European Geriatric Medicine最新文献

{"title":"Association between intrinsic capacity and oral health in older patients in a frailty clinic.","authors":"Shuzo Miyahara, Keisuke Maeda, Koki Kawamura, Yasumoto Matsui, Shosuke Satake, Hidenori Arai, Hiroyuki Umegaki","doi":"10.1007/s41999-024-00956-5","DOIUrl":"10.1007/s41999-024-00956-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate how intrinsic capacity (IC) deficit is associated with oral functional decline.</p><p><strong>Methods: </strong>This cross-sectional study enrolled older adults at a research hospital frailty clinic between July 2021 and May 2023. IC evaluation included the locomotion, cognition, vitality, psychology, and sensory domains. Criteria for deficits were established within each domain, and the number of IC deficit domains was calculated for each patient. Oral function assessment included oral hygiene, oral dryness, occlusal force, tongue-lip motor function, tongue pressure, masticatory function, and swallowing function. Patients who met three or more criteria were classified into the oral hypofunction (OHF) group. Univariate and multivariate logistic regression analyses were performed to investigate the relationship between IC deficit and OHF.</p><p><strong>Results: </strong>Of 222 included patients (mean age 78.3 ± 6.3 years; 39.6% men), 105 (47.3%) met the criteria for OHF. This OHF group showed a significantly higher prevalence of locomotion, cognition, psychology, and sensory domain deficits than the normal oral function group. Multivariate analysis adjusted for age and sex revealed a significant association between IC deficits and OHF (odds ratio [OR], 1.33; 95% confidence interval [CI] 1.04-1.70). A significant association was also observed between the locomotion domain and OHF (OR, 2.06; 95% CI 1.13-3.76).</p><p><strong>Conclusion: </strong>This study highlights the potential relationship between the number of IC domain deficits and oral functional decline, with the most significant domain being locomotion. Furthermore, it suggests a possible link between sensory and oral function.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1119-1127"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029408","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":"Comment on \"Geriatrics and artificial intelligence in Spain (Ger-IA project): talking to ChatGPT, a nationwide survey\".","authors":"Hineptch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s41999-024-00988-x","DOIUrl":"10.1007/s41999-024-00988-x","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1137"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635254","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":"Hospitalization-associated disability prediction using Hospital Frailty Risk Score in older patients undergoing pancreatectomy.","authors":"Tatsuro Inoue, Ryo Momosaki, Akio Shimizu, Keisuke Maeda","doi":"10.1007/s41999-023-00928-1","DOIUrl":"10.1007/s41999-023-00928-1","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty and hospitalization-associated disabilities (HAD) are geriatric conditions that should be managed in older patients undergoing pancreatectomy. The Hospital Frailty Risk Score (HFRS) can evaluate frailty based on medical records and could predict postoperative activities of daily living (ADL) decline. This study aimed to investigate whether HFRS affects the postoperative incidence of HAD in older patients who underwent pancreatectomy.</p><p><strong>Methods: </strong>This retrospective, observational study used data from a nationwide hospital-based database. We included consecutive patients aged ≥ 65 years who were diagnosed with pancreatic cancer (International Statistical Classification of Diseases, 10th revision code C25) and underwent curative pancreatectomy between April 2014 and August 2020. We evaluated preoperative frailty using HFRS. The primary outcome was HAD following pancreatectomy. Logistic regression analysis was performed for analyzing the impact of frailty on HAD following pancreatectomy.</p><p><strong>Results: </strong>We included 671 patients for the analysis (mean age 74.3 ± 5.6, male 54.8%). The prevalence of intermediate and high risk of frailty with HFRS ≥ 5 was 2.7%. The incidence of HAD was significantly higher in the intermediate- and high-risk groups compared to that in the low-risk group (33.3% vs. 8.4%, p < 0.001). Logistic regression analysis demonstrated that intermediate and high risks of frailty increased the likelihood of HAD (odds ratio, 3.55; 95% confidence interval: 1.12-11.2).</p><p><strong>Conclusions: </strong>The risk of frailty evaluated using the HFRS increased the likelihood of developing HAD in older patients undergoing pancreatectomy. Future research on effective perioperative interventions for preventing postoperative HAD and enhancing postoperative ADL recovery is warranted.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1039-1045"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716522","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":"The Multidimensional Prognostic Index predicts incident delirium among hospitalized older patients with COVID-19: a multicenter prospective European study.","authors":"Wanda Morganti, Carlo Custodero, Nicola Veronese, Eva Topinkova, Helena Michalkova, M Cristina Polidori, Alfonso J Cruz-Jentoft, Christine A F von Arnim, Margherita Azzini, Heidi Gruner, Alberto Castagna, Giovanni Cenderello, Romina Custureri, Emanuele Seminerio, Tania Zieschang, Alessandro Padovani, Elisabet Sanchez-Garcia, Alberto Pilotto","doi":"10.1007/s41999-024-00987-y","DOIUrl":"10.1007/s41999-024-00987-y","url":null,"abstract":"<p><strong>Purpose: </strong>Incident delirium is a frequent complication among hospitalized older people with COVID-19, associated with increased length of hospital stay, higher morbidity and mortality rates. Although delirium is preventable with early detection, systematic assessment methods and predictive models are not universally defined, thus delirium is often underrated. In this study, we tested the role of the Multidimensional Prognostic Index (MPI), a prognostic tool based on Comprehensive Geriatric Assessment, to predict the risk of incident delirium.</p><p><strong>Methods: </strong>Hospitalized older patients (≥ 65 years) with COVID-19 infection were enrolled (n = 502) from ten centers across Europe. At hospital admission, the MPI was administered to all the patients and two already validated delirium prediction models were computed (AWOL delirium risk-stratification score and Martinez model). Delirium occurrence during hospitalization was ascertained using the 4A's Test (4AT). Accuracy of the MPI and the other delirium predictive models was assessed through logistic regression models and the area under the curve (AUC).</p><p><strong>Results: </strong>We analyzed 293 patients without delirium at hospital admission. Of them 33 (11.3%) developed delirium during hospitalization. Higher MPI score at admission (higher multidimensional frailty) was associated with higher risk of incident delirium also adjusting for the other delirium predictive models and COVID-19 severity (OR = 12.72, 95% CI = 2.11-76.86 for MPI-2 vs MPI-1, and OR = 33.44, 95% CI = 4.55-146.61 for MPI-3 vs MPI-1). The MPI showed good accuracy in predicting incident delirium (AUC = 0.71) also superior to AWOL tool, (AUC = 0.63) and Martinez model (AUC = 0.61) (p < 0.0001 for both comparisons).</p><p><strong>Conclusions: </strong>The MPI is a sensitive tool for early identification of older patients with incident delirium.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"961-969"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus: a cross sectional study.","authors":"Takuro Shoji, Kenta Kogure, Nagisa Toda, Mariko Hakoshima, Hisayuki Katsuyama, Hidekatsu Yanai, Satoshi Tokunaga, Korin Tateoka, Taishi Tsuji, Tomohiro Okura","doi":"10.1007/s41999-024-00937-8","DOIUrl":"10.1007/s41999-024-00937-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between comorbidities associated with diabetes and higher-level functional status as well as the relationship between comorbidities associated with diabetes and higher-level functional status in older patients with type 2 diabetes mellitus who have better social networks.</p><p><strong>Methods: </strong>Participants were outpatients with type 2 diabetes aged ≥ 65 years, excluding individuals with severe cardiovascular or respiratory illness, hyperglycaemic crisis, type 1 diabetes, or diabetic foot. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to evaluate the higher-level functional status. A TMIG-IC score of ≤ 9, instrumental activities of daily living (IADL) ≤ 4, intellectual activity or social role ≤ 3 were defined as decline in higher-level functional status. The comorbidities investigated included peripheral neuropathy, retinopathy, nephropathy, cognitive impairment, depression, frailty, sarcopenia, low muscle strength, stroke, heart disease, and arthritis.</p><p><strong>Results: </strong>The analysis included 198 patients (mean age 75.9 ± 5.7 years, male 60.1%). After adjusting for potential confounders, depression was associated with TMIG-IC (Prevalence ratio (PR) 2.34, 95% confidence interval (CI) 1.44-3.82), low muscle strength was associated with IADL (PR 2.85, 95% CI 1.30-6.27), and frailty was associated with intellectual activity (PR 1.38, 95% CI 1.10-1.74). In the model with social networks added as a confounder, the relationship between depression or low muscle strength and higher-level functional status was not statistically significant.</p><p><strong>Conclusion: </strong>Comorbidities of depression and low muscle strength for older patients with type 2 diabetes mellitus increase the risk of malfunctioning of higher-level functional status. Increased interactions with family, friends and neighbours may reduce this event.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1101-1110"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of hospital at home: a qualitative interview study of healthcare staff.","authors":"M M Anwar, H Shamaz, N Li, H Crosbie, C Mcgeachy, A Harding, A Ho, E Thacher-Plant, C Armstrong, L Munang, A Degnan, A Anand","doi":"10.1007/s41999-024-00982-3","DOIUrl":"10.1007/s41999-024-00982-3","url":null,"abstract":"<p><strong>Purpose: </strong>Hospital at Home (HaH) services are expanding to provide acute multidisciplinary care in an individual's home. In this pilot study, we interviewed HaH staff to understand challenges and opportunities for service development.</p><p><strong>Methods: </strong>We conducted 23 semi-structured interviews with multidisciplinary staff working across three HaH services in Scotland. The questions focussed on service strengths and challenges.</p><p><strong>Results: </strong>Four themes emerged: raising referral awareness, service design and efficiency, staff security on home visits, and sustainability. HaH staff described Emergency Department posters, experience days for non-HaH staff, and daily communication of virtual bed capacity to raise awareness for referrals. Ideas for maximising clinician time were prioritised to improve service efficiency and investment in electric vehicles was strongly supported to mitigate climate impact.</p><p><strong>Conclusion: </strong>We found high job satisfaction and engagement amongst HaH staff. Our interviews suggest enthusiasm for further development of HaH while raising important challenges to address during service expansion.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1001-1005"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945883","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":"The effect of dexamethasone on the incidence of delirium in patients hospitalized due COVID-19 infection: a retrospective cohort study.","authors":"Marijke Nynke Boersma, Emma Kamperman, Job van der Palen","doi":"10.1007/s41999-024-01000-2","DOIUrl":"10.1007/s41999-024-01000-2","url":null,"abstract":"<p><strong>Purpose: </strong>Delirium has been suggested to be a complication associated with corticosteroid use. Therefore, the association between dexamethasone use and delirium in COVID-19 patients was studied herein.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, 412 patients who were hospitalized because of COVID-19 between March 2020 and January 2021 were included. Delirium was diagnosed using the Delirium Observation Screening Scale. The association between the daily use of dexamethasone 6 mg and delirium was measured via multivariable logistic regression analysis.</p><p><strong>Results: </strong>The incidence of delirium was 11.4% in patients treated with dexamethasone (n = 245) and 9.6% in patients not treated with dexamethasone (n = 167) (RR 1.19, CI 0.67-2.13, p = 0.55). After adjusting for age (mean 69 years) and comorbidity score, the odds ratio for developing delirium when using dexamethasone was 1.11 (CI 0.56-2.21, p = 0.76).</p><p><strong>Conclusion: </strong>The use of dexamethasone in hospitalized COVID-19 patients did not affect the incidence of delirium.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"971-975"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293882","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":"Time to lay to rest any remaining doubts about the utility of continued COVID vaccination.","authors":"Fiona Ecarnot, Jean-Pierre Michel","doi":"10.1007/s41999-024-00995-y","DOIUrl":"10.1007/s41999-024-00995-y","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"939-940"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332350","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":"Challenges related to transitioning from hospital to temporary care at a skilled nursing facility: a descriptive study.","authors":"Lene Vestergaard Ravn-Nielsen, Emma Bjørk, Marianne Nielsen, Stine Galsgaard, Anton Pottegård, Carina Lundby","doi":"10.1007/s41999-024-01003-z","DOIUrl":"10.1007/s41999-024-01003-z","url":null,"abstract":"<p><strong>Purpose: </strong>With decreasing number of hospital beds, more citizens are discharged to temporary care at skilled nursing facilities, requiring increasingly complex care in a non-hospital setting. We mapped challenges related to the transition of citizens from hospital to temporary care at a skilled nursing facility in relation to medication management, responsibility of medical treatment, and communication.</p><p><strong>Methods: </strong>Descriptive study of citizens discharged from Odense University Hospital to temporary care from May 2022 to March 2023.</p><p><strong>Results: </strong>We included 209 citizens (53% women, median age 81 years). Most citizens (97%; n = 109/112) had their medication changed during hospital admission. Citizens used a median of eight medications, including risk medications (96%, n = 108). Medication-related challenges occurred for 37% (n = 77) of citizens and most often concerned missing alignment of medication records. Half of citizens (47%, n = 99) moved into temporary care with all medication needed for further dispensing. Nurses conducted in median three telephone calls (interquartile range [IQR 1-4]) and sent in median two correspondences (IQR 1-3) per citizen within the first 5 days. Nurses most often called the hospital physician (41% of telephone calls, n = 265/643) and sent correspondences to the general practitioner (55% of correspondences, n = 257/469). For 31% (n = 29/95) of citizens requiring action from nursing staff, this could have been avoided if the nurses had had access to the discharge letter.</p><p><strong>Conclusion: </strong>We identified several challenges related to the transition of patients from hospital to temporary care, most often related to medication. A third of actions related to medication management were considered avoidable with improved practices around communication.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"991-999"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of hand-held and stationary ultrasound for detection of sarcopenia in acutely hospitalised older adults-a validity and reliability study.","authors":"Jeppe Grabov Phillip, Lisbeth Rosenbek Minet, Siri Aas Smedemark, Jesper Ryg, Karen Andersen-Ranberg, Kristoffer Kittelmann Brockhattingen","doi":"10.1007/s41999-024-01021-x","DOIUrl":"10.1007/s41999-024-01021-x","url":null,"abstract":"<p><strong>Background and purpose: </strong>Sarcopenia is a growing health concern among geriatric patients. Early diagnostics is importance to intervene and better muscle status and thus physical function. Ultrasound can be a valuable tool for patient-near diagnostics of sarcopenia. In recent time, ultrasound devices have evolved from larger stationary devices to minor hand-held devices that are more portable. However, the literature lacks research comparing quality of the different devices. The purpose of this study was to compare hand-held ultrasound (HH-US) to stationary ultrasound (S-US) in muscle assessment for detection of sarcopenia in acutely hospitalized older adults.</p><p><strong>Methods: </strong>A cross-sectional study using a convenience sample of acutely admitted older patients examined with both HH-US and S-US within a single session by the same examiner. Image analysis was performed using ImageJ, and was conducted by two raters: Rater 2 an experienced US examiner and Rater 1 an US examiner who received training from Rater 2. The Ultrasound sarcopenia index (USI) was used for evaluating sarcopenia. Validity and reliability of HH-US were analyzed using Cohen's Kappa and Student's t-test.</p><p><strong>Results: </strong>21 participants (mean age 83.4 years, 52% female). Results showed \"substantial\" intra-rater reliability (κ = 0.77 for Rater 1) and 'near-perfect' validity (κ = 0.92 for Rater 2). Inter-rater comparisons revealed no significant differences (p < 0.05).</p><p><strong>Conclusion: </strong>HH-US is a potential method for detection of sarcopenia in acutely hospitalized older adults.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":"1017-1022"},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}