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Baker ZG, O’Donnell MG, Garcia-Arias S, Huang Y, Segundo J, Millenbah AN, Neubert OM, Huerta I. Protocol for a telephonic mixed methods study to understand needs and find solutions for bereaved dementia caregivers. BMJ Open 2024; 14:e086559. [PMID: 39038859 PMCID: PMC11268041 DOI: 10.1136/bmjopen-2024-086559] [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: 03/18/2024] [Accepted: 06/16/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Most caregivers of people living with dementia will experience bereavement within 10 years, but study of and support for their needs rarely persists following the death of their care recipients. A single model that leverages theoretical insights as well as observation from lived experience might help identify who will have greater difficulty following dementia-related bereavement and suggest core mechanisms to target to relieve clinical and subclinical consequences. The millions of existing bereaved dementia caregivers likely have considerable insight into ways to improve experience. Rather than creating interventions from scratch, researchers might leverage those insights to more rapidly improve the lives of bereaved dementia caregivers. METHODS AND ANALYSIS This study uses a transformative mixed methods approach to explore the needs of caregivers for individuals with Alzheimer's disease (AD) and AD-related dementias, incorporating both quantitative surveys (n=400) and qualitative semistructured interviews (n=45) across diverse subgroups. The study described in this protocol aims to quantitatively test a new model based on self-determination theory to help understand when and why bereaved dementia caregivers experience better and worse outcomes following bereavement. The study also aims to qualitatively explore the ways that bereaved dementia caregivers might meet their needs to inform future interventions. ETHICS AND DISSEMINATION The study adheres to institutional guidelines, ensuring participant consent and minimising risks through verbal consent procedures and the removal of personal identifiers from survey responses. The study team will share findings widely through academic publications, conferences and targeted outreach to advocacy groups and healthcare professionals, while also providing concise summaries of results to participants and making them accessible through the lab's website.
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Affiliation(s)
- Zachary G Baker
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Mary Gemma O’Donnell
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Sabrina Garcia-Arias
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Yingyan Huang
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Joahana Segundo
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Ashley N Millenbah
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Olivia M Neubert
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Isabel Huerta
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
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Norman SS, Mat S, Kamsan SS, Hamid Md Ali S, Mohamad Yahaya NH, Mei Hsien CC, Md Ramli DB, Tohit NM, Ibrahim N, Shahar S. Mediating Role of Psychological Status in the Association Between Resiliency and Quality of Life Among Older Malaysians Living with Knee Osteoarthritis. Exp Aging Res 2024:1-14. [PMID: 39023096 DOI: 10.1080/0361073x.2024.2377436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/28/2024] [Indexed: 07/20/2024]
Abstract
Resilience increases the ability of an individual to overcome adversity. It has not yet been determined how resilience is linked to quality of life among individuals experiencing knee osteoarthritis symptoms. To explore the inter-relationships of psychological distress, resilience and quality of life among older individuals with knee osteoarthritis. The study examined older adults in Kuala Lumpur and Selangor, identifying osteoarthritis through verified physician diagnosis. Various factors, including resilience, psychological status, and quality of life, were measured. In the study with 338 older adults, 50.9% had knee osteoarthritis. Higher resilience was linked to lower depression, anxiety, and stress, and better quality of life in both groups with and without knee osteoarthritis. Psychological factors consistently mediated the link between resilience and quality of life even after controlling potential confounders. Analysis showed that depression, anxiety, and stress mediate the relationship between resilience and quality of life, indicating a significant influence even when considering various factors. Resilience appears to influence psychological well-being and quality of life among older adult with knee osteoarthritis.
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Affiliation(s)
- Siti Sarah Norman
- Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Salwana Kamsan
- Department of Physical Rehabilitation Sciences, Faculty of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Sawal Hamid Md Ali
- Department of Electrical, Electronics and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Nor Hamdan Mohamad Yahaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Caryn Chan Mei Hsien
- Centre for community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dayang Balkis Md Ramli
- Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Hall L, Lichtenberg PA. Successful Aging Through Financial Empowerment (SAFE): Financial Coaching with Older Adult Victims of Financial Exploitation. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-21. [PMID: 38958203 DOI: 10.1080/01634372.2024.2373288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Abstract
Financial exploitation (FE) of older adults is a growing public health problem. Current estimates of financial exploitation show between 5% and 11% of older adults are victimized each year. This study examined an empowerment-centered financial coaching intervention. Program records and participant baseline and follow-up assessment data were used to detail program dynamics and investigate participant outcomes. Most SAFE participants were very satisfied or satisfied (91%) with the services they received. Participants also reported significantly less stress at the six-month follow-up. These findings demonstrate that empowerment-centered financial coaching interventions can successfully address FE in older adult populations.
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Affiliation(s)
- LaToya Hall
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
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Rivan NFM, Ludin AFM, Clark BC, Shahar S. Predictors for the development of motoric cognitive risk syndrome in older adults. BMC Geriatr 2024; 24:575. [PMID: 38961342 PMCID: PMC11223433 DOI: 10.1186/s12877-024-05179-8] [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: 10/25/2023] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Motoric cognitive risk (MCR) syndrome refers to a condition where both slow gait and memory complaints coexist, which heightens their vulnerability to developing dementia. Considering that the risk factors of MCR are elucidated from cross-sectional studies and also likely vary based on socioeconomic status, we conducted a community-based longitudinal study to determine the predictors of MCR among older adults in Malaysia. METHODS Out of 1,249 older participants (aged 60 years and above) without MCR at baseline (Wave II of LRGS-TUA cohort study), 719 were successfully followed up after 3.5 years to identify predictors of subsequent MCR development. A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, psychosocial, functional status, and dietary intake. Anthropometric measurements, body composition, and physical performance were assessed. Univariate analyses were performed for each variable, followed by a hierarchical logistic regression analysis to identify the predictors of MCR that accounted for confounding effects between the studied factors. RESULTS The incidence rate of MCR was 4.0 per 100 person-years. Smoking (Adjusted Odd Ratio (Adj OR) = 1.782; 95% Confidence Interval (CI):1.050-3.024), hypertension (Adj OR = 1.725; 95% CI:1.094-2.721), decreased verbal memory as assessed by the lower Rey Auditory Verbal Learning Test (RAVLT) (Adj OR = 1.891; 95% CI:1.103-3.243), and decreased functional status measured using instrumental activity of daily living (IADL) (Adj OR = 4.710; 95% CI:1.319-16.823), were predictors for MCR incidence. CONCLUSIONS Our study results provide an initial reference for future studies to formulate effective preventive management and intervention strategies to reduce the growing burden of adverse health outcomes, particularly among Asian older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, OH, USA
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Noguchi T, Shang E. Role of Individual Social Capital in the Association of Physical Frailty With Functional Ability Among Older Adults. J Am Med Dir Assoc 2024; 25:105024. [PMID: 38763164 DOI: 10.1016/j.jamda.2024.105024] [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: 12/12/2023] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES Rich social capital is regarded as an individual's social asset, which may contribute to the maintenance of functional ability, even in a state of frailty. This study examined the moderating role of individual social capital in the association between physical frailty and functional ability among older adults. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS In total, 522 community-dwelling older adults aged ≥60 years were recruited from among visitors to public facilities, including community cultural centers and gymnasiums in Aichi, Japan. METHODS Functional ability was assessed using the 5-item subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence that assesses instrumental self-maintenance, including transportation, finance management, and shopping. Physical frailty was defined by the Fried Frailty Phenotype Questionnaire, including 5 items of fatigue, resistance, ambulation, inactivity, and weight loss, and the participants were classified into 3 groups: non-frailty, pre-frailty, and frailty. Individual social capital was assessed for 2 dimensions: the cognitive dimension (perceptions of community social cohesion) and the structural dimension (informal socializing and social participation). RESULTS The participants' mean age (SD) was 74.1 (6.5) years and 78.0% were women. Among the participants, non-frailty was 46.6%, pre-frailty was 47.0%, and frailty was 6.5%. Multivariable linear regression analysis revealed that physical frailty was associated with lower levels of functional ability compared with non-frailty [pre-frailty: β (95% CI) = -0.07 (-0.22 to 0.08), P = .374; frailty: β = -0.67 (-0.99 to -0.35), P < .001]. However, individual structural social capital showed a negative interaction with physical frailty against low functional ability, indicating a moderating association (P = .027). CONCLUSIONS AND IMPLICATIONS High levels of individual structural social capital mitigated the adverse association between physical frailty and functional ability. Fostering rich social capital may preserve the functional ability of frail older adults, helping their independent lives in the community.
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Affiliation(s)
- Taiji Noguchi
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom; Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan; Japan Society for the Promotion of Science, Chiyoda, Japan.
| | - Erhua Shang
- Department of Human Health, Aichi Toho University, Nagoya, Japan
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Döhring J, Williamson M, Brettschneider C, Fankhänel T, Luppa M, Pabst A, Weißenborn M, Zöllinger I, Czock D, Frese T, Gensichen J, Hoffmann W, König HH, Thyrian JR, Wiese B, Riedel-Heller S, Kaduszkiewicz H. Quality of life in a high-risk group of elderly primary care patients: characteristics and potential for improvement. Qual Life Res 2024; 33:1841-1851. [PMID: 38740640 PMCID: PMC11176227 DOI: 10.1007/s11136-024-03647-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly primary care patients with a high risk of dementia. The main objectives are (a) to determine the role of the factors in this particular group and (b) to assess the proportion of fixed and potentially modifiable factors. METHOD A high-risk group of 1030 primary care patients aged between 60 and 77 years (52.1% females) were enrolled in "AgeWell.de," a cluster-randomized, controlled trial. This paper refers to the baseline data. The multi-component intervention targets to decrease the risk of dementia by optimization of associated lifestyle factors. 8 fixed and 7 modifiable factors potentially influencing QoL served as predictors in multiple linear regressions. RESULTS The highest proportion of explained variance was found in psychological health and age-specific QoL. In comparison to health-related QoL and physical health, the modifiable predictors played a major role (corr. R2: 0.35/0.33 vs. 0.18), suggesting that they hold a greater potential for improving QoL. CONCLUSION Social engagement, body weight, instrumental activities of daily living, and self-efficacy beliefs appeared as lifestyle factors eligible to be addressed in an intervention program for improving QoL. TRIAL REGISTRATION German Clinical Trials Register, reference number: DRKS00013555. Date of registration: 07.12.2017.
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Affiliation(s)
- Juliane Döhring
- Institute of General Practice, University of Kiel, 24105, Kiel, Germany.
| | - Martin Williamson
- Institute of General Practice, University of Kiel, 24105, Kiel, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Thomas Fankhänel
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
| | - Marina Weißenborn
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Isabel Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, 17489, Greifswald, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald, 17489, Greifswald, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), 17489, Greifswald, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Institute for General Practice, 30625, Hannover, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
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Huang CK, Lee PL, Lee HH. Effects of a Taiwanese Adaptation of the Group Cognitive Stimulation Therapy Program on Mild-To-Moderate Dementia: A Quasi-Experimental Trial. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-15. [PMID: 38943515 DOI: 10.1080/01634372.2024.2372103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up.
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Affiliation(s)
- Chih-Kun Huang
- Department of Social Work, National Quemoy University, Kinmen, Taiwan
| | - Pai-Lin Lee
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Hsiao-Han Lee
- Southern Region Senior's Citizens' Home, Ministry of Health and Welfare, Pingtung, Taiwan
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Yamada Y, Nakashima H, Nagae M, Watanabe K, Fujisawa C, Komiya H, Tajima T, Sakai T, Satake S, Takeya Y, Umeda-Kameyama Y, Umegaki H. Dual Sensory Impairment Predicts an Increased Risk of Postdischarge Falls in Older Patients. J Am Med Dir Assoc 2024; 25:105123. [PMID: 38950587 DOI: 10.1016/j.jamda.2024.105123] [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: 03/21/2024] [Revised: 05/22/2024] [Accepted: 05/26/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES The purpose of this study was to determine the associations of vision impairment, hearing impairment, and comorbid vision and hearing impairment [ie, dual sensory impairment (DSI)] on admission to hospital with falls within 3 months of discharge in older patients. DESIGN This prospective multicenter study included patients admitted to and discharged from geriatric wards at 3 university hospitals and 1 national medical center in Japan between October 2019 and July 2023. SETTING AND PARTICIPANTS Of 1848 individuals enrolled during the study period, 1141 were excluded, leaving 707 for inclusion in the analysis. METHODS Participants' background factors were compared in terms of whether they had a fall during the 3 months postdischarge. Logistic regression analysis was then performed using the presence or absence of falls after discharge as the objective variable. Three models were created using vision impairment, hearing impairment, and DSI as covariates. Other covariates included physical function, cognitive function, and depression. In addition, logistic regression analysis was performed with falls during hospitalization as the objective variable. RESULTS DSI was significantly more common in the falls group (P = .004). Logistic regression analysis showed that the risk of falls after discharge was higher in patients with DSI (odds ratio 3.432, P = .006) than in those with vision or hearing impairment alone. When adjusted for physical function, cognitive function, depression, and discharge location, DSI was significantly associated with an increased risk of falls after discharge (odds ratio 3.107, P = .021). The association between DSI and falls during hospitalization did not reach statistical significance, but a trend was observed. CONCLUSIONS AND IMPLICATIONS This study is the first to show an association between DSI and falls after discharge. Simple interventions for patients with DSI may be effective in preventing falls, and we suggest that they be actively implemented early during hospitalization.
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Affiliation(s)
- Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Tomihiko Tajima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Tomomichi Sakai
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shosuke Satake
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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Logue Cook RN, Kern KL, Brown SH. Effectiveness of a home training program on improving pinch force perception in older adults. J Hand Ther 2024:S0894-1130(24)00003-6. [PMID: 38942652 DOI: 10.1016/j.jht.2024.02.002] [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: 06/08/2023] [Revised: 09/07/2023] [Accepted: 02/09/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Hand function is reduced with aging which can lead to impairments in the performance of daily activities and eventually loss of independence. The ability to perceive the forces being applied to an object is an important component of hand control that also declines with age. However, the extent to which force perception can be improved through training remains largely unknown. PURPOSE This study evaluated the effectiveness of a home-training program focused on improving force perception in older adults. STUDY DESIGN Quasi-experimental - Uncontrolled trial. METHODS Eleven independent, healthy adults (mean age: 77.2 ± 6.8 years) participated in a home-based sensorimotor hand training program 6 days/week for 6 weeks. Force perception, the primary outcome variable, was measured as the ability to reproduce a pinch force equal to 25% maximum voluntary contraction in the absence of visual feedback using either the ipsilateral remembered or contralateral concurrent (CC) hand. We also measured hand strength, dexterity, tactile acuity, and cognition before and after training. RESULTS After the program was completed, participants showed a 35% reduction in absolute (p < 0.01, confidence interval (CI): [7.3, 33.2], effect sizes (ES): 0.87) and constant (p = 0.05, CI: [0.0, 34.9], ES: 0.79) force matching errors in the CC condition. Improvements in dominant hand dexterity (Purdue pegboard test) (p < 0.05, CI: [0.2, 2.4], ES: 0.60) and tactile sensitivity (JVP thresholds) (p < 0.05, CI: [-1.7, -0.1], ES: 0.94), as well as cognition (Trail Making Test B) (p < 0.05, CI: [-24,1. -1.6], ES: 0.30) were also observed post-training. CONCLUSIONS The results suggest that home-hand training can be an effective way to improve force perception among older adults.
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Affiliation(s)
- Rachel N Logue Cook
- Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI USA
| | - Kathy L Kern
- Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI USA
| | - Susan H Brown
- Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, MI USA.
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Schrempft S, Baysson H, Graindorge C, Pullen N, Hagose M, Zaballa ME, Preisig M, Nehme M, Guessous I, Stringhini S. Biopsychosocial risk factors for subjective cognitive decline among older adults during the COVID-19 pandemic: a population-based study. Public Health 2024; 234:16-23. [PMID: 38924819 DOI: 10.1016/j.puhe.2024.05.025] [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: 02/23/2024] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES There have been concerns that the COVID-19 pandemic and the measures used to contain it impacted the cognitive health of older adults. We therefore examined the prevalence of subjective cognitive decline, and its associated risk factors and health consequencs, among dementia-free older adults 2 years into the pandemic in Switzerland. STUDY DESIGN Population-based cohort study. METHODS Prevalence of SCD was estimated using the cognitive complaint questionnaire administered to adults aged ≥65 years in June-September 2022 (Specchio-COVID19 cohort, N = 1414), and compared to prepandemic values from 2014 to 2018 (CoLaus|PsyCoLaus cohort, N = 1181). Associated risk factors and health consequences were assessed using logistic and/or linear regression. RESULTS Prevalence of SCD in 2022 (18.9% [95% CI, 16.2-21.9]) was comparable to prepandemic levels in 2014-2018 (19.5% [17.2-22.1]). Risk factors included established risks for dementia-namely health issues, health behaviours, and depressive symptoms. Self-reported post-COVID, perceived worsening of mental health since the start of the pandemic, less frequent social club attendance, and increased loneliness were also risk factors for SCD. In turn, SCD was associated with poorer objective cognitive performance, difficulty performing instrumental activities of daily living, greater risk of falls, and lower well-being at one-year follow-up. CONCLUSIONS While the overall prevalence of SCD in 2022 was comparable to prepandemic levels, we identified several pandemic-related risk factors for SCD, including perceived worsening of mental health and increased isolation since the start of the pandemic. These findings highlight the importance of mental health promotion strategies in reducing cognitive complaints and preventing cognitive decline.
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Affiliation(s)
- S Schrempft
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland.
| | - H Baysson
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - C Graindorge
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - N Pullen
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M Hagose
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M-E Zaballa
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - M Preisig
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - M Nehme
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - I Guessous
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Stringhini
- Division of Primary Care Medicine, Unit of Population Epidemiology, Geneva University Hospitals, Geneva, Switzerland; University Centre for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Nguyen TV, Pham TTX, Nguyen TN. The Burden of Cardiovascular Disease and Geriatric Syndromes in Older Patients Undergoing Chronic Hemodialysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:812. [PMID: 38929058 PMCID: PMC11203679 DOI: 10.3390/ijerph21060812] [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: 05/28/2024] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND There is limited evidence on the complexity of cardiovascular disease (CVD) and geriatric syndromes in older patients with end-stage renal disease. Our aims were to (1) examine the prevalence of CVD in older patients on chronic hemodialysis, (2) compare the burden of geriatric syndromes in patients with and without CVD, and (3) examine the impact of CVD on hospitalization. METHODS This prospective, observational, multi-center study was conducted at two dialysis units of two major hospitals in Vietnam. Consecutive older adults receiving chronic hemodialysis were recruited from November 2020 to June 2021. CVD was defined as having one of these conditions: heart failure, ischemic heart disease, or stroke. Participants were assessed for geriatric conditions including frailty, malnutrition, impairment in instrumental activities/activities of daily living, depression, falls, and polypharmacy. Multivariable logistic regression analysis was applied to examine the impact of CVD on 6-month hospitalization, adjusting for age, sex, duration of dialysis, Charlson Comorbidity Index, and geriatric conditions. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS There were 175 participants (mean age 72.4 ± 8.5 and 58.9% female). CVD was present in 80% of the participants (ischemic heart disease: 49.7%, heart failure: 60.0%, and stroke: 25.7%). Participants with CVD had a higher burden of geriatric syndromes compared to those without CVD. During the 6-month follow-up, 48.6% of the participants were hospitalized (56.4% of those with CVD vs. 17.1% of those without CVD), p < 0.001). CVD independently increased the risk of hospitalization (adjusted OR 3.32, 95% CI 1.12-9.80). CONCLUSIONS In this study, there was a very high prevalence of CVD in older patients undergoing chronic dialysis. Participants with CVD had a higher burden of geriatric syndromes and their risk of 6-month hospitalization increased by three times. There is a need for a multidisciplinary and patient-centered approach to treatment planning for these patients.
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Affiliation(s)
- Tan Van Nguyen
- Department of Geriatrics & Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City 700000, Vietnam
| | - Thu Thi Xuan Pham
- Department of Geriatrics & Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Tu Ngoc Nguyen
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2000, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Sommerfelt K, Schei T, Seton KA, Carding SR. Assessing Functional Capacity in Myalgic Encephalopathy/Chronic Fatigue Syndrome: A Patient-Informed Questionnaire. J Clin Med 2024; 13:3486. [PMID: 38930014 PMCID: PMC11204454 DOI: 10.3390/jcm13123486] [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: 03/29/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an acquired disease with significant morbidity that affects both children and adults. Post-exertional malaise is a cardinal symptom of ME/CFS and impacts a patient's functional capacity (FC). The absence of effective tools to assess FC has significant consequences for timely diagnosis, clinical follow-up, assessments for patient disability benefits, and research studies. In interventional studies, the inability to assess FC can result in an incomplete assessment of the potential benefit of the intervention, leading to beneficial treatment outcomes being missed. Methods: Using extensive, repeated patient feedback, we have developed a new questionnaire, FUNCAP, to accurately assess FC in ME/CFS patients. The questionnaire consists of eight domains divided by activity types: A. personal hygiene/basic functions, B. walking/movement, C. being upright, D. activities in the home, E. communication, F. activities outside the home, G. reactions to light and sound, and H. concentration. Results: Through five rounds of anonymous web-based surveys and a further test-retest validation round, two versions of the questionnaire were developed: a longer version comprising 55 questions (FUNCAP55), developed for improved diagnostic and disability benefit/insurance FC assessments; and a shorter version (FUNCAP27) for clinical patient follow-up and potential use in research. Good reliability and validity and negligible floor and ceiling effects were found, with comparable findings in all aspects in both a large Norwegian (n = 1263) and a separate English-language international sample (n = 1387) demonstrating the validity and reliability of FUNCAP. Conclusions: Our findings support the utility of FUNCAP as an effective, reliable and valid tool for assessing FC in ME/CFS patients.
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Affiliation(s)
- Kristian Sommerfelt
- Children and Youth Clinic, Institute of Clinical Medicine 2, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway
| | - Trude Schei
- Norwegian ME Association, Nedre Slottsgate 4 M, 0157 Oslo, Norway
| | - Katharine A. Seton
- Quadram Institute Biosciences, Norwich Research Park, Norwich NR4 7UQ, UK; (K.A.S.)
| | - Simon R. Carding
- Quadram Institute Biosciences, Norwich Research Park, Norwich NR4 7UQ, UK; (K.A.S.)
- Norwich Medical School, University East Anglia, Norwich NR4 7TJ, UK
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Sahoo DP, Sahoo SS, Nirala SK, Rath RS, Agarwal N, Panda M, Kakkar R, Pandey S, Singh CM, Joshi HS, Nath B. Validation of the Indian (Hindi) version of the life-space assessment scale among community-dwelling older adults: a multicentric cross-sectional study. BMC Geriatr 2024; 24:500. [PMID: 38844833 PMCID: PMC11157764 DOI: 10.1186/s12877-024-05072-4] [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: 01/27/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. METHODS A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. RESULTS The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was - 0.674 (p value < 0.0001). CONCLUSION This study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India.
| | - Soumya Swaroop Sahoo
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Santosh Kumar Nirala
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Rama Shankar Rath
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Neeraj Agarwal
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Meely Panda
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Rakesh Kakkar
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Sanjay Pandey
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - C M Singh
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India
| | - Hari Shanker Joshi
- Dept. of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Bhola Nath
- Dept. of Community Medicine, All India Institute of Medical Sciences, Raebareli, India
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14
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Remillard ET, Koon LM, Mitzner TL, Rogers WA. Everyday Challenges for Individuals Aging With Vision Impairment: Technology Implications. THE GERONTOLOGIST 2024; 64:gnad169. [PMID: 38124344 PMCID: PMC11102008 DOI: 10.1093/geront/gnad169] [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: 07/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There are growing numbers of older adults with long-term vision impairment who are likely to experience everyday activity challenges from their impairment in conjunction with age-related changes. Technology has potential to support activity engagement. To develop effective technologies and interventions, we need to understand the context of activity challenges and identify unmet support needs. RESEARCH DESIGN AND METHODS The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study is a mixed-method approach to explore everyday challenges of people aging with long-term disabilities. Participants included 60 adults aging with long-term vision impairment (63% female; M age = 67, SD = 4.6) who completed in-depth, structured interviews exploring the nature of everyday challenges and their unmet support needs for activity engagement. We conducted a content analysis using a deductive and inductive approach to build a detailed coding scheme of challenge codes and subcodes. RESULTS The analyses provided detailed insights about the nature of challenges people aging with vision impairment experience when performing specific instrumental activities of daily living (IADLs) in the context of home maintenance, transportation, shopping/finance, and managing health. Vision-related challenges and participation restrictions were identified for several activities that require reading, navigation, and identification (e.g., shopping, medication management, public transportation). Emergent challenge themes for performing IADLs included personal limitations (e.g., physical, cognitive, financial) and environmental barriers (e.g., accessibility, technology, transportation). DISCUSSION AND IMPLICATIONS Contextual examples of IADL challenges among individuals aging with vision impairment highlight opportunities for technology design and innovation to support participation in everyday activities.
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Affiliation(s)
- Elena T Remillard
- Center for Inclusive Design and Innovation, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Lyndsie M Koon
- Life Span Institute, University of Kansas, Lawrence, Kansas, USA
| | | | - Wendy A Rogers
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
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15
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Huang HL, Shyu YIL, Hsu WC, Liao YT, Huang HL, Hsieh SH. Effectiveness of a health education program for people with dementia and their family caregivers: An intervention by nurse practitioners. Arch Psychiatr Nurs 2024; 50:147-159. [PMID: 38789227 DOI: 10.1016/j.apnu.2024.03.018] [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: 07/31/2023] [Revised: 01/17/2024] [Accepted: 03/17/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE This study assesses the effectiveness of a health education program on caregiving outcomes for people with dementia and their families. METHODS This quasi-experimental study involved 250 people with dementia and their family caregivers. Behavioral problems in people with dementia were assessed using the Chinese version of the Cohen-Mansfield Agitation Inventory-community form. Family caregiver outcomes were measured using the Agitation Management Self-Efficacy Scale, Caregiver Preparedness Scale, Competence Scale, and Community Resource Awareness and Utilization Assessment. RESULTS Following the intervention, the experimental group demonstrated significant improvements in terms of self-efficacy, preparedness, competence, and awareness and utilization of community resources among family caregivers. Additionally, the experimental group exhibited lower levels of behavioral problems among people with dementia. CONCLUSIONS This study helped improve caregiving outcomes for people with dementia and their family caregivers. Therefore, outpatient healthcare providers can utilize these findings to enhance care for this population.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Yea-Ing L Shyu
- Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Nursing, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Ting Liao
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Hua Hsieh
- Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Nguyen TN, Nguyen TN, Thillainadesan J, Nguyen AT, Nguyen HTT, Nguyen TTH, Nguyen HTT, Nguyen TX, Naganathan V, Vu HTT. Factors associated with frailty in geriatric patients with and without sarcopenia in Vietnam. Australas J Ageing 2024; 43:281-287. [PMID: 37842735 DOI: 10.1111/ajag.13253] [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: 11/07/2022] [Revised: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES This study aimed to investigate the relationship between sarcopenia and frailty and examine factors associated with frailty among older patients with and without sarcopenia. METHODS This cross-sectional study was conducted on older inpatients and outpatients in Vietnam. Participants aged 60 years or older were consecutively enrolled in the study. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Fried's frailty phenotype was applied to define frailty. Logistic regression models with frailty as the dependent variable were applied. RESULTS A total of 835 patients (mean age: 71.3 years, SD 8.4) were recruited. The overall prevalence of frailty was 17%. Among participants with and without frailty, 92% and 47% had sarcopenia, respectively. In unadjusted analysis, sarcopenia was significantly associated with increased frailty (OR 12.3, 95% CI 6.7-22.6) and remained significant after adjustment for sociodemographic factors (OR 6.3, 95% CI: 3.0-12.6) and for both sociodemographic and clinical factors (OR 5.4, 95% CI: 2.4-12.2). Among participants with sarcopenia, older age, inpatient status, having a high risk for falls, malnutrition and a history of hospitalisation in the last year were significantly associated with frailty. Among participants without sarcopenia, the factors associated with frailty were older age, inpatient status, low educational level, high risk of falls and malnutrition. CONCLUSIONS Our study results highlighted that sarcopenia and frailty are two related but distinct geriatric syndromes.
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Affiliation(s)
- Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Tu Ngoc Nguyen
- Faculty of Medicine and Health, Westmead Applied Research Centre, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Janani Thillainadesan
- Department of Geriatric Medicine and Centre for Education and Research on Ageing (CERA), Concord Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Huong Thi Thanh Nguyen
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
- Physiology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Vasi Naganathan
- Department of Geriatric Medicine and Centre for Education and Research on Ageing (CERA), Concord Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
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Su HC, Liu CH, Chen HY, Wu YL, Griffiths MD, Li CY, Hou WH, Lin CY, Yang YC. Assessing intrinsic capacity in Taiwan: Initial psychometric properties of the Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW). BMC Geriatr 2024; 24:477. [PMID: 38822234 PMCID: PMC11141031 DOI: 10.1186/s12877-024-05071-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). METHODS Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). RESULTS The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach's α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=-0.447), and BADL (r=-0.447), with all p-values < 0.001. CONCLUSION The ICOPES-TW could be a useful screening tool for healthcare providers to quickly evaluate intrinsic capacity for Taiwanese older people given that it has moderate to strong associations with age, BADL, IADL, QoL, and frailty.
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Affiliation(s)
- Hui-Chen Su
- Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Hsiu Liu
- Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Hung-Yu Chen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Wen-Hsuan Hou
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Department of Physcial Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan.
- Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Fatin Malek Rivan N, Murukesu RR, Shahar S, Fadilah Rajab N, Subramaniam P, Choon Ooi T, Zul Amin Kamaruddin M, Singh DKA. Synergistic effects of cognitive frailty and comorbidities on disability: a community-based longitudinal study. BMC Geriatr 2024; 24:448. [PMID: 38778287 PMCID: PMC11112824 DOI: 10.1186/s12877-024-05057-3] [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: 10/20/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE In this study, we aimed to assess the synergistic effects of cognitive frailty (CF) and comorbidity on disability among older adults. METHODS Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity. RESULTS Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057-42.158; RERI: 1.501, 95% CI: 1.400-1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378-8.786; RERI: 0.875, 95% CI: 0.831-0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065-11.126; RERI: 0.806, 95% CI: 0.753-0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487-5.671; RERI: 0.607, 95% CI: 0.577-0.637). CONCLUSION These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Resshaya Roobini Murukesu
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
- TUM School of Medicine & Health, Department of Health and Sport Sciences, Technical University of Munich, Munich, Germany
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Theng Choon Ooi
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
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19
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Quintero-Cruz MV, Mantilla-Morrón M, Urina-Jassir M, Pinillos-Patiño Y, Quijano-Del Gordo CI, Buelvas W, De Ávila-Quintana L, Cotes K, Urina-Triana M. Factors associated with frailty among older individuals with chronic diseases: A multicenter study. SAGE Open Med 2024; 12:20503121241255000. [PMID: 38799003 PMCID: PMC11119381 DOI: 10.1177/20503121241255000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Frailty is a syndrome that predisposes older individuals to adverse health outcomes, such as disability, dependence, falls, hospitalization, post-operative complications, and poor health in general. This study aimed to identify factors associated with frailty in older people with chronic diseases in Colombia. Methods A cross-sectional study was conducted with a nonprobabilistic sample of 230 older people (aged ⩾ 60 years) from four Colombian cities. Frailty was based on Fried's phenotype (frail defined as having ⩾3 criteria). Comorbidities were classified based on Charlson's Comorbidity Index and key questionnaires for activities of daily living (ADLs) were evaluated. Results Most were female (57.8%) with a mean ± SD age of 71.9 ± 8 years. Among them, 27.4% were frail and 58.7% were prefrail. Female gender, age ⩾ 75 years, low educational and socioeconomic level, dependence on ADLs, and cognitive impairment were associated with higher odds of prefrailty/frailty. Conclusions Prefrailty and frailty are common among older people with chronic diseases in Colombia. This syndrome is associated with social and health-related conditions, which should be addressed when providing care for these patients.
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Affiliation(s)
| | - Mirary Mantilla-Morrón
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Manuel Urina-Jassir
- Department of Medicine, Boston Medical Center and Boston University Chobanian, Avedisian School of Medicine, Boston, MA, USA
| | - Yisel Pinillos-Patiño
- Faculty of Health Sciences, Physiotherapy Program, Universidad Simón Bolívar, Barranquilla, Colombia
| | | | | | - Luzdaris De Ávila-Quintana
- Centro de Rehabilitación Pulmonar Integral, Cartagena, Cordoba, Colombia
- Universidad de San Buenaventura, Cartagena, Colombia
| | | | - Miguel Urina-Triana
- Faculty of Health Sciences, Universidad Simón Bolívar, Barranquilla, Atlántico, Colombia
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20
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Singh N, Kenney CC, Butcher KS, Buck B, Barber PA, Field TS, Choi PM, Yu AY, Kleinig T, Appireddy R, Molina CA, Muir KW, Hill MD, Coutts SB. A Randomized Controlled Trial of Tenecteplase Versus Standard of Care for Minor Ischemic Stroke with Proven Occlusion (TEMPO-2): Rational and design of a multicenter, randomized open-label clinical trial. Int J Stroke 2024:17474930241253702. [PMID: 38676572 DOI: 10.1177/17474930241253702] [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: 04/29/2024]
Abstract
BACKGROUND Almost half of acute ischemic stroke patients present with mild symptoms and there are large practice variations in their treatment globally. Individuals with an intracranial occlusion who present with minor stroke are at an increased risk of early neurological deterioration and poor outcomes. Individual patient data meta-analysis in the subgroup of patients with minor deficits showed benefit of alteplase in improving outcomes; however, this benefit has not been seen with intravenous alteplase in published randomized trials. DESIGN TEMPO-2 (A Randomized Controlled Trial of Tenecteplase Versus Standard of Care for Minor Ischemic Stroke With Proven Occlusion) is a prospective, open label with blinded outcome assessment, randomized controlled trial, designed to test the superiority of intravenous tenecteplase (0.25 mg/kg) over nonthrombolytic standard of care, with an estimated sample size of 1274 patients. Adult patients presenting with acute ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) ⩽ 5 and visible arterial occlusion or perfusion deficit within 12 h of onset are randomized to receive either tenecteplase (0.25 mg/kg) or standard of care. The primary outcome is return to baseline neurological functioning, measured by the modified Rankin scale (mRS) at 90 days. Safety outcomes include death and symptomatic hemorrhage (intra or extra-cranial). Other secondary outcomes include mRS 0-1, mRS 0-2, ordinal shift analysis of the mRS, partial, and full recanalization on follow-up computed tomography angiogram. CONCLUSION Results of this trial will aid in determining whether there is benefit of using tenecteplase (0.25 mg/kg) in treating patients presenting with minor stroke who are at high risk of developing poor outcomes due to presence of an intracranial occlusion. DATA ACCESS STATEMENT Data will be available upon reasonable request.
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Affiliation(s)
- Nishita Singh
- Neurology Division, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Carol C Kenney
- Departments of Neurosciences, Radiology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Ken S Butcher
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Brian Buck
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Philip A Barber
- Departments of Neurosciences, Radiology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Thalia S Field
- Vancouver Stroke Program, Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Philip M Choi
- Department of Neurosciences, Box Hill Hospital, Faculty of Medicine, Nursing and Health Sciences, Monash University, Box Hill, VIC, Australia
| | - Amy Yx Yu
- Division of Neurology, Department of Medicine, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Timothy Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Ramana Appireddy
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | | | - Keith W Muir
- School of Psychology & Neuroscience, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, UK
| | - Michael D Hill
- Departments of Neurosciences, Radiology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shelagh B Coutts
- Departments of Neurosciences, Radiology and Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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21
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As-Sanie S, Shafrir AL, Halvorson L, Chawla R, Hughes R, Merz M. The Burden of Pelvic Pain Associated with Endometriosis among Women in Selected European Countries and the United States: A Restricted Systematic Review. J Minim Invasive Gynecol 2024:S1553-4650(24)00206-1. [PMID: 38729420 DOI: 10.1016/j.jmig.2024.05.002] [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: 12/23/2023] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To evaluate the burden of endometriosis-associated pelvic pain (EAPP) on health-related quality of life (HRQoL) among women living in similar socio-economic conditions. DATA SOURCES Searches were performed in PubMed and Embase on September 26, 2022. The review was performed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) and was registered on PROSPERO (ID: CRD42023370363). METHODS OF STUDY SELECTION Due to the high volume of eligible publications following initial review, inclusion criteria were restricted to studies undertaken in France, Germany, Italy, Spain, the United Kingdom, and the United States. This restriction was applied before screening as these countries have broad social and economic similarities, and previous studies in the literature suggest pain reporting and experience are influenced by numerous socio-cultural factors. Eligible studies were those published between 2013 and 2022 and include a sample size of ≥50 participants. The search strategy identified all relevant publications relating to the burden of illness due to EAPP. A variety of terms are used in the literature to describe pain associated with endometriosis, and this was considered in the design of the search strategy and screening procedure. TABULATION, INTEGRATION, AND RESULTS The database searches resulted in a total of 6139 records. After removal of duplicates, 3855 records were assessed further. A total of 27 publications were identified as eligible. Fourteen (52%) were from Italy, 5 (19%) were multinational studies, 4 (15%) were from the United States, 3 (11%) were from Spain, and 1 (4%) was from Germany. Most studies were cross-sectional (n = 15; 56%); 7 (26%) were case-control studies; 3 (11%) were cohort studies; and 2 (7%) were longitudinal studies. These publications collectively highlighted an association between EAPP and reduced HRQoL. Several studies showed that EAPP was associated with lower HRQoL when compared with endometriosis without pain and potentially with chronic pelvic pain caused by other conditions, although the evidence is limited in this case. Moreover, the studies reported detrimental effects on general HRQoL, mental health functioning, and sexual functioning, culminating in reduced work productivity and difficulties in performing everyday activities. The associations were generally similar across study populations, including adolescents, as well as younger and older women. Results were consistent across the range of different patient-reported outcome tools used to assess HRQoL. CONCLUSION The existing literature suggests that, among women in selected European countries and the United States, EAPP is associated with reduced HRQoL, including impaired mental and sexual functioning, as well as reduced work performance and productivity; each of which may contribute to the societal burden of endometriosis.
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Affiliation(s)
- Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan (Dr. As-Sanie), Ann Arbor, Michigan.
| | - Amy L Shafrir
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School (Dr. Shafrir), Boston, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, MA
| | - Lisa Halvorson
- Bayer US Pharmaceuticals (Dr. Halvorson), Whippany, New Jersey
| | - Rajinder Chawla
- AccuScript Consultancy (Dr. Chawla), Ludhiana, Punjab, India
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22
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Aghamoosa S, Lopez J, Rbeiz K, Fleischmann HH, Horn O, Madden K, Caulfield KA, Antonucci MU, Revuelta G, McTeague LM, Benitez A. A phase I trial of accelerated intermittent theta burst rTMS for amnestic MCI. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-332680. [PMID: 38719432 DOI: 10.1136/jnnp-2023-332680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/27/2024] [Indexed: 05/15/2024]
Abstract
BACKGROUND Emerging evidence suggests that repetitive transcranial magnetic stimulation (rTMS) enhances cognition in mild cognitive impairment (MCI). Accelerated intermittent theta burst stimulation (iTBS) rTMS protocols are promising as they substantially reduce burden by shortening the treatment course, but the safety, feasibility, and acceptability of iTBS have not been established in MCI. METHODS 24 older adults with amnestic MCI (aMCI) due to possible Alzheimer's disease enrolled in a phase I trial of open-label accelerated iTBS to the left dorsolateral prefrontal cortex (8 stimulation sessions of 600 pulses of iTBS/day for 3 days). Participants rated common side effects during and after each session and retrospectively (at post-treatment and 4-week follow-up). They completed brain MRI (for safety assessments and electric field modeling), neuropsychiatric evaluations, and neuropsychological testing before and after treatment; a subset of measures was administered at follow-up. RESULTS Retention was high (95%) and there were no adverse neuroradiological, neuropsychiatric, or neurocognitive effects of treatment. Participants reported high acceptability, minimal side effects, and low desire to quit despite some rating the treatment as tiring. Electric field modeling data suggest that all participants received safe and therapeutic cortical stimulation intensities. We observed a significant, large effect size (d=0.98) improvement in fluid cognition using the NIH Toolbox Cognition Battery from pre-treatment to post-treatment. CONCLUSIONS Our findings support the safety, feasibility, and acceptability of accelerated iTBS in aMCI. In addition, we provide evidence of target engagement in the form of improved cognition following treatment. These promising results directly inform future trials aimed at optimizing treatment parameters. TRIAL REGISTRATION NUMBER NCT04503096.
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Affiliation(s)
- Stephanie Aghamoosa
- Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James Lopez
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Katrina Rbeiz
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Holly H Fleischmann
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Olivia Horn
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Katrina Madden
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kevin A Caulfield
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michael U Antonucci
- Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Gonzalo Revuelta
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Lisa M McTeague
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson VA Health Care System, Charleston, South Carolina, USA
| | - Andreana Benitez
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
- Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
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23
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Lynch ST, Dornbush R, Shahar S, Mansour R, Klepacz L, Primavera LH, Ferrando SJ. Change in Neuropsychological Test Performance Seen in a Longitudinal Study of Patients With Post-acute Sequelae of COVID-19: A 6-Month Follow-up Study. J Acad Consult Liaison Psychiatry 2024; 65:231-247. [PMID: 38171454 DOI: 10.1016/j.jaclp.2023.12.005] [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: 08/28/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Post-acute sequelae of COVID-19 may include physical, psychiatric, and neurocognitive symptoms. Few studies of cognitive symptoms have been longitudinal, with many following participants briefly after infection and relying on subjective complaints, screening instruments, or computerized testing. This group previously reported diminished neuropsychological (NP) test performance in over half of 60 individuals tested in-person 7 months post-COVID-19, particularly those seeking care for cognitive complaints. The current study describes the initial and 6-month follow-up results of an expanded cohort of 75 participants. OBJECTIVE To measure longitudinal changes in neuropsychological test performance, as well as medical and psychiatric changes, post-COVID-19. METHODS Participants underwent NP, psychiatric, and medical assessments approximately 7 months after acute COVID-19 infection. Sixty-three (84%) returned approximately 6 months later for repeat evaluation. RESULTS At the initial visit, 29 (38.7%) met criteria for low NP performance, and 16 (21.3%) met criteria for extremely low NP performance. At 6-month follow-up, several NP domains that were significantly below normative values at the initial visit were no longer abnormal, with the exception of language. Only measures of delayed memory and fatigue showed significant improvements between the 2 time points. CONCLUSIONS A substantial proportion of individuals recovered from acute COVID-19 infection have persistent neuropsychiatric symptoms over 1 year after infection. While the overall sample in this study showed some improvement in NP test performance relative to norms, only fatigue and delayed memory improved significantly between times 1 and 2. No individual declined in NP test performance, though relatively few individuals made significant clinical improvement, indicating the need for serial neuropsychiatric assessment and treatment supports. Longitudinal follow-up of this cohort is in progress.
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Affiliation(s)
- Sean T Lynch
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY
| | - Rhea Dornbush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY
| | - Sivan Shahar
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY
| | - Rayah Mansour
- School of Public Health, New York Medical College, Valhalla, NY
| | - Lidia Klepacz
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY
| | - Louis H Primavera
- School of Health Sciences, Touro College and University System, Valhalla, NY
| | - Stephen J Ferrando
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY.
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24
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Gamero-Sánchez MDC, Barreto I, Arévalo-Lorido JC, Vázquez-Jarén E, Maese-Calvo J, Mayoral-Testón N, Carretero-Gómez J, Fernández-Bergés D. Multidimensional frailty connection in older patients with diabetes mellitus. Rev Clin Esp 2024; 224:281-287. [PMID: 38608730 DOI: 10.1016/j.rceng.2024.04.007] [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: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Patients with diabetes mellitus (DM) experience accelerated aging and, thus, a high prevalence of frailty. Our aim is to outline the type of frailty and prefrailty from a multidimensional perspective and the interaction of these dimensions in this scenery. MATERIAL AND METHODS Observational study of patients with DM over 60 years-old. Variables related to nutrition, cognitive and emotional status, physical and instrumental functional capacity and social resources were collected. They were divided into three groups (robust, prefrail and frail) according to the Fried scale. Each of the variables in the groups were compared and a correspondence analysis was carried out to see the influence of some dimensions with others in each stage of frailty. RESULTS 188 patients (mean age 72.6 + 7.5) were analysed. Of them, 105 patients had prefrailty and 66 were frail. With the exception of social resources, the rest of the variables had an increasing prevalence depending on the stage of frailty. However, in the correspondence analysis (with 22.9% of variation explained by two dimensions) it was only patients with frailty who were associated with worse functional capacity, cognitive and emotional situation and mild to moderate social incapacity. CONCLUSIONS In our sample there was a high prevalence of prefrailty, and frailty associated with an increase in the prevalence of other different dimensions except social resources. However, the interaction between these dimensions was only evident in the case of patients with frailty.
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Affiliation(s)
- M Del Carmen Gamero-Sánchez
- UCSP Moura (Unidad de Cuidados de Salud Personalizados de Moura), Unidade Local de Saúde do Baixo Alentejo, Rua Dr. António Fernando Covas Lima, 7801-849 Beja, Portugal; Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - I Barreto
- UCSP Moura (Unidad de Cuidados de Salud Personalizados de Moura), Unidade Local de Saúde do Baixo Alentejo, Rua Dr. António Fernando Covas Lima, 7801-849 Beja, Portugal; Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J C Arévalo-Lorido
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain; Servicio de Medicina Interna, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz, Spain.
| | - E Vázquez-Jarén
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J Maese-Calvo
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - N Mayoral-Testón
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
| | - J Carretero-Gómez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Avda de Elvas s/n, 06080, Badajoz, Spain
| | - D Fernández-Bergés
- Grupo Investigación Multidisciplinar de Extremadura, (GRIMEX), C/Sierra Nevada 10-Villanueva de la Serena, CP 06700, Badajoz, Spain
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25
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Lorenz M, Baum F, Kloss P, Langer N, Arsene V, Warner L, Panelli A, Hartmann FV, Fuest K, Grunow JJ, Enghard P, Schaller SJ. Robotic-Assisted In-Bed Mobilization in Ventilated ICU Patients With COVID-19: An Interventional, Randomized, Controlled Pilot Study (ROBEM II Study). Crit Care Med 2024; 52:683-693. [PMID: 38236076 DOI: 10.1097/ccm.0000000000006194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVES The COVID-19 pandemic significantly impacted global healthcare systems, particularly in managing critically ill mechanically ventilated patients. This study aims to assess the feasibility of robotic-assisted mobilization in COVID-19 patients. DESIGN Randomized controlled pilot study. SETTING Four COVID-19 specialized ICUs at Charité-Universitätsmedizin Berlin (March 2021 to February 2022). PATIENTS Twenty critically ill COVID-19 patients expected to require greater than 24 hours of ventilation. INTERVENTIONS A 5-day intervention phase with bid robotic-assisted mobilization greater than or equal to 20 minutes and follow-up at day 180, compared with standard care. MEASUREMENTS AND MAIN RESULTS Intervention sessions were conducted in 98.9% according to protocol, with one session missing due to staff shortage. Primary outcome was the mobilization level measured with the ICU Mobility Scale (IMS) and Surgical ICU Optimal Mobilization Score (SOMS), assessed until day 5 or extubation. Safety events were recorded during mobilization. The median IMS and SOMS were 0 (0-0.16) and 1 (1-1.03) in the intervention group, and 0 (0-0.15) ( p = 0.77) and 0.8 (0.65-1.20) ( p = 0.08) in the standard care group, respectively. Significant secondary outcomes included average number of mobilization sessions (intervention: 8.5 [7.75-10] vs. standard care: 4.5 [3.5-5]; p = 0.001), total mobilization time (intervention: 232.5 min [187.25-266.5 min] vs. standard care: 147.5 min [107.5-167.5 min]; p = 0.011), and healthcare providers per session (intervention: 2 [2-2] vs. standard care: 1 [1-1.4]; p = 0.001) during intervention. Four safety events (hypertension and agitation, n = 2 each) in the intervention group and none in the standard care group were reported. CONCLUSIONS Robotic-assisted mobilization in mechanically ventilated COVID-19 patients appears to be safe and feasible.
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Affiliation(s)
- Marco Lorenz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
- Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anesthesiology and Intensive Care Medicine, Munich, Germany
| | - Felix Baum
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Philipp Kloss
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Nadine Langer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Vanessa Arsene
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Linus Warner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Alessandro Panelli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Frederike V Hartmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Kristina Fuest
- Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anesthesiology and Intensive Care Medicine, Munich, Germany
| | - Julius J Grunow
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
| | - Philipp Enghard
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Nephrology and Medical Intensive Care, Berlin, Germany
| | - Stefan J Schaller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany
- Technical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anesthesiology and Intensive Care Medicine, Munich, Germany
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26
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Piper KS, Suetta C, Schou JV, Ryg J, Andersen HE, Langevad LV, Evering D, Mikkelsen MK, Lund C, Christensen J. The SaVe project - Sarcopenia and Vertigo in aging patients with colorectal cancer: A study protocol for three randomized controlled trials. J Geriatr Oncol 2024; 15:101770. [PMID: 38631243 DOI: 10.1016/j.jgo.2024.101770] [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: 01/13/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Older patients with cancer range from fit to frail with various comorbidities and resilience to chemotherapy. Besides nausea and fatigue, a significant number of patients experience dizziness and impaired walking balance after chemotherapy, which can have great impact on their functional ability and health related quality of life. Symptoms are easily overlooked and therefore often underreported and managed, which is why symptoms could end up as long-lasting side effects. The aim of this study is to investigate the development of dizziness, decline in walking balance, and sarcopenia and the effect of a comprehensive geriatric assessment and 12 weeks of group-based exercise on these symptoms. The exercise intervention includes vestibular and balance exercises, and progressive resistance training, to counteract the symptoms in older patients with colorectal cancer treated with chemotherapy. MATERIALS AND METHODS This is a randomized controlled trial including patients ≥65 years initiating (neo)adjuvant or first-line palliative chemotherapy for colorectal cancer. Patients will undergo a comprehensive assessment program including measures of vestibular function, balance, muscle strength, mass, and endurance, peripheral and autonomic nerve function, and subjective measures of dizziness, concern of falling, and health related quality of life. Tests will be performed at baseline, 12, and 24 weeks. Patients will be placed in three different randomized controlled trials depending on chemotherapy regimen and randomized 1:1 to comprehensive geriatric assessment and exercise three times/week or control. Participants in both groups will continue with usual care, including standardized oncological treatment. In total, 150 patients are needed to assess the two primary outcomes of (1) maintenance of walking balance assessed with Dynamic Gait Index and (2) lower limb strength and endurance assessed with 30 Second Sit-to-Stand Test at 12 weeks. The primary outcomes will be analyzed using a mixed linear regression model investigating the between-group differences. DISCUSSION Trial enrollment began in April 2023 and is the first trial to evaluate reasons for dizziness, decline in walking balance, and sarcopenia in older patients receiving chemotherapy. The trial will provide new and valuable knowledge in how to assess, manage, and prevent dizziness, decline in walking balance, and sarcopenia in older patients with colorectal cancer. TRIAL REGISTRATION The Regional Ethics Committee (j.nr. H-22064206). Danish Data Protection Agency (P-2023-86) and ClinicalTrials.gov (NCT05710809).
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Affiliation(s)
- Katrine Storm Piper
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Charlotte Suetta
- CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Department of Geriatric Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Jakob Vasehus Schou
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Jesper Ryg
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark; Department of Geriatric Medicine, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
| | - Hanne Elkjær Andersen
- Department of Geriatric Medicine, Copenhagen University Hospital, Amager and Hvidovre, Kettegård Alle 30, 2650 Hvidovre, Denmark
| | - Line Vind Langevad
- Department of Geriatric Medicine, Copenhagen University Hospital, Amager and Hvidovre, Kettegård Alle 30, 2650 Hvidovre, Denmark
| | - Delaney Evering
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Marta Kramer Mikkelsen
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Cecilia Lund
- CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Department of Geriatric Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospitals, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark; Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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Hwang WY, Jeon MJ, Suh DH. Minimally Invasive Sacrohysteropexy Versus Vaginal Hysterectomy With Uterosacral Ligament Suspension for Pelvic Organ Prolapse: A Prospective Randomized Non-Inferiority Trial. J Minim Invasive Gynecol 2024; 31:406-413. [PMID: 38336010 DOI: 10.1016/j.jmig.2024.01.018] [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: 04/17/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
STUDY OBJECTIVE To investigate whether minimally invasive Sacrohysteropexy (SH) is non-inferior to vaginal hysterectomy (VH) with uterosacral ligament suspension (USLS) in women with symptomatic uterovaginal prolapse. DESIGN Prospective, randomized, non-inferiority study. SETTING Tertiary university-based hospital. PATIENTS A total of 146 patients with uterovaginal prolapse between July 2016 and August 2019. INTERVENTIONS Patients were randomly assigned in a 1:1 ratio to either laparoscopic or robotic SH surgery or VH with USLS surgery. MEASUREMENTS AND MAIN RESULTS The primary outcome was prolapse recurrence at 1 year after surgery, defined as prolapse ≥ stage 2 evaluated using the pelvic organ prolapse quantification system, bothersome vaginal bulge symptoms, or retreatment for prolapse. The secondary outcomes included operation time, estimated blood loss, hospital stay, operation-related complications, pain intensity, quality of life, and activities of daily living. Of 146 women who underwent randomization, 73 in the SH group and 73 in the VH with USLS group were analyzed. SH was non-inferior for recurrence compared with VH with USLS (16.4% vs 15.8%, 95% confidence interval: -13.0% to 14.2%). Operating duration and transvaginal length were significantly longer in the SH group, while there were no significant differences in the estimated blood loss, length of hospital stay, or postoperative complication rates. Although perioperative pain intensity was greater from 1 week to 1 month in the SH group, the quality of life and activities of daily living did not differ between the groups throughout postoperative year 1. CONCLUSION Laparoscopic or robotic SH was non-inferior to VH with USLS for the recurrence of pelvic organ prolapse at the 1-year follow-up.
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Affiliation(s)
- Woo Yeon Hwang
- Department of Obstetrics and Gynecology, Kyung Hee University College of Medicine, Kyung Hee University Hospital (Dr. Hwang), Seoul
| | - Myung Jae Jeon
- Department of Obstetrics and Gynecology, Seoul National University Hospital (Dr. Jeon), Seoul; Department of Obstetrics and Gynecology, Seoul National University College of Medicine (Drs. Jeon and Suh), Seoul
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine (Drs. Jeon and Suh), Seoul; Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital (Dr. Suh), Seongnam, Republic of Korea.
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M Zapawi MM, You YX, Shahar S, Shahril MR, Malek Rivan NF, Nik Mohd Fakhruddin NNI, Yap AXW. Development of Malaysian-MIND diet scores for prediction of mild cognitive impairment among older adults in Malaysia. BMC Geriatr 2024; 24:387. [PMID: 38693524 PMCID: PMC11064310 DOI: 10.1186/s12877-024-04966-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/11/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer's disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia. METHODS A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries. RESULTS MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p < 0.001). According to hierarchical multivariate binary logistic regression analysis, being in the highest tertile of MY-MINDD score was linked to reduced odds of MCI (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.26-0.72, p < 0.001) in the fully adjusted model in comparison to the lowest tertile. CONCLUSION The development of the MY-MINDD scores for Malaysian older population revealed that a stronger adherence to this diet is linked to a reduced risk of MCI. Further substantiation of the MY-MINDD scores using more objective measures, such as neuroimaging approaches and other neuropsychological batteries, is necessary.
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Affiliation(s)
- Muhamad Mustaqim M Zapawi
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Yee Xing You
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Suzana Shahar
- Dietetic Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mohd Razif Shahril
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nurul Fatin Malek Rivan
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nik Nur Izzati Nik Mohd Fakhruddin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, 47500, Malaysia
| | - Anastasia Xin Wei Yap
- Nutrition Programme, Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
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Petersen CM, DeLucia PR, Oswald FL, Kortum P, Leal SL, Pickens S, Hekel BE. Toward user-centered assistive technologies for aging in place with cognitive impairment: a survey. Disabil Rehabil Assist Technol 2024; 19:1561-1567. [PMID: 37267121 DOI: 10.1080/17483107.2023.2217848] [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: 10/07/2022] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE To reduce the burden of Alzheimer's disease, the use of assistive technologies for patients and their informal caregivers is considered essential. However, these technologies are made as "one size fits all" instead of being tailored to accommodate people with varying degrees of cognitive impairment and those with diverse races/ethnicities. Thus, the aim of this survey was to determine whether the types of assistance needed most, and the technology used by those with cognitive impairment differed by race (White/non-Hispanics, Black or African Americans, and Hispanic/Latinos or Puerto Ricans) and severity of dementia (mild, moderate, severe). RESEARCH DESIGN AND METHODS One hundred and eighty informal caregivers of people with different levels of severity of cognitive impairment and several different races/ethnicities filled out an online survey regarding assistance needed and technologies used. RESULTS The results show that racial minorities considered the needs for assistance with Basic Activities of Daily Living as more important compared to White/non-Hispanics with mild dementia. Furthermore, Hispanic/Latinos or Puerto Ricans and White/non-Hispanics with severe dementia were shown to use technology that is designed to help with Instrumental Activities of Daily Living more than those with moderate dementia. Lastly, during COVID-19, devices to assist with walking, preparing meals and personal hygiene have been used significantly more by White/non-Hispanics with severe dementia compared to Hispanic/Latinos or Puerto Ricans. CONCLUSION The results point to the need to design for those with severe dementia, regardless of race, and should focus on addressing needs related to both Instrumental and Basic Activities of Daily Living.
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Affiliation(s)
| | | | | | - Philip Kortum
- Department of Psychological Sciences, Rice University, Houston, TX, USA
| | - Stephanie L Leal
- Department of Psychological Sciences, Rice University, Houston, TX, USA
| | - Sabrina Pickens
- Institute of Health Sciences-Houston Center College of Nursing, Texas Woman's University, Denton, TX, USA
| | - Barbara E Hekel
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
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Byun JY, Wells R, Bechthold AC, Coffee-Dunning J, Armstrong M, Taylor R, O'Hare L, Dransfield MT, Brown CJ, Vance DE, Odom JN, Bakitas M, Iyer AS. Project EPIC (Empowering People to Independence in COPD): Study protocol for a hybrid effectiveness-implementation pilot randomized controlled trial of telephonic, geriatrics-palliative care nurse-coaching in older adults with COPD and their family caregivers. Contemp Clin Trials 2024; 140:107487. [PMID: 38458558 PMCID: PMC11065558 DOI: 10.1016/j.cct.2024.107487] [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: 12/10/2023] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND EPIC (Empowering People to Independence in COPD) is a geriatric-palliative care telephonic, nurse coach intervention informed by Baltes' Theory of Successful Aging and adapted from the ENABLE (Educate, Nurture, Advise, Before Life Ends) intervention. EPIC, focused on improving independence, mobility, well-being, and COPD symptoms, has undergone formative and summative evaluation for adults with COPD. METHODS The primary study aim is to assess the refined EPIC intervention's feasibility and acceptability via a pilot hybrid effectiveness-implementation randomized control trial in community-dwelling older adults with moderate to severe COPD and their family caregivers. The secondary aim is to explore the impact of EPIC on patient and caregiver outcomes. Older adults with COPD and their family caregivers (target N = 60 dyads) will be randomized to EPIC (intervention) or usual COPD care (control). EPIC includes six patient and four family caregiver weekly, telephone-based nurse coach sessions using a manualized curriculum (Charting Your Course), plus three monthly follow-up calls. Feasibility will be measured as completion of EPIC intervention and trial components (e.g., recruitment, retention, data collection). Acceptability will be evaluated using satisfaction surveys and post-study feedback interviews. A blinded data collector will assess exploratory outcomes (e.g., Life-Space mobility, quality of life, caregiver burden, emotional symptoms, loneliness, cognitive impairment, functional status, healthcare utilization) at baseline, 12, and 24 weeks. DISCUSSION This intervention fills a gap in addressing the geriatrics and palliative care needs and equity for adults with COPD and their family caregivers. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05040386.
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Affiliation(s)
- Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Rachel Wells
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Avery C Bechthold
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Jazmine Coffee-Dunning
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Margaret Armstrong
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Richard Taylor
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Lanier O'Hare
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham Pulmonary Division, THT│ 1900 University Blvd, Birmingham, AL 35294, United States of America.
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham Pulmonary Division, THT│ 1900 University Blvd, Birmingham, AL 35294, United States of America.
| | - Cynthia J Brown
- Department of Internal Medicine, Louisiana State University Health Sciences Center, 2021 Perdido St, New Orleans, LA 70112, United States of America.
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Marie Bakitas
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Anand S Iyer
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, AL, United States of America; Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham Pulmonary Division, THT│ 1900 University Blvd, Birmingham, AL 35294, United States of America; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, United States of America.
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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Keenan TA, Kim AH, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170 Suppl 2:S1-S54. [PMID: 38687845 DOI: 10.1002/ohn.750] [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: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, New York, USA
| | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Tsai Do BS, Bender K, Keenan TA, Palmer CV, Ross EJ, Reyes J, Dhepyasuwan N. Plain Language Summary: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170:1228-1233. [PMID: 38682759 DOI: 10.1002/ohn.751] [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: 02/29/2024] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
The plain language summary explains age-related hearing loss to patients, families, and care partners. The summary is for any patient aged 50 years and older, families, and care partners. It is based on the 2024 "Clinical Practice Guideline: Age-Related Hearing Loss." This plain language summary is a companion publication to the full guideline, which provides greater detail for clinicians. Guidelines and their recommendations may not apply to every patient, but they can be used to find best practices and quality improvement opportunities.
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Affiliation(s)
| | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | - Joe Reyes
- Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Vialaret J, Vignon M, Hirtz C, Badiou S, Baptista G, Fichter L, Dupuy AM, Maceski AM, Fayolle M, Brousse M, Cristol JP, Jeandel C, Lehmann S. Use of dried blood spots for monitoring inflammatory and nutritional biomarkers in the elderly. Clin Chem Lab Med 2024; 62:881-890. [PMID: 37999931 DOI: 10.1515/cclm-2023-0312] [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: 03/27/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Blood microsampling, particularly dried blood spots (DBSs), is an attractive minimally-invasive approach that is well suited for home sampling and predictive medicine associated with longitudinal follow-up of the elderly. However, in vitro diagnostic quantification of biomarkers from DBS poses a major challenge. Clinical mass spectrometry can reliably quantify blood proteins in various research projects. Our goal here was to use mass spectrometry of DBS in a real-world clinical setting and compared it to the standard immunoassay method. We also sought to correlate DBS mass spectrometry measurements with clinical indices. METHODS A clinical trial of diagnostic equivalence was conducted to compare conventional venous samples quantified by immunoassay and DBSs quantified by mass spectrometry in an elderly population. We assayed three protein biomarkers of nutritional and inflammatory status: prealbumin (transthyretin), C-reactive protein, and transferrin. RESULTS The analysis of DBSs showed satisfactory variability and low detection limits. Statistical analysis confirmed that the two methods give comparable results at clinical levels of accuracy. In conclusion, we demonstrated, in a real-life setting, that DBSs can be used to measure prealbumin, CRP and transferrin, which are commonly used markers of nutritional status and inflammation in the elderly. However, there was no correlation with patient frailty for these proteins. CONCLUSIONS Early detection and regular monitoring of nutritional and inflammatory problems using DBS appear to be clinically feasible. This could help resolve major public health challenges in the elderly for whom frailty leads to serious risks of health complications.
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Affiliation(s)
- Jérôme Vialaret
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Margaux Vignon
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Christophe Hirtz
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Stéphanie Badiou
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Gregory Baptista
- Centre de gérontologie clinique Antonin-Balmès, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Laura Fichter
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
| | - Anne-Marie Dupuy
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | | | - Martin Fayolle
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Mehdi Brousse
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Jean-Paul Cristol
- Department of Biochemistry and Hormonology, Univ Montpellier, CHU Montpellier, INSERM, Montpellier, France
| | - Claude Jeandel
- Centre de gérontologie clinique Antonin-Balmès, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Sylvain Lehmann
- LBPC-PPC, Univ Montpellier, CHU Montpellier, INM INSERM, Montpellier, France
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Chang YH, Lin CY, Chou YT, Chen HY, Su HC, Wu YL, Yang YC, Hou WH. A simple scoring algorithm based on intrinsic capacity for functional ability in community-dwelling older adults in Taiwan. BMC Geriatr 2024; 24:370. [PMID: 38664604 PMCID: PMC11044441 DOI: 10.1186/s12877-024-04969-4] [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: 08/08/2023] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a comprehensive indicator of the overall well-being of older adults, and assessing of IC can help identify early stage of disability and tailor intervention to individual needs. However, there is a lack of effective and simple IC assessment tools. This study aimed to establish predictive scoring algorithms of IC to identify older adults at high risk of impaired functional ability. METHODS We conducted a cross-sectional study in Southern Taiwan, measuring IC using 7 subitems: cognition, locomotion, vitality, vision, hearing, psychological well-being, and medication usage were measured. Functional ability outcomes included frailty, basic activities of daily living, and instrumental activities of daily living (IADL). The capability of 7 domains of IC in predicting functional ability was assessed by multivariable logistic regression. The prediction of capability of scoring algorithms was indicated by receiver operating characteristic (AUC) curves and measures of sensitivity and specificity. RESULTS A total of 1,152 older adults were recruited and analyzed. Locomotion emerged as a significant predictor of IADL disability and worsening frailty. The IC-based weighted scoring algorism for predicting IADL demonstrated satisfactory capability (AUC: 0.80), as did the algorithm for predicting worsening frailty (AUC: 0.90). The optimal cutoff points for predicting IADL disability and frailty worse were estimated respectively at 13 and 16, with sensitivity/specificity values of 0.74/0.75 for the IADL prediction algorithm and 0.92/0.77 for the frailty prediction algorithm. CONCLUSION Our 7-domain IC screening tool proves to be sensitive and practical for early identification of functional disability and frailty among community-dwelling older adults in Taiwan.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tsung Chou
- Department of Health Management Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Health Management Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsuan Hou
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
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Chen Y, Zhao Z, Huang J, Wang T, Qu Y. Computer-aided cognitive training combined with tDCS can improve post-stroke cognitive impairment and cerebral vasomotor function: a randomized controlled trial. BMC Neurol 2024; 24:132. [PMID: 38641827 PMCID: PMC11027365 DOI: 10.1186/s12883-024-03613-3] [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: 07/28/2023] [Accepted: 03/26/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Post-stroke cognitive impairment (PSCI) is the focus and difficulty of poststroke rehabilitation intervention with an incidence of up to 61%, which may be related to the deterioration of cerebrovascular function. Computer-aided cognitive training (CACT) can improve cognitive function through scientific training targeting activated brain regions, becoming a popular training method in recent years. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, can regulate the cerebral vascular nerve function, and has an effect on the rehabilitation of cognitive dysfunction after stroke. This study examined the effectiveness of both CACT and tDCS on cognitive and cerebrovascular function after stroke, and explored whether CACT combined with tDCS was more effective. METHODS A total of 72 patients with PSCI were randomly divided into the conventional cognitive training (CCT) group (n = 18), tDCS group (n = 18), CACT group (n = 18), and CACT combined with tDCS group (n = 18). Patients in each group received corresponding 20-minute treatment 15 times a week for 3 consecutive weeks. Montreal Cognitive Assessment (MoCA) and the Instrumental Activities of Daily Living Scale (IADL) were used to assess patients' cognitive function and the activities of daily living ability. Transcranial Doppler ultrasound (TCD) was used to assess cerebrovascular function, including cerebral blood flow velocity (CBFV), pulse index (PI), and breath holding index (BHI). These outcome measures were measured before and after treatment. RESULTS Compared with those at baseline, both the MoCA and IADL scores significantly increased after treatment (P < 0.01) in each group. There was no significantly difference in efficacy among CCT, CACT and tDCS groups. The CACT combined with tDCS group showed greater improvement in MoCA scores compared with the other three groups (P < 0.05), especially in the terms of visuospatial and executive. BHI significantly improved only in CACT combined with tDCS group after treatment (p ≤ 0.05) but not in the other groups. Besides, no significant difference in CBFV or PI was found before and after the treatments in all groups. CONCLUSION Both CACT and tDCS could be used as an alternative to CCT therapy to improve cognitive function and activities of daily living ability after stroke. CACT combined with tDCS may be more effective improving cognitive function and activities of daily living ability in PSCI patients, especially visuospatial and executive abilities, which may be related to improved cerebral vasomotor function reflected by the BHI. TRIAL REGISTRATION NUMBER The study was registered in the Chinese Registry of Clinical Trials (ChiCTR2100054063). Registration date: 12/08/2021.
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Affiliation(s)
- Yin Chen
- Department of Rehabilitation MedicineInstitute/University/Hospita, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Ziqi Zhao
- Department of Rehabilitation MedicineInstitute/University/Hospita, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jiapeng Huang
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, China
| | - Tingting Wang
- Department of Rehabilitation MedicineInstitute/University/Hospita, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yun Qu
- Department of Rehabilitation MedicineInstitute/University/Hospita, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
- College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China.
- Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu, Sichuan, 610041, China.
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Meza-Valderrama D, Sánchez-Rodríguez D, Messaggi-Sartor M, Muñoz-Redondo E, Morgado-Pérez A, Tejero-Sánchez M, De Jaime-Gil E, Leiva-Banuelos N, Marco E. Supplementation with β-hydroxy-β-methylbutyrate after resistance training in post-acute care patients with sarcopenia: A randomized, double-blind placebo-controlled trial. Arch Gerontol Geriatr 2024; 119:105323. [PMID: 38171034 DOI: 10.1016/j.archger.2023.105323] [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: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES This study aimed to evaluate the efficacy of adding β-hydroxy-β- methylbutyrate (HMB) supplementation to a 12-week exercise-based rehabilitation program in older adults with sarcopenia after discharge from a post-acute geriatric rehabilitation unit. STUDY DESIGN A randomized, double-blind, placebo-controlled trial with two parallel groups. The intervention group received 3 g/day of Ca-HMB and participated in a 12- week resistance training program (3 sessions/week). The control group received a placebo and followed the same training program. MAIN OUTCOME MEASURES The primary outcomes were the improvements of handgrip strength and physical performance assessed through the Short Physical Performance Battery (SPPB) and 4-meter gait speed; and handgrip strength. All variables were assessed at baseline, post-intervention, and 1-year follow-up. RESULTS After completing the 12-week exercise program, the intervention group showed significant improvements in SPPB-Balance (1.3, 95 %CI 0.3 to 2.4) and total SPPB score (2.2, 95 %CI 0.4 to 4.0). Intra-group analysis demonstrated gains in the SPPB-Chair Stand (0.7 points, 95 %CI 0.0 to 1.4) and total SPPB score (2.1 points, 95 %CI 0.3 to 3.9) in the intervention group. Improvements in handgrip strength were observed in women (3.7 kg, 95 %CI: 0.2 to 7.3) at the end of the intervention, and persisted at the 1-year follow-up. CONCLUSIONS Our findings suggest that the supplementation of 3 g/day of Ca-HMB with resistance exercise may significantly enhance muscle strength and physical performance among older women with sarcopenia after recent hospitalization. Given this study's limitations, the intervention's effectiveness cannot be drawn, and further studies are needed.
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Affiliation(s)
- Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation, Vía Centenario, 0819 Panamá City, Panamá; Sistema Nacional de Investigación- Secretaria Nacional de Ciencia e Investigación, Clayton Ciudad del Saber Edificio 205, 0819 Panamá City, Panamá.
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A.Van Gehuchten 4, 1020 Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing. Division of Public Health, Epidemiology and Health Economics, University of Liège, Pl. du Vingt Août 7, 4000, Liège, Belgium
| | - Monique Messaggi-Sartor
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elena Muñoz-Redondo
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Andrea Morgado-Pérez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Marta Tejero-Sánchez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elisabet De Jaime-Gil
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Nuria Leiva-Banuelos
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Ester Marco
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain; Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Dr Aiguader Building (Mar Campus), Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain
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Lin GH, Liu JH, Lee SC, Wu BJ, Li SQ, Chiu HJ, Wang SP, Hsieh CL. Developing a machine learning-based short form of the positive and negative syndrome scale. Asian J Psychiatr 2024; 94:103965. [PMID: 38394743 DOI: 10.1016/j.ajp.2024.103965] [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: 10/27/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND HYPOTHESIS The Positive and Negative Syndrome Scale (PANSS) consists of 30 items and takes up to 50 minutes to administer and score. Therefore, this study aimed to develop and validate a machine learning-based short form of the PANSS (PANSS-MLSF) that reproduces the PANSS scores. Moreover, the PANSS-MLSF estimated the removed-item scores. STUDY DESIGN The PANSS-MLSF was developed using an artificial neural network, and the removed-item scores were estimated using the eXtreme Gradient Boosting classifier algorithm. The reliability of the PANSS-MLSF was examined using Cronbach's alpha. The concurrent validity was examined by the association (Pearson's r) between the PANSS-MLSF and the PANSS. The convergent validity was examined by the association (Pearson's r) between the PANSS-MLSF and the Clinical Global Impression-Severity, Mini-Mental State Examination, and Lawton Instrumental Activities of Daily Living Scale. The agreement of the estimated removed-item scores with their original scores was examined using Cohen's kappa. STUDY RESULTS Our analysis included data from 573 patients with moderate severity. The two versions of the PANSS-MLSF comprised 15 items and 9 items were proposed. The PANSS-MLSF scores were similar to the PANSS scores (mean squared error=2.6-24.4 points). The reliability, concurrent validity, and convergent validity of the PANSS-MLSF were good. Moderate to good agreement between the estimated removed-item scores and the original item scores was found in 60% of the removed items. CONCLUSION The PANSS-MLSF offers a viable way to reduce PANSS administration time, maintain score comparability, uphold reliability and validity, and even estimate scores for the removed items.
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Affiliation(s)
- Gong-Hong Lin
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei, Taiwan
| | - Jen-Hsuan Liu
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Graduate School of Advanced Technology (Program for Precision Health and Intelligent Medicine), National Taiwan University, Taipei, Taiwan
| | - Shih-Chieh Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Bo-Jian Wu
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Shu-Qi Li
- Department of Psychiatry, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Hsien-Jane Chiu
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - San-Ping Wang
- Department of Occupational Therapy, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan.
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan.
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Zuleta M, San-José A, Gozalo I, Sánchez-Arcilla M, Carrizo G, Alvarado M, Pérez-Bocanegra C. Patterns of inappropriate prescribing and clinical characteristics in patients at admission to an acute care of the elderly unit. Eur J Clin Pharmacol 2024; 80:553-561. [PMID: 38265499 DOI: 10.1007/s00228-024-03627-3] [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: 08/09/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE Inappropriate prescribing (IP) is common among the elderly and is associated with adverse health outcomes. The role of different patterns of IP in clinical practice remains unclear. The aim of this study is to analyse the characteristics of different patterns of IP in hospitalized older adults. METHODS This is a prospective observational study conducted in the acute care of elderly (ACE) unit of an acute hospital in Barcelona between June and August 2021. Epidemiological and demographic data were collected, and a comprehensive geriatric assessment (CGA) was performed on admitted patients. Four patterns of inappropriate prescribing were identified: extreme polypharmacy (10 or more drugs), potentially inappropriate medications (PIMs), potential prescribing omissions (PPOs) and anticholinergic burden. RESULTS Among 93 admitted patients (51.6% male, mean age of 82.83), the main diagnosis was heart failure (36.6%). Overprescribing patterns (extreme polypharmacy, PIMs, PPOs and anticholinergic burden) were associated with higher comorbidity, increased dependence on instrumental activities of daily living (IADL) and greater prevalence of dementia. Underprescribing (omissions) was associated with important comorbidity, residence in nursing homes, an increased risk of malnutrition, higher social risk and greater frailty. Comparing different patterns of IP, patients with high anticholinergic burden exhibited more extreme polypharmacy and PIMs. In the case of omissions, no association was identified with other IP patterns. CONCLUSIONS We found statistically significant association between patterns of inappropriate prescribing and clinical and CGA variables such as comorbidity, dependency, dementia or frailty. There is a statistically significant association between patterns of overprescribing among patients admitted to the ACE unit.
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Affiliation(s)
- Mónica Zuleta
- Geriatric Unit, Internal Medicine Department, Vall d'Hebron Hospital, 08035, Barcelona, Spain.
| | - Antonio San-José
- Geriatric Unit, Internal Medicine Department, Vall d'Hebron Hospital, 08035, Barcelona, Spain
| | - Inés Gozalo
- Pharmacy Department, Sant Rafael Hospital, Barcelona, Spain
| | | | - Gabriela Carrizo
- Geriatric Unit, Internal Medicine Department, Vall d'Hebron Hospital, 08035, Barcelona, Spain
| | - Marcelo Alvarado
- Geriatric Unit, Internal Medicine Department, Vall d'Hebron Hospital, 08035, Barcelona, Spain
| | - Carmen Pérez-Bocanegra
- Geriatric Unit, Internal Medicine Department, Vall d'Hebron Hospital, 08035, Barcelona, Spain
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Nguyen HT, Do HT, Nguyen HVB, Nguyen TV. Fried Frailty Phenotype in Elderly Patients with Chronic Coronary Syndrome: Prevalence, Associated Factors, and Impact on Hospitalization. J Multidiscip Healthc 2024; 17:1265-1274. [PMID: 38524858 PMCID: PMC10961061 DOI: 10.2147/jmdh.s452462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/14/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose To investigate the prevalence and factors associated with frailty and impact of frailty on hospitalization due to any cause in elderly patients with chronic coronary syndrome (CCS). Patients and Methods We conducted a study wherein we assessed frailty using Fried frailty phenotype for outpatients aged ≥60 years with CCS. Logistic regression analysis was performed to assess the factors associated with frailty. Frailty was adjusted for demographic and geriatric variables and comorbidities to assess its impact on hospitalization. Results Overall, 420 patients (median age 70 years [interquartile range, 65-77]; men, 74.5%) who completed the 3-month follow-up period were analyzed. Coronary revascularization for > 1 year was the most common clinical scenario for CCS (59.8%; n = 251). The prevalence of non-frail, pre-frail, and frail patients were 22.4% (n = 94), 49.7% (n = 209), and 27.9% (n = 117), respectively. In the adjusted model, three factors associated with frailty were age ≥ 75 years (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.39-3.75, P = 0.001), limitations in instrumental activity of daily living (OR 3.89, 95% CI 2.33-6.48, P < 0.001), and heart failure (OR 2.30, 95% CI 1.32-4.02, P = 0.003). The overall 3-month hospitalization rate was higher in frail patients than in non-frail patients (23.9% vs 13.5%, P = 0.012). Frailty was associated with hospitalization (OR 1.85, 95% CI 1.04-3.30, P = 0.037) but in a weak strength of association (r = 0.126). Conclusion The prevalence of frailty was 27.9% in the elderly patients with CCS. Age ≥ 75 years, limitations in functional status, and heart failure were associated with increased odds of frailty. Frailty was a predictor of 3-month all-cause hospitalization in these patients.
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Affiliation(s)
- Huan Thanh Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Huong Thanh Do
- Department of Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Hai Van Be Nguyen
- Department of Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
| | - Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
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Genderson MW, Thomson MD, Siminoff LA. Where you begin is not necessarily where you end: the mental and physical health trajectories of cancer caregivers over time. Support Care Cancer 2024; 32:233. [PMID: 38499880 DOI: 10.1007/s00520-024-08437-y] [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: 10/30/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Cancer caregiving, a critical component in the cancer-care model, has deleterious effects on the caregiver's physical and mental health. The degree to which these negative effects are uniformly experienced by caregivers is unclear; effects may be exacerbated at the end of life when caregiving is intensified. Not all caregivers have the support of an additional involved support person (secondary caregiver). The impact of the secondary caregiver's absence on the primary caregiver's well-being is understudied. METHODS Terminal cancer patient-caregiver dyads (n = 223) were recruited from oncology clinics and followed for six months or until patient death. Longitudinal latent growth models were used to characterize the heterogeneity of caregiver physical health and depressive symptoms; characteristics associated with these trajectories are examined. RESULTS Caregivers were majority female (74%), white (55%) and patient spouses (60%). Two physical health (moderate, stable; initially good, declining) and two depressive symptom (moderate, stable; high, increasing) trajectories were identified. Declining physical health was more likely among caregivers who were healthiest at baseline, had higher levels of education, lower subjective burden, fewer depressive symptoms, cared for patients with fewer functional limitations and reported fewer caregiving tasks rendered by a secondary caregiver. Those with increasing depressive symptoms were more likely to be white, patient's wife, have higher subjective caregiver burden, lower physical health, and care for a patient with greater functional limitations. CONCLUSIONS Decreasing physical health was evident among caregivers who were initially healthier and reported less assistance from secondary caregivers. Increasing depression was seen in white, female spouses with higher subjective burden. Sample heterogeneity revealed hidden groups unexpectedly at risk in the primary cancer caregiver role to which the oncology care team should be alert.
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Affiliation(s)
- Maureen Wilson Genderson
- College of Public Health, Social and Behavioral Sciences, Temple University, 1700 N Broad St, 4th fl Suite 417, Philadelphia, PA, 19122, USA
| | - Maria D Thomson
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 East Main Street Richmond, Richmond, VA, 23219, USA
| | - Laura A Siminoff
- College of Public Health, Social and Behavioral Sciences, Temple University, 1700 N Broad St, 4th fl Suite 417, Philadelphia, PA, 19122, USA.
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Xiang Q, Li Y, Liang R, Song Q, Deng L, Dong B, Yue J. The geriatric nutrition risk index is longitudinally associated with incident Sarcopenia: evidence from a 5-year prospective cohort. Aging Clin Exp Res 2024; 36:52. [PMID: 38438599 PMCID: PMC10912133 DOI: 10.1007/s40520-024-02725-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Previous studies investigating the association between the geriatric nutrition risk index (GNRI) and sarcopenia either lacked longitudinal evidence or narrowly focused on specific populations. AIMS We aimed to reveal longitudinal associations of GNRI with sarcopenia risk in community-dwelling Chinese. We also investigated interaction effects of potential factors on such associations. METHODS We included participants aged ≥ 50 years with sufficient data from the WCHAT study who did not have sarcopenia at baseline and completed sarcopenia assessment during follow-up. GNRI was calculated according to the formula based on serum albumin, height and weight. Sarcopenia was diagnosed according to the 2019 AWGS consensus. Longitudinal associations between GNRI and sarcopenia were estimated by logistic regression with GNRI as either a continuous or categorical variable by tertiles, using generalized estimating equations (GEE) as sensitivity analyses. Subgroup analyses by potential covariates were conducted to detect interaction effects. RESULTS A total of 1907 participants without baseline sarcopenia were finally included, of whom 327 (17.1%) developed incident sarcopenia during 5-year follow-up. After controlling for confounders, sarcopenia risk decreased with each one standard deviation increase in GNRI (ORadjusted=0.36, 95% CI 0.31-0.43), and it also decreased successively from the lowest (< 111.2) through middle (111.2-117.7) to the highest (≥ 117.8) tertile of the GNRI level (P for trend < 0.001). Similar results were yielded by GEE. Such associations generally remained robust across subgroups with distinct characteristics, while significant differences were observed between different age groups (≥ 65 vs. <65 years) (interaction P-value < 0.05). CONCLUSION GNRI is longitudinally associated with sarcopenia risk with possibly age-specific differences in association magnitude, which holds implications for policymakers to conduct population-based risk assessment.
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Affiliation(s)
- Qiao Xiang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China
| | - Yuxiao Li
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China
| | - Rui Liang
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China
| | - Quhong Song
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China
| | - Linghui Deng
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China
| | - Birong Dong
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China.
| | - Jirong Yue
- Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China.
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Takele MD, Eriku GA, Merawie DM, Zinabu FS, Fentanew M, Belay GJ, Kibret AK. Functional disability and its associated factors among community- dweller older adults living in Gondar Town, Ethiopia: a community-based cross-sectional study. BMC Public Health 2024; 24:647. [PMID: 38424543 PMCID: PMC10905928 DOI: 10.1186/s12889-024-18110-y] [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: 11/13/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Functional disability is an emerging public health concern that has an impact on the health and quality of life of older adults. If functional disability recognized early, it will be possible to support them to live independently. Although functional disability is extensively researched in developed countries; studies are scarce in Sub-Saharan Africa, particularly Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of functional disability in activities of daily living among older adults in Gondar town, Ethiopia. METHODS A community-based cross-sectional study was conducted from April to June 2022. Multistage sampling techniques were used to recruit 607 older adults aged 60 years and older. A pre-tested interview-administered questionnaire was used to assess functional disability in basic activities of daily living and instrumental activities of daily living using the Katz Index and Lawton scale, respectively. Bivariate and multivariable logistic regression models were employed. The findings of the study were presented by descriptive statistics and an adjusted odds ratio with 95% CI was used to determine statistical significance. RESULTS The prevalence of functional disability in basic activities of daily living and instrumental activities of daily living among older adults was 34.5% and 54.4, respectively. Age 80 and older [AOR = 2.41, CI (1.41-4.10)], low-income status [AOR = 2.58, CI (1.50-4.46)], multimorbidity [AOR = 2.97, CI (1.92-4.60)], depression [AOR = 2.97, CI (1.63-5.40)], and low level of physical activity [AOR = 3.31, CI (2.11-5.17)] were associated with basic activities of daily living. Age 80 and older (AOR = 3.11, CI = 1.94-5.00), multimorbidity [AOR = 3.06, CI (2.10-4.46)], and depression [AOR = 3.52, CI (2.10-4.46)] were associated with instrumental activities of daily living. CONCLUSION AND RECOMMENDATIONS Our study finding revealed that functional disability affects a large number of older adult residents. The age group of 80 years and older, low-income status, a low level of physical activity, multimorbidity, and depression were associated with basic and instrumental activities of daily living. Therefore, health interventions designed to increase older adults' level of physical activity, management of multimorbidity, and depression, more care for elders 80 years and older, and supporting older adults financially for health insurance coverage could be an important strategy to reduce functional disability among older adults.
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Affiliation(s)
- Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Getachew Azeze Eriku
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaw Marie Merawie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fiseha Sefiwu Zinabu
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Fentanew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Jember Belay
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bakhtiari M, Shaker F, Shirmard FO, Jalali A, Vakili-Basir A, Balabandian M, Khamene SS, Mohammadkhawajah I, Shafiee A, Badrkhahan SZ, Hosseini K. Frailty efficacy as a predictor of clinical and cognitive complications in patients undergoing coronary artery bypass grafting: a prospective cohort study. BMC Cardiovasc Disord 2024; 24:110. [PMID: 38365571 PMCID: PMC10874082 DOI: 10.1186/s12872-024-03781-7] [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: 12/10/2023] [Accepted: 02/11/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Frailty is proposed as a predictor of outcomes in patients undergoing major surgeries, although data on the association of frailty and coronary artery bypass grafting (CABG) are lacking. We assessed the association between frailty and cognitive and clinical complications following CABG. METHODS This prospective study included patients aged over 60 years undergoing elective CABG at Tehran Heart Center from 2020 to 2022. Baseline and three-month follow-up data on frailty using the Frail scale and clinical Frail scale, functional status using the Lawton Instrumental Activities of Daily Living Scale (IADL), cognitive function by Montreal Cognitive Assessment (MoCA), and depression by the Geriatric Depression Scale (GDS) were obtained. The incidence of adverse outcomes was investigated at the three-month follow-up. Outcomes between frail and non-frail groups were compared utilizing T-tests and Mann-Whitney U tests, as appropriate. RESULTS We included 170 patients with a median age of 66 ± 4 years (75.3% male). Of these, 58 cases were classified as frail, and 112 individuals were non-frail, preoperatively. Frail patients demonstrated significantly worse baseline MOCA scores (21.08 vs. 22.41, P = 0.045), GDS (2.00 vs. 1.00, P = 0.009), and Lawton IADL (8.00 vs. 6.00, P < 0.001) compared to non-frail. According to 3-month follow-up data, postoperative MOCA and GDS scores were comparable between the two groups, while Lawton IADL (8.00 vs. 6.00, P < 0.001) was significantly lower in frail cases. A significantly higher rate of readmission (1.8% vs. 12.1%), sepsis (7.1% vs. 19.0%), as well as a higher Euroscore (1.5 vs. 1.9), was observed in the frail group. A mildly significantly more extended ICU stay (6.00 vs. 5.00, p = 0.051) was shown in the frail patient. CONCLUSION Frailty showed a significant association with a worse preoperative independence level, cognitive function, and depression status, as well as increased postoperative complications.
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Affiliation(s)
- Mehrnoosh Bakhtiari
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Farhad Shaker
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Fatemeh Ojaghi Shirmard
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Arash Jalali
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Vakili-Basir
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sima Shamshiri Khamene
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Izat Mohammadkhawajah
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran
| | - Seyedeh Zahra Badrkhahan
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Geriatric Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, Tehran, Iran.
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Wang P, Wang M, Shan J, Liu X, Jing Y, Zhu H, Zheng G, Peng W, Wang Y. Association between residential greenness and depression symptoms in Chinese community-dwelling older adults. ENVIRONMENTAL RESEARCH 2024; 243:117869. [PMID: 38070849 DOI: 10.1016/j.envres.2023.117869] [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: 09/19/2023] [Revised: 11/23/2023] [Accepted: 12/02/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Studies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions. OBJECTIVE This study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China. METHODS A cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity. RESULTS The prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms. CONCLUSION Higher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults.
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Affiliation(s)
- Pengfei Wang
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Meng Wang
- Human Resources Department, Eye & Ent Hospital, Fudan University, Shanghai, China
| | - Jiatong Shan
- Arts and Science Department, New York University Shanghai, Shanghai, China
| | - Xinya Liu
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yurong Jing
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Hongfei Zhu
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Guang Zheng
- Shanghai Institute of Occupational Disease for Chemical Industry, Shanghai, China.
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, China; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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Varas J, Campos MÁ, Tapia E, Sanhueza JL, Salazar C, Vergara N, Tapia N, Mantero G, Bustamante P. Visual-functional impact of people affected by severe ocular trauma during social protests in Chile in 2019. Int Ophthalmol 2024; 44:77. [PMID: 38351240 DOI: 10.1007/s10792-024-02969-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/04/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE To determine the impact on the functionality associated with visual loss (VFIP) in people with severe ocular trauma (SOT) caused by kinetic impact projectiles used in police crowd control through a prioritization tool in people admitted to a rehabilitation program in Santiago de Chile from December 02, 2019, to November 13, 2020. METHODS A cross-sectional descriptive study of SOT victims (N = 85), average age 31.4 ± 11.9. The data were recorded through a new 9-item screening instrument for assessment and prioritization of rehabilitation created for this emergency scenario. RESULTS The impact of the use of kinetic weapons resulted in monocular blindness in the majority of those affected (n = 68; 80.0%). The highest VFIP observed was among young men from lower social strata. There were extreme difficulties in the performance of productive tasks (occupational and/or educational) (n = 42; 49.4%) and the pursuit of hobbies and pastimes (n = 23; 27.1%), as well as a high difficulty in adapting to changes in brightness (n = 29; 34.1%) and handling objects accurately (n = 22; 25.9%). CONCLUSION The use of kinetic weapons for crowd control resulted in high and extreme VFIP and, in most cases, monocular blindness, causing major difficulties in work, study, and development of hobbies and pastimes in the affected population, highlighting the urgent need for effective rehabilitative care, which requires special attention in order to generate an adequate rehabilitation program. The use of kinetic weapons for crowd control contravenes international goals, policies, and plans set by the WHO and the International Agency for the Prevention of Blindness on strategies to prevent avoidable blindness worldwide until 2020. It is essential to ban the use of these weapons in Chile and worldwide, as well as to revise police protocols for crowd control.
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Affiliation(s)
- Joaquín Varas
- Department of Occupational Therapy and Occupational Science, Faculty of Medicine, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Miguel Ángel Campos
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Independencia 1027, 8380453, Santiago, Chile
- Department of Ophthalmology, Hospital Del Salvador, Avenida Salvador 364, Santiago, Chile
| | - Eric Tapia
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Independencia 1027, 8380453, Santiago, Chile
- Instituto de Investigación y Postgrado, Facultad de Medicina y Ciencias de la Salud, Universidad Central de Chile, Lord Cochrane 416, Santiago, Chile
| | - José Luis Sanhueza
- Department of Ophthalmology, Hospital Del Salvador, Avenida Salvador 364, Santiago, Chile
| | - Claudia Salazar
- School of Medical Technology, Faculty of Medicine, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Nayadet Vergara
- School of Medical Technology, Faculty of Medicine, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Nicole Tapia
- Department of Ophthalmology, Hospital Del Salvador, Avenida Salvador 364, Santiago, Chile
| | - Gianinna Mantero
- Department of Ophthalmology, Hospital Del Salvador, Avenida Salvador 364, Santiago, Chile
| | - Patricio Bustamante
- Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Independencia 1027, 8380453, Santiago, Chile.
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Gholami M, Zohrabi Salari F, Yarahmadi R, Mokhayeri Y, Veiskaramian A, Amin A. Effects of balance training on cognitive function and activities of daily living in older adult patients with heart failure: a randomized controlled trial. Ir J Med Sci 2024; 193:111-121. [PMID: 37365444 DOI: 10.1007/s11845-023-03436-0] [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: 05/27/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The potential of the effect of balance training on improving cognitive functions and functional activities in vulnerable groups, including the older adults with heart failure (HF), is unknown. AIM The aim of the present study was to determine the effect of a simple balance training supervised by nurses on cognitive functions and activities of daily living (ADLs) of the older adults with HF. METHODS In this clinical trial study, 75 older adults with HF were allocated to two groups of balance training (BT) and usual care (UC) using stratified block randomization. The intervention consisted of a set of dynamic and static BT, 4 times/session per week, each session lasting 30 min, for 8 weeks, which was performed at the participant's home under the supervision of a nurse. For the control group, UC was provided. The outcomes of the study, including cognitive function, basic ADLs, and instrumental ADLs (IADLs), were measured by the Montreal cognitive assessment-basic (MoCA-B), Barthel index-ADL, and Lawton scale-IADL before and after the intervention. RESULTS The between-group analysis showed, in two groups, a statistically significant difference between the changes in the mean scores: all subscales of cognitive function and MoCA-B total score (P < 0.001), as well as basic ADLs and IADLs (P < 0.001), before and after the intervention. Compared with the control group/UC, the cognitive function, basic ADL, and IADL of the intervention group/BT were improved significantly at 8 weeks. CONCLUSION The results suggested that home-based balance training led by nurse can improve global cognitive function and basic ADL and IADL in the older adults with HF. TRIAL REGISTRATION Clinical trials registration number IRCT20150919024080N18.
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Affiliation(s)
- Mohammad Gholami
- Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Faezeh Zohrabi Salari
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Reza Yarahmadi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yaser Mokhayeri
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Atefeh Veiskaramian
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arash Amin
- Cardiovascular Research Center, Shahid Madani Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
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Vieira RDCA, Pipek LZ, de Oliveira DV, Paiva WS, de Sousa RMC. The Relationship between Injury Characteristics and Post-Traumatic Recovery after Diffuse Axonal Injury. Biomedicines 2024; 12:311. [PMID: 38397913 PMCID: PMC10886783 DOI: 10.3390/biomedicines12020311] [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: 12/02/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The diagnosis and prognosis of diffuse axonal injury (DAI) remain challenging. This research aimed to analyze the impact on activities of daily living (ADL), functional outcomes, quality of life (QoL), and the association between lesion severity and DAI location identified through imaging exams. METHODS This prospective cohort study included 95 patients diagnosed with DAI. Data were collected at admission, three, six, and twelve months post-injury. The associations between variables were evaluated using a mixed-effects model. RESULTS Functional recovery and QoL improved between three and twelve months after DAI. An interaction was observed between independence in performing ADL and subarachnoid hemorrhage (p = 0.043) and intraventricular hemorrhage (p = 0.012). Additionally, an interaction over time was observed between the Glasgow Outcome Scale (GOS) and DAI severity (p < 0.001), brain lesions (p = 0.014), and the Disability Rating Scale (DRS) with injury in brain hemispheres (p = 0.026) and Adams classification (p = 0.013). Interaction effects over time were observed with the general health perceptions and energy/vitality domains with intraventricular hemorrhage, and the social functioning domain with the obliteration of basal cisterns and Gentry's classification. CONCLUSION The use of CT in the acute phase of DAI is important for predicting outcomes. The severity and location of DAI are associated with functional outcomes, ADL, and QoL.
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Affiliation(s)
- Rita de Cássia Almeida Vieira
- Department of Nursing, University of Sergipe, Lagarto 49400-000, Brazil;
- Nursing School, University of Sao Paulo, Sao Paulo 05508-010, Brazil;
| | - Leonardo Zumerkorn Pipek
- Department of Neurology, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil
| | | | - Wellingson Silva Paiva
- Division of Neurosurgery, Clinical Hospital of the University of Sao Paulo, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil;
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Wong HMK, Qi D, Ma BHM, Hou PY, Kwong CKW, Lee A. Multidisciplinary prehabilitation to improve frailty and functional capacity in high-risk elective surgical patients: a retrospective pilot study. Perioper Med (Lond) 2024; 13:6. [PMID: 38263053 PMCID: PMC10807111 DOI: 10.1186/s13741-024-00359-x] [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: 05/12/2023] [Accepted: 01/01/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Frailty is associated with worse outcomes and higher healthcare costs. The long waiting time for surgery is a potential 'teachable' moment. We examined the feasibility and safety of a pilot prehabilitation programme on high-risk frail patients undergoing major elective surgery. METHODS A single-centre, retrospective pilot study (Dec 2020-Nov 2021) on a one-stop prehabilitation programme (structured exercise training, nutritional counselling/therapy, and psychological support) in collaboration with geriatricians and allied health professionals. At least 4 weeks before surgery, patients at high risk of frailty or malnutrition, or undergoing major hepatectomy, esophagectomy, pancreaticoduodenectomy, or radical cystectomy, were referred for prehabilitation (2-3 sessions/week). The primary outcomes were the feasibility and safety of prehabilitation. The secondary outcomes were changes in functional, emotional, and nutritional status and days alive and at home within 30 days after surgery (DAH30) associated with prehabilitation. RESULTS Over a 12-month period, 72 out of 111 patients (64.9%) from the Perioperative Medicine Clinic were eligible for prehabilitation, of which 54 (75%) were recruited. The mean (standard deviation) age was 71.9 (6.9) years. The adherence rate to 3 weeks of prehabilitation was high in 52 (96.3%) participants. Prehabilitation improved exercise capacity (P = 0.08), enhanced some functional mobility measures (P = 0.02), and increased nutritional energy (P = 0.04) and protein intakes (P < 0.01). However, prehabilitation-related changes in muscle strength, cognitive function, and emotional resilience were minimal. The median (interquatile range) DAH30 was 19 (14-23) days. No adverse events were reported. CONCLUSIONS This outpatient-based, one-stop multidisciplinary prehabilitation programme was feasible, safe, and improved several measures of patient's physiological reserve and functional capacity. CLINICAL TRIAL REGISTRATION NCT05668221.
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Affiliation(s)
- Henry Man Kin Wong
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, New Territories, Hong Kong.
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, New Territories, Hong Kong.
| | - Ding Qi
- Department of Medicine and Geriatrics, Shatin Hospital, New Territories, Hong Kong
| | - Bosco Hon Ming Ma
- Department of Medicine and Geriatrics, Shatin Hospital, New Territories, Hong Kong
| | - Pik Yi Hou
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Calvin Ka Woon Kwong
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, New Territories, Hong Kong
| | - Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, New Territories, Hong Kong
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Moon S, Oh E, Chung D, Hong GRS. Changes in instrumental activities daily living limitations and their associated factors according to gender in community-residing older adults: A longitudinal cohort study. PLoS One 2024; 19:e0296796. [PMID: 38206920 PMCID: PMC10783775 DOI: 10.1371/journal.pone.0296796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Increases in dependence among older adults cause increases in care needs and social care burden. Instrumental activities of daily living (IADL) are often used to assess the independence of older adults residing in communities. Various factors affect IADL limitations, but few studies confirm gender differences in IADL limitations in older adults. This study explored the changes in incidence of IADL limitations across 14 years and identified the factors associated with IADL limitations according to gender among older adults in Korea. METHOD This study uses secondary data analysis with 2006-2020 data from the Korean Longitudinal Study of Aging (KLoSA), a longitudinal cohort study. Among the total 10,254 participants, 1,230 adults aged 65 years and over who met the criteria were included in the final analysis. For each IADL item, a limitation was defined when the response was partial or complete dependence. Multivariate logistic regression was performed to identify the factors (in 2006) associated with IADL limitations in 2020. RESULTS The mean age of the participants at baseline was 69.64 years (SD 3.93), and 61.0% of participants were female. Total scores for IADL limitations increased gradually across 14 years in all participants, and observed changes were statistically significant. The top three ranked items of IADL limitations differed according to gender in 2020: the top limitations in men were preparing meals, laundry, and using public transportation, and the top limitations in women were using public transportation, going out, and handling money. Factors associated with total IADL limitations were grip strength in men and age, dementia, fear of fall, and grip strength in women. Factors associated with the top three ranked items of IADL limitations differed according to gender. CONCLUSION The incidence of IADL limitations gradually increased in all participants over a 14-year period. In older adults in Korea, gender differences were confirmed in the factors associated with IADL limitations, as well as in the main limited activities. To minimize IADL limitations in community-residing older adults, it is necessary to plan tailored interventions.
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Affiliation(s)
- SeolHwa Moon
- Department of Nursing, Hoseo University, Cheonan, Republic of Korea
| | - Eunmi Oh
- Research Institute of Nursing Science, Hanyang University, Seoul, Republic of Korea
| | - Daum Chung
- College of Nursing, Hanyang University, Seoul, Republic of Korea
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Yao X, Luo X, Tai Y, Wang K, Shang J. Effectiveness of continuity of care after robot-assisted laparoscopic adrenalectomy under ambulatory mode: a single-center intervention study. J Robot Surg 2024; 18:8. [PMID: 38206493 DOI: 10.1007/s11701-023-01788-4] [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: 09/15/2023] [Accepted: 11/20/2023] [Indexed: 01/12/2024]
Abstract
To investigate the effectiveness of continuity of care after robot-assisted adrenal tumor resection under ambulatory mode. Patients who underwent robot-assisted laparoscopic adrenalectomy (RALA) in the ambulatory surgery department and urology department of our hospital from January 2022 to January 2023 were selected as study subjects. Among them, 50 patients in the Department of Urology as the control group were given routine care. The 50 patients in the ambulatory surgery department as the observation group were given continuity of care on the basis of routine care. Observation indexes include: wound healing, blood pressure, blood potassium, renal function impairment, self-care ability in daily life, medication compliance, follow-up rate, and patient satisfaction. There were no remarkable discrepancies between the two groups in terms of demographic data and basic preoperative conditions of the patients. Compared with the control group, the observation group significantly improved the patients' wound healing, postoperative blood pressure and blood potassium and kidney function (P value all < 0.05). Compared with the control group, the observation group significantly improved postoperative patients' ADL scores, follow-up rates within three months after surgery, and patient satisfaction scores (P value all < 0.05). For patients receiving ambulatory mode robot-assisted laparoscopic adrenalectomy, continuity of care can effectively reduce postoperative complications, improve patients' postoperative self-care ability in daily life, medication compliance and follow-up rate, and improve patient satisfaction, which is worthy of promotion and application by nursing workers.
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Affiliation(s)
- Xue Yao
- Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Xiaoyan Luo
- Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Yanghao Tai
- Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Kang Wang
- Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| | - Jiwen Shang
- Department of Ambulatory Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
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