Annals of Geriatric Medicine and Research最新文献

{"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}

{"title":"Functional Status in Older Adults following Hospitalization for COVID-19: A Cohort Study.","authors":"Pía Izaguirre, Érica Arakaki, Jorge Vogt Boero, Ángeles Zalazar, Mariano Ghirlanda, Diego Caruso","doi":"10.4235/agmr.23.0071","DOIUrl":"10.4235/agmr.23.0071","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) can cause multiple acute complications. This study evaluated the long-term functional status of older patients hospitalized for acute COVID-19.</p><p><strong>Methods: </strong>We analyzed data from a multicenter ambispective cohort study on patients aged &gt;60 years who were hospitalized for COVID-19 at two tertiary care hospitals in Argentina. The participants were contacted by telephone between November 2021 and September 2022 to collect data on their functional status. Ordinal logistic regression was used to identify factors associated with functional limitations after discharge.</p><p><strong>Results: </strong>Among the 374 included patients, 205 (55%) showed functional limitations, including 58 (28%) who died during follow-up. The factors independently associated with functional limitations were low baseline functional status (odds ratio [OR]=9.19; 95% confidence interval [CI], 3.35-25.17) and admission to the intensive care unit (OR=4.41; 95% CI, 2.28-8.53). Men had lower odds of functional impairment (OR=0.55; 95% CI, 0.35-0.86).</p><p><strong>Conclusion: </strong>Older patients had high mortality rates and poor functional status at 2 years post-discharge for COVID-19. Several factors at the time of discharge were associated with a higher risk of functional limitations and can be used to identify patients' long-term needs for support and rehabilitation services.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"286-292"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10541809","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":"Association of Vulnerability Screening on Hospital Admission with Discharge to Rehabilitation-Oriented Care after Acute Hospital Stay.","authors":"Aafke J de Groot, Elizabeth M Wattel, Romke van Balen, Cees M P M Hertogh, Johannes C van der Wouden","doi":"10.4235/agmr.23.0068","DOIUrl":"10.4235/agmr.23.0068","url":null,"abstract":"<p><strong>Background: </strong>We assessed the vulnerability of patients aged ≥70 years during hospital admission based on the Short Dutch Safety Management Screening (DSMS). Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted patients were associated with rehabilitation-oriented care needs.</p><p><strong>Methods: </strong>This retrospective cohort study included community-dwelling patients aged ≥70 years acutely admitted to a tertiary hospital. We recorded patient demographics, morbidity, functional status, malnutrition, fall risk, and delirium and used descriptive analysis to calculate the risks by comparing the discharge destination groups.</p><p><strong>Results: </strong>Among 491 hospital discharges, 349 patients (71.1%) returned home, 60 (12.2%) were referred for geriatric rehabilitation, and 82 (16.7%) to other inpatient post-acute care. Non-home referrals increased with age from 21% (70-80 years) to 61% (&gt;90 years). A surgical diagnosis (odds ratio [OR]=4.92; 95% confidence interval [CI], 2.03-11.95), functional decline represented by Katz-activities of daily living positive screening (OR=3.79; 95% CI, 1.76-8.14), and positive fall risk (OR=2.87; 95% CI, 1.31-6.30) were associated with non-home discharge. The Charlson Comorbidity Index did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>Admission diagnosis and vulnerability screening outcomes were associated with discharge to rehabilitation-oriented care in patients &gt;70 years of age. The usual care data from DSMS vulnerability screening can raise awareness of discharge complexity and provide opportunities to support timely and personalized transitional care.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"301-309"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10554322","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":"Association between Toe Pressure Strength in the Standing Position and Maximum Walking Speed in Older Adults.","authors":"Taishiro Kamasaki, Hiroshi Otao, Mizuki Hachiya, Shinichi Tanaka, Kohei Ochishi, Suguru Shimokihara, Michio Maruta, Gwanghee Han, Yoshihiko Akasaki, Yuma Hidaka, Takayuki Tabira","doi":"10.4235/agmr.23.0113","DOIUrl":"10.4235/agmr.23.0113","url":null,"abstract":"<p><strong>Background: </strong>Considering concerns about conventional toe grip strength, we devised a method to measure toe pressure strength in the standing position, which is close to the actual motion. This study examined the association between toe pressure strength in the standing position and walking speed among older adults.</p><p><strong>Methods: </strong>This cross-sectional study included 150 community-dwelling older adults (81±8 years, 73% female) who participated in the physical fitness test. We analyzed the correlation between the participants' maximum walking speed and physical function. Furthermore, we performed regression analysis with the maximum walking speed as the dependent variable to examine the association with toe pressure strength in the standing position. We also examined the association between maximum walking speed and toe pressure strength in the standing position by introducing a covariate.</p><p><strong>Results: </strong>Correlation analysis revealed a significant positive correlation between maximum walking speed and toe pressure strength in the standing position, with a moderate effect size (r=0.48, p&lt;0.001). Moreover, multiple regression analysis with covariates showed an association between maximum walking speed and toe pressure strength in the standing position (standardization factor=0.13, p&lt;0.026).</p><p><strong>Conclusion: </strong>Toe pressure strength in the standing position was associated with maximum walking speed. This finding clarifies the significance of assessing toe pressure strength in the standing position and suggests that enhanced toe pressure strength in the standing position may increase maximum walking speed.</p>","PeriodicalId":44729,"journal":{"name":"Annals of Geriatric Medicine and Research","volume":" ","pages":"338-345"},"PeriodicalIF":3.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10772338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152013","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}