Annals of Geriatric Medicine and Research最新文献

{"title":"Comprehensive Assessment of Lower Limb Function and Muscle Strength in Sarcopenia: Insights from the Sit-to-Stand Test.","authors":"Tae Sung Park, Myung-Jun Shin","doi":"10.4235/agmr.23.0205","DOIUrl":"10.4235/agmr.23.0205","url":null,"abstract":"<p><p>The sit-to-stand test is an essential tool used to assess lower limb function and muscle strength in older adults and various patient populations, and also plays a role in sarcopenia screening. Among its forms, the five-time sit-to-stand test (FTSST) is widely used, with previous studies suggesting cutoff values of &gt;10 seconds and &gt;11 seconds for the sitting-to-standing and standing-to-sitting transitions, respectively. The 30-second and 1-minute sit-to-stand tests (30STS and 1MSTS, respectively) also provide comprehensive assessments. While much of the current research on sarcopenia focuses on the FTSST, there is a burgeoning need for an in-depth exploration of the 30STS and 1MSTS. Studies on these tests are vital to refine the criteria for sarcopenia, establish accurate cutoff values, and enhance diagnostic precision and treatment effectiveness. This need highlights the importance of further research into the 30STS and 1MSTS for refining the diagnostic criteria for sarcopenia.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"1-8"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703687","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":"Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?","authors":"Nere Larrea Aguirre, Susana García Gutiérrez, Oscar Miro, Sira Aguiló, Javier Jacob, Aitor Alquézar-Arbé, Guillermo Burillo, Cesáreo Fernandez, Pere Llorens, Cesar Roza Alonso, Ivana Tavasci Lopez, Mónica Cañete, Pedro Ruiz Asensio, Beatriz Paderne Díaz, Teresa Pablos Pizarro, Rigoberto Jesús Del Rio Navarro, Núria Perelló Viola, Lourdes Hernández-Castells, Alejandro Cortés Soler, Elena Sánchez Fernández-Linares, Jesús Ángel Sánchez Serrano, Patxi Ezponda, Andrea Martínez Lorenzo, Juan Vicente Ortega Liarte, Susana Sánchez Ramón, Asumpta Ruiz Aranda, Francisco Javier Martín-Sánchez, Juan González Del Castillo","doi":"10.4235/agmr.23.0121","DOIUrl":"10.4235/agmr.23.0121","url":null,"abstract":"<p><strong>Background: </strong>While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes.</p><p><strong>Methods: </strong>We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes.</p><p><strong>Results: </strong>During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years-mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80-0.82) for 30-day mortality.</p><p><strong>Conclusion: </strong>Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"9-19"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592471","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":"Geriatric Medicine in South Korea: A Stagnant Reality amidst an Aging Population","authors":"Sunghwan Ji, H. Jung, J. Baek, Il-Young Jang, Eunju Lee","doi":"10.4235/agmr.23.0199","DOIUrl":"https://doi.org/10.4235/agmr.23.0199","url":null,"abstract":"In the face of an ever-increasing wave of an aging population, this paper provides an update on the current status of geriatric medicine in Korea, comparing it with global initiatives and suggesting future directions. Older adults require a multifaceted approach, addressing not only comorbidity management but also unmet complex medical needs, nutrition, and exercise to prevent functional decline. In this regard, the World Health Organization's Integrated Care for Older People guidelines underscore the importance of patient-centered primary care in preventing a decline in intrinsic capacity. Despite these societal needs and the ongoing aging process, the healthcare system in Korea has yet to show significant movement or a shift toward geriatric medicine, further complicated by the absence of a primary care system. We further explore global efforts in establishing age-integrative patient-centered medical systems in Singapore, Australia, Canada, the United Kingdom, and Japan. Additionally, we review the unmet needs and social issues that Korean society is currently facing, and local efforts by both government and a private tertiary hospital in Korea. In conclusion, considering the current situation, we propose that the framework of geriatric medicine should form the foundation of the future healthcare system.","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":"98 18","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139131840","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 which Influence the Frequency of Cognitive Assessment in the Emergency Department.","authors":"Mohd Idzwan Zakaria, Salimah Suhaimi, Tan Maw Pin, Mohd Amin Mohd Mokhtar, Ahmad Zulkarnain Ahmad Zahedi","doi":"10.4235/agmr.23.0150","DOIUrl":"10.4235/agmr.23.0150","url":null,"abstract":"<p><strong>Background: </strong>The practice of safe emergency medicine requires accurate and adequate assessments. However, screening for cognitive deficits is not performed regularly in the emergency department (ED). This study aimed to determine factors influencing the frequency of cognitive testing by ED doctors.</p><p><strong>Methods: </strong>This study included all doctors working in the EDs of three teaching hospitals. A 17-item online survey instrument that collected information on sex, experience, perceived prevalence, perception, and practice of cognitive assessment was distributed through electronic mail and data messaging services.</p><p><strong>Results: </strong>Of the 210 participants, 72 were male. The estimated mean with standard deviation prevalence of cognitive impairment in older patients in the ED was 39.5%±19.7%. Among the participating ED doctors, 75.8% performed cognitive testing up to 10% of the time. Moreover, the participants ranked cognitive impairment the lowest compared to the other four chronic conditions in terms of its impact on hospitalization outcomes. Multiple linear regression revealed that the doctors' perceptions of the responsible personnel and the importance of cognitive testing, as well as their lack of expertise, were independently associated with the frequency of testing.</p><p><strong>Conclusion: </strong>Lack of expertise, perception of the importance of cognitive testing, and lack of consensus on which discipline is responsible for performing cognitive testing in older patients in the ED were the limiting factors in performing cognitive testing in the ED. Improving perception and awareness of the importance of cognitive assessment as a screening tool could improve the detection and overall management of older patients.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"324-328"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414582","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":"Perceived Stress and Frailty in Older Adults.","authors":"Se Hui Lee, Jinyoung Shin, Sarang Um, Hye Ri Shin, Young Sun Kim, Jae Kyung Choi","doi":"10.4235/agmr.23.0132","DOIUrl":"10.4235/agmr.23.0132","url":null,"abstract":"<p><strong>Background: </strong>Individuals with frailty are susceptible to adverse events. Although a psychological correlation with frailty has been observed, few studies have investigated the link between stress and frailty. This study examined the association between perceived stress and frailty in older adults.</p><p><strong>Methods: </strong>This cross-sectional observational study included participants recruited between September 2021 and January 2022. The Korean version of the Perceived Stress Scale-10 was used to measure stress levels, while the frailty status was assessed using the Korean Frailty Index. Loneliness, depression, and satisfaction were measured using the UCLA Loneliness Scale, Centre for Epidemiological Studies Depression Scale, and Satisfaction with Life Scale, respectively. We used multinomial logistic regression to compare the variables between frail and robust participants.</p><p><strong>Results: </strong>Among 862 study participants (mean age, 73.62 years; 65.5% women), the mean PSS-10 score was 15.26, 10.8% were frail, 22.4% were pre-frail, and 66.8% were robust. Perceived stress was significantly associated with pre-frailty (crude odds ratio [OR]=1.147; 95% confidence interval [CI], 1.093-1.204) and frailty (crude OR=1.417; 95% CI, 1.322-1.520). After adjusting for sociodemographic factors, we examined the associations between perceived stress and prefrailty (adjusted OR=1.140; 95% CI, 1.084-1.199) and frailty (adjusted OR=1.409; 95% CI, 1.308-1.518). After adjusting for all variables, including loneliness, depression, and satisfaction, perceived stress was significantly associated with frailty (adjusted OR=1.172; 95% CI, 1.071-1.283), however, insufficient statistical evidence was observed for pre-frailty (adjusted OR=1.022; 95% CI, 0.961-1.086).</p><p><strong>Conclusion: </strong>Higher levels of perceived stress were associated with frailty in older adults. Stress management efforts may help improve frailty in this population.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"310-314"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10597730","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":"Importance of Health Policy and Systems Research for Strengthening Rehabilitation in Health Systems: A Call to Action to Accelerate Progress.","authors":"Walter R Frontera, Wouter DeGroote, Abdul Ghaffar","doi":"10.4235/agmr.23.0173","DOIUrl":"10.4235/agmr.23.0173","url":null,"abstract":"","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"277-279"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692983","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":"Deep Vein Thrombosis in a Patient with Negative Age-Adjusted D-Dimer Level.","authors":"Monish A Sheth","doi":"10.4235/agmr.23.0110","DOIUrl":"10.4235/agmr.23.0110","url":null,"abstract":"<p><p>D-dimer level, along with a clinical probability tool that uses the Wells score, is commonly used to exclude deep vein thrombosis (DVT). Age-adjusted D-dimer values are routinely used in clinical practice to increase the negative predictive value and avoid unnecessary Doppler ultrasound imaging. We describe a patient with a low pre-test probability of DVT upon admission and a negative D-dimer level based on age-adjusted values who was later diagnosed with DVT. Our experiences with this case highlight that the geriatric population is unique and, at times, frail.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"353-357"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239632","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":"Short Physical Performance Battery Cutoff Points Using Clinical Outcomes for At-Risk Older Adults in Singapore: An Exploratory Study.","authors":"Herb Howard C Hernandez, Daphne Zihui Yang, Cai Ning Tan, Joanne Kua, Noor Hafizah Ismail, Wee Shiong Lim","doi":"10.4235/agmr.23.0164","DOIUrl":"10.4235/agmr.23.0164","url":null,"abstract":"","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"358-360"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427736","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":"Nutritional Status and Risk of Sarcopenia among Hospitalized Older Adults Residing in a Rural Region in Turkey.","authors":"Hacer Alatas, Yeliz Serin, Nurgül Arslan","doi":"10.4235/agmr.23.0064","DOIUrl":"10.4235/agmr.23.0064","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the prevalence of sarcopenia and its associated factors in community-dwelling older adults at risk of malnutrition based on the Mini Nutritional Assessment (MNA), Prognostic Nutritional Index (PNI), and Geriatric Nutritional Risk Index (GNRI).</p><p><strong>Methods: </strong>The study participants were 345 adults aged &gt;65 years who visited Geriatric Internal Medicine outpatient clinics. The study included people without acute illness for whom the risk of malnutrition could be assessed and appropriate measurements taken. At the baseline visit, participants' data and measurements were gathered. The primary data included sociodemographic details, anthropometric measurements, malnutrition screening tests, and functional assessments.</p><p><strong>Results: </strong>The participants' mean age was 76.21±5.59 years, and 57.1% were men (n=97). The prevalence rate of sarcopenia was 45.5%. Compared to individuals without sarcopenia, those with it were older; had lower MNA, PNI, and GNRI scores; and had lower muscle mass, muscle strength, and lower leg circumferences (p&lt;0.001). After adjusting for potential confounding factors, we found that sarcopenia, advanced age, male sex, high risk of malnutrition, calf circumference, and a low PNI score were all significantly associated with a low GNRI score (p&lt;0.001).</p><p><strong>Conclusion: </strong>Sarcopenia was significantly associated with advanced age, male sex, and high risk of malnutrition. Patients' nutritional and functional status should always be assessed for therapeutic interventions and lifestyle changes.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"293-300"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10554320","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":"Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions.","authors":"Justin Chew, Jia Qian Chia, Kay Khine Kyaw, Katrielle Joy Fu, Celestine Lim, Shiyun Chua, Huei Nuo Tan","doi":"10.4235/agmr.23.0124","DOIUrl":"10.4235/agmr.23.0124","url":null,"abstract":"<p><strong>Background: </strong>Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults.</p><p><strong>Methods: </strong>A total of 733 individuals aged ≥65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions.</p><p><strong>Results: </strong>Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4-6 and CFS 7-8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4-6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03-2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04-3.04), whereas these associations were not significant for CFS 7-8.</p><p><strong>Conclusion: </strong>Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"315-323"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41133177","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}