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Roncal-Belzunce V, Gutiérrez-Valencia M, Echeverría-Beistegui I, Martínez-Velilla N. Optipharm: Enhancing pharmacological management skills in healthcare students for geriatric care through gamified e-learning. Int J Med Inform 2024; 190:105535. [PMID: 39047675 DOI: 10.1016/j.ijmedinf.2024.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/01/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Complexities in older patient care and frequent polypharmacy requires tailored tools, specific skills and interdisciplinary collaborations. Traditional disease-centered education often overlooks these issues. Despite digital gamification's relevance in health education, limited exploration exists for gamified platforms addressing polypharmacy, especially within comprehensive geriatric assessment (CGA). OBJECTIVE This study outlines Optipharm's design, a gamified e-learning tool designed to enhance health students' education in managing polypharmacy among older adults. It also assesses its usability using a validated scale. METHODS Optipharm development utilized gamification techniques guided by pedagogical principles. Learning objectives addressed clinical and educational gaps in older adult care. Hosted on a Moodle system, the platform housed a structured clinical case as a SCORM file, a usability scale, a certificate of achievement, and a literature library. Optipharm was assessed by 304 medical students from the University of Navarre, Spain, using the SUS-G-Sp scale. RESULTS An immersive gamified e-learning tool simulating clinical practice settings was developed, requiring users to assume the role of healthcare professionals in multidisciplinary outpatient consultations. The interface, with a 2D cartoon-style aesthetic, aligns with learning objectives, integrating engaging storytelling and clear instructions for CGA in Phase 1 and pharmacological optimization in Phase 2. The evaluation of Optipharm's usability revealed very positive perceptions among users, with high agreement rates on usability items. CONCLUSION Optipharm represents a pioneering gamified tool designed to simulate clinical scenarios, allowing users to engage as healthcare professionals within multidisciplinary teams and address medication-related challenges in older patients with polypharmacy. It provides a secure, interactive learning environment with clear educational objectives and seamless integration of gamification elements, enhancing users' knowledge and skills in managing complex medication regimens. As a platform for experiential learning and knowledge exchange, Optipharm contributes to shaping the future of health education and fostering a culture of patient-centred care among future healthcare professionals.
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Affiliation(s)
- Victoria Roncal-Belzunce
- Public University of Navarre (UPNA), Pamplona, Navarre, Spain; Navarre Institute for Health Research (IdiSNA), Pamplona, Navarre, Spain.
| | - Marta Gutiérrez-Valencia
- Navarre Institute for Health Research (IdiSNA), Pamplona, Navarre, Spain; Innovation and Organization Unit, Navarre Health Service, Pamplona, Navarre, Spain
| | | | - Nicolás Martínez-Velilla
- Public University of Navarre (UPNA), Pamplona, Navarre, Spain; Navarre Institute for Health Research (IdiSNA), Pamplona, Navarre, Spain; Hospital Universitario de Navarra (HUN)- Navarrabiomed, Pamplona, Navarre, Spain
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Biegus J, Pagnesi M, Davison B, Ponikowski P, Mebazaa A, Cotter G. High-intensity care for GDMT titration. Heart Fail Rev 2024; 29:1065-1077. [PMID: 39037564 PMCID: PMC11306642 DOI: 10.1007/s10741-024-10419-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2024] [Indexed: 07/23/2024]
Abstract
Heart failure (HF) is a systemic disease associated with a high risk of morbidity, mortality, increased risk of hospitalizations, and low quality of life. Therefore, effective, systemic treatment strategies are necessary to mitigate these risks. In this manuscript, we emphasize the concept of high-intensity care to optimize guideline-directed medical therapy (GDMT) in HF patients. The document highlights the importance of achieving optimal recommended doses of GDMT medications, including beta-blockers, renin-angiotensin-aldosterone inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter inhibitors to improve patient outcomes, achieve effective, sustainable decongestion, and improve patient quality of life. The document also discusses potential obstacles to GDMT optimization, such as clinical inertia, physiological limitations, comorbidities, non-adherence, and frailty. Lastly, it also attempts to provide possible future scenarios of high-intensive care that could improve patient outcomes.
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Affiliation(s)
- Jan Biegus
- Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wroclaw, Borowska 213, Poland.
| | - Matteo Pagnesi
- Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Beth Davison
- Momentum Research Inc, Durham, NC, USA
- Heart Initiative, Durham, NC, USA
- Université Paris Cité, INSERM UMR-S 942(MASCOT), Paris, France
| | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wroclaw, Borowska 213, Poland
| | - Alexander Mebazaa
- Université Paris Cité, INSERM UMR-S 942(MASCOT), Paris, France
- Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis and Lariboisière Hospitals, FHU PROMICE, DMU Parabol, APHP Nord, Paris, France
| | - Gadi Cotter
- Momentum Research Inc, Durham, NC, USA
- Heart Initiative, Durham, NC, USA
- Université Paris Cité, INSERM UMR-S 942(MASCOT), Paris, France
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Dong H, Liu X, Duan J, Zhang J, Liu H, Shen T. Excessive glucocorticoids combined with RANKL promote the differentiation of bone marrow macrophages (BMM) into osteoclasts and accelerate the progression of osteoporosis by activating the SYK/SHP2/NF-κB signaling pathway. Aging (Albany NY) 2024; 16:206084. [PMID: 39197167 DOI: 10.18632/aging.206084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/13/2024] [Indexed: 08/30/2024]
Abstract
The primary objective of this study was to explore the extensive implications and complex molecular interactions arising from the confluence of excessive glucocorticoids and RANKL on the differentiation process of BMM into osteoclasts, profoundly impacting osteoporosis development. The methodology encompassed X-ray analysis and HE staining for evaluating bone loss in mice, while immunohistochemical staining was utilized to observe phosphorylated SHP2 (p-SHP2) expression. The assessment of several phosphorylated and total protein expression levels, including NF-κB, SHP2, SYK, JAK2, TAK1, NFATC1, c-fos, and Cathepsin K, was conducted via Western blotting. Additional experiments, involving CCK8 and monoclonal proliferation assays, were undertaken to determine BMM proliferation capacity. Immunofluorescence staining facilitated the quantification of TRAP fluorescence intensity. In vivo analysis revealed that glucocorticoid surplus triggers SHP2 signaling pathway activation, accelerating osteoporosis progression. Western blot results demonstrated that SHP2 inhibition could decrease the expression of specific proteins such as p-NF-κB and p-SHP2, with minimal effects on p-SYK levels. In vitro findings indicated that glucocorticoid and RANKL interaction activates the SHP2 pathway through NF-κB and SYK pathways, enhancing expressions of p-JAK2, p-TAK1, NFATC1, c-fos, and Cathepsin K, thereby promoting BMM to osteoclast transformation. Conclusion: Excessive glucocorticoids and RANKL interaction advance osteoclast differentiation from BMM by activating the SYK/SHP2/NF-κB signaling pathway, expediting osteoporosis progression.
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Affiliation(s)
- Hao Dong
- West Campus of Zibo Central Hospital, Zibo, Shandong, China
| | | | - Jiqiang Duan
- West Campus of Zibo Central Hospital, Zibo, Shandong, China
| | - Jing Zhang
- Zibo Central Hospital, Zibo, Shandong, China
| | - Hao Liu
- Zibo Central Hospital, Zibo, Shandong, China
| | - Tiehui Shen
- West Campus of Zibo Central Hospital, Zibo, Shandong, China
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Wu P, Yang Y, Yuan A, Wang Y, Zhang Y. Postoperative delirium increases follow-up mortality following hip arthroplasty in older patients with femoral neck fracture. Australas J Ageing 2024. [PMID: 39186392 DOI: 10.1111/ajag.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVE This study aimed to identify independent perioperative risk factors and follow-up mortality associated with postoperative delirium in older patients undergoing hip arthroplasty at a large teaching hospital in South China. We aimed to establish a specialised model to predict the risk of postoperative delirium. METHODS This retrospective observational study was conducted in the orthopaedics department of the hospital between January 2018 and December 2022. Participants were stratified into two groups: those with and those without postoperative delirium. The study included demographics, clinical characteristics, surgery-related and laboratory specifics, as well as details on delirium. RESULTS In this study of 241 participants, the median age was 80 years (IQR, 74.5-85), with postoperative delirium observed in 43 individuals (18%). Multivariate logistic regression analysis identified age (OR, 1.07; 95% CI, 1.01-1.14; p = .03), arrhythmia (OR, 7.97; 95% CI, 2.25-28.29; p = .001), dementia (OR, 7.08; 95% CI, 1.73-28.95; p = .006) and a lower level of red blood cells (RBC) (OR, .33; 95% CI, .17-.64; p < .001) as independent factors associated with postoperative delirium after hip arthroplasty. Patients experiencing both preoperative and postoperative delirium had significantly higher follow-up mortality compared to those with postoperative delirium only and those without delirium (80% vs. 38% vs. 24%, p = .02). CONCLUSIONS The specialised model was established to effectively predict delirium following hip arthroplasty in patients with femoral neck fracture. Postoperative delirium strongly associates with follow-up mortality. Proactive management is crucial for minimising delirium occurrence after hip arthroplasty and improving patient outcomes.
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Affiliation(s)
- Penghuan Wu
- Department of Orthopaedics, Shaoguan First People's Hospital, Southern Medical University, Guangzhou, Guangdong, China
- The School of Medicine, Nankai University, Tianjin, China
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying Yang
- Department of Orthopaedics, Shaoguan First People's Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Aidong Yuan
- Department of Orthopaedics, Shaoguan First People's Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Wang
- Department of Orthopaedics, Shaoguan First People's Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yingze Zhang
- The School of Medicine, Nankai University, Tianjin, China
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
- Chinese Academy of Engineering, Beijing, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, China
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Gott M, Wiles J, Morgan T, Williams L, Morgan K, Black S, Koh A, Fanueli E, Xu J, Goodwin H, Pilimatalawwe D, Moeke-Maxwell T. Older people's Contributions During the COVID-19 Pandemic Response. J Aging Soc Policy 2024:1-21. [PMID: 39187970 DOI: 10.1080/08959420.2024.2384322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/06/2024] [Indexed: 08/28/2024]
Abstract
During the COVID-19 pandemic, older people were identified as requiring additional support and protection. This multi-method qualitative study shifts this narrative by asking: how did older people contribute to the COVID-19 public health response? We conducted a reflexive thematic analysis of responses from 870 letter-writers and 44 interviewees who were older people living in Aotearoa, New Zealand during the COVID-19 pandemic. Older people made substantial contributions during the COVID-19 pandemic through: 1) volunteering; 2) nurturing; and 3) advocacy/activism. We argue that policy makers should take seriously the ways older people were providers of help and support in this period.
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Affiliation(s)
- Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janine Wiles
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tessa Morgan
- Applied Social Research Group, Department of Public Health and Primary Care, The University of Cambridge, Cambridge, UK
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathryn Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Stella Black
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Anne Koh
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Fanueli
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jing Xu
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Hetty Goodwin
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Dihini Pilimatalawwe
- Applied Social Research Group, Department of Public Health and Primary Care, The University of Cambridge, Cambridge, UK
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Makasi CE, Ngowi B, Mahande MJ, Welte TM, Stelzle D, Guga G, Schmidt V, Rüther C, Lema Y, Fabien Prodjinotho U, Kilale A, Prazeres da Costa C, Mmbaga BT, Winkler AS. Neurocysticercosis and cognitive impairment among people with epilepsy in Taenia solium endemic regions of rural southern Tanzania: A hospital-based cross-sectional study in mental health clinics of selected sites in Tanzania. Epilepsy Behav 2024; 159:110010. [PMID: 39186856 DOI: 10.1016/j.yebeh.2024.110010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/20/2024] [Accepted: 08/20/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Epilepsy poses a significant public health problem in many parts of the world. The majority of people with epilepsy (PWE) are from low-income and middle-income countries (LMICs). Taenia solium neurocysticercosis (NCC) is estimated to cause 30% of preventable epilepsy in PWE in areas of T. solium endemicity. This study was conducted to assess the prevalence of NCC in PWE, evaluate the presence of cognitive impairment in PWE, and assess potential contributing factors. METHODS PWE were recruited within a mental health clinic-based cross-sectional study in rural Southern Tanzania. PWE underwent a detailed neurological examination, and a blood sample was collected for T. solium cysticercosis (CC) serology testing. Patients who were serologically positive for CC and those detected to have prominent neurological deficits apart from epilepsy were invited to receive a cerebral computed tomography (CT) examination. RESULTS Out of the 223 people with epilepsy (PWE) recruited, 221 underwent clinical examination. Among these, 26 (11.8 %) had cognitive impairment, and 2 had additional neurological signs or symptoms. Twenty-five of the 223 PWE (11.2 %) tested positive for CC. A total of 36 participants underwent CT scans, with 18 testing positives for CC and 18 negatives. Of the 36 who had CT scans, 8 (22.2 %) were diagnosed with NCC; 7 were CC positive, and 1 was CC negative. Multivariate logistic regression confirmed that cognitive impairment in PWE was 8.62 times higher for Kongwa participants compared to Chunya, with a statistically significant association (95 % CI: 1.75-156; P<0.037). Additionally, having an education was associated with a 91 % reduction in the odds of NCC (OR=0.09) compared to no education, which was also statistically significant (95 % CI: 0.01 to 0.33; P<0.002). CONCLUSION Our study found a 22.2% prevalence of neurocysticercosis (NCC) among PWE. Cognitive impairment was present in 11.8% of PWE but was not significantly associated with NCC. Socioeconomic and educational factors may play a larger role in cognitive impairment among PWE.
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Affiliation(s)
- Charles E Makasi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
| | - Bernard Ngowi
- Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania.
| | - Michael J Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tamara M Welte
- Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany.
| | - Dominik Stelzle
- Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany.
| | - Godfrey Guga
- Haydom Global Health Research Centre, Haydom Lutheran Hospital, Mbulu, Tanzania
| | - Veronika Schmidt
- Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany.
| | - Charlotte Rüther
- Department of Neuroradiology, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Yakobo Lema
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
| | - Ulrich Fabien Prodjinotho
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany.
| | - Andrew Kilale
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania.
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany; German Center for Infection and Research (DZIF), Munich, Germany.
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania; Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Andrea S Winkler
- Department of Neurology, Technical University of Munich, Munich, Germany; Center for Global Health, Technical University of Munich, Munich, Germany; Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
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Cossio-Bolaños M, Vidal-Espinoza R, Caceres-Bahamondes J, de Campos LFCC, Urzua-Alul L, de Lázari MSR, Luarte-Rocha C, Gomez-Campos R. Translation, validity and reliability of the fall risk scale for older adults. BMC Geriatr 2024; 24:708. [PMID: 39182050 PMCID: PMC11344915 DOI: 10.1186/s12877-024-05292-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/08/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Falls in older adults are a common and serious threat to health and functional independence. It can cause psychological distress, inability to participate in activities of daily living, brain injury, fractures, and even death. The aim was to analyze the psychometric properties of the self-assessed fall risk scale (FRS) that measures the risk of falls in older adults in a central region of Chile, as well as to verify the concurrent validity against functional fitness tests. MATERIALS AND METHODS A descriptive cross-sectional study was carried out in 222 older adults (OA) [34 males and 188 females] with an age range of 65 to 85 years. The 13-item self-perceived fall risk scale (FRS) was validated. Anthropometric measures (weight, height and waist circumference) were assessed. Five functional fitness tests were measured (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test). Validation was performed by construct validation [(exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)] and concurrent validity. RESULTS The EFA revealed 4 factors in the FRS scale [1: fear of falling (variance 27.1%), 2: use of assistive devices (variance 10.6%), 3: loss of sensation (variance 9.3%), and 4: limited mobility (variance 8.3%)]. Factor loadings ranged from ∼ 0.50 to 0.83 across the 4 components. The Kaiser-Meyer Olkin sample adequacy test (KMO) reflected adequate adequacy (KMO = 0.79, chi-square (X2) = 498.806, gl = 78, p = 0.00). The CFA showed a satisfactory final fit [chi-square (X2) = 126.748, Root mean squared error of approximation (RMSEA) = 0.042, Tucker-Lewis Index (TLI) = 0.946, Comparative fit index (CFI) = 0.935 y Normed fit index (NFI) = 0.90. The relationships between the FRS scale and functional fitness tests (right and left hand grip strength, biceps curl, up-and-go, agility and 6-minute walk test) ranged from low to moderate (r= -0.23 to 0.41). CONCLUSION The FRS scale showed acceptable validity and reliability in older adults in central region of Chile. It is expected that this scale will be useful for assessing fall risk in clinical and epidemiological settings in the aging Chilean population.
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Affiliation(s)
- Marco Cossio-Bolaños
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile.
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain.
| | | | | | | | - Luis Urzua-Alul
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago, Chile
| | | | - Cristian Luarte-Rocha
- Facultad de Odontología y Ciencias de la Rehabilitación. Universidad de San Sebastían, Concepción, Chile
| | - Rossana Gomez-Campos
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile.
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain.
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Wang S, Xie J, Zhai D, Wang Z, Qi H, Deng M. Association between ultra-processed food and osteoporosis: a cross-sectional study based on the NHANES database. Nutr Metab (Lond) 2024; 21:69. [PMID: 39180053 PMCID: PMC11342598 DOI: 10.1186/s12986-024-00843-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/08/2024] [Indexed: 08/26/2024] Open
Abstract
AIM Nutritional characteristics and additives in ultra-processed foods (UPF) are directly related to bone health. Physical activity as a modifiable lifestyle intervention also plays a possible role in bone mineral density (BMD), but effect of physical activity on association between UPF and osteoporosis is not fully understood. Herein, this study aims to explore the association of UPF with osteoporosis, and assess the potential mediating effects of some related factors on this pathway. METHODS Data of adults were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. Associations of unprocessed/minimally processed food (MPF), processed culinary ingredient (PCI), processed foods (PF) and UPF with femur neck BMD, total femur BMD and osteoporosis were investigated using linear regression and weighted univariate and multivariate logistic regression analyses respectively. Subgroup analyses of age, gender, physical activity, poverty income ratio (PIR), hypertension, diabetes mellitus (DM), cardiovascular disease (CVD), and dyslipidemia were performed. The potential mediating and interaction effects of physical activity and related factors on association of UPF with osteoporosis were also assessed. The evaluation indexes were β, odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Among 10,678 eligible persons, 454 had osteoporosis. After adjusting for covariates, elevated UPF intake was associated with decreased demur neck and total femur BMD (β=-0.003). A higher UPF intake level (> 57.51%) was linked to higher odds of osteoporosis (OR = 1.789). These relationships were also significant in different subgroups. Physical activity had a potential mediating effect on the association between UPF and osteoporosis (OR = 0.47, mediating proportion = 21.54%). CONCLUSION UPF intake levels were associated with BMD and osteoporosis. Physical activity had an interaction effect with UPF, and had a potential mediating effect on relationship between UPF and osteoporosis.
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Affiliation(s)
- Songfeng Wang
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China
| | - Jiasi Xie
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China
| | - Dandan Zhai
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China
| | - Zhou Wang
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China
| | - Huixuan Qi
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China
| | - Muhong Deng
- Department of Oncology, The First Medical Center of Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Medical School, No. 28 Fuxing Road, Haidian District, Beijing, 100853, P.R. China.
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Zhang L, Yang P, Yin F, Zhang J, Zhao B, Zhou J. Association between frailty and hypoproteinaemia in older patients: meta-analysis and systematic review. BMC Geriatr 2024; 24:689. [PMID: 39154175 PMCID: PMC11329991 DOI: 10.1186/s12877-024-05275-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVE Frailty and hypoproteinaemia are common in older individuals. Although there is evidence of a correlation between frailty and hypoproteinaemia, the relationship between frailty and hypoproteinaemia in hospitalized/critically ill and older community residents has not been clarified. Therefore, the aim of our meta-analysis was to evaluate the associations between frailty and hypoproteinaemia in different types of patients. METHODS A systematic retrieval of articles published in the PubMed, Embase, Medline, Web of Science, Cochrane, Wanfang, and CNKI databases from their establishment to April 2024 was performed to search for studies on the associations between severity of frailty or prefrailty and hypoproteinaemia in older adults. The Newcastle‒Ottawa Scale and the Agency for Healthcare Research and Quality Scale were used to assess study quality. RESULTS Twenty-two studies were included including 90,351 frail older people were included. Meta-analysis revealed an association between frailty or prefrailty and hypoproteinaemia (OR = 2.37, 95% CI: 1.47, 3.83; OR = 1.62, 95% CI: 1.23, 2.15), there was no significant difference in the risk of hypoproteinaemia between patients with severe frailty and those with low or moderate frailty (OR = 0.62, 95% CI:0.44, 0.87). The effect of frailty on the occurrence of hypoproteinaemia was more obvious in hospitalized patients/critically ill patients than in surgical patients (OR = 3.75, 95% CI: 2.36, 5.96), followed by older community residents (OR = 2.30, 95% CI: 1.18, 4.49). CONCLUSION Frailty is associated with hypoproteinaemia in surgical patients, hospitalized older patients and older community residents. Future studies should focus on the benefits of albumin supplementation in preventing or alleviating frailty and related outcomes in the future.
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Affiliation(s)
- Linxue Zhang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Nursing College, Zunyi Medical University, Zunyi, 563000, China
| | - Pingping Yang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Nursing College, Zunyi Medical University, Zunyi, 563000, China
| | - Furong Yin
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Nursing College, Zunyi Medical University, Zunyi, 563000, China
| | - Jinbo Zhang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Nursing College, Zunyi Medical University, Zunyi, 563000, China
| | - Benli Zhao
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Nursing College, Zunyi Medical University, Zunyi, 563000, China
| | - Jiamei Zhou
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
- Nursing College, Zunyi Medical University, Zunyi, 563000, China.
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Moreno-Martin P, Minobes-Molina E, Escribà-Salvans A, Oliveira VR, Rierola-Fochs S, Farrés-Godayol P, Gràcia-Micó P, de Souza DLB, Skelton DA, Jerez-Roig J. Longitudinal Analysis of Functional Capacity in Nursing Home Residents During the COVID-19 Pandemic. J Geriatr Phys Ther 2024:00139143-990000000-00056. [PMID: 39145572 DOI: 10.1519/jpt.0000000000000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
BACKGROUND AND PURPOSE The COVID-19 pandemic has raised concerns about nursing home (NH) residents' well-being, with recent studies indicating a significant increase in functional decline rate during this critical period. However, a comprehensive exploration of functional capacity trajectories in NH residents during the pandemic remains unexplored. This study aims to address this research gap by conducting an in-depth analysis of the impact of the COVID-19 pandemic on NH residents' functional capacity. METHODS A 24-month multicenter prospective study involving 123 NH residents from Spain, with data collected at 6-month intervals over 5 waves, starting just before the pandemic's onset. Functional capacity was assessed using the Modified Barthel Index, and data were analyzed employing the actuarial method, log-rank test, and Cox's regression. RESULTS AND DISCUSSION The likelihood of maintaining functional capacity was unfavorable, with only a 19.3% chance of preservation for a 1-point decline (FD-1) in Barthel scores and a 50.5% probability for a 10-point decline (FD-10). Personal hygiene, eating, and toilet use were identified as the most affected activities of daily living. Urinary continence decline emerged as a risk factor for FD-1, while fecal continence decline was associated with FD-10. The probability of maintaining functional capacity in the initial 6 months of a pandemic was comparable to a 2-year non-pandemic follow-up. Pandemic-induced isolation strategies significantly impacted toileting and personal hygiene. Urinary decline was associated with minor functional decline (FD-1), while fecal decline correlated with major functional decline (FD-10). Notably, the number of days spent in room confinement did not significantly contribute to the observed decline. CONCLUSIONS A substantial increase in the risk of FD among NH residents during the COVID-19 pandemic compared to the pre-pandemic period was found. It is crucial to implement urgent, targeted interventions that prioritize promoting physical activity and the implementation of mobility and toileting programs. These measures are pivotal for mitigating functional decline and enhancing the overall health and well-being of NH residents in a pandemic context.
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Affiliation(s)
- Pau Moreno-Martin
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Eduard Minobes-Molina
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Anna Escribà-Salvans
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Vinicius Rosa Oliveira
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Sandra Rierola-Fochs
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Pau Farrés-Godayol
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Pol Gràcia-Micó
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
| | - Dyego Leandro Bezerra de Souza
- Department of Collective Health, Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dawn A Skelton
- Research Center for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (MO), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life and Health Sciences in Central Catalonia (IRIS-CC), Vic, Spain
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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11
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Liu Y, Lan D, Zhou Y, Tian H, Xiao J, Gan L, Zhang Y. Role of subjective well-being and resilience in the relationship between hopelessness and suicidal ideation among older adults with moderate to severe ADL limitations in Chinese nursing homes. Geriatr Nurs 2024; 59:418-425. [PMID: 39141949 DOI: 10.1016/j.gerinurse.2024.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/11/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE Hopelessness is a risk factor for suicidal ideation, whereas subjective well-being and resilience are protective factors. Nevertheless, the complicated mechanism underlying these factors has not been fully investigated among older people with moderate to severe ADL limitations in nursing homes. This cross-sectional study investigated the potential role of resilience in mediating the relationship between hopelessness and suicidal ideation as well as whether subjective well-being can moderate this mediating effect. METHODS Older individuals (N = 332; aged ≥ 65 years; 158 males, 174 females) with moderate to severe ADL limitations from 10 nursing homes in Chongqing, China, completed this cross-sectional study from July to December 2022. Hopelessness, resilience, subjective well-being and suicidal ideation were measured. The mediating and moderating effects were explored via regression analysis with bootstrap methods. RESULTS A total of 32.8 % (109/332) of the participants reported current suicidal ideation. The relationship between suicidal ideation and hopelessness was partly influenced by resilience (indirect effect = 0.13, 95 % CI = 0.07∼.20). Subjective well-being moderated the impact of resilience on suicidal ideation (moderating effect = 0.01, 95 % CI = 0.00∼.01) and indirectly impacted the effect of hopelessness on suicidal ideation. CONCLUSION These results emphasize the importance of resilience and subjective well-being in mitigating suicidal ideation, which is a prevalent issue among older adults residing in nursing homes with moderate to severe ADL limitations in China.
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Affiliation(s)
- Ying Liu
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Ding Lan
- Department of Training center, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Yujing Zhou
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Hongmei Tian
- Department of Nursing, Faculty of Nursing, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Juan Xiao
- Department of Training center, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China
| | - Lu Gan
- Outpatient Department, Rehabilitation Facility for Retired Cadres, Shapingba District, Chongqing, 400038, China
| | - Yi Zhang
- Higher Education Research Institute, Chongqing Medical and Pharmaceutical College, Shapingba District, Chongqing, 401331, China.
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12
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Nitola-Mendoza L, Sánchez-Cárdenas M, Rodriguez-Chitiva N, Mora Gutiérrez JM, Rodriguez-Pena R, Romero-González G, Bleda Pérez M, Cuenca Casbas P, Calsina-Berna A, Álvaro-Pardo M, Granados Casas V, Garrido Ballart P, Beroiz Groh P, Bover J, Miralles Basseda R, Leiva-Santos JP, Alonso-Babarro A, Julià-Torras J. Nomenclature in Palliative and Kidney Supportive Care: Not Just at the End-of-Life. Nefrologia 2024:S2013-2514(24)00155-X. [PMID: 39127583 DOI: 10.1016/j.nefroe.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 05/14/2023] [Accepted: 05/19/2023] [Indexed: 08/12/2024] Open
Abstract
The multidimensional view of disease is fundamental in the care of complex diseases such as chronic kidney disease (CKD). It is appropriate to define and unify concepts that allow the different professionals involved in care to provide a multidisciplinary approach tailored to the needs of each individual. Given the increasing incidence of CKD worldwide and the fact that the disease may progress at different rates, there is a need to establish personalized, comprehensive approaches for each patient and their families at an earlier stage. This approach goes beyond the simple control of uremic symptoms or congestion and consists of addressing not only symptomatic but also functional, social and coping problems at an early stage, facilitating decision making both in the CKD and in acute situations, potentially irreversible or interventions that do not improve life expectancy. To ensure excellence in care, it is important to assess indicators of palliative care and kidney support, such as the presence of advance and shared care planning, the inclusion of psychosocial, ethical, spiritual and bereavement care. This enables the provision of comprehensive, humanized, and high-quality care for patients and their families. Palliative and kidney care is not just about patients in the last days of life. Defining, unifying, and evaluating the concepts will allow them to be applied in a timely manner at each specific moment of the CKD trajectory.
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Affiliation(s)
| | | | - Néstor Rodriguez-Chitiva
- Nephrology Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), REMAR- IGTP Group (Kidney-affecting Diseases Research Group), Badalona, Spain
| | - José María Mora Gutiérrez
- Nephrology Department, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Rosely Rodriguez-Pena
- Nephrology Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), REMAR- IGTP Group (Kidney-affecting Diseases Research Group), Badalona, Spain
| | - Gregorio Romero-González
- Nephrology Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), REMAR- IGTP Group (Kidney-affecting Diseases Research Group), Badalona, Spain; International Renal Research Institute of Vicenza, Vicenza, Italy
| | | | | | - Agnès Calsina-Berna
- Palliative Care Department, Catalan Institute of Oncology, Badalona, Spain; Chair of Palliative Care, Medical School, Universitat de Vic-Universitat Central de Catalunya, Spain
| | | | | | | | - Patricia Beroiz Groh
- Geriatrics Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Jordi Bover
- Nephrology Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), REMAR- IGTP Group (Kidney-affecting Diseases Research Group), Badalona, Spain
| | | | | | | | - Joaquim Julià-Torras
- Palliative Care Department, Catalan Institute of Oncology, Badalona, Spain; Faculty of Health Sciences, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
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13
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Lo YC, Chen CH, Shih CY, Toma O. Clinical frailty and short-term outcomes after low-energy pelvic fracture in the geriatric population: Nationwide inpatient sample 2016-2018 analysis. Bone 2024; 188:117225. [PMID: 39117161 DOI: 10.1016/j.bone.2024.117225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Pelvic fractures can be life-threatening for elderly individuals with diminished bone strength. Frailty is associated with fracture outcomes, but its impact on pelvic fracture recovery remains unexplored. The aim of this study was to investigate the association between frailty and short-term outcomes in older adults hospitalized for low-energy pelvic fractures. METHODS Data from the Nationwide Inpatient Sample (NIS) covering the years 2005 to 2018 were reviewed. Inclusion criteria were age ≥ 60 years admitted for a low-energy pelvic fracture. Patients were categorized into frail and non-frail groups using the 11-factor modified Frailty Index (mFI-11). Association between frailty and in-hospital outcomes were determined by univariate and multivariable regression analyses. RESULTS A total of 24,688 patients with pelvic fractures were included. The mean patient age was 80.6 ± 0.1 years, and 35 % were classified as frail. After adjustments, frailty was significantly associated with unfavorable discharge (adjusted odds ratio [aOR] = 1.07, 95 % confidence interval [CI]: 1.00-1.15, p = 0.038), prolonged hospitalization (aOR = 1.51, 95 % CI: 1.41-1.62, p < 0.001), complications (aOR = 1.42, 95 % CI:1.34-1.50, p < 0.001), and acute kidney injury (aOR = 1.68, 95 % CI: 1.56-1.82, p < 0.001). Stratified analyses based on age and fracture type showed frailty was consistently associated with adverse outcomes. CONCLUSIONS Persons ≥60 years old with mFI-11 assessed frailty and a low-energy pelvic fracture are at higher risk of adverse in-hospital outcomes than non-frail patients. Additional research is needed to disclose the prognostic impact of clinical frailty on long-term functional outcomes and quality of life after discharge.
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Affiliation(s)
- Yu-Cheng Lo
- Department of Orthopaedics Surgery, Changhua Christian Hospital, No. 135, Nanhsiao Street, Changhua 500, Taiwan.
| | - Chih-Hui Chen
- Department of Orthopaedics Surgery, Changhua Christian Hospital, No. 135, Nanhsiao Street, Changhua 500, Taiwan; Department of Post Baccalaureate Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung City 40227, Taiwan
| | - Chiu Yu Shih
- Department of Orthopaedics Surgery, Changhua Christian Hospital, No. 135, Nanhsiao Street, Changhua 500, Taiwan
| | - Omar Toma
- Department of Orthopaedic Surgery, Cambridge University hospital, Hills Rd, Cambridge CB2 0QQ, England, United Kingdom of Great Britain and Northern Ireland
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14
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Satorres E, Delhom I, Llopis J, Navarro-Prados AB, Bueno C, Meléndez JC. Addressing loneliness in older adults: predictors, protective factors, and implications for social work practice. SOCIAL WORK IN HEALTH CARE 2024:1-17. [PMID: 39097906 DOI: 10.1080/00981389.2024.2386277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
Loneliness significantly impacts the mental well-being of older adults, prompting an examination of psychological predictors and buffering factors associated with it in this demographic. A cross-sectional study involving 246 community-dwelling older adults was conducted. The UCLA Loneliness Scale identified predictors of loneliness, including negative mood, hopelessness (negative future expectations and loss of motivation), and despair. Buffering factors included ego-integrity, personal growth, and purpose in life. Regression analysis revealed that negative mood, negative future expectations, and despair increased loneliness, with negative mood showing a strong association. Conversely, ego-integrity, personal growth, and purpose in life reduced loneliness. The study underscores the complex interplay of psychological factors shaping loneliness in older adults, highlighting the importance of addressing both risk and protective factors. Social work practitioners in healthcare settings can play a pivotal role in addressing loneliness among older adults by leveraging these factors.
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Affiliation(s)
- Encarnacion Satorres
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia (Spain), Valencia, Spain
| | - Iraida Delhom
- Department of Psychology, Faculty of Health Sciences, Universidad Europea de Valencia (Spain), Valencia, Spain
| | - Judit Llopis
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia (Spain), Valencia, Spain
| | - Ana-Belén Navarro-Prados
- Department of Developmental Psychology, Faculty of Psychology, University of Salamanca (Spain), Salamanca, Spain
| | - Carmen Bueno
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia (Spain), Valencia, Spain
| | - Juan C Meléndez
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia (Spain), Valencia, Spain
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15
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Briggs ES, Thomas RM, Frost MC, Fletcher OV, Crothers K, Chalal CK, Shahrir SF, McClure JB, Catz SL, Williams EC. "I Thought Cancer was a Tobacco Issue": Perspectives of Veterans with and without HIV on Cancer and Other Health Risks Associated with Alcohol and Tobacco/Nicotine Use. AIDS Behav 2024; 28:2607-2618. [PMID: 38869757 DOI: 10.1007/s10461-024-04363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/14/2024]
Abstract
U.S. Veterans and people living with HIV (PWH) experience higher rates of unhealthy alcohol and tobacco/nicotine use than non-Veterans and people without HIV (PWoH). Both groups are susceptible to adverse health outcomes associated with alcohol and tobacco/nicotine use. We explored awareness of alcohol- and tobacco/nicotine-related cancer and immune health risks among Veterans Health Administration (VA) patients with and without HIV. Among a sample of 41 (46% PWH; 73% male; 39% Black) purposively-selected VA patients receiving care 2020-2021 we conducted semi-structured interviews via telephone; interviews were recorded, transcribed and analyzed using a Rapid Assessment Process. Purposive selection was based on HIV status, alcohol and/or tobacco/nicotine use, and demographics. Among participants, 66% reported current smoking, and most screened positive for unhealthy alcohol use. Participants had high awareness of cancer and other health risks related to smoking but low awareness of synergistic risks and cancer risks associated with alcohol use despite awareness of a range of other alcohol-related risks. Awareness of alcohol and/or tobacco/nicotine's impacts on the immune system was variable. Findings did not distinctly differ between PWH and PWoH. Low awareness of alcohol-related cancer risk, risks of co-occurring use, and varying awareness of the impacts of alcohol and tobacco/nicotine on the immune system suggest a need for improved messaging regarding substance use-related cancer and immune risk. This may be especially important among PWH, for whom the prevalence and adverse effects of alcohol and tobacco use, and immune dysfunction are higher.
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Affiliation(s)
- Elsa S Briggs
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA.
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
| | - Rachel M Thomas
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Madeline C Frost
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Olivia V Fletcher
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Kristina Crothers
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Clementine K Chalal
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
| | - Shahida F Shahrir
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Center for Health Workforce Studies, Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jennifer B McClure
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA
| | - Emily C Williams
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 3980 15th Ave NE, Seattle, WA, 98105, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
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Tabares Tabares M, Vélez Álvarez C, Bernal Salcedo J, Murillo Rendón S. Anxiety in young people: Analysis from a machine learning model. Acta Psychol (Amst) 2024; 248:104410. [PMID: 39032273 DOI: 10.1016/j.actpsy.2024.104410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
The study addresses the detection of anxiety symptoms in young people using artificial intelligence models. Questionnaires such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) are used to collect data, with a focus on early detection of anxiety. Three machine learning models are employed: Support Vector Machine (SVM), K Nearest Neighbors (KNN), and Random Forest (RF), with cross-validation to assess their effectiveness. Results show that the RF model is the most efficient, with an accuracy of 91 %, surpassing previous studies. Significant predictors of anxiety are identified, such as parental education level, alcohol consumption, and social security affiliation. A relationship is observed between anxiety and personal and family history of mental illness, as well as with characteristics external to the model, such as family and personal history of depression. The analysis of the results highlights the importance of considering not only clinical but also social and family aspects in mental health interventions. It is suggested that the sample size be expanded in future studies to improve the robustness of the model. In summary, the study demonstrates the usefulness of artificial intelligence in the early detection of anxiety in young people and highlights the relevance of addressing multidimensional factors in the assessment and treatment of this condition.
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Affiliation(s)
| | - Consuelo Vélez Álvarez
- Grupo Promoción de la Salud y Prevención de la Enfermedad, Universidad de Caldas, Colombia.
| | | | - Santiago Murillo Rendón
- Grupo Inteligencia Artificial, Universidad de Caldas, Colombia; Grupo Ingeniería de Software, Universidad Autónoma de Manizales, Colombia.
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Ibanez A, Maito M, Botero-Rodríguez F, Fittipaldi S, Coronel C, Migeot J, Lacroix A, Lawlor B, Duran-Aniotz C, Baez S, Santamaria-Garcia H. Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models. NATURE AGING 2024; 4:1153-1165. [PMID: 38886210 PMCID: PMC11333291 DOI: 10.1038/s43587-024-00648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/13/2024] [Indexed: 06/20/2024]
Abstract
Models of healthy aging are typically based on the United States and Europe and may not apply to diverse and heterogeneous populations. In this study, our objectives were to conduct a meta-analysis to assess risk factors of cognition and functional ability across aging populations in Latin America and a scoping review focusing on methodological procedures. Our study design included randomized controlled trials and cohort, case-control and cross-sectional studies using multiple databases, including MEDLINE, the Virtual Health Library and Web of Science. From an initial pool of 455 studies, our meta-analysis included 38 final studies (28 assessing cognition and 10 assessing functional ability, n = 146,000 participants). Our results revealed significant but heterogeneous effects for cognition (odds ratio (OR) = 1.20, P = 0.03, confidence interval (CI) = (1.0127, 1.42); heterogeneity: I2 = 92.1%, CI = (89.8%, 94%)) and functional ability (OR = 1.20, P = 0.01, CI = (1.04, 1.39); I2 = 93.1%, CI = (89.3%, 95.5%)). Specific risk factors had limited effects, especially on functional ability, with moderate impacts for demographics and mental health and marginal effects for health status and social determinants of health. Methodological issues, such as outliers, inter-country differences and publication bias, influenced the results. Overall, we highlight the specific profile of risk factors associated with healthy aging in Latin America. The heterogeneity in results and methodological approaches in studying healthy aging call for greater harmonization and further regional research to understand healthy aging in Latin America.
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Affiliation(s)
- Agustin Ibanez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile.
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA.
- University of Trinity Dublin, Dublin, Ireland.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
- Trinity College Dublin, Dublin, Ireland.
| | - Marcelo Maito
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Felipe Botero-Rodríguez
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia
- Fundación para la Ciencia, Innovación y Tecnología - Fucintec, Bogotá, Colombia
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Trinity College Dublin, Dublin, Ireland
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
| | - Carlos Coronel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
| | - Joaquin Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Andrea Lacroix
- Herbert Wertheim School of Public Health and Human Longevity Science, Health Sciences Office of Faculty Affairs, University California, San Diego (UCSD), San Diego, CA, USA
| | - Brian Lawlor
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Sandra Baez
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Universidad de los Andes, Bogotá, Colombia
| | - Hernando Santamaria-Garcia
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia.
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Fernández Alonso C, Fuentes Ferrer ME, García-Lamberechts EJ, Aguiló Mir S, Jiménez S, Jacob J, Piñera Salmerón P, Gil-Rodrigo A, Llorens P, Burillo-Putze G, Alquezar-Arbé A, Bretones Baena S, Fernández Cardona M, Hernández González R, Moreno Martín M, Barnes Parra A, El Farh I, Valle Borrego B, Quero Motto E, Artieda Larrañaga A, Soy Ferrer E, Hong Cho JU, Gros Bañeres B, Gayoso Martín S, Sánchez Sindín G, Prieto Zapico A, Cirera Lorenzo I, Guardiola Tey JM, Llauger L, González Del Castillo J, Miró Ò. Impact of dementia on 30-, 180-, and 365-day mortality during the first pandemic wave in older adults seen in spanish emergency departments diagnosed with or without COVID-19. Aging Ment Health 2024; 28:1110-1118. [PMID: 38597417 DOI: 10.1080/13607863.2024.2337144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To assess whether dementia is an independent predictor of death after a hospital emergency department (ED) visit by older adults with or without a COVID-19 diagnosis during the first pandemic wave. METHOD We used data from the EDEN-Covid (Emergency Department and Elderly Needs during Covid) cohort formed by all patients ≥65 years seen in 52 Spanish EDs from March 30 to April 5, 2020. The association of prior history of dementia with mortality at 30, 180 and 365 d was evaluated in the overall sample and according to a COVID-19 or non COVID diagnosis. RESULTS We included 9,770 patients aged 78.7 ± 8.3 years, 51.1% men, 1513 (15.5%) subjects with prior history of dementia and 3055 (31.3%) with COVID-19 diagnosis. 1399 patients (14.3%) died at 30 d, 2008 (20.6%) at 180 days and 2456 (25.1%) at 365 d. The adjusted Hazard Ratio (aHR) for age, sex, comorbidity, disability and diagnosis for death associated with dementia were 1.16 (95% CI 1.01-1.34) at 30 d; 1.15 at 180 d (95% CI 1.03-1.30) and 1.19 at 365 d (95% CI 1.07-1.32), p < .001. In patients with COVID-19, the aHR were 1.26 (95% CI: 1.04-1.52) at 30 days; 1.29 at 180 d (95% CI: 1.09-1.53) and 1.35 at 365 d (95% CI: 1.15-1.58). CONCLUSION Dementia in older adults attending Spanish EDs during the first pandemic wave was independently associated with 30-, 180- and 365-day mortality. This impact was lower when adjusted for age, sex, comorbidity and disability, and was greater in patients diagnosed with COVID-19.
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Affiliation(s)
- Cesáreo Fernández Alonso
- Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
| | - Manuel E Fuentes Ferrer
- Investigation Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Sira Aguiló Mir
- Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Sònia Jiménez
- Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Adriana Gil-Rodrigo
- Emergency Department, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | - Pere Llorens
- Emergency Department, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | | | - Aitor Alquezar-Arbé
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | - Ana Barnes Parra
- Emergency Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Imane El Farh
- Emergency Department, Hospital Francecs de Borja, Gandía, Spain
| | | | - Eva Quero Motto
- Emergency Department, Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Òscar Miró
- Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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19
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Félix J, Martínez de Toda I, Díaz-Del Cerro E, González-Sánchez M, De la Fuente M. Frailty and biological age. Which best describes our aging and longevity? Mol Aspects Med 2024; 98:101291. [PMID: 38954948 DOI: 10.1016/j.mam.2024.101291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/01/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
Frailty and Biological Age are two closely related concepts; however, frailty is a multisystem geriatric syndrome that applies to elderly subjects, whereas biological age is a gerontologic way to describe the rate of aging of each individual, which can be used from the beginning of the aging process, in adulthood. If frailty reaches less consensus on the definition, it is a term much more widely used than this of biological age, which shows a clearer definition but is scarcely employed in social and medical fields. In this review, we suggest that this Biological Age is the best to describe how we are aging and determine our longevity, and several examples support our proposal.
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Affiliation(s)
- Judith Félix
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Irene Martínez de Toda
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Estefanía Díaz-Del Cerro
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Mónica González-Sánchez
- Department of Genetics, Physiology, and Microbiology (Unit of Genetics), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Mónica De la Fuente
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
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20
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Michán-Doña A, Jiménez-Varo E, Escribano-Cobalea M, Casto-Jarillo C, López-Ceres A, Campos-Dávila E, Hormigo-Pozo A, Nieto-Ordoñez C, Rodríguez-Juliá MÁ, Escribano-Serrano J. Prevalence and characteristics of anemia in patients with diabetes mellitus aged 50 or older in health unit area of Cadiz (Spain). Rev Clin Esp 2024; 224:457-465. [PMID: 38879004 DOI: 10.1016/j.rceng.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/27/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Anemia is a common comorbidity in patients with diabetes mellitus (DM), particularly in older adults. However, there is a lack of data on the prevalence and the characteristics of anemia in this population in Spain. OBJECTIVE To describe the prevalence and the characteristics of anemia in patients with DM aged 50 or older (PDM50) in a healthcare district in the province of Cádiz. METHODS A retrospective cross-sectional study was conducted that included outpatient's laboratory tests (OLT) performed over 30 months at PDM50. RESULTS The prevalence of anemia was 29.9% (95% CI: 28.7%-31.1%), predominating in women (33.3% vs 26.7%; P < 0.01), in older people stratified by decades (61.7% in 9th decade vs 12% in 5th decade; P < 0.01), and in those with kidney disease (44.7% vs 28%; P < 0.01). Most cases were mild (68.3%), normocytic (78.7%), and hypochromic (52%). Similarly, moderate-to-severe anemia was more frequent in women (39% vs 23%), their prevalence increased with age (45% in the 9th decade vs 24% in the 5th decade), and with the progression of kidney damage, either measured by a decreased glomerular filtration rate (GFR) (49% in G4 vs 25% in G1), or the presence of albuminuria (P < 0.01). No association was found between DM control, based on glycated hemoglobin (HbA1c), and anemia in either sex (P = 0.887). CONCLUSION This study describes a high prevalence of anemia in PDM50, particularly in women, in the most advantageous people and in the presence of kidney disease, even in early stages, highlighting the clinical importance of this coexistence.
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Affiliation(s)
- A Michán-Doña
- Departamento de Medicina, HU Jerez de la Frontera, AGS Norte de Cádiz, Universidad de Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - E Jiménez-Varo
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - M Escribano-Cobalea
- UGC Obstetricia y Ginecología, HU Punta de Europa de Algeciras, AGS Campo de Gibraltar Oeste, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - C Casto-Jarillo
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - A López-Ceres
- UGC Laboratorio Análisis Clínicos, HU la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - E Campos-Dávila
- UGC Farmacia, Hospital de la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - A Hormigo-Pozo
- UGC San Andrés Torcal, AGS Málaga Guadalhorce, Málaga, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - C Nieto-Ordoñez
- UGC San Roque, San Roque, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - M Á Rodríguez-Juliá
- UGC Velada, la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - J Escribano-Serrano
- UGC Velada, la Línea de la Concepción, AGS Campo de Gibraltar Este, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
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21
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Della-Morte D, Pacifici F, Simonetto M, Dong C, Dueker N, Blanton SH, Wang L, Rundek T. The role of sirtuins and uncoupling proteins on vascular aging: The Northern Manhattan Study experience. Free Radic Biol Med 2024; 220:262-270. [PMID: 38729451 DOI: 10.1016/j.freeradbiomed.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Aging affects all organs. Arteries, in particular, are among the most affected. Vascular aging (VA) is defined as age-associated changes in function and structure of vessels. Classical VA phenotypes are carotid intima-media thickness (IMT), carotid plaque (CP), and arterial stiffness (STIFF). Individuals have different predisposition to these VA phenotypes and their associated risk of cardiovascular events. Some develop an early vascular aging (EVA), and others are protected and identified as having supernormal vascular aging (SUPERNOVA). The mechanisms leading to these phenotypes are not well understood. In the Northern Manhattan Study (NOMAS), we found genetic variants in the 7 Sirtuins (SIRT) and 5 Uncoupling Proteins (UCP) to be differently associated with risk to developing VA phenotypes. In this article, we review the results of genetic-epidemiology studies to better understand which of the single nucleotide polymorphisms (SNPs) in SIRT and UCP are responsible for both EVA and SUPERNOVA.
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Affiliation(s)
- David Della-Morte
- Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, 00133, Rome, Italy; Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA; Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166, Rome, Italy.
| | - Francesca Pacifici
- Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, 00133, Rome, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Marialaura Simonetto
- Department of Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, 10021, USA
| | - Chuanhui Dong
- Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Nicole Dueker
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Susan H Blanton
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Liyong Wang
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Tatjana Rundek
- Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
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22
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Aguilar-Palacio I, Maldonado L, Malo S, Castel-Feced S, Cebollada A, Aguilar-Latorre A, Rabanaque MJ. Differences in healthcare use and mortality in older adults during the COVID-19 pandemic: Exploring long-term care users' vulnerability. Heliyon 2024; 10:e34840. [PMID: 39148983 PMCID: PMC11324964 DOI: 10.1016/j.heliyon.2024.e34840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/05/2024] [Accepted: 07/17/2024] [Indexed: 08/17/2024] Open
Abstract
Background The objective of our study is to analyze the health care received by older adults with COVID-19 according to their place of residence (whether or not they live in a long-term care [LTC] facility) and to find out the effect of health care on mortality. Methods Retrospective cohort study based in Aragón (Spain) from March 2020 to March 2021 in patients aged 65 years or older with a confirmed COVID-19 infection. The population was classified according to their place of residence (living in a LTC or not). A propensity score was used to match individuals by sex and age. The effect of living in a LTC facility on healthcare delivery and mortality was conducted using adjusted multivariate models. Varimp was used to estimate the best predictors of mortality for both groups. Results Healthcare services utilization varied depending on whether the patients lived in a LTC facility or not. The time to diagnosis was shorter in institutionalized patients, but the time to hospital admission was longer. Length of hospital stays, risk of ICU admission and 30-day mortality were also different and remained statistically significant in the adjusted models. The variables that were more important in the association between healthcare utilization and mortality were those associated with greater severity of COVID-19. Conclusions There were differences in health care for older adults diagnosed with COVID-19 according to their place of residence. There is a need to strengthen collaboration between professionals in LTC centers and health services to provide equitable health care.
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Affiliation(s)
- Isabel Aguilar-Palacio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Lina Maldonado
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Department of Applied Economics, University of Zaragoza, Zaragoza, Spain
| | - Sara Malo
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Sara Castel-Feced
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Alberto Cebollada
- Biocomputing Unit, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
- Aragonese Primary Care Research Group (GAIAP), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - M José Rabanaque
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
- Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Health Institute (ISCIII), Madrid, Spain
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23
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Medina Ortega JÁ, Urrutia Besaskoa A, Álvarez-Rodríguez E, Martin Carrasco P, Navas Ara MJ. [Use of physical restraints in the elderly in an emergency department. Analysis of clinical, environmental and health care team organization factors associated with decision making]. Rev Esp Geriatr Gerontol 2024; 59:101533. [PMID: 39053084 DOI: 10.1016/j.regg.2024.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJETIVE To determine the influence of different factors involved in the decision to apply physical restraints (PR) in the management the elderly people with conduct disorders in an emergency department (ED) METHODS: A prospective observational study was conducted in the ED of the Hospital Universitario Severo Ochoa (Leganés, Madrid). We included 125 elderly people with disruptive behaviors and collected clinical, patient handling, organizational and environmental variables. Individuals who had undergone PR were analyzed to learn what factors were related to the final decision to restrain. RESULTS 32.8% of the participants underwent PR. The aspects that most influenced the decision to restrain were those related to the organization and environment: specific staff training decreased the probability of restraint by 50% (P<.05) and good support from the whole team reduced the risk of using SF by up to 75% (P<.0005). Related patient handling factors such as verbal restraint, pain relief, family accompaniment and early mobilization significantly reduced the use of PR (P<.05). The only patient-dependent clinical aspect that increased the risk of SF was male sex (P<.05). Other factors unrelated to the probability of applying PR were, among others, nurse-patient ratio, type of behavior, age, or functional/cognitive status. CONCLUSIONS Exclusively clinical factors of the patient had little influence on the decision to restrain the elderly in an ED. However, environmental, organizational, and behavioral handling variables could favor more respectful alternatives and thus reduce the use of PR in the elderly with disruptive behaviors in the ED.
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Affiliation(s)
| | - Ana Urrutia Besaskoa
- Servicio de Urgencias Generales, Hospital Universitario Severo Ochoa, Leganés, Madrid, España; Fundación Cuidados Dignos
| | | | - Paloma Martin Carrasco
- Servicio de Urgencias Generales, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - María José Navas Ara
- Servicio de Urgencias Generales, Hospital Universitario Severo Ochoa, Leganés, Madrid, España; Metodología de las Ciencias de Comportamiento, Facultad de Psicología de la UNED, Madrid, España
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24
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Jiménez-Domínguez C, Mateos-Nozal J, Figueroa-Lin Kí C, Rexach-Cano L. [Advance care planning in nursing homes: about a case]. Rev Esp Geriatr Gerontol 2024; 59:101528. [PMID: 39053081 DOI: 10.1016/j.regg.2024.101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/11/2024] [Indexed: 07/27/2024]
Affiliation(s)
| | - Jesus Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España
| | | | - Lourdes Rexach-Cano
- Unidad de Cuidados Paliativos, Hospital Universitario Ramón y Cajal, Madrid, España
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25
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Beirão S, Costa JG, Ferreira-Pêgo C. Assessing knowledge and awareness of Food and Drug Interactions among nutrition sciences students: Implications for education and clinical practice. Nutr Health 2024:2601060241263409. [PMID: 39042902 DOI: 10.1177/02601060241263409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
BACKGROUND Chronic diseases and polymedication increase the risk of food-drug interactions (FDIs) among the population, negatively impacting health. Nutritionists, as responsible for dietary planning, have a key role in preventing these events. AIM To assess the knowledge about FDIs among a sample of Nutrition Sciences Bachelor students. METHODS A descriptive cross-sectional observational study was conducted, involving 44 students from the 3rd and 4th academic years of different Portuguese universities during the 2023/2024 academic year. Participants completed a self-reported questionnaire, covering general and specific FDIs knowledge, academic background, and perceptions regarding FDIs importance and training adequacy. RESULTS Results revealed a general lack of FDIs knowledge among participants, particularly in identifying specific interactions and appropriate dietary management. While half of the students reported exposure to a subject dedicated to FDIs, only 18.18% considered the knowledge acquired sufficient. Nearly all participants (93.18%) expressed the need for further training in FDIs during their undergraduate course. Furthermore, none of the participants had received additional training or attended workshops on FDIs. Specifically, participants struggled to identify appropriate dietary choices in conjunction with certain medications. Moreover, only a minority of participants demonstrated awareness of the ideal timing for medication intake relative to food consumption. Despite these knowledge gaps, participants recognized the importance of FDIs knowledge for future clinical practice. CONCLUSION Bridging these knowledge gaps through targeted educational interventions and interdisciplinary collaboration is essential to ensure future nutrition professionals are equipped to address the complex challenges posed by FDIs in professional practice.
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Affiliation(s)
- Sofia Beirão
- Escola de Ciências e Tecnologias da Saúde, Universidade Lusófona, Lisboa, Portugal
| | - João G Costa
- CBIOS Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - Cíntia Ferreira-Pêgo
- CBIOS Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
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26
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Meng R, Ying Y, Luo Y, Huang M, Miller CB, Xie Y, Jia Y, Fan L, Chen W, Yi J, Yang N, Xu J, Jiang C, Lu L, Ma H, Spruyt K, Lau EYY. A longitudinal examination of the measurement properties and invariance of the Sleep Condition Indicator in Chinese healthcare students. BMC Psychiatry 2024; 24:518. [PMID: 39039484 PMCID: PMC11264982 DOI: 10.1186/s12888-024-05844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/13/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population. METHODS Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI. RESULTS We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829). CONCLUSION The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.
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Affiliation(s)
- Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China.
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China.
| | - Yiwei Ying
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | | | - Yuhuan Xie
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yuxin Jia
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Lianxia Fan
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Wukang Chen
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jiayu Yi
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Liping Lu
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot, INSERM, Paris, France
| | - Esther Yuet Ying Lau
- Sleep Laboratory, Department of Psychology, The Education University of Hong Kong, Hong Kong, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, China
- Centre for Religious and Spirituality Education, The Education University of Hong Kong, Hong Kong, China
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López-García M, Jiménez-Rejano JJ, Suárez-Serrano CM. Telerehabilitation: Vestibular Physiotherapy vs. Multicomponent Exercise for Functional Improvement in Older Adults: Randomized Clinical Trial. J Clin Med 2024; 13:4279. [PMID: 39064319 PMCID: PMC11277823 DOI: 10.3390/jcm13144279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
The loss of vestibular and motor function can occur naturally with aging. Vestibular physiotherapy exercises (VE) specifically address vestibular rehabilitation to reduce imbalances and improve physical condition, like therapeutic exercise (TE). During COVID-19, technology was used with the elderly for implementation. Objective: to determine if vestibular exercises are as effective as multicomponent exercises in improving functional capacity using technological tools. Methods: A randomized clinical trial compared two intervention groups of 21 subjects with functional limitations and frailty (average age 76.11 years). The intervention involved multicomponent exercise for the control group (Vivifrail protocol) and vestibular exercises for the experimental group (Cawthorne and Cooksey exercises) for 6 weeks with five sessions per week both groups. Two professionals implemented the exercises, and participants received tailored exercise videos. Primary outcomes were gait speed, dynamic balance, and physical capacity. Results: Both groups showed significant improvements. For physical function measured by SPPB (0-12 points), the multicomponent exercise group improved by 1.97 (0.91; 3.03), p < 0.001, and the vestibular exercise group improved by 1.63 (0.65; 2.60), p = 0.002. For dynamic balance measured by the Timed Up and Go (TUG) test, the multicomponent exercise group improved by -0.88 (-1.33; -0.42), p < 0.001, and the vestibular exercise group improved by -0.79 (-1.21; -0.37), p < 0.001. There were no significant differences between groups. Finally, regarding gait speed, there were no differences in either group between pretest and post-test (p > 0.05). Conclusions: Both multicomponent exercise and vestibular exercises improve functional capacities via telerehabilitation as measured by the SPPB, although vestibular physiotherapy does not show superior outcomes compared to the control group.
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Affiliation(s)
- Marina López-García
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (J.J.J.-R.); (C.M.S.-S.)
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Niebla-Cárdenas A, Bueno-Hernández N, Hernández AP, Fuentes M, Méndez-Sánchez R, Arroyo-Anlló EM, Orera I, Lattanzio G, Juanes-Velasco P, Arias-Hidalgo C, Puente-González AS. Potential protein biomarkers in saliva for detection of frailty syndrome by targeted proteomics. Mech Ageing Dev 2024; 221:111974. [PMID: 39038666 DOI: 10.1016/j.mad.2024.111974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/23/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
Frailty is a physiological geriatric syndrome, caused by immunosenescence, inflammation and alterations at the protein level leading to metabolic and microbiota changes. Currently, this syndrome is evaluated clinically with the Frailty-VIG index. The aim of the study was therefore to investigate the potential suitability of saliva as a non-invasive proximal biological fluid for the characterisation and identification of possible protein-level biomarkers in frailty syndrome. This cross-sectional study was conducted in a rural population of older Spanish adults using the SMR proteomics technique. A differential protein profile of eight potential and surrogate proteins (CYTC, CYTD, CYTS, CYTB, MIF, ALBU, CD44 and B2MG) was detected in saliva, all of which correlated with factors characterising frailty syndrome, such as vascular ageing (arterial stiffness and cardiovascular disease), obesity, mood problems, global cognitive impairment, changes in gait and hand pressure strength. The proteins CYTD (r = 0.415, p = 0.013) and CYTC (r = 0.280, p = 0.026), which were detected differentially in the protein profile, were associated with the Frailty-VIG index. All analysed proteins are associated not only with the clinical symptoms of frailty syndrome, but also with an acute inflammatory response, endothelial cell proliferation and the complement system, among others.
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Affiliation(s)
- Alfonssina Niebla-Cárdenas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain
| | - Nallely Bueno-Hernández
- Laboratory for Proteomics and Metabolomics, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City 06720, Mexico
| | - Angela-Patricia Hernández
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain; Department of Pharmaceutical Sciences: Organic Chemistry, Faculty of Pharmacy, University of Salamanca, CIETUS, IBSAL, Salamanca 37007, Spain
| | - Manuel Fuentes
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca, Spain
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain; Institute of Biomedical Research of Salamanca (IBSAL). Physiotherapy, functional recovery and therapeutic exercise group, Salamanca 37007, Spain
| | - Eva María Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, Faculty of Psychology, University of Salamanca, Salamanca 37007, Spain
| | - Irene Orera
- Proteomics Research Core Facility, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza 50009, Spain
| | - Giuseppe Lattanzio
- Proteomics Research Core Facility, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza 50009, Spain
| | - Pablo Juanes-Velasco
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain
| | - Carlota Arias-Hidalgo
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca 37007, Spain
| | - Ana Silvia Puente-González
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, Salamanca 37007, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca, Spain.
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García-Marichal C, Aguilar-Jerez MF, Delgado-Plasencia LJ, Pérez-Hernández O, Armas-González JF, Pelazas-González R, Martín-González C. A Primary Health Care Program and COVID-19. Impact in Hospital Admissions and Mortality. J Gen Intern Med 2024:10.1007/s11606-024-08912-6. [PMID: 39023662 DOI: 10.1007/s11606-024-08912-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Most patients with mild or moderate COVID infection did not require hospital admission, but depending on their personal history, they needed medical supervision. In monitoring these patients in primary care, the design of specific surveillance programs was of great help. Between February 2021 and March 2022, EDCO program was designed in Tenerife, Spain, to telemonitor patients with COVID infection who had at least one vulnerability factor to reduce hospital admissions and mortality. OBJECTIVE The aim of this study is to describe the clinical course of patients included in the EDCO program and to analyze which factors were associated with a higher probability of hospital admission and mortality. DESIGN Retrospective cohort study. PATIENTS We included 3848 patients with a COVID-19 infection age over 60 years old or age over 18 years and at least one vulnerability factor previously reported in medical history. MAIN MEASURES Primary outcome was to assess risk of admission or mortality. KEY RESULTS 278 (7.2%) patients required hospital admission. Relative risks (RR) of hospital admission were oxygen saturation ≤ 92% (RR: 90.91 (58.82-142.86)), respiratory rate ≥ 22 breaths per minute (RR: 20.41 (1.19-34.48), obesity (RR: 1.53 (1.12-2.10), chronic kidney disease (RR:2.31 (1.23-4.35), ≥ 60 years of age (RR: 1.44 (1.04-1.99). Mortality rate was 0.7% (27 patients). Relative risks of mortality were respiratory rate ≥ 22 breaths per minute (RR: 24.85 (11.15-55.38), patients with three or more vulnerability factors (RR: 4.10 (1.62-10.38), oxygen saturation ≤ 92% (RR: 4.69 (1.70-15.15), chronic respiratory disease (RR: 3.32 (1.43-7.69) and active malignancy (RR: 4.00 (1.42-11.23). CONCLUSIONS Vulnerable patients followed by a primary care programme had admission rates of 7.2% and mortality rates of 0.7%. Supervision of vulnerable patients by a Primary Care team was effective in the follow-up of these patients with complete resolution of symptoms in 91.7% of the cases.
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Affiliation(s)
| | | | | | | | | | | | - Candelaria Martín-González
- Hospital Universitario de Canarias, San Cristóbal De La Laguna, Spain.
- Universidad de La Laguna, San Cristóbal De La Laguna, Spain.
- Departamento de Medicina Interna, Dermatología y Psiquiatría, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Canary Islands, Tenerife, Spain.
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30
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Berger A, Castilhos RM, Ismail Z, Camozzato A. Prevalence of psychotic symptoms in mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2024; 100:102431. [PMID: 39029803 DOI: 10.1016/j.arr.2024.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024]
Abstract
INTRODUCTION Neuropsychiatric symptoms may impact prognosis in individuals with mild cognitive impairment (MCI); however, data on frequency of psychotic symptoms are sparse. METHODS We searched MEDLINE, EMBASE, PsychoINFO from inception to June 2023. We included studies reporting patients with MCI prevalence of (delusions and/or hallucinations. Random effects model were performed to estimate the prevalence, and subgroup and meta-regression analyses were performed to explore heterogeneity. RESULTS Of 3145 records identified, 36 studies were included, enrolling 20,426 patients. Overall prevalence of hallucinations was 1.78 % (95 % CI, 1.17 - 2.71) and delusions 3.84 % (95 % CI, 2.71 - 5.42), both with significant heterogeneity (/2 = 90 %). Prevalence of hallucinations and delusions were lower when measured by NPI scales and in population-based samples. DISCUSSION Delusions and hallucinations occur in MCI patients at low rates. Prevalence can be partially explained by the assessment method, sample source and study heterogeneity.
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Affiliation(s)
- Aline Berger
- Programa de Pós-Graduação em Ciências Médicas da Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | | | - Zahinoor Ismail
- Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Analuiza Camozzato
- Programa de Pós-Graduação em Ciências Médicas da Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
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Patil U, Braun KL. Interventions for loneliness in older adults: a systematic review of reviews. Front Public Health 2024; 12:1427605. [PMID: 39091527 PMCID: PMC11291379 DOI: 10.3389/fpubh.2024.1427605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Loneliness in older persons is a major risk factor for adverse health outcomes. Before the COVID-19 pandemic led to unprecedented isolation and hampered programs aimed at preventing or reducing loneliness, many interventions were developed and evaluated. However, previous reviews provide limited or conflicting summaries of intervention effectiveness. This systematic review aimed to assess previous review quality and bias, as well as to summarize key findings into an overarching narrative on intervention efficacy. The authors searched nine electronic databases and indices to identify systematic reviews of interventions to reduce loneliness in older people prior to the COVID-19 pandemic; 6,925 records were found initially. Of these, 19 reviews met inclusion criteria; these encompassed 101 unique primary intervention studies that varied in research design, sample size, intervention setting, and measures of loneliness across 21 nations. While 42% of reviews had minimal risk of bias, only 8% of primary studies appraised similarly. Among the 101 unique articles reviewed, 63% of tested interventions were deemed by article author(s) as effective or partially effective. Generally, interventions that included animals, psychological therapies, and skill-building activities were more successful than interventions focused on social facilitation or health promotion. However, interventions that targeted multiple objectives aimed at reducing loneliness (e.g., improving social skills, enhancing social support, increasing social opportunities, and changing maladaptive social cognition) were more effective than single-objective interventions. Future programs should incorporate multiple approaches, and these interventions should be rigorously tested.
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Affiliation(s)
- Uday Patil
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaiʻi at Mānoa, Honolulu, HI, United States
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Dusi R, Trombini RRDSL, Pereira ALM, Funghetto SS, Ginani VC, Stival MM, Nakano EY, Zandonadi RP. Construction and Content Validation of Mobile Devices' Application Messages about Food and Nutrition for DM2 Older Adults. Nutrients 2024; 16:2306. [PMID: 39064750 PMCID: PMC11280354 DOI: 10.3390/nu16142306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Older adults face a decline in the quality of their diet, which affects their health. The prevalence of DM2 is increasing, as are the associated complications. Effective nutrition education and mobile health (mHealth) interventions offer a viable solution in the scenario of the widespread use of mobile devices. This study aimed to develop and validate messages for a mobile application aimed at older adult Brazilians with DM2 who receive care at the Brazilian Unified Health System (SUS). The educational messages on healthy eating for older adults with DM2 were created from 189 excerpts selected from Brazilian official documents. A total of 37 messages were created, categorized into 20 educational, 12 motivational, and 5 congratulatory, all up to 120 characters. Twenty-one experts validated the messages for clarity and relevance, and 11 messages had to be revised to meet the criteria. Subsequently, the 36 messages approved by the experts were tested on a sample of 57 older adults, guaranteeing clarity rates of over 80%. This study developed and validated 36 messages for a mobile health app aimed at older adults with type 2 diabetes mellitus in Brazil. Expert evaluation ensured clarity and relevance, confirmed by older adult participants who evaluated clarity. This research highlights the potential of mHealth to overcome barriers to accessing healthcare in the SUS, emphasizing personalized interventions for the effective management of older adults' health.
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Affiliation(s)
- Rafaella Dusi
- University of Brasília, Faculty of Health Sciences, Department of Nutrition, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil;
| | - Raiza Rana de Souza Lima Trombini
- University of Brasília, Graduate Program in Health Sciences and Technologies, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.R.d.S.L.T.); (A.L.M.P.); (S.S.F.); (M.M.S.)
| | - Alayne Larissa Martins Pereira
- University of Brasília, Graduate Program in Health Sciences and Technologies, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.R.d.S.L.T.); (A.L.M.P.); (S.S.F.); (M.M.S.)
| | - Silvana Schwerz Funghetto
- University of Brasília, Graduate Program in Health Sciences and Technologies, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.R.d.S.L.T.); (A.L.M.P.); (S.S.F.); (M.M.S.)
| | - Verônica Cortez Ginani
- University of Brasília, Faculty of Health Sciences, Department of Nutrition, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil;
| | - Marina Morato Stival
- University of Brasília, Graduate Program in Health Sciences and Technologies, Campus Universitario Ceilândia, Brasília 72220-275, Brazil; (R.R.d.S.L.T.); (A.L.M.P.); (S.S.F.); (M.M.S.)
| | - Eduardo Yoshio Nakano
- University of Brasília, Department of Statistics, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil;
| | - Renata Puppin Zandonadi
- University of Brasília, Faculty of Health Sciences, Department of Nutrition, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil;
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Malgrat-Caballero S, Kannukene A, Orrego C. Instruments and Warning Signs for Identifying and Evaluating the Frequency of Adverse Events in Intermediate and Long-Term Care Centres: A Narrative Systematic Review. J Healthc Qual Res 2024:S2603-6479(24)00054-X. [PMID: 39013688 DOI: 10.1016/j.jhqr.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/27/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION There is a lack of data about adverse events (AE) in intermediate and long-term care centers (ILCC). We aimed to synthesize the available scientific evidence on instruments used to identify and characterize AEs. We also aimed to describe the most common adverse events in ILCCs. MATERIAL AND METHODS A narrative systematic review of the literature was conducted according to Prisma recommendations. The PubMed database was searched for articles published between 2000 and 2021. Two reviewers independently screened and reviewed the studies through blind and independent review. We evaluated bias risk with Cochrane's risk of bias tool. Disagreements were resolved by consensus. Discrepancies that were not resolved by discussion were discussed with a third reviewer. Descriptive data was extracted and qualitative content analysis was performed. RESULTS We found 2191 articles. Based on the inclusion and exclusion criteria, 272 papers were screened by title and abstract, and 66 studies were selected for full review. The instruments used to identify AEs were mostly tools to identify specific AEs or risks of AEs (94%), the remaining 6% were multidimensional. The most frequent categories detected medication-related AEs (n=26, 40%); falls (n=7, 11%); psychiatric AEs (6.9%); malnutrition (4.6%), and infections (4.6%). The studies that used multidimensional tools refer to frailty, dependency, or lack of energy as predictors of AEs. However, they do not take into account the importance of detecting AEs. We found 2-11 adverse drug events (ADE) per resident/month. We found a prevalence of falls (12.5%), delirium (9.6-89%), pain (68%), malnutrition (2-83%), and pressure ulcers (3-30%). Urinary tract infections, lower respiratory tract infections, skin and soft tissue infections, and gastroenteritis were the most common infections in this setting. Transitions between different care settings (from hospitals to ILCC and vice versa) expose AE risk. CONCLUSION There are many instruments to detect AEs in ILCC, and most have a specific approach. Adverse events affect a significant proportion of patients in ILCC, the nurse-sensitive outcomes, nosocomial infections, and adverse drug events are among the most common. The systematic review was registered with Prospero, ID: CRD42022348168.
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Affiliation(s)
- S Malgrat-Caballero
- Centre d'Atenció Intermèdia, Parc Sanitari Pere Virgili, Barcelona, Spain; REFiT-BCN (Research Group on Aging, Frailty and Care Transitions in Barcelona), VHIR (Vall d'Hebron Research Institute), Barcelona, Spain; Programa de Doctorat Interuniversitari de Cures Integrals i Serveis de Salut, Universitat de Vic-Universitat Central de Catalunya, Spain.
| | - A Kannukene
- University of Tartu, Junior Researcher and PhD Student L. Puusepa 8, 50406 Tartu, Estonia
| | - C Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; Faculty of Medicine, Universitat Autónoma de Barcelona (UAB), 08025 Barcelona, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
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Infante Hernández S, Gómez Rivas J, Moreno Sierra J. Benign prostatic hyperplasia. Med Clin (Barc) 2024:S0025-7753(24)00307-5. [PMID: 39013719 DOI: 10.1016/j.medcli.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 07/18/2024]
Abstract
Benign prostatic hyperplasia (BPH) is a histopathologic definition associated with enlargement of the prostate gland that causes obstruction of the lower urinary tract and manifests clinically with characteristic symptoms that are what bring patients for consultation. Urinary tract symptoms are common, especially in an increasingly aging population. Diagnosis and the decision on when and how to treat depend on the patient's quality of life and objective clinical parameters. An individualized, risk-based approach is necessary to guide conservative, pharmacologic, or surgical treatment.
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Affiliation(s)
| | - Juan Gómez Rivas
- Servicio de Urología, Hospital Clínico San Carlos, Madrid, España; Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, Sección de Urología, Madrid, España
| | - Jesús Moreno Sierra
- Servicio de Urología, Hospital Clínico San Carlos, Madrid, España; Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, Sección de Urología, Madrid, España
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Rodriguez-Espeso EA, Verdejo-Bravo C, Cherubini A, Gudmundsson A, Petrovic M, Soiza RL, O'Mahony D, Cruz-Jentoft AJ. The Association of Dementia With Incident Adverse Drug Reactions in Hospitalized Older Adults. J Am Med Dir Assoc 2024; 25:105151. [PMID: 39013474 DOI: 10.1016/j.jamda.2024.105151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Older adults with dementia commonly receive multiple medications and have higher hospitalization rates, elevating the risk of potentially inappropriate prescribing and in-hospital adverse drug reactions (ADRs). There is limited evidence examining ADRs in older adults with dementia during hospitalization. OBJECTIVES Our aim was to assess the association between dementia and incidence of ADRs during hospitalization and to identify prevalent types of ADRs and medications linked to ADRs. DESIGN Secondary analysis of the SENATOR trial database, which was a randomized controlled trial of an intervention to reduce ADRs in older inpatients with multimorbidity. SETTING AND PARTICIPANTS A total of 1537 patients (47.2% females) with a mean age of 78.1 years were recruited from 6 European hospitals. METHODS Sociodemographic data, functional status, cognitive status, clinical information, and ADR-related outcomes were extracted from the SENATOR database. Inpatients with dementia were identified based on prior International Classification of Diseases, Tenth Revision (ICD-10), dementia diagnosis, receiving acetylcholinesterase inhibitors or memantine, or a Mini-Mental State Examination score ≤24 at admission without concurrent delirium. RESULTS Among participants, 392 (25.5%) were identified as having dementia. The proportion of patients with probable or certain incident in-hospital ADRs was similar between the groups with and without dementia (22.4% vs 25.4%, P > .05). However, in-hospital rates of probable or certain ADRs from 12 common categories were less frequently identified in patients with dementia compared to those without (19.4% vs 23%, P = .025). Major constipation (6.4% vs 9.9%, P = .03) and acute dyspepsia, nausea, or vomiting (2.8% vs 5%, P = .03) were less commonly observed ADRs in patients with dementia. CONCLUSIONS AND IMPLICATIONS We did not observe an increased risk of in-hospital ADRs among inpatients with dementia. However, ADRs related to the gastrointestinal tract and identified by subjective symptoms were less frequently identified in this group. This study lays the groundwork for developing new tools for ADR diagnosis for older patients with dementia.
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Affiliation(s)
| | | | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | - Roy L Soiza
- Ageing Clinical and Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom; Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland, United Kingdom
| | - Denis O'Mahony
- Department of Medicine (Geriatrics), School of Medicine, University College Cork, Cork, Ireland
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Kong SH, Cho W, Park SB, Choo J, Kim JH, Kim SW, Shin CS. A Computed Tomography-Based Fracture Prediction Model With Images of Vertebral Bones and Muscles by Employing Deep Learning: Development and Validation Study. J Med Internet Res 2024; 26:e48535. [PMID: 38995678 PMCID: PMC11282387 DOI: 10.2196/48535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 01/27/2024] [Accepted: 05/30/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND With the progressive increase in aging populations, the use of opportunistic computed tomography (CT) scanning is increasing, which could be a valuable method for acquiring information on both muscles and bones of aging populations. OBJECTIVE The aim of this study was to develop and externally validate opportunistic CT-based fracture prediction models by using images of vertebral bones and paravertebral muscles. METHODS The models were developed based on a retrospective longitudinal cohort study of 1214 patients with abdominal CT images between 2010 and 2019. The models were externally validated in 495 patients. The primary outcome of this study was defined as the predictive accuracy for identifying vertebral fracture events within a 5-year follow-up. The image models were developed using an attention convolutional neural network-recurrent neural network model from images of the vertebral bone and paravertebral muscles. RESULTS The mean ages of the patients in the development and validation sets were 73 years and 68 years, and 69.1% (839/1214) and 78.8% (390/495) of them were females, respectively. The areas under the receiver operator curve (AUROCs) for predicting vertebral fractures were superior in images of the vertebral bone and paravertebral muscles than those in the bone-only images in the external validation cohort (0.827, 95% CI 0.821-0.833 vs 0.815, 95% CI 0.806-0.824, respectively; P<.001). The AUROCs of these image models were higher than those of the fracture risk assessment models (0.810 for major osteoporotic risk, 0.780 for hip fracture risk). For the clinical model using age, sex, BMI, use of steroids, smoking, possible secondary osteoporosis, type 2 diabetes mellitus, HIV, hepatitis C, and renal failure, the AUROC value in the external validation cohort was 0.749 (95% CI 0.736-0.762), which was lower than that of the image model using vertebral bones and muscles (P<.001). CONCLUSIONS The model using the images of the vertebral bone and paravertebral muscle showed better performance than that using the images of the bone-only or clinical variables. Opportunistic CT screening may contribute to identifying patients with a high fracture risk in the future.
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Affiliation(s)
- Sung Hye Kong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Wonwoo Cho
- Kim Jaechul Graduate School of AI, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - Jaegul Choo
- Kim Jaechul Graduate School of AI, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Vázquez FL, Blanco V, Andrade E, Otero P, Bueno AM, Simón MA, Torres ÁJ. Resilience as a protective factor against depression in informal caregivers. Front Psychol 2024; 15:1370863. [PMID: 39049940 PMCID: PMC11267987 DOI: 10.3389/fpsyg.2024.1370863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Although previous research has demonstrated that resilience can be protective against various mental health conditions such as depression, existing studies examining the relationship between resilience and depression have limitations. To our knowledge, the moderators of the relationship have not been examined. The aim of this study was to determine whether resilience acts as a protective factor against depression in informal caregivers and to examine potential moderators of the relationship between these variables. Methods In this cross-sectional study, 554 randomly selected informal caregivers participated (86.8% women, average age = 55.3 years). Major depressive episode, depressive symptomatology, resilience, positive environmental reward, negative automatic thoughts, self-efficacy, and personality were assessed. Results A total of 16.1% of informal caregivers met criteria for a depressive episode and 57.4% were at risk of developing depression. The average resilience score was 26.3 (SD = 7.6); 62.6% of participants were in the lower quartile of the resilience scale. The gender of the informal caregiver and self-efficacy acted as moderating variables in the relationship between resilience and depression. The impact of resilience on depressive symptoms was more pronounced in female informal caregivers, and increased as self-efficacy increased. Discussion Based on these findings, programs aimed at preventing depression in informal caregivers should focus on promoting resilience, especially in women, and introduce strategies to enhance self-efficacy to increase their impact.
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Affiliation(s)
- Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Elena Andrade
- Department of Social Psychology, Basic Psychology and Methodology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Ana M. Bueno
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Miguel A. Simón
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Ángela J. Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
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Martín Moreno V, Martínez Sanz MI, Fernández Gallardo M, Martín Fernández A, Benítez Calderón MP, Alonso Samperiz H, Pérez Rico E, Calderón Jiménez L, Guerra Maroto S, Sánchez Rodríguez E, Sevillano Fuentes E, Sánchez González I, Recuero Vázquez M, Herranz Hernando J, León Saiz I. The influence of nationwide COVID-19 lockdown on the functional impairment and long-term survival of dependent people for carrying out basic activities of daily living in a neighborhood of the city of Madrid, Spain: Orcasitas Cohort Longitudinal Study. Front Public Health 2024; 12:1385058. [PMID: 39045161 PMCID: PMC11263189 DOI: 10.3389/fpubh.2024.1385058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 06/14/2024] [Indexed: 07/25/2024] Open
Abstract
Background Prolonged confinement can lead to personal deterioration at various levels. We studied this phenomenon during the nationwide COVID-19 lockdown in a functionally dependent population of the Orcasitas neighborhood of Madrid, Spain, by measuring their ability to perform basic activities of daily living and their mortality rate. Methods A total of 127 patients were included in the Orcasitas cohort. Of this cohort, 78.7% were female, 21.3% were male, and their mean age was 86 years. All participants had a Barthel index of ≤ 60. Changes from pre- to post-confinement and 3 years afterward were analyzed, and the effect of these changes on survival was assessed (2020-2023). Results The post-confinement functional assessment showed significant improvement in independence over pre-confinement for both the Barthel score (t = -5.823; p < 0.001) and the classification level (z = -2.988; p < 0.003). This improvement progressively disappeared in the following 3 years, and 40.9% of the patients in this cohort died during this period. These outcomes were associated with the Barthel index (z = -3.646; p < 0.001) and the level of dependence (hazard ratio 2.227; CI 1.514-3.276). Higher mortality was observed among men (HR 1.745; CI 1.045-2.915) and those with severe dependence (HR 2.169; CI 1.469-3.201). Setting the cutoff point of the Barthel index at 40 provided the best detection of the risk of death associated with dependence. Conclusions Home confinement and the risk of death due to the COVID-19 pandemic awakened a form of resilience in the face of adversity among the population of functionally dependent adults. The Barthel index is a good predictor of medium- and long-term mortality and is a useful method for detecting populations at risk in health planning. A cutoff score of 40 is useful for this purpose. To a certain extent, the non-institutionalized dependent population is an invisible population. Future studies should analyze the causes of the high mortality observed.
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Affiliation(s)
- Vicente Martín Moreno
- Orcasitas Health Care Center and i+12 Research Institute of the Doce de Octubre Hospital, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - María Inmaculada Martínez Sanz
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Miriam Fernández Gallardo
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Amanda Martín Fernández
- Polibea Concert, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - María Palma Benítez Calderón
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Helena Alonso Samperiz
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Elena Pérez Rico
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Laura Calderón Jiménez
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Sara Guerra Maroto
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Elena Sánchez Rodríguez
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Eva Sevillano Fuentes
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Irene Sánchez González
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Miguel Recuero Vázquez
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Nursing Home Care Unit of the Center, Madrid, Spain
| | - Julia Herranz Hernando
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
| | - Irene León Saiz
- Orcasitas Health Care Center, Grupo de Investigación sobre Dependencia en Orcasitas (GIDO Collaborative Group), Madrid, Spain
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Ortonobes S, Herranz S, Lleal M, Sevilla-Sánchez D, Jordana R, Mascaró O, Ferrández O, de Jaime E, Estrada R, Nazco GJ, Baré M. Multidisciplinary medication review during older patient hospitalization according to STOPP/START criteria reduces potentially inappropriate prescriptions: MoPIM cohort study. BMC Geriatr 2024; 24:584. [PMID: 38978009 PMCID: PMC11232270 DOI: 10.1186/s12877-024-05185-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024] Open
Abstract
PURPOSE Multimorbidity and polypharmacy in older adults converts the detection and adequacy of potentially inappropriate drug prescriptions (PIDP) in a healthcare priority. The objectives of this study are to describe the clinical decisions taken after the identification of PIDP by clinical pharmacists, using STOPP/START criteria, and to evaluate the degree of accomplishment of these decisions. METHODS Multicenter, prospective, non-comparative cohort study in patients aged 65 and older, hospitalized because of an exacerbation of their chronic conditions. Each possible PIDP was manually identified by the clinical pharmacist at admission and an initial decision was taken by a multidisciplinary clinical committee. At discharge, criteria were re-applied and final decisions recorded. RESULTS From all patients (n = 674), 493 (73.1%) presented at least one STOPP criteria at admission, significantly reduced up to 258 (38.3%) at discharge. A similar trend was observed for START criteria (36.7% vs. 15.7%). Regarding the top 10 most prevalent STOPP criteria, the clinical committee initially agreed to withdraw 257 (34.2%) prescriptions and to modify 93 (12.4%) prescriptions. However, the evaluation of final clinical decisions revealed that 503 (67.0%) of those STOPP criteria were ultimately amended. For the top 10 START criteria associated PIDP, the committee decided to initiate 149 (51.7%) prescriptions, while a total of 198 (68.8%) were finally introduced at discharge. CONCLUSIONS The clinical committee, through a pharmacotherapy review, succeeded in identifying and reducing the degree of prescription inadequacy, for both STOPP and START criteria, in older patients with high degree of multimorbidity and polypharmacy. TRIAL REGISTRATION NCT02830425.
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Affiliation(s)
- Sara Ortonobes
- Pharmacy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208, Sabadell, Spain.
| | - Susana Herranz
- Acute Care Geriatric Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208, Sabadell, Catalonia, Spain
- Research Network On Health Services in Chronic Patients (REDISSEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Marina Lleal
- Clinical Epidemiology and Cancer Screening Department, Parc Taulí Hospital Universitari, Institut d'Investigació I Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine and Public Health, Autonomous University of Barcelona (UAB), 08193, Bellaterra, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | | | - Rosa Jordana
- Internal Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
| | - Oscar Mascaró
- Internal Medicine Department, University Hospital of Vic, Multidisciplinary Inflamation Research Group (MIRG), Facultat de Medicina, Universitat de Vic, Universitat Central de Catalunya, 08500, Vic, Spain
| | - Olivia Ferrández
- Pharmacy Department, Consorci Parc de Salut Mar, 08003, Barcelona, Spain
| | - Elisabet de Jaime
- Geriatrics Department, Consorci Parc de Salut Mar, 08003, Barcelona, Spain
| | - Rafael Estrada
- Internal Medicine, Hospital Galdakao-Usansolo, 48960, Galdakao, Spain
| | - Gloria Julia Nazco
- Pharmacy Department, Hospital Universitario de Canarias, 38320, La Laguna, Spain
| | - Marisa Baré
- Research Network On Health Services in Chronic Patients (REDISSEC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Primary Care Center, CAP Can Rull, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), 08206, Sabadell, Spain.
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40
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Gvili RL, Bodner E. An Intergenerational Telehealth Music Therapy Group Intervention to Improve Grandparents' Meaning in life. J Music Ther 2024:thae015. [PMID: 38970819 DOI: 10.1093/jmt/thae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2024] [Accepted: 06/12/2024] [Indexed: 07/08/2024]
Abstract
The lockdown policies in Israel during the COVID-19 pandemic hampered familial grandparents-grandchildren relations. There is initial evidence that older adults' meaning in life and will-to-live decreased. Grandparents could no longer meet their grandchildren in person. In response, we utilized an intergenerational telehealth music therapy group intervention during the onset of the COVID-19 pandemic. Forty-four pairs of grandparents and grandchildren enrolled in a quasi-experimental study with an intervention and waitlist control group. Twenty-one pairs of grandparents-grandchildren participated in a weekly virtual group music therapy intervention (via Zoom) for 8 weeks (experimental group) and the remainder were waitlisted and received no intervention (control group). Participants in both groups completed the same questionnaires in parallel before and after the intervention. The grandparents' meaning in life, will-to-live and behavioral grandparenthood increased compared to no change observed in the control group. Further research with randomized-controlled treatment is recommended.
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Affiliation(s)
| | - Ehud Bodner
- Department of Music, Bar-Ilan University, Ramat-Gan, Israel
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
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Karabacak M, Lampros M, Mavridis O, Jagtiani P, Feng R, Shrivastava R, Margetis K. Atypical and anaplastic meningiomas in the later decades of life: A national cancer database analysis. Acta Neurochir (Wien) 2024; 166:282. [PMID: 38967664 DOI: 10.1007/s00701-024-06157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE We conducted a National Cancer Database (NCDB) study to investigate the epidemiological characteristics and identify predictors of outcomes associated with geriatric meningiomas. METHODS The NCDB was queried for adults aged 60-89 years diagnosed between 2010 and 2017 with grade 2 and 3 meningiomas. The patients were classified into three age groups based on their age: 60-69 (hexagenarians), 70-79 (septuagenarians), and 80-89 (octogenarians). The log-rank test was utilized to compare the differences in overall survival (OS). Univariate and multivariate Cox proportional hazards regressions were used to evaluate the mortality risk associated with various patient and disease parameters. RESULTS A total of 6585 patients were identified. Hexagenerians were the most common age group (49.8%), with the majority of meningiomas being classified as grade 2 (89.5%). The incidence of high-grade meningiomas increased in all age groups during the study period. Advanced age, male sex, black race, lower socioeconomic status, Charlson-Deyo score ≥ 2, and higher tumor grade were independent factors of poor survival. Among the modes of treatment, the extent of surgical resection, adjuvant radiotherapy, and treatment at a noncommunity cancer program were linked with better outcomes. CONCLUSION In geriatric patients with high-grade meningiomas, the greater extent of surgical resection and radiotherapy are associated with improved survival. However, the management and outcome of geriatric patients with higher-grade meningiomas are also associated with several socioeconomic factors.
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Affiliation(s)
- Mert Karabacak
- Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA
| | - Marios Lampros
- Department of Neurosurgery, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Olga Mavridis
- Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Pemla Jagtiani
- School of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Rui Feng
- Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA
| | - Raj Shrivastava
- Department of Neurosurgery, Mount Sinai Health System, New York, NY, USA
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Toledo D, Mayordomo-Cava J, Jurado P, Díaz A, Serra-Rexach JA. Trends in hip fracture rates in spain from 2001 to 2018. Arch Osteoporos 2024; 19:57. [PMID: 38958797 DOI: 10.1007/s11657-024-01406-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/24/2024] [Indexed: 07/04/2024]
Abstract
The present study includes the longest period of analysis with the highest number of hip fracture episodes (756,308) described in the literature for Spain. We found that the age-adjusted rates progressively decreased from 2005 to 2018. We believe that this is significant because it may mean that measures such as prevention and treatment of osteoporosis, or programs promoting healthy lifestyles, have had a positive impact on hip fracture rates. PURPOSE To describe the evolution of cases and rates of hip fracture (HF) in patients 65 years or older in Spain from 2001 to 2018 and examine trends in adjusted rates. METHODS Retrospective, observational study including patients ≥65 years with acute HF. Data from 2001 to 2018 were obtained from the Spanish National Record of the Minimum Basic Data Set of the Ministry of Health. We analysed cases of HF, crude incidence and age-adjusted rates by sex, length of hospital stay (LOS) and in-hospital mortality, and used joinpoint regression analysis to explore temporal trends. RESULTS We identified 756,308 HF cases. Mean age increased 2.5 years, LOS decreased 4.5 days and in-hospital mortality was 5.5-6.5%. Cases of HF increased by 49%. Crude rate per 100,000 was 533.3 (95% confidence interval [CI], 532.1-534.5), increasing 14.0% (95%CI, 13.7-14.2). Age-adjusted HF incidence rate increased by 6.9% from 2001 (535.7; 95%CI, 529.9-541.5) to 2005 (572.4; 95%CI, 566.7-578.2), then decreased by 13.3% until 2017 (496.1, 95%CI, 491.7-500.6). Joinpoint regression analysis indicated a progressive increase in age-adjusted incidence rates of 1.9% per year from 2001 to 2005 and a progressive decrease of -1.1% per year from 2005 to 2018. A similar pattern was identified in both sexes. CONCLUSIONS Crude incidence rates of HF in Spain in persons ≥65 years from 2001 to 2018 have gradually increased. Age-adjusted rates show a significant increase from 2001 to 2005 and a progressive decrease from 2005 to 2018.
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Affiliation(s)
- D Toledo
- Department of Admissions and Clinical Documentation, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - J Mayordomo-Cava
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Institute for Health Research of the Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, Madrid, Spain
| | - P Jurado
- Department of Admissions and Clinical Documentation, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Díaz
- Preventive Medicine and Healthcare and Quality Improvement Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J A Serra-Rexach
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Institute for Health Research of the Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Biomedical Research Networking Centre on Frailty and Healthy Ageing, CIBERFES, Madrid, Spain
- Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
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Chavarro-Carvajal DA, Pabón-Martínez EJ, Negrette Soto AK, Santacruz Escudero JM, Cano-Gutierrez CA. [Characterization of older adult patients admitted to an acute unit of a high complexity hospital in Bogotá, Colombia]. Rev Esp Geriatr Gerontol 2024; 59:101527. [PMID: 38964263 DOI: 10.1016/j.regg.2024.101527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND AND OBJECTIVES The objective is to describe the demographic, clinical, functional characteristics and outcomes of older adult patients hospitalized in the acute unit of the San Ignacio University Hospital (HUSI). METHODS Descriptive, cross-sectional observational study, based on the review of the medical records of patients hospitalized in the Geriatrics Unit of the HUSI during the period 2019-2021. VARIABLES Demographics, comorbidities, baseline situation, main cause of entry and outcomes. The diagnosis of geriatric syndromes was made through the Barthel index, the Lawton and Brody scale, FRAIL scale, mini nutritional assessment short form and Confusion Assessment Method criteria. RESULTS A total of 4601 patients were analyzed, whose average age was 83years (56.2% women). 72.4% had some degree of dependency for basic activities of daily living, 90.8% had some degree of dependency for instrumental activities of daily living, 32.2% had malnutrition, 15. 7% falls, 9.9% oropharyngeal dysphagia, 32.2% frailty, 28.1% delirium, 54.1% previous dementia. The main comorbidities presented were arterial hypertension, chronic obstructive pulmonary disease and diabetes. 2.9% had some complication during their hospitalization, 10.8% died, and the hospital stay was 5days. CONCLUSION Older adult patients admitted to the acute unit of the HUSI have a high frequency of dependency, dementia and nutritional disturbances.
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Affiliation(s)
- Diego Andrés Chavarro-Carvajal
- Semillero de Neurociencias y Envejecimiento del Instituto de Envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Eduardo José Pabón-Martínez
- Semillero de Neurociencias y Envejecimiento del Instituto de Envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Ana Karina Negrette Soto
- Semillero de Neurociencias y Envejecimiento del Instituto de Envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jose Manuel Santacruz Escudero
- Semillero de Neurociencias y Envejecimiento del Instituto de Envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Centro de memoria y cognición, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento del Instituto de Envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia; Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
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Reinoso-Párraga PP, González-Montalvo JI, Menéndez-Colino R, Perkisas S, Rivera-Deras I, Garmendia-Prieto B, Arain SJ, Tung-Chen Y, Vilches-Moraga A. Usefulness of point of care ultrasound in older adults: a multicentre study across different geriatric care settings in Spain and the United Kingdom. Age Ageing 2024; 53:afae165. [PMID: 39051145 DOI: 10.1093/ageing/afae165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/29/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Point of care ultrasound (POCUS) is an imaging technique performed bedside. To date, few published studies have reported the usefulness of multiorgan POCUS in Geriatrics. The objective of this study was to describe the utility of multiorgan POCUS in the care of older adults admitted to geriatric care settings. METHODOLOGY Observational retrospective study of patients admitted to geriatric settings in Spain and UK. Multiorgan POCUS was performed when there was a specific clinical suspicion or unexplained torpid clinical course despite physical examination and complementary tests. A geriatrician with a certificate degree in comprehensive ultrasound and long-standing experience in POCUS carried out POCUS. All patients underwent multiorgan POCUS in a cephalo-caudal manner. RESULTS Out of 368 patients admitted to geriatric units, 29% met the inclusion criteria. Average age was 85.9 years (SD ± 6.1). POCUS identified 235 clinically significant findings (2.2 per patient). Findings were classified as 37.9% confirmed diagnosis, 16.6% ruled out diagnosis, 14.9% unsuspected relevant diagnoses and 30.6% clinical follow-ups. POCUS findings led to changes in pharmacological and non-pharmacological treatment in 66.3 and 69.2% respectively, resulted in completion or avoidance of invasive procedures in 17.8 and 15.9%, respectively, facilitating early referrals to other specialities in 14.9% and avoiding transfers in 25.2% of patients. CONCLUSION Multiorgan POCUS is a tool that aids in the assessment and treatment of patients receiving care in geriatrics units. These results show the usefulness of POCUS in the management of older adults and suggest its inclusion in any curriculum of Geriatric Medicine speciality training.
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Affiliation(s)
- Paola Pastora Reinoso-Párraga
- Department of Geriatrics, La Paz University Hospital, Madrid, Spain
- Research Institute La Paz (IdiPAZ), Madrid, Spain
| | - Juan Ignacio González-Montalvo
- Department of Geriatrics, La Paz University Hospital, Madrid, Spain
- Research Institute La Paz (IdiPAZ), Madrid, Spain
- Department of Medicine. Universidad Autónoma de, Madrid, Spain
| | - Rocío Menéndez-Colino
- Department of Geriatrics, La Paz University Hospital, Madrid, Spain
- Research Institute La Paz (IdiPAZ), Madrid, Spain
- Department of Medicine. Universidad Autónoma de, Madrid, Spain
| | - Stany Perkisas
- University Centre for Geriatrics ZNA (Ziekenhuis Netwerk Antwerpen) University of Antwerp, Antwerp, Belgium
| | | | - Blanca Garmendia-Prieto
- Department of Geriatrics, Cruz Roja University Hospital, Madrid, Spain
- Department of Medicine, Alfonso X El Sabio University, Madrid, Spain
| | | | - Yale Tung-Chen
- Research Institute La Paz (IdiPAZ), Madrid, Spain
- Department of Medicine, Alfonso X El Sabio University, Madrid, Spain
- Department of Internal Medicine. La Paz University Hospital, Madrid, Spain
| | - Arturo Vilches-Moraga
- Department of Geriatrics and Long-term Care, Hamad Medical Corporation, Doha, Qatar
- School of Medicine, Bolton University, Bolton, UK
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Ruiz-Figueroa I, Minguela MÁ, Munuera P. A Social Work Analysis of Facilitators of and Barriers to Adopting Technology in Older Adults: A Systematic Literature Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:639-659. [PMID: 38605522 DOI: 10.1080/01634372.2024.2339977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024]
Abstract
Increasing concern within social work about delivering comprehensive and high-quality care to older adults necessitates exploring their interest in information and communication technologies. The aim is to determine, via a systematic review using the PRISMA method, how the scientific literature on older adults' technology experiences through the lens of the Technology Acceptance Model (TAM). The review differentiates between enabling factors and barriers that influence older adults' use and acceptance of technology from their own perspective. It provides social workers with a comprehensive overview of use of technologies and identify general guidelines to enhance older adults' personal and communal autonomy.
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Affiliation(s)
- Ismael Ruiz-Figueroa
- Departamento de Trabajo Social, Universidad Complutense de Madrid, Pozuelo de Alarcón (Madrid), España
| | - M Ángeles Minguela
- Área de Trabajo Social y Servicios Sociales, Universidad de Cádiz, Jerez de la Frontera (Cádiz), España
| | - Pilar Munuera
- Departamento de Trabajo Social, Universidad Complutense de Madrid, Pozuelo de Alarcón (Madrid), España
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46
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Padilla-Rojas LG, Tamayo-Cosio J, Garín-Zertuche DE, Rojas-Herrera CA, Vallejo L, Leal JA, Soarez-Hungria JO, Caiero MT, Tabares-Neyra H, González Roig JL, Giordano V. Trauma center rehabilitation systems in Latin America. OTA Int 2024; 7:e332. [PMID: 39114374 PMCID: PMC11301634 DOI: 10.1097/oi9.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/21/2023] [Accepted: 01/30/2024] [Indexed: 08/10/2024]
Abstract
Trauma is a leading cause of mortality and morbidity worldwide with high rates of disability in survivors. With improvements in care, rehabilitation of the trauma patient is a cornerstone to reducing sequelae. A lack of well-established hospital rehabilitation units and standardized protocols for managing posttraumatic injuries is a common problem in Latin American countries. Future studies should seek to understand the barriers and gaps in care so that consensus and ultimately best practice guidelines can be developed and included in rehabilitation programs throughout trauma centers in Latin America.
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Affiliation(s)
- Luis G. Padilla-Rojas
- Mexican Federation of Orthopaedic and Traumatology FEMECOT International Committee Chair, Metropolitana de Guadalajara University, Puerta de Hierro Hospital, Guadalajara, Jal. México
| | - Johnatan Tamayo-Cosio
- Director of CORE Rehabilitation and Physiotherapy Center, Professor Madrid School of Osteopathy Campus Mexico, Guadalajara, México
| | - Darío E. Garín-Zertuche
- Mexican Federation of Orthopaedic and Traumatology FEMECOT President, Autónoma de Baja Californa University. Angeles Hospital, Tijuana, BCN, México
| | | | - Linda Vallejo
- Mayor Mederi University Hospital, Police Hospital, San José Infantil Hospital, Bogotá, Colombia
| | - Jaime A. Leal
- Mayor Mederi University Hospital, La Samaritana University Hospital, Bogotá, Colombia
| | | | - Marcelo T. Caiero
- Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Horacio Tabares-Neyra
- Cuban Orthopedics and Traumatology Society President, Head of the Surgical Department of the Center for Research in Longevity, Aging and Health (CITED), La Havana, Cuba
| | | | - Vincenzo Giordano
- Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
- Ortopedia, Clínica São Vicente, Rede D’or São Luiz, Rio de Janeiro, Brazil
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47
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Mira JJ, Torres D, Gil V, Carratalá C. Loneliness impact on healthcare utilization in primary care: A retrospective study. J Healthc Qual Res 2024; 39:224-232. [PMID: 38670900 DOI: 10.1016/j.jhqr.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/13/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND An increased number of patients seek help for loneliness in primary care. OBJECTIVE To analyze whether loneliness was associated with a higher utilization of healthcare facilities. METHODS Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person's social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data. RESULTS A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6-9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year. CONCLUSION Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.
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Affiliation(s)
- J J Mira
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain; Health Psychology Department, Universidad Miguel Hernandez, Elche, Spain; RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain.
| | - D Torres
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain
| | - V Gil
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
| | - C Carratalá
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
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Nascimento LR, Boening A, Rocha RJ, do Carmo WA, Ada L. Walking training with auditory cueing improves walking speed more than walking training alone in ambulatory people with Parkinson's disease: a systematic review. J Physiother 2024; 70:208-215. [PMID: 38897907 DOI: 10.1016/j.jphys.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
QUESTIONS In people with Parkinson's disease, what is the effect of adding external cueing (ie, visual, auditory or somatosensorial cueing) to walking training compared with walking training alone in terms of walking, mobility, balance, fear of falling and freezing? Are any benefits carried over to participation or maintained beyond the intervention period? DESIGN Systematic review of randomised trials with meta-analysis. PARTICIPANTS Ambulatory adults with Parkinson's disease. INTERVENTION Walking training with external cueing compared with walking training without external cueing. OUTCOME MEASURES Walking (ie, speed, stride length and cadence), mobility, balance, fear of falling, freezing and participation. RESULTS Ten trials involving a total of 309 participants were included. The mean PEDro score of the included trials was 5 (range 4 to 8). Walking training with auditory cueing improved walking speed by 0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone. Although the best estimate was that auditory cueing may also improve stride length by 5 cm, this estimate was imprecise (95% CI -2 to 11). The addition of visual cueing to walking training did not improve walking speed or stride length. Results regarding cadence, mobility, balance, fear of falling, and freezing and maintenance of benefits beyond the intervention period remain uncertain. CONCLUSION This systematic review provided low-quality evidence that walking training with auditory cueing is more effective than walking training alone for improving walking speed in Parkinson's disease. Cueing is an inexpensive and easy to implement intervention, so the mean estimate might be considered clinically worthwhile, although the confidence interval spans clinically trivial and worthwhile effects. REGISTRATION PROSPERO CRD42021255065.
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Affiliation(s)
- Lucas R Nascimento
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil.
| | - Augusto Boening
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Rafaela Js Rocha
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Willian A do Carmo
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Louise Ada
- Sydney School of Health Sciences, Discipline of Physiotherapy, The University of Sydney, Sydney, Australia
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49
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Ignacio Expósito JM, Carrillo Peñas N, Rosety Rodríguez M, Lagares Franco C. [Medicine consumption as a factor associated with the state of fragility of the elderly patient in Spain]. Semergen 2024; 50:102177. [PMID: 38295618 DOI: 10.1016/j.semerg.2023.102177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Frailty in the elderly is a concept in constant evolution, with a significant impact on the morbidity and mortality of patients. We assessed the associative strength of the Timed Up and Go test (TUG) and medication consumption in frailty and associated risk using various methods. MATERIAL AND METHODS Observational, cross-sectional, multicenter study carried out in 128 Primary Care Centers distributed throughout Spain, has a total sample of 2422 patients over 65 years of age, estimating the prevalence of frailty with the TUG test. Descriptive analysis of the categorical variables and associative strength of TUG for frailty and medication consumption was performed with distribution of absolute and relative frequencies and multinomial logistic regression. SPSS 22.0 was used, considering statistical significance p=0.05. RESULTS The prevalence of frailty in the sample was 13.7%, accepting as frailty those subjects who obtained a score >20s in performing the TUG test. A third of these subjects classified as frail took more than 30s to complete the test and 32.5% of those studied would be classified as "pre-frail". We found a slight difference in the prevalence of frailty if we analyze the data according to sex, being 10.8% in men compared to 15.8% in women. Regarding pharmacological consumption, 72.8% of the subjects consume 5 or more drugs daily with similar proportions by sex, and with an average consumption of 6.57 drugs. The drugs with the greatest association with the degree of frailty were drugs used for dementia (40% of individuals who consumed them were considered frail), antiparkinsonian drugs (38%), antipsychotics (34%), antianemics (26.2%), anticoagulants (22.2%) and antiepileptics (21.1%). CONCLUSIONS The incidence of frailty in elderly patients in Spain is initially notable, being present in 13.7% through the application of the TUG test. The age variable is the one that is most significantly associated with the frailty of the elderly patient. An association was demonstrated between the degree of frailty and total medication consumption. The prevalence of frailty was 4.7% in the non-polypharmacy group compared to 15.4% in the polypharmacy group and reaching 23.4% in the extreme polypharmacy group. The drugs with a greater association with the patient's degree of frailty were those used in the neurological/psychiatric sphere (antidementia, antiparkinsonian, antipsychotic or antiepileptic drugs).
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Affiliation(s)
| | - N Carrillo Peñas
- Medicina Familiar y Comunitaria, Centro de Salud La Laguna, Cádiz, España
| | | | - C Lagares Franco
- Departamento de Estadística e Investigación Operativa, Universidad de Cádiz, Cádiz, España
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50
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Soiza RL, Niven M. The COVID-19 Vaccine Gamble-By luck they worked in the oldest, frailest people. Rev Esp Geriatr Gerontol 2024; 59:101427. [PMID: 38402747 DOI: 10.1016/j.regg.2023.101427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 02/27/2024]
Affiliation(s)
- Roy L Soiza
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK; Ageing Clinical & Experimental Research Group, University of Aberdeen, UK.
| | - Megan Niven
- Ageing Clinical & Experimental Research Group, University of Aberdeen, UK
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