[The "Lübeck Worlds of Movement Model"-results of the effects evaluation]

[Strengthening prevention and health promotion in and for old age]

BACKGROUND

Disease prevention and health promotion in and for old age have become increasingly more important. Nevertheless, more (national) research and implementation in practice is needed, as the international comparison shows.

OBJECTIVE

To develop guiding principles for research and practice on prevention and health promotion in and for old age.

MATERIAL AND METHODS

As part of an iterative process, members of the German Society of Gerontology and Geriatrics came together in workshops and symposia to formulate key guiding principles and fields of action for prevention and health promotion.

RESULTS

The following were worked out: 1) prevention and health promotion are useful and possible up to oldest age, 2) prevention and health promotion for advanced age should start early, 3) prevention and health promotion must take into account the diversity and heterogeneity of the life situations of old people, 4) prevention and health promotion promote and demand self-determination and participation, 5) prevention of multiple illnesses must be given greater attention, 6) prevention of the need for long-term care and prevention in long-term care must be treated equally, 7) prevention and health promotion must be thought of in terms of life worlds and across sectors, paying particular attention to aspects of social inequality and a focus on resources, 8) prevention and health promotion and the related research must be interdisciplinary and transdisciplinary and be applied at different levels, from molecular to societal.

DISCUSSION

The guiding principles outline the focal points of future-oriented ageing, health and healthcare research and open up fields of action but also show the limits of this approach for political decision-makers, researchers and practitioners.

[Assessment of mobility/motor skills in old age : Based on the S1 guideline "Geriatric assessment level 2, living guideline"]

In addition to locomotion, mobility also includes any motor performance that serves other purposes and movements that are unplanned. This article presents the instruments mentioned in the S1 guideline "Geriatric assessment level 2, living guideline", as well as additional ones that are less known. The classification is into three categories: instruments that focus on the upper extremities, instruments without performance, which mainly focus on the functions and capabilities of the lower extremities, and those that do this using performance tests.

[Positioning the hand to act-Validation of the 8-point reaching range test]

BACKGROUND

The standardized geriatric assessment of the upper extremities is often limited to measurement of hand strength. The only other instrument mentioned in the S1 guidelines on level 2 geriatric assessment is the 20 cents test (20-C-T); however, in addition to strength and fine motor skills, successful hand placement is a prerequisite for self-care.

OBJECTIVE

The 8‑point reaching range test (8P-GRT) was developed for standardized separate testing of sides in a seated person concerning hand positioning relevant to daily living. The purpose of the study was to determine quality criteria of the 8P-GRT in geriatric hospital patients.

MATERIAL AND METHODS

Between 31 July 2019 and 23 September 2019, a total of 82 inpatients were examined at the Hospital Red Cross Lübeck Geriatrics Center using the 8P-GRT, shoulder pain and disability index (SPADI), a questionnaire on self-care activities corresponding to the hand positions of the 8P-GRT, hand strength measurement and the 20-C‑T.

RESULTS

The interrater reliability was 0.99 and the retest reliability was 0.95 for the right side and 0.90 for the left side. On the individual level a ceiling effect (both sides score 8) occurred in 4.1% (n = 3) but no floor effect was observed. The internal consistency (Cronbach's alpha) of the two-factorial test according to factor analysis was 0.78 (right) and 0.76 (left). Each of the other tests correlated more closely with the 8P-GRT on the right side, whereby the correlation was highest with the abovenamed questionnaire (-0.72), followed by the SPADI (-0.60).

CONCLUSION

A standardized survey of hand strength, fine motor skills and active positioning of the hand (e.g., 8P-GRT) synthesizes the main aspects of upper extremity functioning into an overall picture.

Bewegungsförderung für Bewohner in Pflegeheimen

Ältere Menschen zeigen nach Aufnahme in eine Einrichtung der stationären Pflege oft eine Reduktion ihres Bewegungsverhaltens mit konsekutiver weiterer Verschlechterung der Mobilität und Selbstversorgungsfähigkeiten. Das Präventionsgesetz beinhaltet den Auftrag, auch in der Lebenswelt Pflegeheim unter Einbezug der Wünsche der Senioren nach Möglichkeiten zu suchen, über eine Zunahme der bewegungsassoziierten Aktivitäten eine Verbesserung der weiteren Prognose und Lebensqualität zu erreichen. POLKA setzt in zweifacher Hinsicht auf Kombinationen: Es bietet sowohl Gesundheitsförderung für das in Pflegeheimen tätige Personal als auch die Bewohner an und erhöht die Kompetenz des Personals in Sachen Bewegungsförderung durch das Tandem aus fest im Pflegeteam verankerten Bewegungsexperten und einem noch umfassender qualifizierten Bewegungslotsen. Die Tätigkeit als Bewegungsexperte bietet die Möglichkeit, täglich als Sachverständiger in Sachen Bewegungsförderung zu fungieren, aber auch die, sich zweimal wöchentlich selbst beraten zu lassen bzw. gemeinsam mit dem Bewegungslotsen relevante Bewegungs-Ziele der Bewohner zu verfolgen. Damit die Auswahl der Ziele und der Wege, diese zu erreichen, zu den realen Möglichkeiten der pflegebedürftigen Person passen, bedarf es eines geriatrischen Assessments. Der Bewegungslotse beherrscht dieses vollumfänglich, der Bewegungsexperte und andere im Pflegeteam erlernen zwei Instrumente, deren Anwendung ihnen hilft, Bewegungsförderung systematisch durchzuführen. Als Interventionen stehen u. a. drei verschiedene Formate des von der Forschungsgruppe Geriatrie Lübeck entwickelten Trainings in „Bewegungswelten“ zur Verfügung.

High Salt Diet Impacts the Risk of Sarcopenia Associated with Reduction of Skeletal Muscle Performance in the Japanese Population

The World Health Organization has recommended 5 g/day as dietary reference intakes for salt. In Japan, the averages for men and women were 11.0 g/day and 9.3 g/day, respectively. Recently, it was reported that amounts of sodium accumulation in skeletal muscles of older people were significantly higher than those in younger people. The purpose of this study was to investigate whether the risk of sarcopenia with decreased muscle mass and strength was related to the amount of salt intake. In addition, we investigated its involvement with renalase. Four groups based on age and salt intake ("younger low-salt," "younger high-salt," "older low-salt," and "older high-salt") were compared. Stratifying by age category, body fat percentage significantly increased in high-salt groups in both younger and older people. Handgrip strength/body weight and chair rise tests of the older high-salt group showed significant reduction compared to the older low-salt group. However, there was no significant difference in renalase concentrations in plasma. The results suggest that high-salt intake may lead to fat accumulation and muscle weakness associated with sarcopenia. Therefore, efforts to reduce salt intake may prevent sarcopenia.