Geriatrics最新文献

{"title":"Inflammaging in Multidrug-Resistant Sepsis of Geriatric ICU Patients and Healthcare Challenges.","authors":"Nishitha R. Kumar, Tejashree A. Balraj, Kusuma K. Shivashankar, Tejaswini C. Jayaram, Akila Prashant","doi":"10.3390/geriatrics9020045","DOIUrl":"https://doi.org/10.3390/geriatrics9020045","url":null,"abstract":"Multidrug-resistant sepsis (MDR) is a pressing concern in intensive care unit (ICU) settings, specifically among geriatric patients who experience age-related immune system changes and comorbidities. The aim of this review is to explore the clinical impact of MDR sepsis in geriatric ICU patients and shed light on healthcare challenges associated with its management. We conducted a comprehensive literature search using the National Center for Biotechnology Information (NCBI) and Google Scholar search engines. Our search incorporated keywords such as \"multidrug-resistant sepsis\" OR \"MDR sepsis\", \"geriatric ICU patients\" OR \"elderly ICU patients\", and \"complications\", \"healthcare burdens\", \"diagnostic challenges\", and \"healthcare challenges\" associated with MDR sepsis in \"ICU patients\" and \"geriatric/elderly ICU patients\". This review explores the specific risk factors contributing to MDR sepsis, the complexities of diagnostic challenges, and the healthcare burden faced by elderly ICU patients. Notably, the elderly population bears a higher burden of MDR sepsis (57.5%), influenced by various factors, including comorbidities, immunosuppression, age-related immune changes, and resource-limited ICU settings. Furthermore, sepsis imposes a significant economic burden on healthcare systems, with annual costs exceeding $27 billion in the USA. These findings underscore the urgency of addressing MDR sepsis in geriatric ICU patients and the need for tailored interventions to improve outcomes and reduce healthcare costs.","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140750648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes after Surgical Aortic Valve Replacement in 681 Octogenarians: A Single-Center Real-World Experience Comparing the Old Patients with the Very Old Patients.","authors":"Wilhelm Mistiaen, I. Deblier, Karl Dossche, A. Vanermen","doi":"10.3390/geriatrics9020044","DOIUrl":"https://doi.org/10.3390/geriatrics9020044","url":null,"abstract":"Aortic valve disease is a lethal condition, once it becomes symptomatic. Surgical aortic valve replacement (SAVR) has, for a long time, been the only treatment option. In patients aged 85 and older, the consequences of SAVR have rarely been investigated. A total of 681 octogenarian patients were subdivided into a group with patients between 80 and 84 years (n = 527) and a group with patients aged 85 or older (n = 154). For each group, the temporal referral pattern, preoperative comorbid profile, operative data, postoperative need for resources, and adverse postoperative events including 30-day mortality and long-term survival were determined using the chi-squared test, Student's t-test, and log-rank test. For both age groups, the predictors for mortality were identified using a logistic regression analysis. In the oldest patient group, there were significantly more prior episodes of heart failure (75/154 vs. 148/527) and a greater need for urgent SAVR (45/150 vs. 109/515). The operative data and the need for postoperative resources were comparable, but the 30-day mortality was almost twice as high (24/154 vs. 45/527). The need for urgent SAVR was twice as high in the oldest group (odds ratio of 3.12 vs. 6.64). A logistic regression analysis for all 681 patients showed that age over 85 ranked fourth of six predictors for 30-day mortality. Five-year survival was favorable for both groups (67.8 ± 2.1% vs. 60.0 ± 4.3%). A Cox proportional hazard analysis failed to identify an age over 85 as a predictor for long-term mortality. Aortic valve disease and its effect on the left ventricle seemed to be more advanced in the highest age group. The mortality rate was almost double the need for urgent SAVR. This can be avoided by obtaining an earlier referral.","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2-Minutes Walking Test Is Not Correlated with Aerobic Fitness Indices but with the 5-Times Sit-to-Stand Test Performance in Apparently Healthy Older Adults.","authors":"M. Gil-Calvo, JOSE ANTONIO DE PAZ, Alba Herrero-Molleda, Arthur Zecchin, María Teresa Gómez-Alonso, Beatriz Alonso-Cortés, Daniel Boullosa","doi":"10.3390/geriatrics9020043","DOIUrl":"https://doi.org/10.3390/geriatrics9020043","url":null,"abstract":"The 2-minutes walking test (2-MWT) is a valid and reliable test that has a high correlation with the distance walked in the 6-minutes walking test (6-MWT). However, to date, no study has determined the relationship between 2-MWT performance and the aerobic fitness indices obtained during a maximal incremental test to confirm if this test is a valid surrogate of aerobic fitness in apparently healthy older adults. The main objective of this work was to identify the factors associated to the performance in the 2-MWT, including aerobic fitness, functional and spatial-temporal gait parameters. Seventeen elderly adults performed a maximal incremental cycling test to determine maximum oxygen consumption (VO2max) and ventilatory thresholds (VT1 and VT2), two static standing balance tests with open and close eyes, a 5-times sit-to-stand test (5-TSTS), a handgrip test, and a 2-MWT on three different days over 2 weeks. No correlations were found between aerobic fitness indices and the distance covered in 2-MWT, but significant moderate correlations were found between the distance covered in 2-MWT and the time to perform the 5-TSTS (rho = -0.49) and with stride length (rho = 0.52) during the test. In conclusion, the 2-MWT does not seem a good test to assess aerobic capacity while it showed to be associated to the 5-TSTS performance of the elderly.","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Advance Care Planning on End-of-Life Indicators for Nursing Home Residents—An Experimental Study with a Retrospective Chart Review","authors":"Yu-Tai Lo, Jin-Jy Wang, Yi-Ching Yang, Chiu-Yen Yu, Chia-Ming Chang, Ya-Ping Yang","doi":"10.3390/geriatrics9020042","DOIUrl":"https://doi.org/10.3390/geriatrics9020042","url":null,"abstract":"Advance care planning (ACP) has the potential to improve the outcomes of end-of-life care for residents in nursing homes. The aim of this study was to determine whether an ACP program was beneficial for nursing home residents by assessing end-of-life indicators. An experimental study with a retrospective chart review was conducted. In total, 37 residents in the intervention group participated in an institutional advance care planning program for 1 year, and their chart data over 1 year were collected following the completion of the program; 33 residents in the control group had died within 1 year before the start date of program, and their chart data were reviewed retrospectively. Chi-square and t tests were used to examine four indicators of the quality of end-of-life care. Compared with the control group, the intervention group had a higher proportion of do-not-resuscitate directives, hospice care before death, and deaths in the nursing home, and fewer hospitalizations and deaths in an emergency department. ACP programs may improve the quality of end-of-life care for nursing home residents in Taiwan. Further research across different long-term care facilities is warranted.","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Functional Health Patterns and Frailty in Hospitalized Geriatric Patients","authors":"E. I. Hirișcău, Omar Cauli, V. Donca, Luminita-Aurelia Marinescu, A. Macarie, L. Avram, Oana-Gabriela Cancel, Steliana Donca, E. Buzdugan, Dana-Alina Crisan, C. Bodolea","doi":"10.3390/geriatrics9020041","DOIUrl":"https://doi.org/10.3390/geriatrics9020041","url":null,"abstract":"This study investigates the association between the Functional Health Pattern Assessment Screening Tool (FHPAST) and frailty in hospitalized geriatric patients. One hundred and forty patients (mean age 78.2 years, age range 65–90) were screened for frailty using the Frail Scale during hospitalization in the geriatric unit. Among them, 57 patients were identified as prefrail (40.7%), and 83 were identified as frail (59.3%). A comparative analysis between groups in terms of the FHPAST components covering health risk, general well-being, and health promotion was performed. Correlations between FHAPST components, socio-demographic data, frailty criteria, as well as logistic regression to identify variables that better predict frailty were also sought. Frailty was mainly associated with difficulty urinating, limitations in performing activities of daily living and walking, physical discomfort, less positive feelings in controlling one’s own life, lower compliance with recommendations from the healthcare provider, and engagement in seeking healthcare services. Patients with difficulty urinating and walking had a probability of 4.38 times (OR = 4.38, CI 95% [1.20–15.94]), p = 0.025) and 65.7 times (OR = 65.7, CI 95% [19.37–223.17], p < 0.001) higher of being frail rather than prefrail. The relationship between frailty and prefrailty in hospitalized geriatric patients and components of nursing Functional Health Patterns (FHP) has yet to be explored. This study provides evidence of the most prevalent needs of frail geriatric patients in hospital settings.","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement in the Postural Assessment of Older Adults by Physical Therapists Using Clinical and Imaging Methods.","authors":"Naoki Sugiyama, Yoshihiro Kai, Hitoshi Koda, Toru Morihara, Noriyuki Kida","doi":"10.3390/geriatrics9020040","DOIUrl":"10.3390/geriatrics9020040","url":null,"abstract":"<p><p>Postural assessment is one of the indicators of health status in older adults. Since the number of older adults is on the rise, it is essential to assess simpler methods and automated ones in the future. Therefore, we focused on a visual method (imaging method). The purpose of this study is to determine the degree of agreement between the imaging method and the palpation and visual methods (clinical method). In addition, the influence of differences in the information content of the sagittal plane images on the assessment was also investigated. In this experiment, 28 sagittal photographs of older adults whose posture had already been assessed using the clinical method were used. Furthermore, based on these photographs, 28 gray and silhouette images (G and S images) were generated, respectively. The G and S images were assessed by 28 physical therapists (PTs) using the imaging method. The assessment was based on the Kendall classification, with one of four categories selected for each image: ideal, kyphosis lordosis, sway back, and flat back. Cross-tabulation matrices of the assessments using the clinical method and imaging method were created. In this table, four categories and two categories of ideal and non-ideal (KL, SB, and FB) were created. The agreement was evaluated using the prevalence-adjusted bias-adjusted kappa (PABAK). In addition, sensitivity and specificity were calculated to confirm the reliability. When comparing the clinical and imaging methods in the four posture categories, the PABAK values were -0.14 and -0.29 for the S and G images, respectively. In the case of the two categories, the PABAK values were 0.57 and 0.5 for the S and G images, respectively. The sensitivity and specificity were 86% and 57% for the S images and 76% and 71% for the G images, respectively. The four categories show that the imaging method is difficult to assess regardless of the image processing. However, in the case of the two categories, the same assessment of the clinical method applied to the imaging method for both the S and G images. Therefore, no differences in image processing were observed, suggesting that PTs can identify posture using the visual method.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proposal for a Multidisciplinary Integrated Oral Health Network for Patients Undergoing Major Orthopaedic Surgery (IOHN-OS).","authors":"Matteo Briguglio, Thomas W Wainwright, Marialetizia Latella, Aurora Ninfa, Claudio Cordani, Cecilia Colombo, Giuseppe Banfi, Luca Francetti, Stefano Corbella","doi":"10.3390/geriatrics9020039","DOIUrl":"10.3390/geriatrics9020039","url":null,"abstract":"<p><p>The passing of the years of life physiologically leads to the accumulation of changes in tissues in the oral cavity, influencing dentition, chewing and swallowing mechanisms, and the oral microbiota. Some diseases and medications can aggravate oral symptoms and negatively influence eating behaviours, increasing the likelihood of becoming malnourished. This could make older individuals more vulnerable to complications when undergoing major orthopaedic surgery. Hidden infection foci in the oral cavity are a recognised cause of post-operative periprosthetic joint infections. Dysfunctional oral problems might also compromise feeding after surgery when good nutrition represents a fundamental aspect of a proper recovery. To manage these shortcomings, in this article, the authors hypothesise a multidisciplinary path of care named the Integrated Oral Health Network applied to major Orthopaedic Surgery (IOHN-OS). This peri-operative initiative would include pre-operative oral health screening and risk management by a dental team, patient education programmes before and after surgery, and bedside gerodontology actions like oral care and meal and eating support for fragile individuals. The IOHN-OS has the potential to reshape the concept of suitability for major orthopaedic surgery and generate momentum for designing community-based surveillance programmes that can keep the mouths of older subjects healthy for a long time.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope Mediates Stress to Reduce Burden in Family Caregivers of Persons with Alzheimer's Disease.","authors":"Jocelyn Shealy McGee, Edward C Polson, Dennis R Myers, Angela McClellan, Rebecca Meraz, Weiming Ke, Holly Carlson Zhao","doi":"10.3390/geriatrics9020038","DOIUrl":"10.3390/geriatrics9020038","url":null,"abstract":"<p><p>The experience of burden among family caregivers of persons with Alzheimer's disease and other forms of dementia may be deleterious for their health and well-being. Little is known, however, about the degree to which internal positive psychological resources, such as hope, influence burden perceptions in this population. The current study is novel in that it examined how multiple dimensions of hope, hope-agency and hope-pathway, influenced burden in a sample of one-hundred and fifty-five family caregivers of persons with Alzheimer's disease. The stress process model was used as the theoretical framework for variable specification in this study. Hope was conceptualized using Snyder and colleagues' hope theory. Supporting our first hypothesis, we found that burden was negatively associated with hope-agency, r = -0.33, <i>p</i> < 0.001 and hope-pathway, r = -0.24, <i>p</i> < 0.01. Multiple regression was used to determine if hope-agency and hope-pathway independently contributed to burden. Analysis revealed that hope-agency but not hope-pathway influenced burden when other key variables were taken into consideration. Findings from mediation analysis affirmed that hope-agency had a small but significant mediation effect between stress and burden in this sample. This study provides evidence for the relevance of assessing multiple dimensions of hope when working with caregivers of persons with Alzheimer's. Although replication studies are warranted, the current study confirms a need for further development and refinement of hope-bolstering behavioral interventions which may mediate stress and burden in this population. These interventions should be systematically assessed for efficacy and effectiveness via implementation studies in real-world settings.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive Effects of an Online Brain Health Program and Weekly Telehealth Support Group in Older Adults with Subjective Memory Loss: A Pilot Study.","authors":"Ryan M Glatt, Amylee Amos, David A Merrill, John F Hodes, Claudia L Wong, Karen J Miller, Prabha Siddarth","doi":"10.3390/geriatrics9020037","DOIUrl":"10.3390/geriatrics9020037","url":null,"abstract":"<p><strong>Introduction: </strong>Adopting healthy lifestyle behaviors has the potential to slow cognitive decline in older adults by reducing risks associated with dementia. Curriculum-based group health coaching may aid in establishing behavior change centered for dementia risk factors.</p><p><strong>Methods: </strong>In this pilot clinical care patient group study (<i>n</i> = 6), we examined the effects of a six-month online Cognitive Health Program combined with a weekly telehealth support group led by the course creator, and personalized health optimization by a collaborating physician, in older adults with subjective cognitive decline. Cognition was assessed at baseline and post-intervention using a computerized battery.</p><p><strong>Results: </strong>Cognitive changes were estimated with nonparametric tests and effect sizes (Cohen's d). Results showed significant improvements in global cognition (<i>p</i> < 0.03, d = 1.6), spatial planning (<i>p</i> < 0.01, d = 2.3), and visuospatial processing (<i>p</i> < 0.05, d = 1.1) compared to baseline. Participants reported high levels of satisfaction with the virtual group format and online curriculum.</p><p><strong>Conclusions: </strong>This small pilot study suggests that a virtual six-month personalized health coaching group with self-paced online health education is feasible and potentially efficacious for improving cognition in participants with subjective cognitive complaints. This format may facilitate behavior change to slow cognitive decline. Future studies should include a control group, a larger, more diverse sample as well as assessing mood and other subjective measures.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderating Effect of Muscular Strength in the Association between Cardiovascular Events and Depressive Symptoms in Middle-Aged and Older Adults-A Cross Sectional Study.","authors":"Diogo Veiga, Miguel Peralta, Élvio R Gouveia, Marcelo de Maio Nascimento, Laura Carvalho, Jorge Encantado, Adilson Marques","doi":"10.3390/geriatrics9020036","DOIUrl":"10.3390/geriatrics9020036","url":null,"abstract":"<p><strong>Background: </strong>Depression and cardiovascular diseases are two main health conditions contributing to the global disease burden. Several studies indicate a reciprocal association between them. It is still unclear how changes in overall muscle strength may impact this association. This study aimed to analyse how muscular strength moderates the relationship between cardiovascular events and depressive symptoms among middle-aged and older adults.</p><p><strong>Methods: </strong>Wave 8 of the population-based Survey of Health, Ageing, and Retirement in Europe (2019/2020) cross-sectional data, which included 41,666 participants (17,986 men) with a mean age of 70.65 (9.1) years old, was examined. Grip strength was measured twice on each hand using a dynamometer. The 12-item EURO-D scale was employed to gauge depressive symptoms.</p><p><strong>Results: </strong>Grip strength negatively moderates the link between cardiovascular events and depressive symptoms (male: B = -0.03, 95% CI = -0.04, -0.03; female: B = -0.06, 95% CI = -0.06, -0.05). Additionally, the grip strength moderation values in the significant zone for males and females were less than 63.2 kg and 48.3 kg, respectively.</p><p><strong>Conclusions: </strong>Muscular strength modifies depressive symptoms and lessens their correlation with cardiovascular diseases. Muscle-strengthening activities could be incorporated into primary and secondary preventive strategies to reduce the burden of depression in people with CVD.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}