were less likely to achieve their LDL-C target compared to men (unadjusted OR 0.34, 95% CI 0.20–0.59). This association was still significant in the adjusted model (adjusted OR 0.43, 95% CI 0.24–0.78). Other factors that were significantly associated with LDL-C target achievement included age, smoking, sedentary lifestyle, LDL-C level on admission, history of using statin before admission, and high-intensity statin prescribed at discharge. Conclusions. Our study found that nearly a half of older patients with ACS did not achieve their LDL-C target after 3 months, and suboptimal control of LDL-C was more common in women.
      Citation: Geriatrics
      PubDate: 2022-06-24
      DOI: 10.3390/geriatrics7040071
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 72: Diagnostic Accuracy of the Overlapping
           Infinity Loops, Wire Cube, and Clock Drawing Tests in Subjective Cognitive
           Decline, Mild Cognitive Impairment and Dementia

    • Authors: Sigourney Costa, Rebecca J. St George, James Scott McDonald, Xinyi Wang, Jane Alty
      First page: 72
      Abstract: Figure drawing tasks are commonly used standalone or as part of broader screening tests to detect cognitive impairment. Only one study has compared the classification accuracy of three common drawing tasks—overlapping infinity loops, wire cube, and the clock drawing task (CDT)—in mild cognitive impairment (MCI) and dementia, but age and education, which impact performance, were not accounted for. We replicated the research, adjusting for age and education and, for the first time, assessed subjective cognitive decline (SCD) too. Participants were recruited from the Tasmanian ISLAND Cognitive Clinic and healthy controls from a community sample. All participants completed the three figure drawing tasks. The clinic patients were categorised according to interdisciplinary consensus diagnosis. Binomial logistic regression and area under ROC curves (AUC) were calculated to determine the discriminatory ability of each drawing task. Overall, 112 adults were recruited; 51 had normal cognition (NC), 21 SCD, 24 MCI, and 16 had dementia. The infinity loops test did not discriminate any of the groups, casting some doubt on its usefulness. The wire cube discriminated NC from dementia (AUC 0.7; p < 0.05). The CDT discriminated NC from dementia (AUC 0.77; p < 0.01), NC from cognitive impairment (dementia + MCI; AUC 0.59; p < 0.05), and MCI from dementia (AUC 0.76; p < 0.01). None of the tests discriminated NC from MCI or NC from SCD. The CDT was the most discriminatory test, followed by the wire cube. This may help guide clinicians who often choose just one figure drawing task due to time constraints or patient fatigue.
      Citation: Geriatrics
      PubDate: 2022-07-05
      DOI: 10.3390/geriatrics7040072
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 73: The Role of Cognitive Performance and
           Physical Functions in the Association between Age and Gait Speed: A
           Mediation Study

    • Authors: Marcelo de Maio Nascimento, Élvio Rúbio Gouveia, Bruna R. Gouveia, Adilson Marques, Priscila Marconcin, Cíntia França, Andreas Ihle
      First page: 73
      Abstract: Introduction: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. Methods: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. Results: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. Conclusions: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.
      Citation: Geriatrics
      PubDate: 2022-07-07
      DOI: 10.3390/geriatrics7040073
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 74: The Prevalence of Low Handgrip Strength and
           Its Predictors among Outpatient Older Adults in a Tertiary Care Setting: A
           Cross-Sectional Study

    • Authors: Manchumad Manjavong, Apichart So-ngern, Panita Limpawattana, Natapong Manomaiwong, Thanisorn Kamsuanjig, Chudapha Khammak, Pongsak Chokkhatiwat, Kamolthorn Srisuwannakit
      First page: 74
      Abstract: Background: Low muscle strength is linked to several adverse health outcomes. However, there are limited data regarding its prevalence and associated factors in Thai older adults. This study aimed to fill that gap. Methods: This cross-sectional study was conducted with patients aged ≥ 60 years at the outpatient clinic of the internal medicine department of a tertiary care hospital from April 2020 to December 2021. Patient characteristics were collected, and a handgrip dynamometer was used to measure handgrip strength (HGS). Low HGS was defined according to the 2019 recommendations of the Asian Working Group for Sarcopenia. Results: In total, 198 patients were recruited. The prevalence of low HGS was 51%. Median HGS was 17.8 kg and 27.7 kg in women and men, respectively. Every age per year increase, greater number of medications of any type, and lower Montreal Cognitive Assessment (MoCA) score were independent factors associated with low HGS, with adjusted odds ratios of 1.1, 1.2, and 0.9, respectively. Conclusions: Low HGS was prevalent among older patients in this setting, indicating a high degree of possible sarcopenia. As there were some modifiable factors associated with low HGS, routine measurement, medication review, and cognitive evaluation are recommended for early diagnosis and management.
      Citation: Geriatrics
      PubDate: 2022-07-08
      DOI: 10.3390/geriatrics7040074
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 75: Cheese Intake Exhibits an Alteration of
           Glycolipid Profile and Impacts on Non-Alcoholic Fatty Liver in Bahraini
           Older Adults

    • Authors: Simone Perna, Layla H. Hammad, Mohamed Wael Mohamed, Dalal Alromaihi, Mariam Alhammadi, Noora Al-Khater, Anas Rashed Alchuban, Mawadh Ali Aledrisy, Zahra Ilyas, Tariq A. Alalwan, Mariangela Rondanelli
      First page: 75
      Abstract: Background: Metabolic syndrome (MetS) is a multifactorial condition characterized by a complex interrelation between genetic and environmental factors that heighten the risk of cardiovascular diseases and all-cause mortality. It is hypothesized that diet may play an important role in the regulation of metabolic syndrome factors and influence the process. Therefore, the main objective of this study was to investigate the specific dietary patterns associated with metabolic syndrome markers and quantify the possible effects of dietary patterns among Bahrain older adults. Methods: This is a cross-sectional study that included 151 Bahraini patients diagnosed with MetS, 89 (58.7%) were females and 62 (41.3%) males. Results: The prevalence of Non-Alcoholic Fatty Liver was 89%. Statistically significant correlations were found between dairy products with low fat and SBP (r = 0.182, p < 0.001) body mass index (BMI) (r = −0.195; p < −0.01). Higher chicken consumption was associated with reduction of BMI (r = −0.273; p < −0.01). A higher consumption of ricotta and cheddar cheese (high in fat) was associated with higher levels of triglycerides (p < 0.01). Higher frequent consumption of rice (basmati) was associated with lower glucose levels (r = −0.200; p < −0.01). Fatty liver has been associated with high consumption of cream cheese (p < 0.01). Conclusion: In older Bahraini adults with metabolic syndrome, higher frequency of food consumption of full-fat cheese was linked with a derangement of lipid profile and Non-Alcoholic Fatty Liver. Positive effects on BMI have been recorded with higher-frequency consumption of basmati rice and chicken.
      Citation: Geriatrics
      PubDate: 2022-07-20
      DOI: 10.3390/geriatrics7040075
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 76: The Relationship between Metabolic Syndrome
           and Frailty in Older People: A Systematic Review and Meta-Analysis

    • Authors: Hiep Huu Hoang Dao, Mason Jenner Burns, Richard Kha, Clara K. Chow, Tu Ngoc Nguyen
      First page: 76
      Abstract: Aims: Both metabolic syndrome (MetS) and frailty are associated with increased all-cause mortality, yet the complex interplay between these two conditions has not adequately been elucidated. We aim to analyse the relationship between MetS and frailty through a systematic review of the literature with meta-analyses. Methods: A literature search was conducted via MEDLINE and EMBASE. Studies were included if validated frameworks for defining frailty and MetS (presence of at least 3 out of the five constitutive components: abdominal obesity, high fasting blood glucose, hypertension, hypertriglyceridaemia, and low high-density lipoprotein level) were utilised, in addition to the inclusion of participants aged 60 or older. Results: Eleven studies were included, all observational. All were in community-dwelling older people, 9 cross-sectional and 2 longitudinal. Most of the studies used Fried’s frailty phenotype. The prevalence of frailty ranged from 0.9% to 14.8% in population-based studies and 35.6% in the outpatient clinic setting. The prevalence of MetS was also higher in the outpatient clinic setting at 47.5%, compared to 17.5–41.0% in the community-dwelling populations. The meta-analysis of 11 studies showed that MetS was associated with an increased risk of frailty (pooled OR 1.73, 95% CI, 1.41–2.13). Conclusion: This systematic review and meta-analysis suggest that frailty was more prevalent in older patients with MetS compared to older patients without MetS. The study findings suggest the importance of frailty screening in older people with MetS and a distinct role of managing MetS in preventing frailty in older people.
      Citation: Geriatrics
      PubDate: 2022-07-26
      DOI: 10.3390/geriatrics7040076
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 77: Cataract Surgery during the COVID-19
           Pandemic: Insights from a Greek Tertiary Hospital

    • Authors: Tsironi, Kavvadas, Delis, Bekiaridou, Kapourani, Loizou, Apostolidou, Misiou, Theofrastou, Panakleridou, Psimenidou, Sarafi, Fadel, Karachrysafi
      First page: 77
      Abstract: Background: COVID-19 has affected everyday clinical practice, having an impact on the quality of healthcare provided, even in eye clinic departments. The aim of this study is to evaluate the consequences of this worldwide pandemic on cataract surgery in a Greek tertiary university hospital. Methods: A total of 805 patients were included in this study. The number of cataract surgeries (CS), the type, the unilateral or bilateral appearance as well as the stage of cataract were recorded for the months between January and June 2019 (pre-COVID period) and compared with the same period in 2021 (during the pandemic outbreak) in the Department of Ophthalmology of Thessaloniki General Hospital G. Papanikolaou. Results: A significant reduction in the number of CS as well as a significant increase in advanced and/or bilateral cataracts in 2021 compared to the pre-COVID period were observed. Conclusion: The COVID-19 pandemic has affected equally the value of ophthalmic interventions as well as the patients’ quality of life, being a powerful reminder of the significant physical and psychological benefits of CS, especially for older adults and patients with comorbidities.
      Citation: Geriatrics
      PubDate: 2022-07-26
      DOI: 10.3390/geriatrics7040077
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 78: Efficiency of Diagnostic Test for SARS-CoV-2
           in a Nursing Home

    • Authors: Sergio Salmerón, Alonso López-Escribano, Inmaculada García-Nogueras, Joaquina Lorenzo, Juan Manuel Romero, Antonio Hernández-Martínez, Francisco García-Alcaraz
      First page: 78
      Abstract: Background: there is no consensus on how to optimally use diagnostic tests in each stage of COVID-19 pandemic. The objective of this research is to determine the efficiency of sorting positive antibody test quarterly. Methods: this research uses a retrospective, observational study. COVID-19 diagnostic tests performed and avoided refer to a Spanish nursing home. Population: 261 employees and 107 residents. A quarterly antibody test was performed on subjects who had tested positive during the first wave of coronavirus, and a antibody rapid test on the remaining subjects. Results: during the first wave, 24.0% of the employees and 51.4% of the residents had a positive antibody test. Seronegativization was observed in 7.6% of employees and 1.6% of residents. An employee was infected with COVID-19 in September 2020, followed by a nursing home outbreak in October: 118 Polymerase Chain Reactions tests were avoided in residents and 18 in employees, which in turn prevented 15 workers from going on sick leave and the quarantine of 59 residents. This represents savings of about $15,000. Conclusions: our study supports the need to know and apply the strategies for early detection, surveillance and control of COVID-19 for future outbreaks. We conclude that surveillance for positive COVID-19 serology among long-term care staff and residents may be a cost-effective strategy during a pandemic.
      Citation: Geriatrics
      PubDate: 2022-07-26
      DOI: 10.3390/geriatrics7040078
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 79: Weighted Blankets’ Effect on the
           Health of Older People Living in Nursing Homes

    • Authors: Eva Hjort Telhede, Susann Arvidsson, Staffan Karlsson, Andreas Ivarsson
      First page: 79
      Abstract: Background: An increasingly aging population is a global phenomenon. While considered a positive step forward, vulnerability to age-related health problems increases along with the ageing population. The aim of the study was to investigate weighted blankets’ effect on health regarding quality of life (QoL), sleep, nutrition, cognition, activities of daily living ADL and medication in older people living in nursing homes. Methods: In total, 110 older people were involved in an intervention with weighted blankets, and 68 older people completed the intervention. Measures before and after were performed regarding quality of life; QoL-AD, EQ-VAS, sleep; MISS, nutrition; MNA, cognition; S -MMSE (ADL) and medication. Comparative statistical analyses were applied. Results: After intervention with weighted blankets, health in general, such as QoL, improved. Sleep also improved significantly, especially with respect to waking up during the night. Nutrition was enhanced, health as a cognitive ability improved, and medication in the psychoanaleptic group decreased. The effect size varied between small and large. Conclusions: A weighted blanket seems to be an effective and safe intervention for older people in nursing homes, as several improvements were made regarding the health of older people.
      Citation: Geriatrics
      PubDate: 2022-07-29
      DOI: 10.3390/geriatrics7040079
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 80: New Trends in Cognitive Aging and Mild
           Cognitive Impairment

    • Authors: David Facal, Carlos Spuch, Sonia Valladares-Rodriguez
      First page: 80
      Abstract: In this editorial, we aim to highlight some lessons learned in our field and to discuss some open questions regarding the continuum between healthy cognitive aging and dementia [...]
      Citation: Geriatrics
      PubDate: 2022-08-01
      DOI: 10.3390/geriatrics7040080
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 81: Healthcare-Associated Adverse Events in
           Alternate Level of Care Patients Awaiting Long-Term Care in Hospital

    • Authors: Guillaume J. Lim Fat, Aquila Gopaul, A. Demetri Pananos, Mary-Margaret Taabazuing
      First page: 81
      Abstract: Introduction: A growing number of Canadian older adults are designated alternate level of care (ALC) and await placement into long-term care (LTC) while admitted to hospital. This creates infrastructural challenges by using resources allocated for acute care during disproportionately long hospital stays. For ALC patients, hospital environments maladapted to their needs impart risk of healthcare-associated adverse events. Methods: In this retrospective descriptive study, we examined healthcare-associated adverse events in 156 ALC patients, 65 years old and older, awaiting long-term care while admitted to two hospitals in London, Ontario in 2015–2018. We recorded incidence of infections and antimicrobial days prescribed. We recorded incidence of non-infectious adverse events including delirium, falls, venothrombotic events, and pressure ulcers. We used a restricted cubic spline model to characterize adverse events as a function of length of stay. Results: Patients waited an average of 56 ALC days (ranging from 6 to 333 days) before LTC placement, with seven deaths occurring prior to placement. We recorded 362 total adverse events accrued over 8668 ALC days: 94 infections and 268 non-infectious adverse events. The most common hospital-acquired infections were urinary-tract infections and respiratory infections. The most common non-infectious adverse events were delirium and falls. A total of 620 antimicrobial days were prescribed for infections. Conclusions: ALC patients incur a meaningful and predictable number of adverse events during their stay in acute care. The incidence of these adverse events should be used to educate stakeholders on risks of ALC stay and to advocate for strategies to minimize ALC days.
      Citation: Geriatrics
      PubDate: 2022-08-08
      DOI: 10.3390/geriatrics7040081
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 82: Home-Dwelling Older Adults’ Day-to-Day
           Community Interactions: A Qualitative Study

    • Authors: Elodie Perruchoud, Armin von Gunten, Tiago Ferreira, Alcina Matos Queirós, Henk Verloo
      First page: 82
      Abstract: Background: Many home-dwelling older adults present abnormal behaviours related to dementia or to non-dementia cognitive impairment (e.g., agitation, anxiety, apathy, etc.). Because many older adults live at home alone or are able to hide any signs of abnormal behaviours from others, the non-healthcare workers who interact with older adults on a daily basis are key actors in detecting those behaviours and orienting older adults towards appropriate support services. To the best of our knowledge, no studies to date have explored the daily interactions experienced between older adults and the various non-healthcare workers whom they regularly encounter in the community. This work aimed to identify the non-healthcare workers who are regularly in direct contact with older adults during their day-to-day activities and then develop specific training for these workers on the subject of abnormal behaviours among the elderly. Methods: This qualitative and ethnographic study asked 21 home-dwelling older adults aged 65 years old or more to answer open-ended questions. Sixteen had no self-reported cognitive impairments, and five had a probable or diagnosed slight cognitive impairment or mild-to-moderate dementia. A thematic analysis of the data was carried out. Results: The non-healthcare workers who spent the most time with older adults with and without reported cognitive impairments were those working in cafés or tea rooms and leisure or activity centres. Conclusions: In view of the significant amounts of contact between home-dwelling older adults and non-healthcare workers, it seems necessary and sensible to increase non-healthcare workers’ knowledge about abnormal behaviours, especially by offering them training. The proactive detection and identification of older adults’ abnormal behaviours by non-healthcare workers will ensure earlier care and reduce avoidable hospitalisations, institutionalisations and costs linked to geriatric healthcare.
      Citation: Geriatrics
      PubDate: 2022-08-12
      DOI: 10.3390/geriatrics7040082
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 83: Nutritional Intervention Effectiveness on
           Slowing Time to Dialysis in Elderly Patients with Chronic Kidney
           Disease—A Retrospective Cohort Study

    • Authors: Simone Perna, Fatima Faisal, Daniele Spadaccini, Tariq A. Alalwan, Zahra Ilyas, Clara Gasparri, Mariangela Rondanelli
      First page: 83
      Abstract: Chronic kidney disease (CKD) is a global health issue. Evidence of the effectiveness of nutritional intervention on slowing time to dialysis is limited in Arab countries. Therefore, this study aims to contribute to current research by providing new insights on the efficacy of personalized nutritional intervention in pre-dialysis patients in the Kingdom of Bahrain. Methods: This retrospective cohort study included 265 CKD patients (163 males and 108 females) who were admitted to the nephrology outpatient clinic at Salmaniya Medical Complex in Bahrain. The nutritional intervention group (NIG) receiving dietary advice by an expert renal dietitian consisted of 121 patients, while the non-nutritional intervention control group (non-NIG) that did not receive any nutritional support consisted of 150 patients. Patients were evaluated at baseline and follow-up. Results: The NIG had a significant increase in the estimated glomerular filtration rate (eGFR) compared to the non-NIG that had a significant decrease (5.16 vs. −2.85 mL/min/1.73 m2 (p = 0.000), respectively). When adjusted for age and gender, the mean difference was greater (8.0 mL/min/1.73 m2, p = 0.000). Additionally, there was a significant reduction in blood urea nitrogen and serum creatinine (−2.19 mmol/L and −25.31 µmol/L; p = 0.000, respectively). Moreover, the intervention had a positive impact on weight loss and body mass index (−1.84 kg and−0.69 kg/m2, respectively; p = 0.000) and lipid profile, with a significant reduction in total cholesterol and triglyceride levels (−0.17 mmol/L, p = 0.006 and −0.15 mmol/L, p = 0.026, respectively). Additional significant results from the NIG included reduced uric acid (−28.35 µmol/L, p = 0.006), serum phosphorus (−0.05 mol/L, p = 0.025), fasting blood glucose (−0.70 mmol/L, p = 0.016) and glycated hemoglobin (1.10 mmol/mol, p = 0.419). Conclusions: This study suggests that, in patients of CKD, nutritional intervention counselling plays a significant role in reducing the time needed for dialysis and improves nutritional-related biomarkers compared to patients not receiving this intervention.
      Citation: Geriatrics
      PubDate: 2022-08-13
      DOI: 10.3390/geriatrics7040083
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 84: Comparative Outcomes and Surgical Timing for
           Operative Fragility Hip Fracture Patients during the COVID-19 Pandemic: A
           Retrospective Cohort Study

    • Authors: Katherine A. Rowe, Kiryung Kim, Nathan H. Varady, Marilyn Heng, Arvind G. von von Keudell, Michael J. Weaver, Ayesha Abdeen, Edward K. Rodriguez, Antonia F. Chen
      First page: 84
      Abstract: The COVID-19 pandemic had wide-reaching effects on healthcare delivery, including care for hip fractures, a common injury among older adults. This study characterized factors related to surgical timing and outcomes, length-of-stay, and discharge disposition among patients treated for operative hip fractures during the first wave of the COVID-19 pandemic, compared to historical controls. A retrospective, observational cohort study was conducted from 16 March 2020-20 May 2020 with a consecutive series of 64 operative fragility hip fracture patients at three tertiary academic medical centers. Historical controls were matched based on sex, surgical procedure, age, and comorbidities. Primary outcomes included 30-day mortality and time-to-surgery. Secondary outcomes included 30-day postoperative complications, length-of-stay, discharge disposition, and time to obtain a COVID-19 test result. There was no difference in 30-day mortality, complication rates, length-of-stay, anesthesia type, or time-to-surgery, despite a mean time to obtain a final preoperative COVID-19 test result of 17.6 h in the study group. Notably, 23.8% of patients were discharged to home during the COVID-19 pandemic, compared to 4.8% among controls (p = 0.003). On average, patients received surgical care within 48 h of arrival during the COVID-19 pandemic. More patients were discharged to home rather than a facility with no change in complications, suggesting an opportunity for increased discharge to home.
      Citation: Geriatrics
      PubDate: 2022-08-13
      DOI: 10.3390/geriatrics7040084
      Issue No: Vol. 7, No. 4 (2022)
       
  • Geriatrics, Vol. 7, Pages 50: Predictors of Functional Improvement, Length
           of Stay, and Discharge Destination in the Context of an Assess and Restore
           Program in Hospitalized Older Adults

    • Authors: Beatrise Edelstein, Jillian Scandiffio
      First page: 50
      Abstract: Assess and restore programs such as Humber’s Elderly Assess and Restore Team (HEART) provide short-term restorative care to prevent functional decline in hospitalized older adults. The aim of this retrospective observational study was to determine which HEART participant characteristics are predictive of functional improvement, decreased length of stay, return to home, and decreased readmission to hospital. Electronic health records were retrospectively examined to gather predictor data. Differences in functional status, excessive length of stay, discharge destination, and hospital readmissions were compared in 547 HEART patients and 547 matched eligible non-participants using ANOVAs, Mann–Whitney, and chi-square tests. The greatest functional improvements (percent Barthel change) were seen in those requiring a one-person assist (M = 39.56) and using a walker (M = 46.07). Difference in excessive length of stay between HEART and non-HEART participants was greatest in those who used a walker (Mdn = 3.80), required a one-person assist (Mdn = 2.00), had a high falls risk (Mdn = 1.80), and had either a lower urinary tract infection (Mdn = 2.25) or pneumonia (Mdn = 1.70). Predictor variables did not affect readmission to the hospital nor return to home. Predictive characteristics should be considered when enrolling patients to assess and restore programs for optimal clinical outcomes.
      Citation: Geriatrics
      PubDate: 2022-04-20
      DOI: 10.3390/geriatrics7030050
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 51: Longitudinal Study on Sustained Attention to
           Response Task (SART): Clustering Approach for Mobility and Cognitive
           Decline

    • Authors: Rossella Rizzo, Silvin P. Knight, James R. C. Davis, Louise Newman, Eoin Duggan, Rose Anne Kenny, Roman Romero-Ortuno
      First page: 51
      Abstract: The Sustained Attention to Response Task (SART) is a computer-based go/no-go task to measure neurocognitive function in older adults. However, simplified average features of this complex dataset lead to loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we combine a novel method to visualise individual trial (raw) information obtained from the SART test in a large population-based study of ageing in Ireland and an automatic clustering technique. We employed a thresholding method, based on the individual trial number of mistakes, to identify poorer SART performances and a fuzzy clusters algorithm to partition the dataset into 3 subgroups, based on the evolution of SART performance after 4 years. Raw SART data were available for 3468 participants aged 50 years and over at baseline. The previously reported SART visualisation-derived feature ‘bad performance’, indicating the number of SART trials with at least 4 mistakes, and its evolution over time, combined with the fuzzy c-mean (FCM) algorithm, individuated 3 clusters corresponding to 3 degrees of physiological dysregulation. The biggest cluster (94% of the cohort) was constituted by healthy participants, a smaller cluster (5% of the cohort) by participants who showed improvement in cognitive and psychological status, and the smallest cluster (1% of the cohort) by participants whose mobility and cognitive functions dramatically declined after 4 years. We were able to identify in a cohort of relatively high-functioning community-dwelling adults a very small group of participants who showed clinically significant decline. The selected smallest subset manifested not only mobility deterioration, but also cognitive decline, the latter being usually hard to detect in population-based studies. The employed techniques could identify at-risk participants with more specificity than current methods, and help clinicians better identify and manage the small proportion of community-dwelling older adults who are at significant risk of functional decline and loss of independence.
      Citation: Geriatrics
      PubDate: 2022-04-22
      DOI: 10.3390/geriatrics7030051
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 52: Progressive Unspecified Motor Speech
           Disorder: A Longitudinal Single Case Study of an Older Subject

    • Authors: Benedetta Basagni, Sonia Martelli, Livia Ruffini, Anna Mazzucchi, Francesca Cecchi
      First page: 52
      Abstract: Introduction: In a few cases, neurodegenerative diseases debut with a speech disorder whose differential diagnosis can be difficult. Case Report: We describe the case of a right-handed woman with a progressive speech impairment, which debuted when she was 80 years old. We report the results of neurological, neuropsychological, and imaging assessments with positron emission tomography (PET) over a period of nine years. Metabolic PET with 18F-FDG was performed at the age of 81 and repeated two years later due to the worsening of symptoms; amyloid PET with 18F-flutemetamol was performed at the age of 86. All PET results were quantitatively analyzed. A speech impairment remained the isolated neurological symptom for a long time, together with a mood disorder. Early FDG-PET showed hypometabolism in the left superior and inferior frontal areas, in the left superior temporal area, and in the right superior frontal area. Two years later, the hypometabolic area was more extensive. Amyloid PET was qualitatively and quantitatively normal. Nine years after the first symptoms, the speech production progressively worsened until complete anarthria, in association with writing impairment onset and signs of behavioral impairments. No signs of motor involvement were found. Conclusions: A progressive articulatory disorder without an evolution of motor disorders may be a distinct neurological degenerative entity, mainly affecting speech production for very a long time and with a specific early metabolic pattern in brain FDG-PET in the language production area. Monitoring patients with FDG-PET could predict the disease evolution years before a clinical deterioration.
      Citation: Geriatrics
      PubDate: 2022-04-24
      DOI: 10.3390/geriatrics7030052
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 53: Hair Cortisol Concentration, Perceived
           Stress, Mental Well-Being, and Cardiovascular Health in African American
           Older Adults: A Pilot Study

    • Authors: Ericka L. Richards, Kathy D. Wright, Ingrid K. Richards Adams, Maryanna D. Klatt, Todd B. Monroe, Christopher M. Nguyen, Karen M. Rose
      First page: 53
      Abstract: (1) Background: African Americans experience high rates of psychological stress and hypertension, which increases their risk of cardiovascular disease with age. Easy-to-collect psychological and biological stress data are valuable to investigations of this association. Hair cortisol concentration (HCC), as a proxy biomarker of chronic stress exposure, provides such advantages in contrast to collection of multiple daily samples of saliva. Objective: To examine the relationships among HCC, perceived stress, mental well-being, and cardiovascular health (systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP)). (2) Methods: Cross-sectional secondary data (N = 25) were used from a mind–body intervention study in hypertensive African Americans ages 65 and older. Data included HCC, a four-item perceived stress scale, SF-36 mental components summary, and SBP/DBP. SBP + 2 (DBP)/3 was used to calculate MAP. (3) Results: The relationship between mental well-being and perceived stress (r = −0.497, p = < 0.01) and mental well-being and DBP (r = −0.458, p = 0.02) were significant. HCC change was not significant. In a regression model, every unit increase in well-being predicted a 0.42 decrease in DBP (β = −0.42, 95% CI (−0.69–0.15)) and a 1.10 unit decrease in MAP (β = −1.10, 95% CI (−1.99–0.20)). (4) Conclusions: This study contributes to the knowledge of physiologic data regarding the relationship between MAP and well-being. Findings from this study may aid in the development of interventions that address mental well-being and cardiovascular health in African American older adults with hypertension.
      Citation: Geriatrics
      PubDate: 2022-04-29
      DOI: 10.3390/geriatrics7030053
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 54: Comparing Auditory and Visual Distractions
           for Reducing Pain Severity and Pain Anxiety in Older Outpatients with
           Burn: A Randomized Controlled Trial

    • Authors: Yaghob Moradipoor, Nahid Rejeh, Majideh Heravi Karimooi, Seyed Davood Tadrisi, Mostafa Dahmardehei, Tahereh Bahrami, Mojtaba Vaismoradi
      First page: 54
      Abstract: Pain and anxiety are major issues among older patients with burn injuries. Complementary medicine and non-pharmacological methods can relieve pain and anxiety in older people, but comparison of the effects of these methods needs further research. This study aimed to compare the effects of auditory and visual distractions on pain severity and pain anxiety in older outpatients referred to a burn clinic for dressing change. In this randomized controlled clinical trial, older men were randomly assigned to three groups as auditory distraction, visual distraction, and control (n = 45 in each group). The Visual Analogue Scale (VAS) and the Burn Specific Pain Anxiety Scale (BSPAS) were used to asses pain severity and pain anxiety before and immediately after the interventions, and after wound dressing. Reduction in pain severity and pain anxiety after visual distraction was reported. Auditory distraction only reduced pain anxiety. Therefore, visual distraction had a better effect on alleviating pain anxiety compared with auditory distraction. Visual distraction is suggested to be used during dressing changes for older outpatients with burn injuries in outpatient clinics in order to reduce their burn-related suffering and improve their collaboration with the therapeutic regimen.
      Citation: Geriatrics
      PubDate: 2022-04-30
      DOI: 10.3390/geriatrics7030054
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 55: Ageing and Disability According to the
           Perspective of Clinical Psychology of Disability

    • Authors: Donatella R. Petretto, Roberto Pili
      First page: 55
      Abstract: The progressive ageing of the global population is an important anthropological and social phenomenon, and it is due to the overall increasing of life expectancy and the overall increasing of health and living conditions, even if with various trends and speeds in various countries all over the world [...]
      Citation: Geriatrics
      PubDate: 2022-05-10
      DOI: 10.3390/geriatrics7030055
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 56: Disrupted Value-Directed Strategic
           Processing in Individuals with Mild Cognitive Impairment: Behavioral and
           Neural Correlates

    • Authors: Lydia T. Nguyen, Elizabeth A. Lydon, Shraddha A. Shende, Daniel A. Llano, Raksha A. Mudar
      First page: 56
      Abstract: Value-directed strategic processing involves attending to higher-value information while inhibiting lower-value information. This preferential processing is relatively preserved in cognitively normal older adults but is impaired in individuals with dementia. No studies have investigated whether value-directed strategic processing is disrupted in earlier stages of cognitive decline, namely, mild cognitive impairment (MCI). The current study examined behavioral and EEG differences in value-directed strategic processing between 18 individuals with MCI and 18 cognitively normal older controls using a value-directed list learning task. Behaviorally, individuals with MCI recalled fewer total and high-value words compared to controls, but no group differences were observed in low-value word recall. Neurally, individuals with MCI had reduced theta synchronization relative to controls between 100 and 200 ms post-stimulus. Greater alpha desynchronization was observed for high- versus low-value words between 300 and 400 ms in controls but not in the MCI group. The groups showed some processing similarities, with greater theta synchronization for low-value words between 700 and 800 ms and greater alpha desynchronization for high-value words between 500 and 1100 ms. Overall, value-directed strategic processing was compromised in individuals with MCI on both behavioral and neural measures relative to controls. These findings add to the growing body of literature on differences between typical cognitive aging and MCI.
      Citation: Geriatrics
      PubDate: 2022-05-11
      DOI: 10.3390/geriatrics7030056
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 57: Meaning of Respect for Older People in
           Family Relationships

    • Authors: Soheila Shamsikhani, Fazlollah Ahmadi, Anoshirvan Kazemnejad, Mojtaba Vaismoradi
      First page: 57
      Abstract: Background: Older people have various physical and mental health needs and often receive help from their family members to perform their daily life activities. This research aimed to explore the meaning of respect for older people in family relationships. Methods: A qualitative study using a content analysis approach was conducted. Semi-structured interviews were performed with sixteen older people and four family members. Results: Three main categories were developed: “respect for personal interests”, “kind and sincere respect” and “respect for autonomy”. Understanding of the meaning of respect for older people was influenced by special expectations from family members in terms of meeting personal needs, consideration of preferences and interests and empowerment and support to help preserve older people’s independence and autonomy. Conclusions: Family members should be informed and educated with regard to their expected roles in family relationships, and should consider respect as an important factor affecting older people’s well-being.
      Citation: Geriatrics
      PubDate: 2022-05-18
      DOI: 10.3390/geriatrics7030057
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 58: Increased Knowledge of Adult-Onset Dystonia
           Amongst Medical Students via Brief Video Education: A Systematic Review
           and Cohort Study

    • Authors: Sana Khan, Nina Sowemimo, Jane Alty, Jeremy Cosgrove
      First page: 58
      Abstract: Most doctors have limited knowledge of dystonia, a movement disorder that can affect people of all ages; this contributes to diagnostic delay and poor quality of life. We investigated whether a brief educational intervention could improve knowledge of dystonia amongst medical students. We conducted a systematic review on undergraduate knowledge of dystonia and created an eight-minute video on the condition. We invited medical students at the University of Leeds, UK, to answer 15 multiple choice questions before and immediately after watching the video, and again one month later. Only one previous study specifically assessed medical students’ knowledge of dystonia whilst five others tested their knowledge of movement disorders, or neurology generally, with some questions on dystonia. Of the University of Leeds medical students, 87 (100%), 77 (89%) and 40 (46%) completed the baseline, immediate-recall and delayed-recall questionnaires, respectively. The mean score for students who completed all three questionnaires increased from 7.7 (out of 15) to 12.5 on the immediate-recall questionnaire (p < 0.001), and to 10.1 on the delayed-recall questionnaire (p < 0.001). At baseline, 76% of students rated their confidence in recognising dystonia as low. After watching the video, 78% rated their confidence as a high, and none rated it low. A brief video improved their knowledge substantially, with sustained effects. This method could be incorporated into medical curricula to reduce diagnostic delays.
      Citation: Geriatrics
      PubDate: 2022-05-18
      DOI: 10.3390/geriatrics7030058
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 59: Potential Targets for Deprescribing in
           Medically Complex Older Adults with Suspected Cognitive Impairment

    • Authors: Juliessa M. Pavon, Theodore S. Z. Berkowitz, Valerie A. Smith, Jaime M. Hughes, Anna Hung, Susan N. Hastings
      First page: 59
      Abstract: Deprescribing may be particularly beneficial in patients with medical complexity and suspected cognitive impairment (CI). We describe central nervous system (CNS) medication use and side effects in this population and explore the relationship between anticholinergic burden and sleep. We conducted a cross-sectional analysis of baseline data from a pilot randomized-controlled trial in older adult veterans with medical complexity (Care Assessment Need score > 90), and suspected CI (Telephone Interview for Cognitive Status score 20–31). CNS medication classes included antipsychotics, benzodiazepines, H2-receptor antagonists, hypnotics, opioids, and skeletal muscle relaxants. We also coded anticholinergic-active medications according to their Anticholinergic Cognitive Burden (ACB) score. Other measures included self-reported medication side effects and the Pittsburgh Sleep Quality Index (PSQI). ACB association with sleep (PSQI) was examined using adjusted linear regression. In this sample (N = 40), the mean number of prescribed CNS medications was 2.2 (SD 1.5), 65% experienced ≥ 1 side effect, and 50% had an ACB score ≥ 3 (high anticholinergic exposure). The ACB score ≥ 3 compared to ACB < 3 was not significantly associated with PSQI scores (avg diff in score = −0.1, 95% CI −2.1, 1.8). Although results did not demonstrate a clear relationship with worsened sleep, significant side effects and anticholinergic burden support the deprescribing need in this population.
      Citation: Geriatrics
      PubDate: 2022-05-19
      DOI: 10.3390/geriatrics7030059
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 60: “I Think Deprescribing as a Whole Is a
           Gap!”: A Qualitative Study of Student Pharmacist Perceptions about
           Deprescribing

    • Authors: Sydney P. Springer, Alina Cernasev, Rachel E. Barenie, David R. Axon, Devin Scott
      First page: 60
      Abstract: Introduction: Older adults often manage multiple medications simultaneously, contributing to significant pill burden. Pill burden is a major concern for both patients and providers alike, and student pharmacists may play a role in decreasing that burden. Few studies exist evaluating student pharmacists’ roles in and perceptions of deprescribing in the healthcare team. Thus, the aim of this study was to explore student pharmacist perceptions regarding deprescribing in their pharmacy curricula. Methods: This study used a focus group discussion (FGD) methodology to facilitate discussion on deprescribing among student pharmacists. The theory of planned behavior (TPB) informed the conceptualization of this study, data collection, and thematic analysis. Student pharmacists enrolled in three different colleges of pharmacy across various geographical regions of the U.S. were recruited to participate in the study. Data collection occurred in the Fall of 2021, and recruitment proceeded until thematic saturation was achieved. The audio recordings were transcribed verbatim, and the transcripts were uploaded into Dedoose®, a qualitative software that facilitated the data analysis. The inductive codes were grouped into categories based on similarities that resulted in the themes. Results: Three colleges, totaling 1366 student pharmacists across different geographic regions of the U.S., were invited to participate in this study (UTHSC, N = 682; UNE, N = 158, University of Arizona, N = 526). Twenty-six student pharmacists participated in four FGDs. Of 26 participants, fourteen self-identified as male and two declined to state their gender identity. The mean age was 24 years old, with participants ranging from 21 to 37 years old. Thematic analysis revealed two major themes: (1) student pharmacists indicated that they possessed limited information about the deprescribing process, which is best illustrated by the following quote: “I think deprescribing as a whole is a gap!”; and (2) student pharmacists recommended increasing emphasis on deprescribing in pharmacy curricula. Conclusions: Student pharmacists identified few educational experiences on deprescribing in their curriculum while demonstrating a strong desire for more emphasis on deprescribing in the pharmacy curricula. This study highlights an opportunity to improve the integration of deprescribing education into pharmacy curricula, and colleges of pharmacy should evaluate whether, where, and to what extent the incorporation of this topic into their curricula is appropriate.
      Citation: Geriatrics
      PubDate: 2022-06-02
      DOI: 10.3390/geriatrics7030060
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 61: Cognitive Decline in Older People with
           Multiple Sclerosis—A Narrative Review of the Literature

    • Authors: Hsueh-Sheng Chiang, Alka Khera, Barbara E. Stopschinski, Olaf Stuve, John Hart, Brendan Kelley, Trung Nguyen
      First page: 61
      Abstract: Several important questions regarding cognitive aging and dementia in older people with multiple sclerosis (PwMS) are the focus of this narrative review: Do older PwMS have worse cognitive decline compared to older people without MS' Can older PwMS develop dementia or other neurodegenerative diseases such as Alzheimer’s disease (AD) that may be accelerated due to MS' Are there any potential biomarkers that can help to determine the etiology of cognitive decline in older PwMS' What are the neural and cellular bases of cognitive aging and neurodegeneration in MS' Current evidence suggests that cognitive impairment in MS is distinguishable from that due to other neurodegenerative diseases, although older PwMS may present with accelerated cognitive decline. While dementia is prevalent in PwMS, there is currently no consensus on defining it. Cerebrospinal fluid and imaging biomarkers have the potential to identify disease processes linked to MS and other comorbidities—such as AD and vascular disease—in older PwMS, although more research is required. In conclusion, one should be aware that multiple underlying pathologies can coexist in older PwMS and cause cognitive decline. Future basic and clinical research will need to consider these complex factors to better understand the underlying pathophysiology, and to improve diagnostic accuracy.
      Citation: Geriatrics
      PubDate: 2022-06-05
      DOI: 10.3390/geriatrics7030061
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 62: Effects of Wearing Face Masks on
           Cardiorespiratory Parameters at Rest and after Performing the Six-Minute
           Walk Test in Older Adults

    • Authors: Patchareeya Amput, Sirima Wongphon
      First page: 62
      Abstract: The effects of wearing cloth masks and surgical masks were investigated on respiratory rate, heart rate, blood pressure, oxygen saturation and perceived exertion at rest and after performing a six-minute walk test (6MWT) in older adults. Forty older adults were recruited and randomized into six groups including wearing no mask, cloth masks and surgical masks, at rest and during the 6MWT. At rest, all subjects sat quietly wearing no mask, a cloth mask or a surgical mask. All subjects performed a 6MWT by walking as fast as possible without running while wearing no mask, a cloth mask or a surgical mask. Respiratory rate, heart rate, blood pressure, oxygen saturation and perceived exertion were assessed before and after the rest and the 6MWT. Results showed that cloth masks and surgical masks did not impact cardiorespiratory parameters at rest or after performing a 6MWT, while an increase in perceived exertion was apparent in the groups wearing surgical masks and cloth masks after performing the 6MWT (p < 0.01). Cloth masks and surgical masks did not have an impact on cardiorespiratory fitness at rest and after performing the 6MWT in older adults.
      Citation: Geriatrics
      PubDate: 2022-06-07
      DOI: 10.3390/geriatrics7030062
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 63: Nurses’ Death Anxiety and Ageism
           towards Older Adults Amid the COVID-19 Pandemic: The Moderating Role of
           Symbolic Immortality

    • Authors: Mohammad Rababa, Shatha Al-Sabbah, Dania Bani-Hamad
      First page: 63
      Abstract: The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of individuals’ lives and behaviors, including the behaviors of nurses. Specifically, the pandemic has impacted the way that nurses treat older adults and has led to the spread of ageism among nurses. This study was conducted using self-report tools on 163 nurses to examine the problem of ageism amid the COVID-19 pandemic. The results suggest that critical care nurses have higher levels of death anxiety and ageism in comparison to medical/surgical nurses. After controlling for the work department, low levels of symbolic immortality were associated with high levels of ageism and death anxiety among nurses. These results might provide an insight into the development of a psychological intervention to reduce nurses’ death anxiety and ageism toward older adults.
      Citation: Geriatrics
      PubDate: 2022-06-09
      DOI: 10.3390/geriatrics7030063
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 64: Impact of Hydrotherapy on Antioxidant Enzyme
           Activity in an Elderly Population

    • Authors: Ana Valado, Stephanie Fortes, Márcia Morais, Rogério Barreira, João Paulo Figueiredo, Armando Caseiro
      First page: 64
      Abstract: Oxidative stress is defined as the imbalance between reactive species and antioxidant agents. One of the effects of oxidative stress is the normal process of cellular aging that stems from the accumulation of tissue damage. Epidemiological studies show that regular physical exercise prevents the injuries caused by aging. The objective was to evaluate whether the practice of hydrotherapy, in an elderly population, positively influenced the activity of the enzymes superoxide dismutase, glutathione peroxidase and reductase that act by reducing reactive species in the body. The study involved 37 participants aged ≥ 60 years, of both sexes, divided into experimental and control groups. The experimental group performed 15 hydrotherapy sessions. Enzyme activity was evaluated in two moments: T0-before the first session, and T1-after the last session, with blood collections conducted in both. In T1, there was a significant increase vs. T0 of glutathione peroxidase activity (57.72 ± 19.99 vs. 48.14 ± 17.22 U/g Hb) and glutathione reductase activity (100.18 ± 30.85 vs. 78.44 ± 21.26 U/L). Both sexes tended to show higher values at T1. We concluded that hydrotherapy proved to be a positive stimulus for the enzymatic antioxidant activity of the elderly, suggesting that a regular and moderate practice of physical exercise induces better and higher quality of life.
      Citation: Geriatrics
      PubDate: 2022-06-13
      DOI: 10.3390/geriatrics7030064
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 65: The Impact of Perioperative and Predisposing
           Risk Factors on the Development of Postoperative Delirium and a Possible
           Gender Difference

    • Authors: Maria Wittmann, Andrea Kirfel, Diane Jossen, Andreas Mayr, Jan Menzenbach
      First page: 65
      Abstract: (1) Background: Postoperative delirium (POD) is an undesirable event especially for older patients after surgery. Perioperative risks for POD development are multiple, but gender differences are still poorly considered. In this observational study, predisposing and precipitating risk factors of POD and the possible gender influence are distinguished. (2) Methods: This observational prospective trial enrolled 1097 patients in a tertiary hospital from September 2018 until October 2019. POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 ‘A’s Test (4AT) or Delirium Observation Screening (DOS) scale was positive on one of five assessment days. (3) Results: POD incidence was 23.5% and the mean age of study population was 72.3 ± 7.3 years. The multiple logistic regression model showed a significant impact of age (Odds Ratio (OR) 1.74; 95% Confidence Interval (CI): 1.37–2.22), American Society of Anesthesiologists (ASA) (OR 1.67; 95% CI: 1.25–2.26), surgery risk (OR 2.10; 95% CI: 1.52–2.95) and surgery duration (OR 1.17; 95% CI: 1.07–1.28), ventilation time (OR 1.64; 95% CI: 1.27–2.24), as well as the male sex (OR 1.74; 95% CI: 1.37–2.22) on POD risk. (4) Conclusions: Perioperative and predisposing risk factors had an impact on the development of POD. The influence of male sex should be considered in future research.
      Citation: Geriatrics
      PubDate: 2022-06-14
      DOI: 10.3390/geriatrics7030065
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 66: Caring for Homebound Veterans during
           COVID-19 in the U.S. Department of Veterans Affairs Medical Foster Home
           Program

    • Authors: Leah M. Haverhals, Chelsea E. Manheim, Maya Katz, Cari R. Levy
      First page: 66
      Abstract: The onset of the COVID-19 pandemic made older, homebound adults with multiple chronic conditions increasingly vulnerable to contracting the virus. The United States (US) Department of Veterans Affairs (VA) Medical Foster Home (MFH) program cares for such medically complex veterans residing in the private homes of non-VA caregivers rather than institutional care settings like nursing homes. In this qualitative descriptive study, we assessed adaptations to delivering safe and effective health care during the early stages of the pandemic for veterans living in rural MFHs. From December 2020 to February 2021, we interviewed 37 VA MFH care providers by phone at 16 rural MFH programs across the US, including caregivers, program coordinators, and VA health care providers. Using both inductive and deductive approaches to thematic analysis, we identified themes reflecting adaptations to caring for rural MFH veterans, including care providers rapidly increased communication and education to MFH caregivers while prioritizing veteran safety. Telehealth visits also increased, MFH veterans were prioritized for in-home COVID-19 vaccinations, and strategies were applied to mitigate the social isolation of veterans and caregivers. The study findings illustrate the importance of clear, regular communication and intentional care coordination to ensure high-quality care for vulnerable, homebound populations during crises like the COVID-19 pandemic.
      Citation: Geriatrics
      PubDate: 2022-06-15
      DOI: 10.3390/geriatrics7030066
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 67: Exploring Meal Provision and Mealtime
           Challenges for Aged Care Residents Consuming Texture-Modified Diets: A
           Mixed Methods Study

    • Authors: Wu, Yousif, Miles, Braakhuis
      First page: 67
      Abstract: Dysphagia has become more prevalent with age. Thus, the demand for texture-modified diets (TMDs) has increased. While the nutritional perspectives have been studied, the provision of TMDs and mealtime practice has received less attention. This study aimed to explore the TMD provision and mealtime challenges of residents requiring TMDs in aged care facilities. The study was conducted across five aged care facilities using a mixed methods design involving 14 TMD menu audits by a foodservice dietitian, 15 mealtime observations, and semi-structured interviews with residents and staff (n = 18). TMD menus failed to meet all nutrition requirements and foodservice and clinical standards based on the dietitian NZ foodservice and nutrition audit tool. A content analysis offered three main themes: (1) Foodservice production. Inconsistent quality and meal portions were observed. The variety, choice, and portion size of TMDs required improvement based on the residents’ preferences; (2) Serving procedures. There was a lack of standardisation of meal distribution and feeding assistance; and (3) Dining environment. The dining room set-up varied across facilities, and residents expressed different preferences towards the dining environment. There is a need to improve staff awareness of mealtime consistency and optimise feeding assistance. The dining environment should be individualised to accommodate residents’ psychosocial needs. Standardised policies and continuous training can facilitate quality mealtime implementation.
      Citation: Geriatrics
      PubDate: 2022-06-15
      DOI: 10.3390/geriatrics7030067
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 68: Elevated All-Cause Mortality among
           Overweight Older People: AI Predicts a High Normal Weight Is Optimal

    • Authors: Kei Nakajima, Mariko Yuno
      First page: 68
      Abstract: It has been proposed that being overweight may provide an advantage with respect to mortality in older people, although this has not been investigated fully. Therefore, to confirm that and elucidate the underlying mechanism, we investigated mortality in older people using explainable artificial intelligence (AI) with the gradient-boosting algorithm XGboost. Baseline body mass indexes (BMIs) of 5699 people (79.3 ± 3.9 years) were evaluated to determine the relationship with all-cause mortality over eight years. In the unadjusted model, the first negative (protective) BMI range for mortality was 25.9–28.4 kg/m2. However, in the adjusted cross-validation model, this range was 22.7–23.6 kg/m2; the second and third negative BMI ranges were then 25.8–28.2 and 24.6–25.8 kg/m2, respectively. Conversely, the first advancing BMI range was 12.8–18.7 kg/m2, which did not vary across conditions with high feature importance. Actual and predicted mortality rates in participants aged <90 years showed a negative-linear or L-shaped relationship with BMI, whereas predicted mortality rates in men aged ≥90 years showed a blunt U-shaped relationship. In conclusion, AI predicted that being overweight may not be an optimal condition with regard to all-cause mortality in older adults. Instead, it may be that a high normal weight is optimal, though this may vary according to the age and sex.
      Citation: Geriatrics
      PubDate: 2022-06-16
      DOI: 10.3390/geriatrics7030068
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 69: Path Model Factors Associated with
           Depressive Symptoms among Older Thais Living in Rural Areas

    • Authors: Inthira Roopsawang, Suparb Aree-Ue, Surinrat Baurangthienthong, Jansudaphan Boontham, Yuwadee Phiboonleetrakun
      First page: 69
      Abstract: Depressive symptoms are complex and are often more severe in older people. However, there is limited research exploring the causal relationships between depression and its associated factors in the geriatric population, particularly in Thailand. We aimed to evaluate the direction of these complex relationships in the Thai population. A cross-sectional design was conducted on 312 Thai community-dwelling older adults aged 60 years or above who registered for primary care services. The participants were recruited from July 2019 to January 2020, and they responded to standard assessments. The relationships between pain, the number of medications, frailty, locomotive syndrome, and depressive symptoms were investigated using path analysis. The results showed that most participants were women and had multiple diseases, mild pain, frailty, and grade I–II locomotive syndrome. The prevalence of depressive symptoms was 16%. The model showed significant positive direct and indirect paths from locomotive syndrome to depressive symptoms (β = 0.296, p < 0.01; β = 0.099, p < 0.01, respectively). There was a significant positive direct path from frailty to depressive symptoms (β = 0.219, p < 0.01) and a significant positive indirect path from pain to depressive symptoms (β = 0.096, p < 0.01).
      Citation: Geriatrics
      PubDate: 2022-06-16
      DOI: 10.3390/geriatrics7030069
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 70: Factors Influencing the Data Communication
           Equipment Competence in Korean Older People

    • Authors: HeeYoung Kim
      First page: 70
      Abstract: The purpose of this study was to identify the most vulnerable group among older Korean adults regarding information literacy. Once that was identified, the study aimed to provide basic data for developing strategies to improve information literacy by investigating the factors that influence the ability to utilize the Data Communication Equipment (DCE). The subjects included 10,073 older adults from the 10,299 participants of the 2017 Korean National Survey of Older Adults. The mean age of the older people was 74.06 years from a range of 65 to 106 years old. This study excluded the 216 individuals who did not complete the survey. The data were analyzed using the SPSS 18.0 program. A univariate analysis was performed to identify the most vulnerable group with regard to DCE competence. To investigate the factors that influence DCE competence, a logistic regression analysis was performed on the significant variables in the univariate analysis, while the nominal variables were treated as dummies. Senior citizens in Korea were less able to utilize DCE when they had higher ages, lower education levels, were women, lived alone, lower incomes, decreased sensory function, decreased cognitive function, negative value of learning, no lifelong learning, and smaller social networks. The factors influencing DCE competence in older adults were as follows: age, education level, income level, health status, cognitive function, social networks, lifelong learning, and the value of learning. For DCE competence in older adults to be effectively improved, adequate support must be provided to the vulnerable group. Furthermore, support for personalized DCE utilization seems essential and should consider a person’s age, education level, income, health status, cognitive function, social networks, lifelong learning and the value of learning.
      Citation: Geriatrics
      PubDate: 2022-06-17
      DOI: 10.3390/geriatrics7030070
      Issue No: Vol. 7, No. 3 (2022)
       
  • Geriatrics, Vol. 7, Pages 23: Feasibility of a Small Group Otago Exercise
           Program for Older Adults Living with Dementia

    • Authors: Julie D. Ries, Martha Carroll
      First page: 23
      Abstract: Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable.
      Citation: Geriatrics
      PubDate: 2022-02-24
      DOI: 10.3390/geriatrics7020023
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 24: The Multifaceted Role of Neuroprotective
           Plants in Alzheimer’s Disease Treatment

    • Authors: Tarek Zieneldien, Janice Kim, Chuanhai Cao
      First page: 24
      Abstract: Alzheimer’s disease (AD) is an age-related, progressive neurodegenerative disorder characterized by impaired cognition, memory loss, and altered personality. Many of the available pharmaceutical treatments do not alter the onset of disease progression. Recently, alternatives to developed drug candidates have been explored including medicinal plants and herbal treatments for the treatment of AD. This article examines the role of herbal plant extracts and the neuroprotective effects as alternative modes of intervention for AD progression. These extracts contain key metabolites that culminate alterations in AD progression. The traditional plant extracts explored in this article induce a variety of beneficial properties, including antioxidants, anti-inflammatory, and enhanced cognition, while also inducing activity on AD drug targets such as Aβ degradation. While these neuroprotective aspects for AD are relatively recent, there is great potential in the drug discovery aspect of these plant extracts for future use in AD treatment.
      Citation: Geriatrics
      PubDate: 2022-02-26
      DOI: 10.3390/geriatrics7020024
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 25: Biomarker Signatures of Two Phenotypical
           Prefrailty Types in the Irish Longitudinal Study on Ageing

    • Authors: Palina Piankova, Roman Romero-Ortuno, Aisling M. O’Halloran
      First page: 25
      Abstract: We investigated the biomarker signatures of two previously reported phenotypical prefrailty (PF) types in the first wave of The Irish Longitudinal Study on Ageing (TILDA): PF1 (unexplained weight loss and/or exhaustion) and PF2 (one or two among slowness, weakness, and low physical activity). Binary logistic regression models evaluated the independent associations between available plasma biomarkers and each PF type (compared to robust and compared to each other), while adjusting for age, sex, and education. A total of 5307 participants were included (median age 61 years, 53% women) of which 1473 (28%) were prefrail (469 PF1; 1004 PF2), 171 were frail, and 3663 were robust. The PF2 median age was eight years older than the PF1 median age. Higher levels of lutein and zeaxanthin were independently associated with the lower likelihood of PF1 (OR: 0.77, p < 0.001 and OR: 0.81, p < 0.001, respectively). Higher cystatin C was associated with PF1 (OR: 1.23, p = 0.001). CRP (OR: 1.19, p < 0.001), cystatin C (OR: 1.36, p < 0.001), and HbA1c (OR: 1.18, p < 0.001) were independently associated with PF2, while a higher total (OR: 0.89, p = 0.004) and HDL (OR: 0.87, p < 0.001) cholesterol seemed to be PF2-protective. While PF1 seemed to be inversely associated with serum carotenoid concentrations and hence has an oxidative signature, PF2 seemed to have pro-inflammatory, hyperglycemic, and hypolipidemic signatures. Both PF types were associated with higher cystatin C (lower kidney function), but no biomarkers significantly distinguished PF1 vs. PF2. Further research should elucidate whether therapies for different PF types may require targeting of different biological pathways.
      Citation: Geriatrics
      PubDate: 2022-02-27
      DOI: 10.3390/geriatrics7020025
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 26: Determinants of Undernutrition and
           Associated Factors of Low Muscle Mass and High Fat Mass among Older Men
           and Women in the Colombo District of Sri Lanka

    • Authors: Samantha Chandrika Vijewardane, Aindralal Balasuriya, Phyo Kyaw Myint, Alexandra M. Johnstone
      First page: 26
      Abstract: Undernutrition is a health challenge due to an expanding older population. The aims of the study were to assess the prevalence and determinants of undernutrition and, associated factors of low muscle and high fat mass among older men and women in the Colombo district of Sri Lanka. A cross sectional study was conducted using a multistage cluster sampling technique. Undernutrition was defined based on anthropometry and body composition assessed using bio-electrical impedance. Sex-specific multivariable logistic regression analyses were conducted. Of 800 participants (30.6% men), 35.3% were undernourished. The factors significantly associated with undernutrition among older women were hypertension with an adjusted odds ratio (aOR) (1.97; 1.36–2.88) and musculoskeletal disabilities aOR (2.19; 1.36–3.53). Among women, age ≥ 70 (1.79; 1.18–3.34) and diabetes (1.77; 1.10–2.84) were associated with low muscle mass and age ≥ 70 (2.05; 1.21–3.47), diabetes (2.20; 1.35–3.59) and disability in chewing (2.39; 1.30–4.40) were associated with high fat mass. Among men, age ≥ 70 years, no/up to grade 5 education, diabetes, visual disability, little/no responsibility in food shopping and not getting nutritional advice from media were associated with reduced odds of low muscle mass and no/up to grade 5 school education, disability in chewing and little/no responsibility in food shopping were associated with reduced odds of high fat mass. Undernutrition among older people is common in Sri Lanka. We have identified key factors associated with low muscle mass and high fat mass in this setting. Given the potential consequences of these conditions, our study provides potential targets for prevention of undernutrition and sarcopenic obesity.
      Citation: Geriatrics
      PubDate: 2022-02-28
      DOI: 10.3390/geriatrics7020026
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 27: Inhalation Therapy with Nebulized Capsaicin
           in a Patient with Oropharyngeal Dysphagia Post Stroke: A Clinical Case
           Report

    • Authors: Pekacka-Egli, Herrmann, Spielmanns, Georg, Schulz, Zenker, Windisch, Kulnik
      First page: 27
      Abstract: Dysphagia and aspiration risk are common sequelae of stroke, leading to increased risk of stroke-associated pneumonia. This is often aggravated by stroke-related impairment of cough, the most immediate mechanical defense mechanism against aspiration. In humans, reflex cough can be repeatedly and safely elicited by inhalation of nebulized capsaicin, a compound contained in chili peppers. Could this cough-eliciting property of capsaicin support the recovery of stroke survivors who present with dysphagia and aspiration risk' We present a clinical case report of a 73-year-old man, admitted to inpatient stroke rehabilitation following a right middle cerebral artery infarct with subsequent dysphagia and hospital-acquired pneumonia. A course of daily inhalation therapy with nebulized capsaicin was initiated, triggering reflex coughs to support secretion clearance and prevent recurrence of pneumonia. Clinical observations in each inhalation therapy session demonstrate good patient response, safety and tolerability of nebulized capsaicin in this mode of application. Repeated Fiberoptic Endoscopic Evaluation of Swallowing (FEES) assessments show concurrent improvement in the patient’s swallowing status. Inhalation therapy with nebulized capsaicin may offer a viable treatment to facilitate coughing and clearing of secretions, and to minimize aspiration and risk of aspiration-related pneumonia post stroke. Further investigation in a randomized controlled trial design is warranted.
      Citation: Geriatrics
      PubDate: 2022-02-28
      DOI: 10.3390/geriatrics7020027
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 28: Exploring Telehealth Readiness in a Resource
           Limited Setting: Digital and Health Literacy among Older People in Rural
           India (DAHLIA)

    • Authors: Tshepo Mokuedi Rasekaba, Pratibha Pereira, Vinaya Rani. G, Riya Johnson, Rebecca McKechnie, Irene Blackberry
      First page: 28
      Abstract: An ageing population, disproportionally affecting developing countries, increases demand on healthcare systems. Digital health offers access to healthcare for older people, particularly those residing in rural areas, as is the case for 71% of older adults in India. This research examined technology uptake and digital and health literacy (eHEALS) among a sample of 150 older adults in rural Mysore and Suttur, India. The study utilised mixed-method, with descriptive analysis of quantitative data and thematic analysis of qualitative data. Low rates of digital (11%) and health literacy (3–27% across domains) were identified. Mobile phone ownership was 50%, but very few owned or used a smartphone and less than 10% used the Internet to contact health professionals. Qualitative analysis found low technology usage, driven by limited exposure and confidence in using digital devices. Barriers to usage included poor traditional literacy and physical aspects of ageing like poor vision. Social support from neighbours, family and local primary healthcare staff may enable adoption of digital health. Access to healthcare through digital means among Indian rural older adults needs to consider low rates of both digital and health literacy and leverage the value of support from family and primary healthcare providers.
      Citation: Geriatrics
      PubDate: 2022-03-01
      DOI: 10.3390/geriatrics7020028
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 29: Economic Evaluation of Healthcare Resource
           Utilization and Costs for Newly Diagnosed Dementia-Related Psychosis

    • Authors: Nazia Rashid, James B. Wetmore, Muna Irfan, Victor Abler
      First page: 29
      Abstract: This retrospective cohort study described changes in all-cause healthcare resource utilization (HCRU) and associated costs in dementia patients newly diagnosed with psychosis. Dementia and incident psychosis were identified using diagnostic and pharmacy claims using a Medicare 20% random sample dataset. All-cause HCRU and unweighted and weighted (by person-years of follow-up) HCRU-associated costs were evaluated in the year prior to and the 4 years following diagnosis of psychosis. In 49,509 dementia patients with psychosis, physician visits per patient per year increased from a mean of 26.7 (standard deviation (SD) 20.0) prior to psychosis to 38.4 (SD 41.9) post-psychosis diagnosis. The number of inpatient stay claims increased from 1.0 (SD 1.4) to 1.7 (SD 5.8). Mean unweighted costs for inpatient stays and home healthcare/hospice during 2008–2016 were USD 9989 and USD 3279 prior to a diagnosis of psychosis but increased to USD 25,982 and USD 9901 (weighted: USD 11,779 and USD 6709), respectively, in the year after a psychosis diagnosis. This pattern of a sharp increase in mean costs was also observed in costs adjusted to 2015 USD, and in both unweighted and weighted total and psychosis-related costs. These results indicate the importance of identifying newly diagnosed psychosis in dementia patients as well as the pressing need for management strategies and treatments that can reduce HCRU and costs.
      Citation: Geriatrics
      PubDate: 2022-03-08
      DOI: 10.3390/geriatrics7020029
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 30: The Challenge of Subjective Cognitive
           Complaints and Executive Functions in Middle-Aged Adults as a Preclinical
           Stage of Dementia: A Systematic Review

    • Authors: Felipe Webster-Cordero, Lydia Giménez-Llort
      First page: 30
      Abstract: Subjective cognitive complaints correspond to a heterogeneous construct that frequently occurs in the early stages of older adult life. Despite being a common source of worry for middle-aged people, it can be underestimated when clinical and neuropsychological assessments discard any underlying pathological processes. Negative age stereotyping but also self-stereotyping can contribute to doing so. Although its diagnosis is a challenge, its implication as a possible predictor of mild cognitive impairment or dementia increases the interest in its early diagnosis and intervention. The present systematic review analyzes the empirical data on the relationship between these complaints and early executive dysfunction with possible predictive value for preclinical stages of dementia. The sixteen papers obtained from the PubMed and Embase databases were exploratory, cross-sectional and prospective in scope. The studies corroborated the relationship between subjective cognitive complaints and some executive processes, which is noteworthy since many people with subjective executive complaints progress to dementia. The relational studies confirmed that impaired executive performance is associated with CSF biomarkers and reduced cortical volume in specific brain regions. However, the heterogeneity of reports in these studies demands stronger efforts in future research with specific tools applied in clinical and neuropsychological assessments and analyzed under a gender perspective.
      Citation: Geriatrics
      PubDate: 2022-03-08
      DOI: 10.3390/geriatrics7020030
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 31: Program of All-Inclusive Care for the
           

    • Authors: Daniel Arku, Mariana Felix, Terri Warholak, David R. Axon
      First page: 31
      Abstract: The Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive health and social services to community-dwelling older United States (US) adults. However, little is known about how PACE outcomes compare to similar caregiving programs. This scoping review searched nine databases to identify studies that compared economic, clinical, or humanistic outcomes of PACE to other caregiving programs in the US. Two reviewers independently screened and extracted data from relevant articles and resolved discrepancies through consensus. From the 724 articles identified, six studies were included. Example study outcomes included: limitations and needs, survival and mortality, healthcare utilization, and economic outcomes. In conclusion, there are few published comparisons of PACE outcomes versus other caregiving programs for older US adults, and identified studies indicate mixed results. Further studies are needed to compare PACE outcomes to other programs so that policymakers are well informed to manage and optimize health outcomes for the growing US older adult population.
      Citation: Geriatrics
      PubDate: 2022-03-12
      DOI: 10.3390/geriatrics7020031
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 32: Disaster Response in Italian Nursing Homes:
           A Qualitative Study during the COVID-19 Pandemic

    • Authors: Barbara Plagg, Giuliano Piccoliori, Adolf Engl, Christian J. Wiedermann, Angelika Mahlknecht, Verena Barbieri, Dietmar Ausserhofer, Peter Koler, Sara Tauber, Manuela Lechner, Walter A. Lorenz, Andreas Conca, Klaus Eisendle
      First page: 32
      Abstract: Nursing homes (NHs) have been among the care settings most affected by both the virus itself and collateral damage through infection protection and control measures (IPC). However, there is a paucity of research regarding disaster response and preparedness of these institutions. The present study aimed to analyze disaster response and management and to develop prospective strategies for disaster management in NHs. A qualitative survey including (i) residents, (ii) nursing staff, (iii) relatives of residents, and (iv) NHs’ medical leads was performed. Data were collected by 45 in-depth interviews. Our results indicate that the shift from resident-centered care towards collective-protective approaches led through the suspending of established care principles to an emergency vacuum: implementable strategies were lacking and the subsequent development of temporary, immediate, and mostly suboptimal solutions by unprepared staff led to manifold organizational, medical, and ethical conflicts against the background of unclear legislation, changing protocols, and fear of legal consequences. IPC measures had long-lasting effects on the health and wellbeing of residents, relatives, and professionals. Without disaster preparedness protocols and support in decision-making during disasters, professionals in NHs are hardly able to cope with emergency situations.
      Citation: Geriatrics
      PubDate: 2022-03-17
      DOI: 10.3390/geriatrics7020032
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 33: An Ounce of Prevention, a Pound of
           Complications: A Case of Statin-Induced Necrotizing Myopathy in a Frail
           Elderly Patient

    • Authors: Oleg Stens, Bradley Neutel, Elizabeth L. Goodman
      First page: 33
      Abstract: The use of statins for primary prevention in older adults remains controversial. In this manuscript, we present a case of an 81-year-old woman with a history of HTN, HLD, Alzheimer’s dementia and osteoporosis, who presented to a geriatrics clinic with profound muscle weakness accompanied by new functional deficits in the setting of taking double her prescribed dose of atorvastatin. She was admitted to the hospital where she was found to have rhabdomyolysis. Muscle biopsy and serologic work up revealed anti-HMG statin co-reductase myopathy as the cause of her symptoms. The patient was treated with steroids IVIG and immunomodulators with marked improvement in her weakness; however, her course was complicated by delirium and multiple falls, resulting in several fragility fractures. This case highlights the need to conduct a risk–benefit analysis prior to initiating new therapies in patients with limited life expectancy, including the consideration of the potential for medication errors.
      Citation: Geriatrics
      PubDate: 2022-03-18
      DOI: 10.3390/geriatrics7020033
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 34: Age as a Risk Factor in the Occurrence of
           Complications during or after Bronchoscopic Lung Biopsy

    • Authors: Irina Pocienė, Rasa Gauronskaitė, Domantas Galkauskas, Antanas Mainelis, Vygantas Gruslys, Edvardas Danila
      First page: 34
      Abstract: Introduction: Bronchoscopic lung biopsy (BLB) is a widely used procedure. As the world’s population is ageing, more BLBs are performed for older people with comorbidities. The aim of the study was to investigate if an older age is a risk factor for BLB related complications. Materials and Methods: A prospective study at the Centre of Pulmonology and Allergology of Vilnius University Hospital Santaros klinikos was conducted. Seven hundred and eighty-six patients (male 60.6%), mean age 57 ± 16, who underwent BLB, were included. The complications that occurred due to BLB were evaluated. Bleeding and pneumothorax were classified into I° or II° grades depending on their severity. Potential determinants, which may increase the risk of complications, emphasizing on age, were analyzed. Results: Fifty-seven (7.2%) BLB-related complications occurred. There were 27 (3.4%) pneumothoraxes, and 19 (70%) of them required thoracic drainage. Thirty (3.8%) bleeding complications occurred, and four (16%) of them were severe. Higher rates of bleeding were found in the age group ≥65 years, p = 0.001. The risk of bleeding in older patients was 3.2 times higher (95% CI 1.51–6.87). Conclusions: Older age is related to a higher incidence of mild bleeding during BLB. However, the risk of life-threatening complications is low despite the age, and older age should not be considered as a contraindication for the procedure if needed.
      Citation: Geriatrics
      PubDate: 2022-03-21
      DOI: 10.3390/geriatrics7020034
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 35: Barriers and Facilitators to Screening for
           Cognitive Impairment in Australian Rural Health Services: A Pilot Study

    • Authors: Sean MacDermott, Rebecca McKechnie, Dina LoGiudice, Debra Morgan, Irene Blackberry
      First page: 35
      Abstract: Australian National standards recommend routine screening for all adults over 65 years by health organisations that provide care for patients with cognitive impairment. Despite this, screening rates are low and, when implemented, screening is often not done well. This qualitative pilot study investigates barriers and facilitators to cognitive screening for older people in rural and regional Victoria, Australia. Focus groups and interviews were undertaken with staff across two health services. Data were analysed via thematic analysis and contextualized within the i-PARIHS framework. Key facilitators of screening included legislation, staff buy-in, clinical experience, appropriate training, and interorganisational relationships. Collaborative implementation processes, time, and workloads were considerations in a recently accredited tertiary care setting. Lack of specialist services, familiarity with patients, and infrastructural issues may be barriers exacerbated in rural settings. In lieu of rural specialist services, interorganisational relationships should be leveraged to facilitate referring ‘outwards’ rather than ‘upwards’.
      Citation: Geriatrics
      PubDate: 2022-03-22
      DOI: 10.3390/geriatrics7020035
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 36: Heart Failure in Older Adults: Medical
           Management and Advanced Therapies

    • Authors: Ellen Liu, Brent C. Lampert
      First page: 36
      Abstract: As the population ages and the prevalence of heart failure increases, cardiologists and geriatricians can expect to see more elderly patients with heart failure in their everyday practice. With the advancement of medical care and technology, the options for heart failure management have expanded, though current guidelines are based on studies of younger populations, and the evidence in older populations is not as robust. Pharmacologic therapy remains the cornerstone of heart failure management and has improved long-term mortality. Prevention of sudden cardiac death with implantable devices is being more readily utilized in older patients. Advanced therapies have provided more options for end-stage heart failure, though its use is still limited in older patients. In this review, we discuss the current guidelines for medical management of heart failure in older adults, as well as the expanding literature on advanced therapies, such as heart transplantation in older patients with end-stage heart failure. We also discuss the importance of a multidisciplinary care approach including consideration of non-medical co-morbidities such as frailty and cognitive decline.
      Citation: Geriatrics
      PubDate: 2022-03-23
      DOI: 10.3390/geriatrics7020036
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 37: Factors Affecting Hospitalization and Death
           of Older Patients Who Need Long-Term Care—The Necessity of the
           Support for Dysphagia in Home Dental Care

    • Authors: Yoko Wakasugi, Chiaki Susa, Shino Murata, Jun Aida, Jun Sasaki, Junichi Furuya, Haruka Tohara
      First page: 37
      Abstract: The demand for home dental care is increasing, but how it should be involved in the continuation of life at home for elderly people who need care has not been examined. Therefore, we examined whether items examined by dentists can affect hospitalization and death. The study included 239 patients with oral intake. They were divided into regular and non-regular diet groups, and ages, nutritional statuses, activities of daily living (ADLs), Charlson Comorbidity Indexes (CCI) and swallowing functions were compared. The nutritional statuses and ADLs of the three groups at the first visit and after one year were compared. The groups included those with stable, declined and improved diet forms. Factors influencing hospitalization and death over three years were examined. Nutritional status, swallowing function, CCI and ADLs were worse in the non-regular diet group. The declined diet form group had lower ADL levels and nutritional statuses at the first visit. A proportional hazards analysis showed significant differences in the changes in diet form for the stable and declined groups related to hospitalization (hazard ratio (HR): 6.53) and death (HR: 3.76). Changes in diet form were thought to affect hospitalization and death, and it is worthwhile to assess swallowing function in home dental care.
      Citation: Geriatrics
      PubDate: 2022-03-25
      DOI: 10.3390/geriatrics7020037
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 38: Lipid-Targeted Atherosclerotic Risk
           Reduction in Older Adults: A Review

    • Authors: Lauren J. Hassen, Steven R. Scarfone, Michael Wesley Milks
      First page: 38
      Abstract: Aggressive lipid-lowering lifestyle modifications and pharmacologic therapies are the cornerstones of the primary and secondary prevention of atherosclerotic cardiovascular disease events. While statins are highly effective, inexpensive, and generally well-tolerated medications, many clinicians and patients express uncertainty regarding the necessity of statin treatment in older adults. Citing concerns such as polypharmacy, muscle symptoms, and even potential cognitive changes with statins, many patients and health care providers elect to de-intensify or discontinue statin therapy during the process of aging. A lack of clear representation of older individuals in many clinical trials and practice guidelines may contribute to the ambiguity. However, the recently prevailing data and practice patterns supporting the benefits, safety, and tolerability of a variety of lipid-lowering therapeutics in older adults are discussed here, with particular mention of a potential protective effect from incident dementia among a statin-treated geriatric population and an admonishment of the historical concept of “too-low” low-density lipoprotein cholesterol (LDL-C) levels.
      Citation: Geriatrics
      PubDate: 2022-03-25
      DOI: 10.3390/geriatrics7020038
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 39: Institutional Place Identity and Life
           Adaptation among Elderly People in Taiwan

    • Authors: Ning-Chun Chuang, Pei-Chun Kuo, Yi-Wen Chiu
      First page: 39
      Abstract: Background: Many elderly people in Taiwan move to institutional care due to disability or insufficient family resources. This study aimed to understand the place identity and life adaptation of institutional residents and their influencing factors, and to explore the correlation between these two. Methods: This study adopted a cross-sectional survey method. A total of 120 cases were collected with structured questionnaires, and SPSS 22.0 software package was used for statistical analysis. Results: The place identity was the highest in the sense of belonging, while the sense of participation was the worst; adaptation to life was the best in terms of care management, and the worst in terms of adaptation to life and assistive devices. The length of stay in the institution, daily activities, and the number of chronic diseases were significantly different from place identity, and the number of chronic diseases was significantly different from life adaptation. Conclusions: The results of this study can be used as a reference for institutions to improve the quality of care. It is suggested that institutions can organize more activities to promote interaction and participation among residents, to strengthen their local identity and life adaptation.
      Citation: Geriatrics
      PubDate: 2022-03-29
      DOI: 10.3390/geriatrics7020039
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 40: Living with Dysphagia

    • Authors: John Mirams
      First page: 40
      Abstract: I am 88 years old—a widower and retired businessman living in West Sussex [...]
      Citation: Geriatrics
      PubDate: 2022-03-29
      DOI: 10.3390/geriatrics7020040
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 41: Eating, Drinking, and Swallowing
           Difficulties: The Impacts on, and of, Religious Beliefs

    • Authors: Paula Leslie, Judith Broll
      First page: 41
      Abstract: Eating, drinking, and swallowing (EDS) are fundamental to the biomechanical model of the body. They are the processes by which the body obtains fuel essential for existence but are so much more than this mere function. What, when, and how we eat, with whom, even what we do not eat, and when we do not eat, are not physiological restrictions. The Equality Act 2010 prohibits discrimination of patients based on a list of protected characteristics, including religion. There is a paucity of literature addressing religion and EDS issues despite most religions having laws regarding food sourcing, preparation, consumption, and fasting. The diverse perspectives of our patients may influence engagement with services unless we appreciate the significance of the interplay of EDS and religious belief. Our paper addresses religion and EDS with a focus on the activities that lead up to food or drink consumption. Religion, as with many important aspects of humanity, is a highly individual experience. Thus, we need to establish what is important to each person that we deal with, whilst using general knowledge of a religion to guide us. An informed multidisciplinary team including stakeholders from chaplaincy services is critical for optimal patient care.
      Citation: Geriatrics
      PubDate: 2022-03-30
      DOI: 10.3390/geriatrics7020041
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 42: Prevalence Rates and Characteristics of
           Malnutrition, Frailty, and Other Nutrition and Muscle Mass-Related
           Conditions Document Potential Quality of Care Gap for Medicare Patients in
           US Skilled Nursing Facilities

    • Authors: Mary Beth Arensberg, Cory Brunton, Susan Drawert, Brenda Richardson
      First page: 42
      Abstract: Changes to the payment structure of the United States (U.S.) healthcare system are leading to an increased acuity level of patients receiving short-term skilled nursing facility care. Most skilled nursing facility patients are older, and many have medical conditions that cannot be changed. However, conditions related to nutrition/muscle mass may be impacted if there is early identification/intervention. To help determine the diagnosis and potential impact of nutrition/muscle mass-related conditions in skilled nursing facilities, this study evaluated 2016–2020 US Medicare claims data. Methods aimed to identify a set of skilled nursing facility claims with one or more specific diagnoses (COVID-19, malnutrition, sarcopenia, frailty, obesity, diabetes, and/or pressure injury) and then to determine length of stay, discharge status, total charges, and total payments for each claim. Mean values per beneficiary were computed and between–group comparisons were performed. Results documented that each year, the total number of Medicare skilled nursing facility claims declined, whereas the percentage of claims for each study diagnosis increased significantly. For most conditions, potentially related to nutrition/muscle mass, Medicare beneficiaries had a shorter length of skilled nursing facility stays compared to those without the condition(s). Furthermore, a lower percentage of these Medicare beneficiaries were discharged home (except for those with claims for sarcopenia and obesity). Total claim charges for those with nutrition/muscle mass-related conditions exceeded those without (except for those with sarcopenia). We conclude that although the acuity level of patients in skilled nursing facilities continues to increase, skilled nursing facility Medicare claims for nutrition/muscle mass-related conditions are reported at lower levels than their likely prevalence. This represents a potential care gap and requires action to help improve patient health outcomes and skilled nursing facility quality metrics.
      Citation: Geriatrics
      PubDate: 2022-03-31
      DOI: 10.3390/geriatrics7020042
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 43: Home Monitoring of Oxygen Saturation Using a
           Low-Cost Wearable Device with Haptic Feedback to Improve Sleep Quality in
           a Lung Cancer Patient: A Case Report

    • Authors: Walter Lachenmeier, Dirk W. Lachenmeier
      First page: 43
      Abstract: This study reports the case of a lung cancer patient with increasing difficulties in falling asleep and frequent periods of wakefulness. Severe dyspnea related to pneumonitis caused as a side effect of immunotherapy worsened the situation. Eventually, a fear of falling asleep developed, including panic attacks and anxiety around choking, which was shown to lead to nights of complete wakefulness. The patient did not only sleep poorly; he did not sleep at all at night for several days, as evidenced by the notes he made during the night. Polygraphy showed no evidence of sleep-disordered breathing, but frequent periods of wakefulness and a reduced basal saturation of around 90% during sleep due to lung changes such as an extensive functional failure of the left upper lobe with position-dependent shunts. The authors hypothesized that the symptoms described were causally related to a drop in oxygen saturation in the patient’s blood. Therefore, they pursued the goal of finding a measurement technique that is as inexpensive as possible and that the patient can operate without outside assistance and great effort. Thus, the patient started using a low-cost wearable device that allows simultaneous measurements of blood oxygen content, pulse rate, and movement intensity. It consists of a finger ring with a pulse oximetry sensor and a wristband with a control unit containing a vibration motor. The described device reliably warned of disturbances in the oxygen concentration in the blood during the night with its vibration alarm. By use of that device during the whole night at home, the events of reduced oxygen saturation and anxiety symptoms were reduced. Sleep disturbances with sudden awakenings did not occur when using the device. The patient benefited from the security gained in this way and slept much more peacefully, and he could spend nights without waking up again. In conclusion, wearable oximeters with vibration alarms can be recommended for patients’ home care in lung cancer patients.
      Citation: Geriatrics
      PubDate: 2022-03-31
      DOI: 10.3390/geriatrics7020043
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 44: Factors Influencing Length of Stay and
           Discharge Destination of Patients with Hip Fracture Rehabilitating in a
           Private Care Setting

    • Authors: Zoe Thornburgh, Dinesh Samuel
      First page: 44
      Abstract: Background: Rehabilitation after a hip fracture has long-term importance, prompting some patients to utilise private services. Insufficient data regarding private rehabilitation in the UK can cause ambiguity and potential problems for all involved. Aim: The present study, involving patients with hip fractures rehabilitating in a private UK care setting, examined relationships between length of stay (LoS), discharge destination (DD) and 12 predictor variables. Methods: The variables included the retrospective measurement of the Functional Independence Measure. The variables were informed by a literature review and patient and public involvement. Retrospective data from the records of patients with hip fractures were utilised. Data were analysed using Spearman’s rho, Mann–Whitney U, Kruskal–Wallis H and chi-squared tests as appropriate. Odds ratios, distribution quartiles and survivor analysis were also utilised. Results: The median length of stay (LoS) was 20.5 days: 82% returned home, 6.5% died and 11.5% remained as long-term residents. Significant relationships existed between LoS and age (p = 0.004), comorbidities (p = 0.001) and FIMadmission (p = 0.001). DD was associated with age (p = 0.007), delirium (p = 0.018), comorbidities (p = 0.001) and both FIMpre-fracture and FIMadmission (p = 0.000). Conclusions: Factors associated with length of stay were identified, but further research incorporating multiple sites is required for greater predictor precision. Discharge destination was evident by 90 days, facilitating long-term planning.
      Citation: Geriatrics
      PubDate: 2022-03-31
      DOI: 10.3390/geriatrics7020044
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 45: Efficacy Comparison Study of Human Epidermal
           Growth Factor (EGF) between Heberprot-P® and Easyef® in Adult
           Zebrafish and Embryo under Presence or Absence Combination of Diabetic
           Condition and Hyperlipidemia to Mimic Elderly Patients

    • Authors: Kyung-Hyun Cho, Ju-Hyun Kim, Hyo-Seon Nam, Dae-Jin Kang
      First page: 45
      Abstract: Recombinant human epidermal growth factor (EGF) has been used to treat adult diabetic foot ulcers and pediatric burns by facilitating wound healing and epithelization, especially for elderly patients. Several formulation types of EGF from different expression hosts are clinically available, such as intralesional injection and topical application. On the other hand, no study has compared the in vivo efficacy of EGF products directly in terms of tissue regeneration and wound healing activity. The present study compared two commercial products, Heberprot-P75® and Easyef®, in terms of their tissue regeneration activity in adult zebrafish and the developmental speed of zebrafish embryos. Fluorescence spectroscopy showed that the two EGF products had different Trp fluorescence emission spectra: Easyef® showed a wavelength of maximum fluorescence (WMF) of 337 nm with weak fluorescence intensity (FI), while Heberprot-P75® showed WMF of 349 nm with a 4.1 times stronger FI than that of Easyef®. The WMF of Heberprot-P75® was quenched by adding singlet oxygen in ozonated oil, while the WMF of Easyef® was not quenched. Treatment with Heberprot-P75® induced greater embryo development speed with a higher survival rate after exposure to EGF in water and microinjection into embryos. Under normal diet (ND) consumption, Heberprot-P75® showed a 1.4 times higher tail fin regeneration activity than Easyef® during seven days from the intraperitoneal injection (10 μL, 50 μg/mL) after amputating the tail fin. Under ND consumption and diabetic condition caused by streptozotocin (STZ) treatment, Heberprot-P75® showed 2.1 times higher tail fin regeneration activity than Easyef® from the same injection and amputation protocol. Under a high-cholesterol diet (HCD) alone, Heberprot-P75® showed 1.2 times higher tail fin regeneration activity than the Easyef® group and PBS group from the same injection and amputation. Under diabetic conditions (STZ-injected) and HCD consumption, the Heberprot-P75® group showed 1.7 and 1.5 times higher tail fin regeneration activity than the Easyef® group and PBS group, respectively, with a distinct and clean regeneration pattern. In contrast, the Easyef® group and PBS group showed ambiguous regeneration patterns with a severe fissure of the tail fin, which is a typical symptom of a diabetic foot. In conclusion, Heberprot-P75® and Easyef® have different Trp fluorescence properties in terms of the WMF and fluorescence quenching. Treatment of Heberprot-P75® induced a greater developmental speed of zebrafish embryos in both water exposure and microinjection. Heberprot-P75® induced significantly higher wound healing and tissue regeneration activity than Easyef® and PBS in the presence or absence of diabetic conditions and cholesterol supplementation.
      Citation: Geriatrics
      PubDate: 2022-04-06
      DOI: 10.3390/geriatrics7020045
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 46: A Narrative Review of Specialist
           Parkinson’s Nurses: Evolution, Evidence and Expectation

    • Authors: Emma Tenison, Alice James, Louise Ebenezer, Emily J. Henderson
      First page: 46
      Abstract: Extended nursing roles have existed since the 1940s. The first specialist nurse for Parkinson’s disease, a complex neurodegenerative disease, was appointed in the United Kingdom (UK) in 1989. A review was undertaken using MEDLINE and Cumulative Index to the Nursing and Allied Health Literature (CINAHL), relating to the role and evidence for Parkinson’s disease nurse specialists (PDNSs). PDNSs fulfil many roles. Trials of their effectiveness have failed to show a positive benefit on health outcomes, but their input appears to improve the wellbeing of people with Parkinson’s. Now embedded in the UK Parkinson’s multidisciplinary team, this care model has since been adopted widely, including successful dissemination of training to countries in Sub-Saharan Africa. The lack of evidence to support the benefit of PDNSs may reflect an insufficient duration and intensity of the intervention, the outcome measures selected or the need to combine PDNS input with other evidence-based interventions. Whilst the current evidence base for their effectiveness is limited, their input appears to improve subjective patient wellbeing and they are considered a vital resource in management. Better evidence in the future will support the development of these roles and may facilitate the application of specialist nurses to other disease areas.
      Citation: Geriatrics
      PubDate: 2022-04-07
      DOI: 10.3390/geriatrics7020046
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 47: Influence of Sociodemographic,
           Health-Related, and Behavioral Factors on Food Guidelines Compliance in
           Older Adults: A Hierarchical Approach from the Chilean National Health
           Survey 2016–17 Data

    • Authors: Leticia de Albuquerque-Araújo, Daiana Quintiliano-Scarpelli, Dominique Masferrer Riquelme, Jair Licio Ferreira Santos
      First page: 47
      Abstract: Dietary habits are determinants in the development of a range of conditions and age-related diseases. We explored the associations of sociodemographic, health-related indicators, and health behavioral factors on dietary guideline compliance in elderly Chileans. We used a cross-sectional design using the publicly available database from the last Chilean National Health Survey (2016–17). The sample of 1831 older adults (≥60 y) from a national representative sample. The dependent variable was compliance with Food Guidelines (FG) (daily consumption of water, dairy, and fruits and vegetables; and weekly consumption of legumes and fish). The independent variables included sociodemographic, health-related, and behavioral factors. Over half (51.8%) of the sample was female and 85.7% belonged to the 60–79 age group. Satisfactory compliance to FG was observed in 3.9% of the sample. In the adjusted analysis, for those between 60 and 79 y, marital status was the only significant variable associated with FG noncompliance (PR: 1.34; 95%CI: 1.04–1.71). For those over 80 y, income of >2 minimum wages (PR: 0.10; 95%CI: 0.02–0.61), living alone (PR: 1.72; 95%CI: 1.20–2.47), and self-reported cardiovascular disease (PR: 0.63; 95%CI: 0.43–0.93) were associated with FG noncompliance. We observed low FG compliance among elderly Chilean adults, especially in the oldest group. Factors associated with the FG compliance was different between age groups.
      Citation: Geriatrics
      PubDate: 2022-04-08
      DOI: 10.3390/geriatrics7020047
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 48: Relationship between Measured Aerobic
           Capacity and Total Energy Expenditure Obtained by the Doubly Labeled Water
           Method in Community-Dwelling, Healthy Adults Aged 81–94 Years

    • Authors: Jun Yasukata, Yosuke Yamada, Hiroyuki Sagayama, Yasuki Higaki, Hiroaki Tanaka
      First page: 48
      Abstract: The doubly labeled water method is a gold-standard method for the measurement of total energy expenditure in daily life. We aimed to identify the relationship between measured aerobic capacity and total energy expenditure, activity energy expenditure, or physical activity level using the doubly labeled water method in adults of advanced old age. A total of 12 physically independent older adults (10 men and 2 women), aged 81–94 years, participated in this study. The aerobic capacity was evaluated according to the lactate threshold. Total energy expenditure under free-living conditions was assessed using the doubly labeled water method, and self-reported physical activity was obtained using the Japanese version of the International Physical Activity Questionnaire. The lactate threshold was significantly positively correlated with total energy expenditure, activity energy expenditure, and physical activity level after adjusting for age and sex. We found that the aerobic capacity of the lactate threshold was positively and independently correlated with total energy expenditure, activity energy expenditure, or physical activity level. The present results suggest that maintaining aerobic capacity is an important factor in preventing frailty, although further research is required.
      Citation: Geriatrics
      PubDate: 2022-04-15
      DOI: 10.3390/geriatrics7020048
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 49: Translation, Adaptation and Validation of
           the Five-Word Test (Test Delle 5 Parole, T5P) in an Italian Sample: A
           Rapid Screening for the Assessment of Memory Impairment

    • Authors: Farina, Borgnis, Scioli, d’Arma, D’Amico, Saibene
      First page: 49
      Abstract: Discriminating between Alzheimer’s disease (AD), mild cognitive impairment (MCI) and functional memory disorders (FMD) can sometimes be difficult because amnesic syndrome can be confused with memory dysfunction due to aging and/or depression. This work aims to translate, adapt and validate the five-word test (FWT) in an Italian sample (Test delle 5 Parole, T5P). FWT is a screening memory task specifically built to discriminate the hippocampal memory deficit—typical of AD and amnesic MCI—from those related to functional disorders. We involved a large number of subjects (n = 264): 60 with AD, 80 with MCI, 46 with FMD, and 78 healthy controls (CTRL). Two traditional screening tests and the T5P were administered to all participants. Results showed an excellent convergent validity of the T5P (p < 0.05). Moreover, the T5P appeared as an effective test able to discriminate between the four conditions, except for FMD and CTRL. In particular, a total score of ≤9 allowed for accurately discriminating subjects with AD + MCI compared to participants with FMD + CTRL with high sensitivity (83.87%) and specificity (76.43%). Overall, the T5P is a simple, rapid and sensible test of the hippocampal memory that is recommended in clinical practice to screen persons with subjective/probable amnesic difficulties and to discriminate between patients with AD or MCI and CTRL.
      Citation: Geriatrics
      PubDate: 2022-04-15
      DOI: 10.3390/geriatrics7020049
      Issue No: Vol. 7, No. 2 (2022)
       
  • Geriatrics, Vol. 7, Pages 10: The Impact of Pain on Functionality,
           Postural Control and Fall Risk in Woman Aged 45 to 64 Years Old

    • Authors: Priscilla Beaupré, Rubens A. da Silva, Tommy Chevrette
      First page: 10
      Abstract: Background: Ageing in women is associated with chronic degenerative pain leading to a functional decrease and therefore increase fall risk. It is therefore essential to detect early functional decreases in the presence of pain related to osteoarthritis. Objective: This cross-sectional study aimed to assess the impact of pain on functionality, postural control and fall risk in women aged between 45 to 64 years old. Methods: Twenty-one (21) women aged 45 to 64 were evaluated by clinical and functional measures such as a pain questionnaire (Lequesne Index), functional tests (Stair Step Test, 5 times sit-to-stand, 6MWD, Timed-up and Go) and postural performance (under force platform). Women were classified into 2 groups from the Lequesne Pain Index (PI): low pain (score ≤ 9) and strong pain (score ≥ 10) for subsequent comparisons on functionality (physical and postural control performance). Results: A significant impact was observed between the pain index (strong PI) and 3 of the 4 functional tests carried out including Stair Step Test (p = 0.001; g = 1.44), walking distance (p = 0.003; g = 1.31) and Timed-up and Go (p = 0.04; g = −0.93). The group with a strong PI score reported further poor postural control under force platform compared to the weak pain group. Conclusion: Pain and severity based on the PI index negatively modulate physical and postural control performance in women aged 45 to 64 years old.
      Citation: Geriatrics
      PubDate: 2022-01-01
      DOI: 10.3390/geriatrics7010010
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 11: The Impact of Drug Interactions in Patients
           with Community-Acquired Pneumonia on Hospital Length of Stay

    • Authors: Johannes Peter Schmitt, Andrea Kirfel, Marie-Therese Schmitz, Hendrik Kohlhof, Tobias Weisbarth, Maria Wittmann
      First page: 11
      Abstract: (1) Background: An aging society is frequently affected by multimorbidity and polypharmacy, which, in turn, leads to an increased risk for drug interaction. The aim of this study was to evaluate the influence of drug interactions on the length of stay (LOS) in hospitals. (2) Methods: This retrospective, single-centre study is based on patients treated for community-acquired pneumonia in the hospital. Negative binomial regression was used to analyse the association between drug interactions and the LOS in the hospital. (3) Results: The total cohort contained 503 patients, yet 46 inpatients (9%) that died were not included in the analyses. The mean age was 74 (±15.3) years, 35% of patients older than 65 years were found to have more than two drug interactions, and 55% had a moderate, severe, or contraindicated adverse drug reaction. The regression model revealed a significant association between the number of drug interactions (rate ratio (RR) 1.02; 95%-CI 1.01–1.04) and the severity of drug interactions (RR 1.22; 95%-CI 1.09–1.37) on the LOS for the overall cohort as well as for the subgroup of patients aged 80 years and older. (4) Conclusion: Drug interactions are an independent risk factor for prolonged hospitalisation. Standardised assessment tools to avoid drug interactions should be implemented in clinical routines.
      Citation: Geriatrics
      PubDate: 2022-01-04
      DOI: 10.3390/geriatrics7010011
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 12: The Red and Orange Complex Subgingival
           Microbiome of Cognitive Impairment and Cognitively Normal Elderly with
           Periodontitis

    • Authors: Fatimah Maria Tadjoedin, Sri Lelyati C. Masulili, Muhammad Ihsan Rizal, Lindawati S. Kusdhany, Yuda Turana, Raden Irawati Ismail, Boy M. Bachtiar
      First page: 12
      Abstract: Increasing evidence has shown an association between periodontitis and cognitive impairment. Subgingival microbiota play a great role in periodontitis pathogenesis. However, the correlation between the subgingival microbiome and cognitive impairment remains unclear. This study aimed to evaluate the red and orange complex subgingival microbiome of cognitively impaired and cognitively normal elderly Indonesian subjects with periodontitis. Twenty-eight elderly subjects diagnosed with periodontitis underwent two cognitive examinations using the Hopkins Verbal Learning Test and the Mini-Mental State Examination. Gingival crevicular fluid taken from the periodontal pocket, at a depth between 5 and 7 mm, using a paper point was used as the subgingival samples. The subgingival microbiome in the cognitive impairment group (n = 14) and cognitively normal group (n = 14) was compared using the 16S rRNA Metagenomic iSeq™ 100 Sequencing System. There was β-diversity in the subgingival microbiota between the cognitively impaired and cognitively normal subjects. The metagenomic analysis showed a higher abundance of Porphyromonas and Treponema bacteria in the cognitive impairment group than in the normal cognitive group (p < 0.05). The abundance of Porphyromonas gingivalis and Treponema denticola was higher in the cognitively impaired elderly subjects. The role of P. gingivalis and T. denticola in the pathogenesis of cognitive impairment needs further investigation.
      Citation: Geriatrics
      PubDate: 2022-01-04
      DOI: 10.3390/geriatrics7010012
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 13: A Randomized, Open-Label Study to Assess
           Efficacy of Weekly Assumption of Cholecalciferol versus Calcifediol in
           Older Patients with Hypovitaminosis D

    • Authors: Chukwuma Okoye, Valeria Calsolaro, Filippo Niccolai, Alessia Maria Calabrese, Riccardo Franchi, Sara Rogani, Giulia Coppini, Virginia Morelli, Nadia Caraccio, Fabio Monzani
      First page: 13
      Abstract: The aim of this single-center, open-label, randomized controlled study was to evaluate which formulation of vitamin D—between cholecalciferol and calcifediol—is most effective in the treatment of hypovitaminosis D in older adults. Demographic characteristics, clinical history, and comprehensive geriatric assessment were recorded at admission. Eligible patients were randomly assigned an equivalent vitamin D supplement, either with cholecalciferol or calcifediol, from the time of hospital admission to three months after discharge. Among the 140 older patients included (mean age 83 ± 6.6 years, 57.8% females), 69 received cholecalciferol and 71 received calcifediol. The mean plasma values of 25-hydroxyvitamin D3 (25OH-vitamin D3) found at the time of enrollment were 16.8 ± 9.9 ng/mL in patients receiving cholecalciferol and 18.8 ± 13.3 ng/mL in those treated with calcifediol (p = 0.31). At the three month follow-up, the mean concentration of 25OH-vitamin D3 was significantly higher in patients treated with calcifediol than in those receiving cholecalciferol (30.7 ± 8.4 vs. 45.4 ± 9.8 ng/mL, respectively; p < 0.001). Supplementation with either cholecalciferol or calcifediol effectively results in reaching the optimal circulating values of 25OH-vitamin D3 in older patients suffering from hypovitaminosis D. However, supplementation with calcifediol led to average circulating values of 25OH-vitamin D3 that were significantly higher (over 50%) than those obtained with cholecalciferol.
      Citation: Geriatrics
      PubDate: 2022-01-07
      DOI: 10.3390/geriatrics7010013
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 14: Evidence-Informed Approach to De-Prescribing
           of Atypical Antipsychotics (AAP) in the Management of Behavioral
           Expressions (BE) in Advanced Neurocognitive Disorders (NCD): Results of a
           Retrospective Study

    • Authors: Atul Sunny Luthra, Raymond LinBin Gao, Shannon Remers, Peter Carducci, Joanna Sue
      First page: 14
      Abstract: The LuBAIR™ Paradigm is a novel approach to ascribe meaning to behavioral expressions in advanced neurocognitive disorders when the reliability of a clinical assessment is limited. The meaning ascribed to each behavioral category was used to identify those which are likely to respond to the use of atypical antipsychotics, in their management. De-prescribing was attempted on patients who qualified to enter this retrospective study. De-prescribing was defined as successful if individuals were completely withdrawn from AAP and remained off them for 60 days, without the re-emergence of behaviors. The LuBAIR™ Inventory was filled on two occasions. The data collected on the second occasion, in the successful and failed de-prescribed groups, were compared in this retrospective study. MANOVA, Chi-Square paired t-test statistical analyses were used to detect the differences in the behavioral categories between the two cohorts. Cohen d was used to measure effect size. Patients who did not have Mis-Identification and Goal-Directed Expressions were more likely to successfully de-prescribe: X2 (1, N = 40) = 29.119 p < 0.0001 and X2 (1, N = 40) = 32.374, p < 0.0001, respectively. Alternatively, the same behavioral categories were more likely to be present in patients who failed de-prescribing: MANOVA and paired t-test (p < 0.0001). Atypical antipsychotics, in their role as an antipsychotic and mood stabilizer, may be used to manage Mis-Identification and Goal-Directed Expressions, respectively.
      Citation: Geriatrics
      PubDate: 2022-01-26
      DOI: 10.3390/geriatrics7010014
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 15: Acknowledgment to Reviewers of Geriatrics in
           2021

    • Authors: Geriatrics Editorial Office Geriatrics Editorial Office
      First page: 15
      Abstract: Rigorous peer-reviews are the basis of high-quality academic publishing [...]
      Citation: Geriatrics
      PubDate: 2022-01-27
      DOI: 10.3390/geriatrics7010015
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 16: The Acute Effects of Breakfast Drinks with
           Varying Protein and Energy Contents on Appetite and Free-Living Energy
           Intake in UK Older Adults

    • Authors: Daniel Crabtree, Adrian Holliday, William Buosi, Claire Fyfe, Graham Horgan, Alexandra Johnstone, on behalf of the Full4Health-study Group
      First page: 16
      Abstract: Proposed strategies for preventing protein deficiencies in older patients include increasing protein intake at breakfast. However, protein is highly satiating and the effects of very high protein intakes at breakfast on subsequent appetite and free-living energy intake (EI) in older adults are unclear. This study compared the acute effects of two breakfast drinks varying in protein and energy contents on appetite and free-living EI in healthy older adults using a randomized 2 × 2 crossover design. Participants (n = 48 (20 men, 28 women); mean ± SD age: 69 ± 3 years; BMI: 22.2 ± 2.0 kg·m−2; fat-free mass: 45.5 ± 8.0 kg) consumed two drinks for breakfast (high-protein (30.4 ± 5.3 g), low-energy (211.2 ± 37.1 kcal) content (HPLE) and very high-protein (61.8 ± 9.9 g), fed to energy requirements (428.0 ± 68.9 kcal) (VHPER)) one week apart. Appetite perceptions were assessed for 3 h post-drink and free-living EI was measured for the remainder of the day. Appetite was lower in VHPER than HPLE from 30 min onwards (p < 0.01). Free-living energy and protein intake did not differ between conditions (p = 0.814). However, 24 h EI (breakfast drink intake + free-living intake) was greater in VHPER than HPLE (1937 ± 568 kcal vs. 1705 ± 490 kcal; p = 0.001), as was 24 h protein intake (123.0 ± 26.0 g vs. 88.6 ± 20.9 g; p < 0.001). Consuming a very high-protein breakfast drink acutely suppressed appetite more than a low-energy, high-protein drink in older adults, though free-living EI was unaffected. The long-term effects of adopting such a breakfast strategy in older adults at high risk of energy and protein malnutrition warrants exploration.
      Citation: Geriatrics
      PubDate: 2022-01-30
      DOI: 10.3390/geriatrics7010016
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 17: Ageist No More: Interprofessional Training
           for Undergraduate Healthcare Students

    • Authors: Aniela Mendez, Mildred Lopez, Karina Rodriguez-Quintanilla, Belinda Carrion
      First page: 17
      Abstract: Ageism seeps deep into our society, whether in law, policies, or healthcare practices it segregates individuals based on their age. The aim of this work was to evaluate the impact of an educational strategy in ageist attitudes against older adults in healthcare undergraduate students. A five-week intervention: Healthy environments and self-care for the older adults was implemented. To assess the impact of this strategy in ageist attitudes in participants, a simulated consultation with an older adult was conducted. Participants’ perspectives on the experience were collected using an online survey. One hundred and thirty-eight undergraduate students from health programs were included. They highlighted growth in the understanding of the normal aging process and the prejudices that surround aging. During the role-play activity, participants identified communication, empathy, and professionalism as the abilities developed with this strategy and the need to show empathy and avoid prejudice against older adults in their clinical interactions. Educational interventions are a great tool to promote cultural changes, diminish prejudices and misconceptions of ageism in future healthcare professionals.
      Citation: Geriatrics
      PubDate: 2022-02-07
      DOI: 10.3390/geriatrics7010017
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 18: Primary Arthroplasty or Internal Fixation in
           Intertrochanteric Femur Fractures: A Survey of Surgical Attitudes of
           Orthopedic Surgeons in Turkey

    • Authors: Hakan Cici, Yunus Emre Bektas, Nihat Demirhan Demirkiran, Ramadan Ozmanevra
      First page: 18
      Abstract: This study aimed to examine the primary arthroplasty attitudes of Turkish orthopedics and traumatology specialists and residents to patients with intertrochanteric fractures, of various ages, comorbidity situations and fracture types, using an internet-based questionnaire. Between March and April 2021, a cross-sectional survey was conducted with a total of 159 orthopedics and traumatology specialists and residents in Turkey, using an online questionnaire that consisted of 16 different patient scenarios of varying intertrochanteric fracture types, ages, and comorbidity conditions. Respondents’ preference ratio for primary arthroplasty was 24.1% in the scenarios with patients over the age of 71, while it was 8.4% in the scenarios with patients aged between 50 and 70. The ratios of primary arthroplasty preference were 12.4%, 21% and 27.3% in 2-part, 3-part and 4-part fracture scenarios, respectively. The primary arthroplasty preferences of respondents with 10 years or more of professional experience were observed to be statistically significantly different to those of the respondents with 1 to 10 years of experience in the 4-part fracture scenario where the patient was aged 71 years and above with an ASA (American Society of Anesthesiologists) score of 3–4 (p < 0.05). Despite varying opinions in the literature in recent years, primary arthroplasty can be considered a valuable alternative approach for Turkish surgeons, and in older adult patients with unstable intertrochanteric fractures, particularly those who need early mobilization and have high ASA scores.
      Citation: Geriatrics
      PubDate: 2022-02-14
      DOI: 10.3390/geriatrics7010018
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 19: Perceptions of Burden and Preparedness for
           Caregiving among the Family Caregivers of Hospitalised Older Adults: A
           Cross-Sectional Study

    • Authors: Carla Gomes da Rocha, Béatrice Perrenoud, Anne-Sylvie Ramelet
      First page: 19
      Abstract: Background: Due to the increasing care needs of older adults, family caregivers are more and more solicited. This can have a negative impact on their quality of life related to a lack of preparedness for caregiving and feelings of burden. Objectives: To measure perceptions of burden and preparedness for caregiving among the family caregivers of hospitalised older adults, and to explore their possible associations. Methods: A cross-sectional study conducted in two university hospital geriatrics wards in Switzerland. Principal family caregivers of hospitalised older adults were invited to complete sociodemographic, the Zarit Burden Interview, and the Preparedness for Caregiving Scale questionnaires. Descriptive and correlational data analyses were performed. Results: Of the 38 responding caregivers, 80% provided informal care to their spouse or parent; 45% reported a lack of preparedness to provide care and 61% reported substantial levels of burden. There was no statistically significant correlation between preparedness and burden (𝜌 ≤ − 0.30, p = 0.07). Conclusions: A significant proportion of caregivers reported burden and a lack of preparedness. Healthcare professionals should provide adequate support to help informal caregivers to fulfil their roles.
      Citation: Geriatrics
      PubDate: 2022-02-15
      DOI: 10.3390/geriatrics7010019
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 20: Non-Vitamin K Oral Anticoagulants Assessment
           in High Risk of Bleeding Patients with Non-Valvular Atrial Fibrillation

    • Authors: Pedro Silva Cunha, André Viveiros Monteiro, Madalena Coutinho Cruz, Paula Malveiro, João Pedro Reis, Guilherme Portugal, Ana Dias, Rui Cruz Ferreira, Mário Martins Oliveira
      First page: 20
      Abstract: Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectiveness and safety of NOAC in a group at high risk of bleeding complications, in a real-world setting. We conducted a retrospective analysis of a high-risk cohort of 418 patients (pts) followed-up in our anticoagulation unit; data on patient characteristics, anticoagulation treatment, and bleeding and thrombotic complications were evaluated. The population had a median age of 77.8 ± 10.3 years and the mean CHA2DS2-VASc score was 3.85 (SD ± 1.4). Overall, 289 (69.1%) were ≥75 years old. During a mean follow-up time of 51.2 ± 35.7 months, we observed a rate of any bleeding of 7, a clinically relevant non-major bleeding rate of 4.8, a major bleeding rate of 2.2, a stroke rate of 1.6, and a rate of thrombotic events of 0.28 per 100 patient-years. There were 59 hospitalizations due to any cause (14.1%) and 36 (8.6%) deaths (one due to ischemic stroke). A structured follow-up, with judicious prescribing and drug compliance, may contribute to preventing potential complications.
      Citation: Geriatrics
      PubDate: 2022-02-17
      DOI: 10.3390/geriatrics7010020
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 21: Pitfalls of Early Systemic Corticosteroids
           Home Therapy in Older Patients with COVID-19 Pneumonia

    • Authors: Okoye, Rogani, Franchi, Pompilii, Calabrese, Mazzarone, Bianchi, Lemmi, Calsolaro, Monzani
      First page: 21
      Abstract: Corticosteroids have been widely used for acute respiratory distress syndrome (ARDS), but their role in the early phase of SARS-CoV-2 infection is controversial. Our study aimed to determine the effectiveness of early corticosteroid therapy (ECT) in preventing the progression of disease, reducing the escalation of care and improving clinical outcome in older patients hospitalized for COVID-19 pneumonia. A total of 90 subjects (47.7% women; mean age = 82.3 ± 6.7 years) were enrolled. ECT was administered to 33 out of 90 patients before the hospitalization. At admission, no difference was detected in median SOFA score (2, IQR:2 vs. 2, IQR: 2). We found a significant difference in mean PaO2/FiO2 ratio during the first week of hospitalization between ECT patients and controls (F = 5.49, p = 0.002) and in mean PaO2/FiO2 ratio over time (F = 6.94, p < 0.0001). We detected no-significant differences in terms of in-hospital mortality and transfer to ICU between ECT patients and controls (27.1% vs. 22.8%, respectively, p = 0.63). ECT was associated with worse clinical outcomes, showing no benefit in attenuating the progression of the disease or reducing the escalation of care. These findings are crucial given the current pandemic, and further studies are needed to provide additional data on the optimal timing of initiating corticosteroid treatment.
      Citation: Geriatrics
      PubDate: 2022-02-17
      DOI: 10.3390/geriatrics7010021
      Issue No: Vol. 7, No. 1 (2022)
       
  • Geriatrics, Vol. 7, Pages 22: Efficacy of Single Tocilizumab
           Administration in an 88-Year-Old Patient with Severe COVID-19 and a Mini
           Literature Review

    • Authors: Cid Ould Ouali, Nadia Ladjouzi, Khidher Tamas, Hendriniaina Raveloson, Jihene Ben Hassen, Nesrine El Omeiri, Georges Zouloumis, Mohamed Moataz Al Zoabi, Muneer Asadi, Aziza Jhouri, Joël Schlatter
      First page: 22
      Abstract: The new coronavirus disease 2019 (COVID-19) could be associated with elevated inflammatory cytokine levels, suggesting the involvement of cytokine release syndrome. This syndrome is characterized by release of interleukin 6 correlated with COVID-19 severity and mortality. Targeting IL-6 with Tocilizumab treatment could be a potential therapeutic option for old patients. We report the case of an 88-year-old man with COVID-19 disease who presented at the admission with anemia, fever, oxygen desaturation (92%), and inflammatory syndrome (C-reactive protein (CRP) at 182.5 mg/L; reference range <5.0 mg/L). After remaining CRP level increase (206.6 mg/L), Tocilizumab administration led to rapid clinical outcome and resolution of his inflammatory syndrome. This case report represents a supplementary data confirming the efficacy and safety of Tocilizumab for COVID-19 in elderly patients.
      Citation: Geriatrics
      PubDate: 2022-02-21
      DOI: 10.3390/geriatrics7010022
      Issue No: Vol. 7, No. 1 (2022)
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 44.210.21.70
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-