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Skoumal M, Lindner-Rabl S, Honegger M, Pertinatsch C, Kadane C, Neubacher B, Herzog C, Roller-Wirnsberger R. Goal Setting for Participatory Person-Centered Geriatric Rehabilitation-From Function-Centered Rehabilitation towards Digitally Supported Personalized and Integrated Care for Older People. J Clin Med 2024; 13:4134. [PMID: 39064173 PMCID: PMC11277607 DOI: 10.3390/jcm13144134] [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: 06/10/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
As chronic illness is common among older people, self-care practices for older people are needed to control health status, to prevent possible complications and to ensure optimal quality of life. The literature has demonstrated that integrated care approaches are one key success factor for delivering person-centered and sustainable care for older people, with rehabilitation being a cornerstone in tertiary care prevention for older citizens. The current paper addresses the state of the literature for person-centered geriatric rehabilitation (GR) and the importance of personalized and participatory goal setting. In accordance with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), social participation and the related goals are of particular importance for the entire rehabilitation process. The social participation of individuals enrolled into GR is therefore one of the milestones to be achieved during GR. Personalized goal setting during the entire rehabilitation process, Comprehensive Geriatric Assessment (CGA) and shared decision making allow a comprehensive care approach separate from solely function-based rehabilitation. The review also focusses on recent developments in digitalization in healthcare and delivers insights into how healthcare professionals' collaborative practice supports sustainable rehabilitation results in patients of advanced chronological age.
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Affiliation(s)
- Martin Skoumal
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Sonja Lindner-Rabl
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
| | - Martina Honegger
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Christoph Pertinatsch
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Christof Kadane
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Britta Neubacher
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
- Department for Scientific Research in Rehabilitation, Pension Insurance Austria, 1021 Vienna, Austria
| | - Carolin Herzog
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
| | - Regina Roller-Wirnsberger
- Department of Internal Medicine, Research Unit for Aging and Life Long Health, Medical University of Graz, 8036 Graz, Austria; (M.S.); (M.H.); (C.P.); (C.K.); (B.N.); (C.H.)
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Dibello V, Lozupone M, Manfredini D, Dibello A, Zupo R, Sardone R, Daniele A, Lobbezoo F, Panza F. Oral frailty and neurodegeneration in Alzheimer's disease. Neural Regen Res 2021; 16:2149-2153. [PMID: 33818486 PMCID: PMC8354109 DOI: 10.4103/1673-5374.310672] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/04/2020] [Accepted: 01/30/2021] [Indexed: 12/12/2022] Open
Abstract
Frailty is a critical intermediate status of the aging process with a multidimensional and multisystem nature and at higher risk for adverse health-related outcomes, including falls, disability, hospitalizations, institutionalization, mortality, dementia, and Alzheimer's disease. Among different frailty phenotypes, oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions. We briefly reviewed existing evidence on operational definitions of oral frailty, assessment and screening tools, and possible relationships among oral frailty, oral microbiota, and Alzheimer's disease neurodegeneration. Several underlying mechanism may explain the oral health-frailty links including undernutrition, sarcopenia linked to both poor nutrition and frailty, psychosocial factors, and the chronic inflammation typical of oral disease. Oral microbiota may influence Alzheimer's disease risk through circulatory or neural access to the brain and the interplay with periodontal disease, often causing tooth loss also linked to an increased Alzheimer's disease risk. On this bases, COR388, a bacterial protease inhibitor targeting Porphyromonas gingivalis implicated in periodontal disease, is now being tested in a double-blind, placebo-controlled Phase II/III study in mild-to-moderate Alzheimer's disease. Therefore, oral status may be an important contributor to general health, including Alzheimer's disease and late-life cognitive disorders, suggesting the central role of preventive strategies targeting the novel oral frailty phenotype and including maintenance and improvement of oral function and nutritional status to reduce the burden of both oral dysfunction and frailty.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | | | - Roberta Zupo
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
| | - Rodolfo Sardone
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Francesco Panza
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
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Dibello V, Zupo R, Sardone R, Lozupone M, Castellana F, Dibello A, Daniele A, De Pergola G, Bortone I, Lampignano L, Giannelli G, Panza F. Oral frailty and its determinants in older age: a systematic review. THE LANCET HEALTHY LONGEVITY 2021; 2:e507-e520. [DOI: 10.1016/s2666-7568(21)00143-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023]
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Sardella A, Quattropani MC, Basile G. Can cognitive reserve protect frail individuals from dementia? THE LANCET. HEALTHY LONGEVITY 2021; 2:e67. [DOI: 10.1016/s2666-7568(20)30070-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/07/2020] [Indexed: 11/28/2022] Open
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