Geriatrics最新文献

{"title":"'I Knew Nothing About Parkinson's': Insights into Receiving a Diagnosis of Parkinson's Disease and the Impact of Self-Management, Self-Care, and Exercise Engagement, from People with Parkinson's and Family Members' Perspectives: Qualitative Study.","authors":"Leanne Ahern, Catriona Curtin, Suzanne Timmons, Sarah E Lamb, Ruth McCullagh","doi":"10.3390/geriatrics10030073","DOIUrl":"10.3390/geriatrics10030073","url":null,"abstract":"<p><p>This paper draws on stories of receiving the diagnosis of Parkinson's disease, which emerged from a broader narrative study exploring beliefs about exercise and challenges facing people with Parkinson's disease.</p><p><strong>Background/objectives: </strong>By interviewing people with Parkinson's disease (PwPD) and their family members, this paper aimed to gain insights into PwPD's experiences with diagnosis, its influence on exercise engagement, and access to services in Ireland.</p><p><strong>Methods: </strong>This study employed a qualitative research design, using purposeful and maximum variation sampling. PwPD (varying in age, sex, geographical setting, and disease severity) were recruited from urban physiotherapy services. Semi-structured interviews with 12 PwPD and a group interview with four family members were conducted between November 2022 and January 2023. The interviews were recorded, transcribed, and analysed using thematic analysis.</p><p><strong>Results: </strong>Four themes emerged: (1) firstly, there was disempowerment and emotional shock at diagnosis: PwPD expressed frustration with delays in diagnosis and with how language and empathy affected their ability to cope initially. (2) There was a lack of signposting and services access: a strong need exists for clear information on services and resources to prevent social disengagement. (3) In terms of exercise education and self-management support, PwPD lacked early exercise education and guidance, relying on self-education. (4) With regard to the emotional burden on family caregivers, family members manage care logistics and face emotional burdens, which they try to conceal.</p><p><strong>Conclusions: </strong>The delivery of a Parkinson's diagnosis could be improved by recognising its psychosocial impact on PwPD and families. Providing clear information on services within weeks of diagnosis was considered crucial. Limited exercise education affected PwPD's ability to self-manage. Early physiotherapy access is strongly recommended to help delay functional decline and encourage an active lifestyle.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484103","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":"Implementation Outcomes for Agitation Detection Technologies in People with Dementia: A Systematic Review.","authors":"Nicolas Farina, Lorna Smith, Melissa Rajalingam, Sube Banerjee","doi":"10.3390/geriatrics10030070","DOIUrl":"10.3390/geriatrics10030070","url":null,"abstract":"<p><p><b>Background</b>: Experiencing agitation can be particularly distressing for people with dementia and their caregivers. Using technologies to detect agitation can help monitor and intervene when agitation occurs, potentially reducing overall care and support needs. This systematic review aims to explore the implementation outcomes related to the use of agitation detection technologies in people with dementia. By adopting a taxonomy of implementation outcomes, this review seeks to provide insights valuable for the real-world adoption of such technologies for people with dementia. <b>Methods:</b> Searches were conducted in the following databases: SCOPUS, PubMed, PsychINFO, IEEEXplore, and CINAHL Plus. Included studies were required to have implemented, evaluated, or validated technology with the intention to detect agitation in people with dementia in real-time. <b>Results:</b> On 14 May 2024, 1697 records were identified, and 19 were included in the review. The median sample size was 10, and around two-thirds of the records (n = 12, 63%) used 'multimodal' technologies for detecting agitation. Over half of the records (n = 10, 53%) were reporting from two studies. Across technologies, there was evidence of acceptability and feasibility, though there was a general absence of primary data related to implementation outcomes. There were, however, a number of technical issues and limitations that affected the fidelity and appropriateness of the technology, albeit not unique to people with dementia. <b>Conclusions:</b> There is a need for more empirical data on this topic to maximise uptake and adoption. Future research needs to ensure that the voice of the person with dementia is integrated within the evaluation process.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484104","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":"Pain Localization Shift During the Convalescence Period of Osteoporotic Vertebral Compression Fracture.","authors":"Oded Hershkovich, Mojahed Sakhnini, Raphael Lotan","doi":"10.3390/geriatrics10030071","DOIUrl":"10.3390/geriatrics10030071","url":null,"abstract":"<p><strong>Introduction: </strong>Vertebral Compression Fractures (VCF) are the most common vertebral fractures, usually osteoporotic, with rising incidence. The natural history of VCFs-related pain remains unclear, and treatment protocols are still being evaluated, ranging from conservative to surgical. Patient-reported measures have been proven inaccurate and carry significant biases. This study examines maximal tenderness location (MTL) to palpation and percussion on physical examination during VCF healing and the postoperative period.</p><p><strong>Methods: </strong>A prospective study included 40 patients treated for VCFs per the NICE guidelines (2013) from 2019 to 2021. Treatment was either conservative (<i>n</i> = 12) or surgical (<i>n</i> - 28), Balloon Kyphoplasty (BKP). All patients' MTL were recorded in EMR (Electronic Medical Record) on every visit. BKP was offered for severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management, progressive fracture collapse, or lack of union. Follow-up was six months. Pain evolution was analyzed using Kaplan-Meier survival curves, Log-Rank tests, Mann-Whitney U tests, <i>t</i>-tests, and logistic regression models. A <i>p</i>-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>12 patients were treated conservatively, and 28 underwent BKP for T12-L2 VCFs, accounting for 75% of fractures, mostly single-level fractures. All initially suffered MTL over the VCF; BKP patients showed local VCF pain resolution after 3.5 weeks following surgery while lasting seven weeks under conservative treatment. Lumbosacral pain was more prevalent following BKP (OR = 4, <i>p</i> = 0.05) and developed earlier.</p><p><strong>Conclusions: </strong>This study is novel in relating physical examination findings to fracture age and treatment provided, suggesting that VCFs-related pain is a time-related shift from local fracture pain to lumbosacral pain. Patient-reported pain scales may not reliably distinguish between these varying pain patterns. These findings suggest that only local VCF pain should be considered for surgical treatment. Future studies evaluating VCF outcomes should address physical examination and not rely solely on patient-reported metrics.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484105","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":"Risk Factors for Non-Carbapenemase-Producing Carbapenem-Resistant <i>Enterobacterales</i> Infections: A Retrospective Cohort Study.","authors":"Sayaka Mabuchi, Tsukasa Nakamura, Toshihiro Imada, Junji Mashino, Takeshi Morimoto","doi":"10.3390/geriatrics10030069","DOIUrl":"10.3390/geriatrics10030069","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Carbapenem-resistant Enterobacterales (CRE) infections are widespread, and the risk factors for carbapenemase-producing CRE (CP-CRE) infections are known. Non-CP-CRE (NCP-CRE) infections occur frequently; however, the associated risk factors remain elusive. Therefore, we investigated the risk factors for NCP-CRE infections, especially those caused by Enterobacter and Citrobacter species. <b>Methods:</b> We conducted a retrospective cohort study of patients aged ≥ 18 years with Enterobacter or Citrobacter infections who were admitted to the Department of General Medicine of a tertiary care hospital in Japan from October 2014 to September 2020. We used the data at first detection and performed univariate and multivariate logistic regression analyses to assess the associations between NCP-CRE infections and risk factors such as patient characteristics and antibiotics. <b>Results:</b> In total, 1416 participants were evaluated. The mean age of the patients was 74 ± 17 (range: 18-107) years, of whom 746 (53%) were men. Past use of antibiotics (≥4 days before specimen collection) was not significantly associated with NCP-CRE infections (133 [84%] vs. 1034 [82%], <i>p</i> = 0.5); however, recent use (≤3 days before sample collection) was significantly associated with NCP-CRE infections (42 [27%] vs. 245 [19%], <i>p</i> = 0.036). In the multivariate logistic model, recent use of antibiotics (odds ratio: 1.50, 95% confidence interval: 1.03-2.18) was an independent risk factor for NCP-CRE infections. <b>Conclusions:</b> NCP-CRE infection may be associated with recent antibiotic exposure, but not with the host's immune status. Therefore, alternative risk factors for NCP-CRE infection may exist.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484108","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":"Case Report: Multifactorial Intervention for Safe Aging in Place.","authors":"Ashwini Kulkarni","doi":"10.3390/geriatrics10030068","DOIUrl":"10.3390/geriatrics10030068","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. <b>Methods</b>: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant's residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. <b>Results:</b> The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy-International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. <b>Conclusions</b>: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127203","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":"Effect of a Six-Month Dance Intervention on Postural Control and Fall-Related Outcomes in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.","authors":"Ulrich Thiel, Nicole Halfpaap, Berit K Labott, Fabian Herold, Corinna Langhans, Kristinn Heinrichs, Patrick Müller, Notger G Müller, Anita Hökelmann","doi":"10.3390/geriatrics10030067","DOIUrl":"10.3390/geriatrics10030067","url":null,"abstract":"<p><strong>Background/objectives: </strong>Older adults with mild cognitive impairment often exhibit reduced postural control and increased fall risk. As fall-related injuries consume substantial healthcare resources, the development of fall-preventive interventions is of public health relevance. This study aims to investigate the effects of a six-month dance intervention on postural control and fall-related measures in older adults with mild cognitive impairment.</p><p><strong>Methods: </strong>In this randomized controlled trial, 55 participants were allocated to either an intervention group or a control group. The intervention group performed two 90-min dance training sessions per week for six months, while the control group maintained their usual activities of daily living. Postural control was operationalized via balance performance, which was measured with the Sensory Organization Test and the Limits of Stability Test. Neuromuscular function of the lower extremities was assessed via muscle contraction velocity using tensiomyography. Fear of falling was quantified with the Falls Efficacy Scale, and participants reported fall history over the past year. It was hypothesized that older adults with mild cognitive impairment participating in the six-month dance training would show significantly greater improvements in postural control and fall-related outcomes than those in the control group.</p><p><strong>Results: </strong>A mixed analysis of variance (time × group) revealed no significant improvements in balance performance or neuromuscular function following the dance intervention (<i>p</i> > 0.05). However, several main effects for time were observed in the Sensory Organization Test, Limits of Stability Test, and muscle contraction velocity. Scores on the Falls Efficacy Scale improved significantly in the intervention group, reflecting reduced fear of falling, although only shown by a paired-samples <i>t</i>-test (t(23)= 2.276, <i>p</i> = 0.032, d = 0.465).</p><p><strong>Conclusions: </strong>This study did not provide evidence that a six-month dance intervention improves postural or neuromuscular functions. However, it cannot be ruled out that such null findings are related to confounding factors, such as insufficient training specificity or duration. Nonetheless, the fear of falling was significantly reduced in the intervention group, suggesting potential benefits for perceived fall risk in older adults with mild cognitive impairment.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126276","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":"Osteoporosis Is Associated with Cerebral Small Vessel Disease in Stroke-Free Individuals: A Retrospective Observational Study.","authors":"Xueling Xiao, Luling Chen, Manxiang Deng, Jingqi Liu, Jiayan Cai, Chuhan Su","doi":"10.3390/geriatrics10030066","DOIUrl":"10.3390/geriatrics10030066","url":null,"abstract":"<p><p><b>Objectives</b>: This study aimed to investigate the relationship between osteoporosis and cerebral small vessel disease (CSVD) burden in stroke-free individuals, as well as its specific imaging markers, including lacunes, enlarged perivascular spaces (EPVSs), white matter hyperintensities (WMHs), and brain atrophy (BA). <b>Methods</b>: A total of 684 stroke-free patients who underwent both bone mineral density (BMD) assessments and brain MRI were included. Clinical data, CSVD burden scores, imaging markers of CSVD, and bone density parameters were collected. Logistic regression models were used to evaluate the relationship between BMD and CSVD burden and imaging markers. <b>Results</b>: Osteoporosis, including hip and vertebral osteoporosis, was independently associated with CSVD burden (OR = 2.332, 95%CI: [1.345, 4.039], <i>p</i> = 0.003; OR = 2.598, 95%CI: [1.540, 4.384], <i>p</i> < 0.001; OR = 1.515, 95%CI: [1.010, 2.272], <i>p</i> = 0.044). Increased BMD in the hip and spine correlated with reduced CSVD burden (OR = 0.929, 95%CI: [0.887, 0.972], <i>p</i> = 0.001; OR = 0.952, 95%CI: [0.917, 0.989], <i>p</i> = 0.012). Hip osteoporosis was a risk factor for lacunes (OR = 2.215, 95%CI: [1.197, 4.1], <i>p</i> = 0.011), multiple lacunes (OR = 2.274, 95%CI: [1.039, 4.980], <i>p</i> = 0.04), severe WMH (OR = 2.611, 95%CI: [1.171, 5.823], <i>p</i> = 0.019), and EPVS ≥ 2 (OR = 1.99, 95%CI: [1.133, 3.495], <i>p</i> = 0.017). No significant association was found between osteoporosis and BA (<i>p</i> = 0.928). In sex-stratified analyses, both hip and vertebral osteoporosis were independently associated with a higher CSVD burden in female patients (hip: OR = 2.529, 95%CI: [1.122, 5.703], <i>p</i> = 0.025; vertebral: OR = 3.129, 95%CI: [1.517, 6.455], <i>p</i> = 0.002; general osteoporosis: OR = 1.755, 95%CI: [1.057, 2.912], <i>p</i> = 0.03), whereas no significant association was observed in male patients (all <i>p</i> > 0.05). <b>Conclusions</b>: Osteoporosis was independently associated with an increased burden of CSVD, particularly evident in female patients. These findings suggest that bone health may be important in CSVD management, particularly for women.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127312","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 Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection.","authors":"Felipe Webster-Cordero, Lydia Giménez-Llort","doi":"10.3390/geriatrics10030065","DOIUrl":"10.3390/geriatrics10030065","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. <b>Methods:</b> This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009-2024). <b>Results:</b> A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. <b>Conclusions:</b> Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127288","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":"Overview of Systematic Reviews on Factors Related to the Structure and Functioning of Residential Long-Term Care Facilities for Older Adults.","authors":"Aurélio Matos Andrade, Karine Rodrigues Afonseca, Tatiana de Almeida Jube, Suelen Meira Góes, Maíra Catharina Ramos, Flavia Tavares da Silva Elias","doi":"10.3390/geriatrics10030064","DOIUrl":"10.3390/geriatrics10030064","url":null,"abstract":"<p><p><b>Objective:</b> To identify factors influencing the structure and functioning of long-term residential care facilities for older adults worldwide, in order to uncover practices and support evidence-based improvements in care delivery. <b>Method:</b> An overview of systematic reviews was performed according to the PRISMA protocol and registered on the PROSPERO platform (no. CRD42023486204). Research was carried out on 21 September 2023, using the following databases: PubMed (via MedLine), EMBASE, Web of Science, Scopus, Virtual Health Library (VHL), and Epistemonikos. <b>Results:</b> The search yielded 12,040 articles, including 61 systematic reviews. Analyzing the primary outcomes, personnel structure, and risk management were the most-studied outcomes of the systematic reviews, followed by pharmaceuticals, food services, mobility/accessibility, and technological and physical structures. In terms of primary outcomes of the systematic reviews, the personnel structure was the most highlighted (in 39.34%), followed by risk management (in 32.79%), while the least highlighted was physical structure (in 9.84%). <b>Conclusions:</b> Personnel are critical to the safe and effective functioning of Long-Term Care Facility (LTCF) operations. Future research is needed to identify associations between models of care and structural concerns, including physical environment, as they relate to quality of care in LTCFs, particularly in low and middle-income countries (LMIC).</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127315","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":"What Combination of Generic Bedside Screening Tools Is Optimal to Capture Patients with Penetration/Aspiration Due to Dysphagia? Comparing Single Bedside Tools Versus Combinations of Tools for Sensitivity and Specificity.","authors":"Albert Westergren, David Smithard, Johannes Riis, Christina Emborg, Anne Lund Krarup, Dorte Melgaard","doi":"10.3390/geriatrics10030063","DOIUrl":"10.3390/geriatrics10030063","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). <b>Methods</b>: In this cross-sectional study, participants diagnosed with chronic pulmonary disease (<i>n</i> = 25), Parkinson's disease (<i>n</i> = 26), multiple sclerosis (<i>n</i> = 24), or stroke (<i>n</i> = 25) participated. Patient-reported outcomes and clinical-rated assessments included: the four-question test (4QT), the Minimal Eating Observation Form-II, the Volume-Viscosity Swallow Test (V-VST), the Penetration-Aspiration Scale, and the FEES. Activities in daily living were assessed with the Barthel Index. The sensitivity, specificity, negative predictive value (NPV), positive predictive value, and accuracy were calculated. <b>Results</b>: The 100 participants' median age was 72 years, and 42 were women. In total, 78 patients had eating difficulties (MEOF-II). According to the 4QT, 69 patients had dysphagia while 62 had it according to the V-VST. Furthermore, 29 patients had penetration/aspiration according to the FEES. All generic bedside tools performed better when combined with another tool, when compared to the identification of penetration/aspiration according to the FEES. The combination of the MEOF-II and 4QT as well as the combination of the MEOF-II and V-VST proved to have very high sensitivity (96.1-96.3%) and NPVs (92.3% in both instances). Combining the three tools, the MEOF-II, 4QT, and V-VST, did not improve the sensitivity or NPV. <b>Conclusions</b>: A combination of the MEOF-II and 4QT or the MEOF-II and V-VST bedside tools is recommended for identifying patients at risk of penetration/aspiration and in need of further in-depth clinical assessment.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127340","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}