European Geriatric Medicine最新文献

{"title":"The perspectives on advance care planning of older people with psychotic illnesses and their carers.","authors":"Anne Wand, Aspasia Karageorge, Yucheng Zeng, Roisin Browne, Meg Sands, Daniella Kanareck, Vasi Naganathan, Anne Meller, Carolyn Smith, Carmelle Peisah","doi":"10.1007/s41999-025-01161-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01161-8","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the attitudes, experiences, and perceived facilitators and barriers to Advance Care Planning (ACP), of older people with schizophrenia and other psychotic illness and their carers.</p><p><strong>Methods: </strong>Older people with a psychotic illness and carers were recruited from public mental health services in Sydney, Australia. Semi-structured interviews to explore attitudes, experiences, and perceived barriers and facilitators to ACP were conducted by an external clinician. Consumers' medical, psychiatric and drug health diagnoses were recorded and they completed cognitive and symptom rating scales. Reflexive thematic analysis was used to analyse the transcripts of interviews, within an interpretive description framework.</p><p><strong>Results: </strong>Thematic saturation was achieved with 12 consumers and 5 carers. Emergent themes from consumer interviews were (i) 'What is ACP?'; (ii) 'I have not done ACP because…..'; (iii) 'I want to do ACP'; (iv) 'If I was to do ACP I would need..'; and (v) 'Mental health clinicians have the skills to help me with ACP'. Carer themes included (i) 'We do not participate in ACP', (ii) 'I want to participate in ACP', and (iii) 'Key clinician skills are needed'. There was convergence of themes from both groups.</p><p><strong>Conclusion: </strong>This study demonstrates that older people with a psychotic illness can express views regarding ACP, despite ongoing symptoms of psychosis, cognitive impairment and mild-moderate severity of illness. The emergent themes highlight opportunities to intervene to overcome barriers to ACP, including education for both participant groups and clinicians, practical considerations and the need for all to collaborate, including with primary care.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the nurse directed frailty assessment tool, to identify patients at risk of emergency department visits, hospitalisation, and 1-year all-cause mortality.","authors":"P H Drop, C van Ham, A C M Mulder, P A Veeken-Dijkstra, J O Daal, L A R Zwart","doi":"10.1007/s41999-025-01182-3","DOIUrl":"https://doi.org/10.1007/s41999-025-01182-3","url":null,"abstract":"<p><strong>Methods: </strong>This is a validation study of a new frailty assessment that can be administered by outpatient care nurses. The nurse directed frailty assessment (NDFA) encompasses the medical, psychological, social, and functional domain, based on standard care, and can be performed without any specialised equipment. Performance of the NDFA is compared to a comprehensive geriatric assessment (CGA)-based frailty index (FI), with generalised linear model with reporting of hazard ratios (HR) and 95% confidence intervals (95% CI). The best cutoff value for the NDFA was assessed by Youden index and the area under the receiver operator curve (ROC).</p><p><strong>Results: </strong>Within 1 year, 15 patients (5%) died, 57 (18%) had an unplanned hospital admission, and 83 (26%) visited the emergency department (ED). Based on the Youden index and ROC curve, the best cutoff value for the NDFA was 4 points. With a binary logistic regression model, an HR of 3.59 (95% CI 1.16-11.15, p < 0.001) was found for mortality. In the general mixed model with Poisson logistic regression, an HR of 1.78 (95% CI 1.06-2.97, p 0.028) was found for unplanned hospital and an HR of 1.87 (95% CI 1.25-2.78, p 0.002) was found for ED visits. The HR and 95% CI of the FI were similar for all three outcome measures.</p><p><strong>Conclusions: </strong>The NDFA identifies patients at risk for hospitalisation, emergency department visits, and mortality within 12 months equally well as the FI. Further research is necessary to determine the effectiveness of the NDFA in other settings than the geriatric medicine outpatient population.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychomotor disadaptation syndrome: a scoping review.","authors":"Antonella Merendino, France Mourey, Thomas Renoncourt, Sofia Da Silva, Mélanie Dipanda, Fabrice Larosa, Alain Putot, Patrick Manckoundia","doi":"10.1007/s41999-025-01176-1","DOIUrl":"https://doi.org/10.1007/s41999-025-01176-1","url":null,"abstract":"<p><strong>Background: </strong>Clinical features of psychomotor disadaptation syndrome (PDS) include posture, gait, psycho-behavioral, and neurological disorders, which increase the risk of falling. Psychomotor regression syndrome, described in 1986, was renamed PDS following improvements in its pathophysiological understanding, including the preeminent role of subcortical-frontal lesions. Because frailty in aging contributes to the appearance of PDS, the geriatric professionals need to be aware of its existence.</p><p><strong>Purpose: </strong>This article aims to provide a scoping review on PDS. Moreover, we searched for epidemiological studies and assessed whether or not all the aspects of PDS are recognized.</p><p><strong>Methods: </strong>The studies were retrieved from three electronic databases (PubMed, Science Direct, and Google Scholar) using these terms: psychomotor disadaptation syndrome, psychomotor regression syndrome, frontal-sub-cortical dysfunction syndrome, backward disequilibrium, retropulsion, post-fall syndrome, reactional hypertonia, axial akinesia, and older adults.</p><p><strong>Results: </strong>Out of 456 shortlisted articles, 45 met the inclusion criteria. Our results show that PDS is poorly known, especially outside of France, which had the largest number of published studies on this syndrome. Abroad, only three aspects have been described (post-fall syndrome, retropulsion, and fear of falling). Often, they are not recognized as belonging to a real syndrome, but rather an association of signs. Post-fall syndrome, found in 14 studies, is the best known and most studied aspect of PDS. There were no epidemiological studies.</p><p><strong>Conclusion: </strong>With the increasing number of frail older adults, there will be an inevitable growth in the incidence of PDS. Raising awareness about PDS among medical and paramedical geriatrics professionals is essential.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fndc5/irisin mediates the benefits of aerobic exercise intervention on aging-associated sarcopenia in mice.","authors":"Yuxia Ma, Yi Liu, Jiachuang Zheng, Zhixia Zheng, Jingjing Li","doi":"10.1007/s41999-025-01181-4","DOIUrl":"https://doi.org/10.1007/s41999-025-01181-4","url":null,"abstract":"<p><strong>Methods: </strong>In this study, 24-month-old (aged) mice were used as a naturally occurring model of aging-associated sarcopenia, while 2-month-old (young) mice served as the normal control. Six weeks of treadmill training was employed as an aerobic exercise intervention. The mRNA and protein levels of fibronectin type III domain-containing protein 5 (Fndc5/irisin), MuRF1, and Atrogin-1 in gastrocnemius muscles were analyzed using qRT-PCR and Western blot. Oxidative stress was assessed using relevant detection kits. Skeletal muscle function was evaluated through the four-paw hanging test, rotarod test, grip strength assay, and measurements of quadriceps, tibialis anterior, and gastrocnemius muscle mass.</p><p><strong>Results: </strong>Aerobic exercise interventions enhanced skeletal muscle function by increasing hanging time, maximum speed, grip strength, and increased quadriceps, gastrocnemius, and tibialis anterior muscle mass. On the other hand, aerobic exercise reduced MuRF1 and Atrogin-1 expression in the gastrocnemius muscles of sarcopenia mice, along with lower malondialdehyde levels, and higher superoxide dismutase activity, T-ATPase, and glutathione peroxidase activity. A decline in Fndc5/irisin expression was further detected in the gastrocnemius muscles with aging. In Fndc5-knockout aged mice, aerobic exercise failed to improve skeletal muscle function compared to wild-type aged mice, as evaluated by hanging time, grip strength, maximum speed, and quadriceps, gastrocnemius, and tibialis anterior muscle mass, further validating the involvement of Fndc5 in the improvement of aging-associated sarcopenia.</p><p><strong>Conclusion: </strong>Aerobic exercise improves aging-associated sarcopenia in mice, with Fndc5/irisin playing a role in this process.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of psychiatric vulnerability and neurocognitive disorders in nursing homes: impact on care levels.","authors":"Katrin Gillis, Hanne Van Herbruggen, Marianne De Witte, Lore Baeck, Melanie Elisabeth Benoit Van Bogaert, Hilde Lahaye, Linda van Diermen","doi":"10.1007/s41999-025-01179-y","DOIUrl":"https://doi.org/10.1007/s41999-025-01179-y","url":null,"abstract":"<p><strong>Purpose: </strong>There is an increasing number of residents with more complex needs in nursing homes. Due to the deinstitutionalisation of mental health care, more individuals with psychiatric vulnerabilities are being referred to nursing homes. The aim of this study is to gain insight into the prevalence of psychiatric vulnerability in Belgian nursing homes and its impact on care levels.</p><p><strong>Methods: </strong>After screening 3238 patient files of residents in twenty-four Belgian nursing homes, informed consent was obtained from 1155 of the 1608 residents or their legal representatives with a neurocognitive and/or psychiatric diagnosis. Residents were classified into three groups: residents with only a psychiatric diagnosis, with only a neurocognitive diagnosis, and both a psychiatric and neurocognitive diagnosis. The Health of Nations Outcome Scale 65 + was used to assess residents' behaviour, limitations, symptoms, and functioning.</p><p><strong>Results: </strong>Of all residents, 17.5% had a lifetime psychiatric diagnosis and 41.8% had a neurocognitive disorder. Most prevalent were depressive disorder (8.2%) and Alzheimer's disease (19.3%). Scores for behavioural problems (1.4 and 1.4 versus 0.9, p < 0.0001) and symptoms (5.5 and 5.1 versus 4.4, p < 0,0001) were higher in residents with only a psychiatric or both diagnoses compared to those with only neurocognitive disorders. Conversely, scores for limitations were higher in residents with only a neurocognitive disorder (3.6 versus 2.2 and 3.1, p < 0.0001).</p><p><strong>Conclusion: </strong>With almost 1 in 5 nursing home residents having a psychiatric vulnerability with higher levels of symptoms and behavioural problems, more attention towards improving nursing home caregivers' competence in psychiatric care is recommended.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty trajectories and mortality risk in community-dwelling older adults: a 9-year follow-up study.","authors":"Gabriela Cabett Cipolli, Daniela de Assumpção, Ivan Aprahamian, Mallak Khalid Alzahrani, Ligiana Pires Corona, Yeda Aparecida de Oliveira Duarte, Mônica Sanches Yassuda, Qian-Li Xue","doi":"10.1007/s41999-025-01177-0","DOIUrl":"https://doi.org/10.1007/s41999-025-01177-0","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty is a well-established risk factor for adverse health outcomes, yet its dynamic nature and predictors remain partially understood. This study aimed to investigate factors influencing frailty transitions and mortality risk among community-dwelling older adults.</p><p><strong>Methods: </strong>We conducted a longitudinal study using a 9-year follow-up data from the Health, Well-being, and Aging Study (SABE, as known in Portuguese). A Markov model, fitted via multinomial logistic regression, identified factors independently associated with frailty transitions between waves. Four trajectory groups were identified: stable, worsening, improving, and fluctuating.</p><p><strong>Results: </strong>A total of 1399 individuals aged 60 and older (61.8% female) were enrolled, with a mean age of 73.9 (SD ± 9.2) years. Among frailty transitions, 37.8% remained stable, 56.4% worsened, 1.3% improved, and 4.4% fluctuated. After adjusting for baseline variables, we found that older age, cognitive impairment, multimorbidity, and depressive symptoms were significantly linked to a higher risk of being frail at the next visit. The mortality risk was associated with male sex, older age, frailty, cognitive impairment, and multimorbidity.</p><p><strong>Conclusion: </strong>Sociodemographic and health-related factors contribute to increased risk of experiencing frailty and mortality among community-dwelling older adults. Further research is needed to identify modifiable factors influencing frailty transitions.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Caregiving outcomes among informal caregivers of persons with multimorbidity and dementia: a scoping review.","authors":"Ruotong Liu, Katherine Peak, Em Trubits, Ana R Quiñones","doi":"10.1007/s41999-025-01183-2","DOIUrl":"10.1007/s41999-025-01183-2","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SURGE-ahead postoperative delirium prediction: external validation and open-source library.","authors":"Thomas Derya Kocar, Philip Wolf, Christoph Leinert, Simone Brefka, Marina L Fotteler, Adriane Uihlein, Felix Wezel, Martin Wehling, Nuh Rahbari, Hans Kestler, Florian Gebhard, Dhayana Dallmeier, Michael Denkinger","doi":"10.1007/s41999-025-01180-5","DOIUrl":"https://doi.org/10.1007/s41999-025-01180-5","url":null,"abstract":"<p><strong>Purpose: </strong>In this prospective external validation study, we examined the performance of the Supporting SURgery with GEriatric Co-Management and AI (SURGE-Ahead) postoperative delirium (POD) prediction algorithm. SURGE-Ahead is a collaborative project that aims to develop a clinical decision support system that uses predictive models to support geriatric co-management in surgical wards. Delirium is a common complication in older adults after surgery, leading to poor outcomes and increased healthcare costs. Early and accurate prediction of POD is crucial for timely intervention and prevention strategies.</p><p><strong>Methods: </strong>The SURGE-Ahead algorithm utilizes a linear support vector machine model with a comprehensive set of 15 clinical and demographic features. In our validation, we analyzed 173 study participants, of which 50 developed POD.</p><p><strong>Results: </strong>The study found that the SURGE-Ahead POD prediction algorithm yielded state-of-the-art performance, using only preoperative data, with a receiver operating characteristics area under the curve of 0.86. In addition, the SURGE-Ahead algorithm exhibited good calibration as shown by a Brier Score of 0.14. The algorithm is openly available on GitHub, facilitating its implementation and adaptation to different surgical settings.</p><p><strong>Conclusion: </strong>Our findings contribute to the development of reliable POD prediction tools, ultimately supporting the improvement of patient care in hospitalized older adults.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of prescribing and health-related quality of life in older adults: a narrative review with a special focus on patients with atrial fibrillation and multimorbidity.","authors":"Cheima Amrouch, Deirdre A Lane, Amaia Calderón-Larrañaga, Mirko Petrovic, Delphine De Smedt","doi":"10.1007/s41999-025-01175-2","DOIUrl":"https://doi.org/10.1007/s41999-025-01175-2","url":null,"abstract":"<p><strong>Purpose: </strong>To summarise the association between potentially inappropriate prescribing (PIP) and health-related quality of life (HRQOL) in older adults, with a special focus on those with atrial fibrillation (AF) and multimorbidity, while exploring potential interventions to improve prescribing quality and their impact on HRQOL.</p><p><strong>Methods: </strong>A comprehensive search strategy was conducted in MEDLINE using the PubMed interface on August 16th, 2024, focusing on key terms related to \"potentially inappropriate prescribing\" and \"quality of life\". Additionally, the reference lists of included studies were screened. Only studies utilising validated assessment tools for HRQOL or measuring global self-perceived health status were considered. Studies involving populations with an average age of  ≥ 65 years were included.</p><p><strong>Results: </strong>Of the 1810 articles screened, 35 studies were included. The findings indicate that the quality of prescribing, independent of polypharmacy, may negatively influence HRQOL. The review identified a range of interventions aimed at improving prescribing quality among older adults, including pharmacist-driven, general practitioner-driven, and multidisciplinary approaches. Interventions were assessed among distinct population groups and specifically in residential care homes. While some interventions demonstrated improvements in prescribing quality, the overall evidence regarding their impact on HRQOL remains limited.</p><p><strong>Conclusion: </strong>The relationship between prescribing quality and HRQOL remains underexplored in older adults with AF and multimorbidity, despite the high prevalence of PIP. Effective pharmacotherapy should be coupled with a comprehensive assessment of patients' clinical and functional parameters, considering their HRQOL. Adopting a multidisciplinary, integrated, patient-centred approach is essential for sustainable and appropriate prescribing practices and may enhance HRQOL.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Comprehensive Geriatric Assessment (CGA) in medical education: a scoping review.","authors":"Regina Roller-Wirnsberger, Carolin Herzog, Sonja Lindner-Rabl, Mathias Schlögl, Maddalena Illario, Maria Cristina Polidori, Katrin Singler","doi":"10.1007/s41999-025-01157-4","DOIUrl":"https://doi.org/10.1007/s41999-025-01157-4","url":null,"abstract":"<p><strong>Purpose: </strong>To gather and summarize evidence on educational and training formats for medical doctors in performing Comprehensive Geriatric Assessment (CGA) in under- and postgraduate medical education.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using the databases Medline, CINAHL, Cochrane and Embase to identify educational intervention studies and cohort studies related to CGA education and training for medical professionals. Additional references were incorporated through reference tracking. Studies included were then grouped according to competence level addressed during CGA trainings to create a current competence-based framework on educational tools to teach CGA to medical students and doctors.</p><p><strong>Results: </strong>Sixty eligible studies were identified, with 42 addressing the full implementation of CGA and 18 focusing on specific CGA domains. High variability in duration, intervention design and evaluation methods was consistently observed across the included studies.</p><p><strong>Conclusion: </strong>The findings underscore the need for further coordinated research in CGA education and training to consolidate evidence and pave the way to more innovative, high-quality healthcare systems capable of addressing the complexities of an aging society.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}