Annals of Geriatric Medicine and Research最新文献

{"title":"Evaluation of Activities of Daily Living: Current Insights and Future Horizons.","authors":"Jin-Ho Kim, Seok Bum Lee","doi":"10.4235/agmr.24.0172","DOIUrl":"https://doi.org/10.4235/agmr.24.0172","url":null,"abstract":"<p><p>Activities of Daily Living (ADL) assessments are crucial for evaluating functional independence and formulating care strategies for older adults. However, the existing tools encounter challenges, including cultural bias, subjectivity, and limited sensitivity to subtle changes in functional abilities. This review examines these limitations across Basic, Instrumental, and Extended ADL categories and explores the integration of emerging technologies, such as artificial intelligence, sensor-based systems, and remote monitoring tools, to address these gaps. Technological advancements have the potential to enhance the accuracy, efficiency, and inclusivity of ADL assessment by providing objective data, supporting real-time evaluations, and enabling personalized care plans. By bridging the gap between traditional methods and innovative technologies, this review highlights a pathway for more equitable and effective assessments, ensuring that older adults across diverse contexts receive tailored support to maintain their independence and improve their quality of life.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411122","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":"Angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers in elderly patients with acute myocardial infarction after a successful stent implantation.","authors":"Geum Ko, Jae-Geun Lee, Ki Yung Boo, Joon-Hyouk Choi, Song-Yi Kim, Seung-Jae Joo, Jin-Yong Hwang, Seung-Ho Hur, Seok Kyu Oh, Myung Ho Jeong","doi":"10.4235/agmr.24.0187","DOIUrl":"https://doi.org/10.4235/agmr.24.0187","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the long-term clinical outcomes of patients with acute myocardial infarction (AMI) who underwent successful stent implantation and were subsequently treated with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB).</p><p><strong>Methods: </strong>Among 13104 patients enrolled in the Korean AMI registry, 2763 elderly patients aged 70 years or older, who were prescribed either ACEI or ARB at discharge, were included in this study. Propensity score matching (PSM) was performed to adjust for baseline confounders. The primary outcome was a composite of cardiac death and recurrent myocardial infarction (MI) at the 3-year follow-up.</p><p><strong>Results: </strong>In PSM cohort, use of ACEI at discharge was associated with a significantly lower incidence of primary outcome (hazard ratio, 1.60; 95% confidence interval, 1.20-2.14; p=0.001) compared to those of ARB at discharge. Additionally, incidences of cardiac death, recurrent MI and all-cause death were lower in use of ACEI at discharge than in those of ARB. However, there were no statistically significant differences between the two groups in hospitalization for heart failure, any revascularization, stent thrombosis, or stroke.</p><p><strong>Conclusions: </strong>The findings of this study suggest that ACEI use at discharge, compared with ARB use, was associated with lower incidences of cardiac death, and recurrent MI in elderly patients with AMI after successful stent implantation.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411119","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":"Hypoalbuminemia as an unusual presentation of undiagnosed atypical celiac disease in an 84-year-old woman.","authors":"Filip Ernoić, Marko Vodanović, Ana Maria Vrga, Marinko Marušić, Filip Sedlić, Krešimir Luetić","doi":"10.4235/agmr.24.0154","DOIUrl":"10.4235/agmr.24.0154","url":null,"abstract":"<p><p>Celiac disease is a chronic, immune-mediated enteropathy that is precipitated by dietary gluten in genetically predisposed individuals. Classical form of the disease is characterized by gastrointestinal symptoms and signs of malabsorption, while patients with nonclassical celiac disease lack significant gastrointestinal symptoms. We report an uncommon case of celiac disease in an 84 -year-old oligosymptomatic female with a recently treated colon tumor, diagnosed during the investigation of profound hypoproteinemia and hypoalbuminemia. In this case, two factors could have been misleading about the cause of hypoalbuminemia: malignant tumor and advanced age. Since the oncological disease was in remission, and the albumin concentration in the healthy elderly people in the community usually exceeds 38 g/L until after the age of 90, we pursued an alternative cause, leading to the diagnosis of celiac disease. Even in the absence of intestinal symptoms, advanced age, or other diagnoses, celiac disease should be considered a potential differential diagnosis in every patient presenting with hypoalbuminemia.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411138","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":"Perceptions of the Intensity of Heart Failure Medications among Hospitalized Older Adults: A Pilot Qualitative Study.","authors":"Nuzha A Amjad, Saeed Shoar, Catherine Bryant, Meghan Hunt, Min Ji Kwak","doi":"10.4235/agmr.24.0182","DOIUrl":"https://doi.org/10.4235/agmr.24.0182","url":null,"abstract":"<p><strong>Background: </strong>Guidelines for heart failure (HF) management recommend high target doses for medications. These targets are based on standardized dosing regimens that rarely consider the complex challenges faced by older patients. However, little is known about such challenges perceived by older adults. We assessed older adults' perceived challenges with HF medication utilization, which may guide a more patient-centered definition of the target intensity for HF medications.</p><p><strong>Methods: </strong>We conducted a pilot qualitative study using one-on-one, semi-structured interviews with older adults. We included patients over the age of 65 years admitted to the acute cardiac care units (cardiac intensive care unit or cardiac intermediate care unit) with a known diagnosis of HF. We conducted a deductive and inductive thematic analysis based on a prior conceptual framework for the Medication-Related Burden Quality of Life tool. Subthemes and themes were finalized with two other coders who were study investigators.</p><p><strong>Results: </strong>Ten patients were enrolled in the study. Six major themes were identified in the perception of challenges of HF medication utilization. The most common themes were experiencing adverse drug effects (80%) and psychological distress (80%), followed by problems in logistics (70%), the burden from the number of medications (70%), impact from patient-doctor relations (70%), and burden from the cost (40%).</p><p><strong>Conclusions: </strong>The results from this pilot study provide preliminary insight into the perceived challenges of HF medication utilization and the distinctive ways the treatment burden is experienced by patients. These results will need validation in larger studies and different patient settings.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411141","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":"Factors Associated with the Patient Safety Activities among Home-Visit Caregiver: A Cross-Sectional Study.","authors":"Soon-Hee Cho, Sujin Kang, Youngji Kim","doi":"10.4235/agmr.24.0159","DOIUrl":"https://doi.org/10.4235/agmr.24.0159","url":null,"abstract":"<p><strong>Background: </strong>Home-visit care should prioritize patient safety and promote positive safety awareness to maintain caregivers' commitment to providing safe care. This descriptive study aims to examine the relationship between home-visit caregivers' knowledge, attitudes, awareness of patient safety, and safety-related activities.</p><p><strong>Methods: </strong>The participants were 210 adult home-visit caregivers, aged 20 years or older, with more than six months of experience working at six long-term care centers in D Metropolitan City. Data were collected using a structured self-report questionnaire to measure participants' general characteristics and their patient safety knowledge, attitudes, awareness, and activities and analyzed using SPSS/WIN 28.0.</p><p><strong>Results: </strong>This study demonstrated that patient safety activities were significantly positively correlated with patient safety knowledge (r=.63, p˂.001), patient safety attitude (r=.49, p ˂.001), and patient safety awareness (r=.69, p˂.001). The factors affecting patient safety activities were patient safety awareness and patient safety knowledge, with an explanatory power of 55%.</p><p><strong>Conclusion: </strong>To practice patient safety activities and maintain a desirable attitude, an educational strategy that promotes cognitive change, such as a systematic and continuous practice-oriented campaign, is needed. Furthermore, efforts to improve the working environment to extend the tenure of experienced caregivers are required.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013828","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":"Impact of Physical Activity Level on Whole-Body and Muscle-Cell Function in Older Adults.","authors":"Hyo-Seong Yeo, Jae-Young Lim","doi":"10.4235/agmr.24.0141","DOIUrl":"https://doi.org/10.4235/agmr.24.0141","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to examine the effects of different levels of physical activity on functional capacity, muscle strength, and the contractile properties of single muscle fibers in older adults.</p><p><strong>Methods: </strong>Twenty-ones older adults (71.1±3.7 years) were divided into the high physical activity (HPA, n=10) and low physical activity (LPA, n=11) groups. Physical activity was assessed using a short form of the International Physical Activity Questionnaire (IPAQ). Physical function and muscle strength tests were performed. The fiber cross-sectional area (CSA), maximal force (Po), maximal force normalized to CSA (specific force, SF), maximal shortening velocity (Vo), and myosin heavy chain isoform expression were determined in single muscle fibers.</p><p><strong>Results: </strong>IPAQ walking and total scores were higher in the HPA than in the LPA. The differences in body composition of the LPA and HPA were not significant. The 4-m walking velocity and isometric and isokinetic knee extensor strength were higher in the HPA than in the LPA. There was a significant difference between the two groups in Vo, but not fiber CSA, peak force, and SF. In addition, the Vo was significantly higher in the HPA than in the LPA for type I but not type II fibers. The correlation between total physical activity level and Vo was positive.</p><p><strong>Conclusion: </strong>In older adults, higher levels of physical activity may have a greater impact on muscle function than on body composition. Moreover, increased physical activity is associated with higher Vo at the muscle cell level. Thus, we propose that enhancing overall physical activity levels should be considered an effective strategy for improving muscle function in older adults.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796490","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":"Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients.","authors":"Kota Hori, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Aomi Kuzuhara, Takenori Hamada, Kouki Yoneda, Kenichiro Maekawa","doi":"10.4235/agmr.24.0020","DOIUrl":"10.4235/agmr.24.0020","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.</p><p><strong>Methods: </strong>This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1-2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.</p><p><strong>Results: </strong>Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1-3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.</p><p><strong>Conclusions: </strong>Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"388-394"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898281","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":"Correlation between Phase Angle and the Number of Medications in Older Inpatients: A Cross-Sectional Study.","authors":"Toshiyuki Moriyama, Mizuki Tokunaga, Ryoko Hori, Akiko Hachisuka, Hideaki Itoh, Mitsuhiro Ochi, Yasuyuki Matsushima, Satoru Saeki","doi":"10.4235/agmr.24.0096","DOIUrl":"10.4235/agmr.24.0096","url":null,"abstract":"<p><strong>Background: </strong>Muscle weakness in older adults elevates mortality risk and impairs quality of life, with the phase angle (PhA) indicating cellular health. Polypharmacy, common in geriatric care, could influence PhA. This investigates whether the number of medications and polypharmacy with PhA as a biomarker of muscle quality in older inpatients aged ≥65 and determines the extent to which multiple medications contribute to the risk of reduced muscle quality.</p><p><strong>Methods: </strong>This retrospective cross-sectional study analyzed data from older inpatients requiring rehabilitation. PhA was measured using bioelectrical impedance analysis. The number of medications taken by each patient was recorded at admission. Polypharmacy was defined as the concurrent use of five or more medications at admission.</p><p><strong>Results: </strong>In this study of 517 hospitalized older adults (median age 75 years; 47.4% men), 178 patients (34.4%) were diagnosed with sarcopenia. Polypharmacy was present in 66% of patients. The median PhA was 4.9° in men and 4.3° in women. Multivariate linear regression analysis was performed separately for men and women. In men, PhA was negatively correlated with the number of medications (β=-0.104, p=0.041) and polypharmacy (β=-0.045, p=0.383). In women, PhA was negatively correlated with the number of medications (β=-0.119, p=0.026) and polypharmacy (β=-0.098, p=0.063). Analyses were adjusted for age, body mass index, sarcopenia, C-reactive protein, and hemoglobin levels.</p><p><strong>Conclusion: </strong>The number of medications at admission negatively impacted PhA in older inpatients, highlighting the importance of reviewing prescribed drugs and their interactions.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"419-426"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477592","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":"Unraveling the Impact of Destabilizing Shoes on Balance Control and Fall Prevention in Older Adults: A Systematic Review.","authors":"In-Ju Kim","doi":"10.4235/agmr.24.0030","DOIUrl":"10.4235/agmr.24.0030","url":null,"abstract":"<p><strong>Background: </strong>Falls pose a significant risk to older adults, often leading to severe injury and disability. One potential contributing factor to falls is footwear, particularly shoes with destabilizing features. This systematic review assessed the effects of destabilizing shoes on stability control and fall prevention in older adults, highlighting their effectiveness in balance control and fall prevention, and the detailing the specific review methodology.</p><p><strong>Methods: </strong>We thoroughly searched relevant databases and meticulously screened the identified studies based on predetermined inclusion and exclusion criteria. We then extracted data from 30 eligible studies with various study designs and shoe types and synthesized this information to assess the impact of destabilizing shoes on balance and gait measures, fall incidence, and other relevant outcomes.</p><p><strong>Results: </strong>While certain types of destabilizing shoes may improve specific aspects of balance and proprioception, they can also adversely affect steadiness control and potentially increase the risk of falls if not appropriately used. Therefore, the use of destabilizing shoes should be carefully considered and tailored to individual needs, with proper guidance and training to minimize fall risk.</p><p><strong>Conclusion: </strong>The findings of this review significantly inform footwear design and selection in older adults and emphasize the need for additional research. By synthesizing the available evidence, this review highlights the potential benefits and risks associated with destabilizing shoes and suggests the need for careful evaluation of their use on a case-by-case basis. This review serves as a basis for future guidelines on the use of destabilizing shoes in older adults with the aim of developing effective fall prevention interventions.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":"28 4","pages":"377-387"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923701","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":"Machine Learning for Movement Pattern Changes during Kinect-Based Mixed Reality Exercise Programs in Women with Possible Sarcopenia: Pilot Study.","authors":"Yunho Sung, Ji-Won Seo, Byunggul Lim, Shu Jiang, Xinxing Li, Parivash Jamrasi, So Young Ahn, Seohyun Ahn, Yuseon Kang, Hyejung Shin, Donghyun Kim, Dong Hyun Yoon, Wook Song","doi":"10.4235/agmr.24.0033","DOIUrl":"10.4235/agmr.24.0033","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a muscle-wasting condition that affects older individuals. It can lead to changes in movement patterns, which can increase the risk of falls and other injuries.</p><p><strong>Methods: </strong>Older women participants aged ≥65 years who could walk independently were recruited and classified into two groups based on knee extension strength (KES). Participants with low KES scores were assigned to the possible sarcopenia group (PSG; n=7) and an 8-week exercise intervention was implemented. Healthy seniors with high KES scores were classified as the reference group (RG; n=4), and a 3-week exercise intervention was conducted. Kinematic movement data were recorded during the intervention period. All participants&apos; exercise repetitions were used in the data analysis (number of data points=1,128).</p><p><strong>Results: </strong>The PSG showed significantly larger movement patterns in knee rotation during wide squats compared to the RG, attributed to weakened lower limb strength. The voting classifier, trained on the movement patterns from wide squats, determined that significant differences in overall movement patterns between the two groups persisted until the end of the exercise intervention. However, after the exercise intervention, significant improvements in lower limb strength in the PSG resulted in reduced knee rotation range of motion and max, thereby stabilizing movements and eliminating significant differences with the RG.</p><p><strong>Conclusion: </strong>This study suggests that exercise interventions can modify the movement patterns in older individuals with possible sarcopenia. These findings provide fundamental data for developing an exercise management system that remotely tracks and monitors the movement patterns of older adults during exercise activities.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"427-436"},"PeriodicalIF":2.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634917","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}