Geriatrics最新文献

{"title":"Tau Imaging: Use and Implementation in New Diagnostic and Therapeutic Paradigms for Alzheimer's Disease.","authors":"Alexandra Gogola, Brian J Lopresti, Davneet S Minhas, Oscar Lopez, Ann Cohen, Victor L Villemagne","doi":"10.3390/geriatrics10010027","DOIUrl":"10.3390/geriatrics10010027","url":null,"abstract":"<p><p>Alzheimer's disease (AD) affects an estimated 6.9 million older adults in the United States and is projected to impact as many as 13.8 million people by 2060. As studies continue to search for ways to combat the development and progression of AD, it is imperative to ensure that confident diagnoses can be made before the onset of severe clinical symptoms and new therapies can be evaluated effectively. Tau positron emission tomography (PET) has emerged as one method that may be capable of both, given its ability to recognize the presence of tau, a primary pathologic hallmark of AD; its usefulness in determining the spatial distribution of tau, which is necessary for differentiating AD from other tauopathies; and its association with measures of cognition. This review aims to evaluate the scope of tau PET's utility in clinical trials and practice. Firstly, the potential of using tau PET for differential diagnoses, distinguishing AD from other dementias, is considered. Next, the value of tau PET as a tool for staging disease progression is investigated. Finally, tau PET as a prognostic method for identifying the individuals most at risk of cognitive decline and, therefore, most in need of, and likely to benefit from, intervention, is discussed.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491505","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":"Engaging Health and Aged Care Workers in Rural and Remote Australia Around Factors Impacting Their Access to and Participation in Dementia Training.","authors":"Sandra C Thompson, Jessica Valentine, Kira Gusterson, Katrina P Fyfe, Alex Beilby, John A Woods, Myles Clarkson Fletcher, Pascale Dettwiller, Kathryn W Fitzgerald","doi":"10.3390/geriatrics10010028","DOIUrl":"10.3390/geriatrics10010028","url":null,"abstract":"<p><p><b>Objective:</b> To better understand barriers and enablers to uptake of dementia training in rural and remote areas using input from rural and remote aged and health care workers into how dementia training could be offered to better meet their needs. <b>Methods</b>: Roundtable focus groups were conducted in six diverse rural and remote locations in four jurisdictions around Australia. Sixty-seven workers from predominantly nursing, allied health, and support worker roles involved in dementia care participated. Data were collected by site and used a mixture of face-to-face and virtual facilitated 'roundtable' discussions. Each group discussed barriers and enablers to participation in training and their preferences for how dementia training should be provided. <b>Results</b>: Commonalities emerged in barriers for accessing dementia training. Participants emphasised the need for strong organisational support and locally relevant, interactive and flexible delivery methods to address rural challenges. Significant challenges related to staffing levels, time constraints, and competing priorities. Enablers of training uptake included support from employers covering time and costs of training, local collaboration, and training accessibility for all job roles rather than profession specific. Participants emphasised the importance of practical, local training relevant to their scope of practice delivered by experienced trainers. The need for culturally safe aged care practices was noted in all sites. <b>Discussion and Conclusions</b>: Collaborative approaches across organisations and the aged care workforce and training relevant to local rural contexts were favoured. The opportunity to learn from external experts was greatly appreciated. Workers want training that enhances culturally safe practices. Organisational support is critical for training implementation.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491717","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":"Echocardiographic Assessment of Cardiac Structure and Function of Centenarians: A Systematic Review.","authors":"Andrea Sonaglioni, Gian Luigi Nicolosi, Giovanna Elsa Ute Muti-Schünemann, Alessio Polymeropoulos, Michele Lombardo, Paola Muti","doi":"10.3390/geriatrics10010026","DOIUrl":"10.3390/geriatrics10010026","url":null,"abstract":"<p><p><b>Background:</b> During the last two decades, a limited number of studies have provided echocardiographic details regarding the cardiac structure and function of individuals aged ≥100 years. These studies analyzed limited sample sizes of centenarians using different methodologies. The present systematic review was primarily designed to summarize the main findings of these studies and to examine the overall influence of extremely advanced age on cardiac structure and function. <b>Methods:</b> All echocardiographic studies that evaluated the cardiac structure and function in individuals aged ≥100 years, selected from the PubMed, Embase, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases, were included. There was no limitation on the time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. <b>Results:</b> A total of eight studies with 1340 centenarians [median age 101.4 years (IQR 101-103 years)] met the eligibility criteria and were analyzed. The centenarians were predominantly females [76.3% (IQR 60-85%)] with a small body surface area, long history of hypertension and slightly impaired renal functional reserve. The centenarian population showed a reduced burden of cardiovascular disease but an increased comorbidity burden, as assessed using the Charlson [median value 3.7 (IQR 1.8-5.5)] and Katz [median value 2.1 (IQR 1.1-3.1)] indexes. The echocardiographic findings comprised left ventricular (LV) concentric remodeling, with first-degree diastolic dysfunction [median E/A ratio 0.8 (IQR 0.7-0.9)], a moderate increase in LV filling pressure [median E/e' ratio 16.8 (IQR 16.2-17)], normal LV systolic function [median left ventricular ejection fraction (LVEF) 60.9% (IQR 55-84%)] and mild-to-moderate pulmonary hypertension [median systolic pulmonary artery pressure 42.1 mmHg (IQR 37-54 mmHg)]. The pooled prevalence of LV systolic dysfunction (LVEF < 50%) was 15.8%. Moderate-to-severe valvular heart diseases were detected in less than one-third of the centenarians. Compared with the outpatient and in-home cohorts, hospitalized centenarians were less commonly females and were more likely to be affected by significant LV hypertrophy with a supra-normal LVEF, higher degrees of valvulopathies and impaired pulmonary hemodynamics. <b>Conclusions:</b> The evidence currently suggests that centenarians have typical LV concentric remodeling with increased myocardial stiffness and diastolic dysfunction, which predispose them to heart failure with a preserved ejection fraction (HFpEF). Cardioprotective treatment should be considered for personalized implementation and uptitration in this special population.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491687","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":"Psychometric Properties of the Spanish Versions of the Activity Restriction Scale.","authors":"Laura García-García, Lucía Jiménez-Gonzalo, José A Fernandes-Pires, Brent T Mausbach, Luis Manuel Pérez-Cardona, Claudia Benito-Rincón, Andrés Losada-Baltar","doi":"10.3390/geriatrics10010024","DOIUrl":"10.3390/geriatrics10010024","url":null,"abstract":"<p><p><b>Introduction:</b> Activity restriction (i.e., feeling limited in performing certain activities) has been studied in relation to psychological distress. The Activity Restriction Scale (ARS) has been widely used, with a two-factor structure obtained in previous studies. However, there is no validated instrument for this measure in Spanish. This study aims to analyze the psychometric properties of the Spanish version of the original ARS and to create an adapted version for older adults. <b>Method:</b> In Phase 1, the original ARS was tested in 143 Spanish family caregivers. In Phase 2, this version was explored through a pilot study with 10 Spanish older adults. In Phase 3, the ARS-Older Adults version (ARS-OA) was tested in a sample of 246 Spanish older adults. Confirmatory factor analysis was conducted in Phases 1 and 3, in addition to testing reliability, and convergent and concurrent validity. A descriptive analysis was carried out in Phase 2. <b>Results:</b> Both factor analyses provided support for a two-factor solution: instrumental and expressive activity restriction. Cronbach's alpha was 0.86 (Phase 1) and 0.81 (Phase 3). The data also suggested good convergent and concurrent validity. <b>Conclusions:</b> The results revealed good psychometric properties of both versions of the ARS, suggesting that it is a suitable instrument for assessing activity restriction in Spanish-speaking populations. Activity restriction is suggested as a relevant variable to take into account in understanding people's mental health.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491499","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":"Analysing Differences in Cognitive Health, Physical Fitness and Brain Activity in Older Women With and Without MCI.","authors":"Wookwang Cheon, Jidong Tian, Jinkee Park","doi":"10.3390/geriatrics10010025","DOIUrl":"10.3390/geriatrics10010025","url":null,"abstract":"<p><p>The purpose of this study is analyse the differences in cognitive health, geriatric fitness, and brain activity between female elderly people with and without mild cognitive impairment (MCI) to contribute to the development of strategies for the prevention and management of MCI. The study included 56 female elderly residents of G city, and the participants were divided into an MCI group (32) and a non-MCI group (24). Cognitive health was assessed by an MMSE, and geriatric physical fitness was measured by various indicators such as strength, flexibility, and balance ability. Brain activity was measured by EEG(Electroencephalogram) to record concentration, stress, and left and right brain activity. Data were processed using independent samples <i>t</i>-tests and multiple regression analyses. The results showed that the MCI group was older, had more chronic diseases, and had a lower MMSE scores compared to the non-MCI group. In geriatric fitness measures, the non-MCI group had higher scores in handgrip strength and balance ability. In brain activity analyses, the MCI group had higher workloads and left brain activity than the non-MCI group, but there was no significant correlation with overall cognitive health. Regression analyses showed that, among the elderly physical fitness variables, vigour had a significant effect on cognitive health, suggesting that physical robustness may enhance cognitive reserve. The MCI group had lower cognitive health and physical fitness compared to the non-MCI group and showed some differences in brain activity. In particular, handgrip strength had a significant effect on cognitive health, suggesting that an exercise programme focused on strength training may be an effective intervention for the prevention and management of MCI.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491771","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":"Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial.","authors":"Kap-Soo Han, Myoung-Hwan Ko","doi":"10.3390/geriatrics10010023","DOIUrl":"10.3390/geriatrics10010023","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This clinical trial aimed to determine whether perturbation-based gait training (PBGT) on a split-belt treadmill enhances balance and muscle strength in older adults, comparing its effectiveness with walking-only training on a treadmill. <b>Methods</b>: This single-center, prospective, single-blind (assessor), randomized controlled trial included 24 older adults from the Rehabilitation Center of Jeonbuk National University Hospital. Participants were equally divided into the PBGT and control groups. Both groups underwent 12 training sessions, three times a week for 4 weeks, for a total of 43 min per session. The outcomes, including the Five Times Sit-to-Stand Test (FTSST), Falls Efficacy Scale International, timed up-and-go (TUG) test, functional reach test, and lower-extremity manual muscle test scores, were measured at three time points: pre-training, post-training, and four weeks after training. <b>Results</b>: While there were no significant differences between the two groups, the PBGT group demonstrated significant improvements in its FTSST and TUG values. <b>Conclusions</b>: Unpredictable perturbation training on a split-belt treadmill can be safely performed by older adults and may serve as an alternative exercise method to enhance physical performance and balance ability for fall prevention.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491715","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":"Effects of Twelve Weeks of Square Stepping Exercises on Physical and Cognitive Function and Plasma Content of SMP30: A Randomised Control Trial.","authors":"Juan Manuel Franco-García, Jorge Pérez-Gómez, Antonio Castillo-Paredes, Pedro Cosme Redondo, Jorge Rojo-Ramos, Noelia Mayordomo-Pinilla, Santos Villafaina, Mari Carmen Gómez-Álvaro, Maria Melo-Alonso, Jorge Carlos-Vivas","doi":"10.3390/geriatrics10010022","DOIUrl":"10.3390/geriatrics10010022","url":null,"abstract":"<p><strong>Background: </strong>Ageing and sedentary lifestyles affect physical and cognitive function and markers of frailty, increasing the risk of falls in older adults and affecting their quality of life. The aim of this study was to evaluate the effects of a Square Step Exercise programme on physical and cognitive function and plasma SMP30 levels for the prevention of falls in older adults.</p><p><strong>Methods: </strong>A randomised controlled trial was designed with 44 participants assigned to an experimental group (SSE group) and a control group. The SSE group performed SSE sessions twice a week for three months, with a follow-up in the fourth month. The assessments of physical function included tests such as the Four-Square Step Test, Brisk Walking and its dual-task variant, Time Up and Go and its imagined and dual-task variants, 30 s Sit-to-Stand and its dual-task and imagined variants and a 6 min walking test. Questionnaires were also used to assess the risk and fear of falling. Resting EEG activity was also recorded to assess electrocortical brain activity. SMP30 levels were measured by Western blotting.</p><p><strong>Results: </strong>The SSE group showed significant improvements compared to the control group in the Four-Square Step Test (<i>p</i> < 0.001), Brisk Walking (<i>p</i> < 0.05) and reduction in the fear of falling (<i>p</i> < 0.001) after the training programme, but these adaptations were not maintained one month after the programme ended (<i>p</i> < 0.05). No significant changes were observed in the remaining variables of physical function, cognitive function, fall risk questionnaire, EEG activity or plasma levels of SMP30 compared to the control group (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>The SSE programme showed efficacy in improving balance, gait speed and reducing fear of falling in older adults but did not show improvement over the control group in other areas of physical or cognitive function or plasma SMP30 levels for fall prevention.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491690","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":"The Implementation of Infant Anoesis and Adult Autonoesis in the Retrogenesis and Staging System of the Neurocognitive Disorders: A Proposal for a Multidimensional Person-Centered Model.","authors":"Alessandro Pirani","doi":"10.3390/geriatrics10010020","DOIUrl":"10.3390/geriatrics10010020","url":null,"abstract":"<p><p><b>Background:</b> Retrogenesis is the process by which the degenerative and vascular mechanisms of dementia reverse the order of acquisition in the normal development. <b>Objective:</b> The development of memory/knowledge after birth may help to know the biopsychosocial and functional characteristics (biosphere) of the retrogenesis. <b>Methods:</b> A literature review was performed in the PubMed, Google Scholar, and Scopus databases using 43 keywords related to retrogenesis: 234 eligible records were selected. <b>Results:</b> The infantile amnesia, characterized from anoesis, was described along the infant/child's biosphere in which the limbic system progressively develops the acquisition of the body knowledge (Anoetic Body Consciousness, AnBC). Anoesis is the infant memory state characterized by the absence of long-term memories of the many stressful/painful experiences that accompany the acquisition under the long-life voluntary control of the long-term memories fundamental for the body growth and survival (mainly chewing/swallowing and walking). At the age of 3-4 years, usually, the AnBC evolves, as a continuum, into the adulthood autonoesis with the emergence, in the child/adolescent, of the consciousness of \"self\" trough the development of the Episodic Autobiographic Memory (EAM) and the Autonoetic Mind Consciousness (AuMC). The development of cognition and knowledge is due to the progressive maturation of the whole limbic system and not only of the hippocampus. In the biopsychosocial retrogenesis, the EAM/AuMC vanishes progressively along the mild, moderate, and severe stages of dementia when the infant AnBC resurfaces, losing progressively the basic activities of daily living in a retrogenetic order of acquisition where the last functions to disappear are chewing/swallowing. <b>Conclusion</b>: The transition from the adult EAM-AuMC to the infant AnBC, as a continuum in the individual biosphere, adds a contribution to the assessment of the retrogenesis in dementia from a multidimensional person-centered model.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491516","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":"The Use and Understanding of Mild Cognitive Impairment in Routine Specialist Care: A Survey Among German Memory Clinics.","authors":"Gloria S Benson, Claudia Bartels, Feride Stamatis, Michael Belz, Hermann Esselmann, Lutz Frölich, Lucrezia Hausner","doi":"10.3390/geriatrics10010021","DOIUrl":"10.3390/geriatrics10010021","url":null,"abstract":"<p><p><b>Objectives</b>: Mild cognitive impairment (MCI) is a heterogeneous clinical syndrome and is important for the diagnosis and management of Alzheimer's disease (AD). With the expansion of biomarker-based diagnostics, the aim of this study is to clarify the current attitudes towards and the use of MCI, and MCI due to AD, in German memory clinics. <b>Methods</b>: An online survey (50 items) was performed in 2022 among specialized clinicians (<i>N</i> = 45) in German memory clinics to assess the use of MCI and biomarkers in current diagnosis and treatment. Attitudinal and frequency items were assessed with a five-point numeric scale (<i>strongly disagree</i> = 1 to <i>completely agree</i> = 5 and <i>never</i> = 1 to <i>always</i> = 5, respectively). <b>Results</b>: All respondents used MCI as a clinical diagnosis. The benefits of diagnosing MCI were labeling deficits as disease symptoms (<i>M</i> = 4.4, <i>SD</i> = 0.7), improving coping with symptoms (<i>M</i> = 4.1, <i>SD</i> = 0.9), and motivating risk reduction activities (<i>M =</i> 4.0, <i>SD</i> = 0.9). Overall, 37 respondents used specialized diagnostic criteria for MCI due to AD, and all had access to biomarker diagnostics. Patients with MCI due to AD received more frequent counseling on memory training (<i>p</i> < 0.001), other non-pharmacological treatments (<i>p</i> < 0.001), and antidementive drug treatment (<i>p</i> < 0.001) than patients with MCI of other etiologies. Acetylcholinesterase inhibitors were prescribed significantly more frequently to patients with MCI due to AD (<i>p</i> < 0.001) compared to other MCI patients. <b>Conclusions</b>: MCI is commonly used as a clinical diagnosis in German memory clinics. AD biomarker assessment is well established and influences patient counseling and treatment recommendations.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491521","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":"Identification of Barriers and Needs in the Discontinuation of Benzodiazepine Receptor Agonists in Elderly Patients of a Rural Community-A Qualitative Study.","authors":"Tiago de Barros Mendes, Marta Nazha, Ana Luísa Neves, Paula Broeiro-Gonçalves","doi":"10.3390/geriatrics10010018","DOIUrl":"10.3390/geriatrics10010018","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients' point of view. No previous studies were identified that have been conducted in Portugal on this subject. We proposed to identify the barriers and facilitators in the discontinuation of BZRA from the perceptions of elderly patients under prolonged prescription of BZRA, belonging to the same rural community. The contributions for further research are intended to be the identification of potential intervention targets directed at patients to reduce the prevalence of elderly patients under prolonged prescription of BZRA. <b>Methods</b>: A set of 15 semi-structured interviews with patients under prolonged prescription of BZRA was conducted. Content analysis was done by the main researcher and a reviewer to identify original emerging themes for the two underlying domains. <b>Results</b>: Four themes were identified as barriers to the discontinuation of BZRA: (1) patient characteristics, (2) clinical factors, (3) medication-related factors, and (4) context and external factors. Seven themes were identified as facilitators to the discontinuation of BZRA: (1) motivation, (2) patients' knowledge, (3) perception of BZRA insufficiency, (4) access to written information, (5) access to alternatives, (6) time for decision-making, and (7) attitudes of health professionals. <b>Conclusions</b>: The findings highlight the challenging nature of BZRA discontinuation and the range of barriers and facilitators that impact patients' behaviour towards this purpose. We subdivided the elements identified in two areas, therefore aiming at producing significant knowledge to outline potential intervention targets.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491781","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}