medRxiv - Geriatric Medicine最新文献

{"title":"Comparative accuracy of five screening tools for sarcopenia in community older adults:a systematic review and a network meta-analysis","authors":"Jie Li, Yujie Yang, Menglin Gao, Huaihong Yuan","doi":"10.1101/2024.04.16.24305890","DOIUrl":"https://doi.org/10.1101/2024.04.16.24305890","url":null,"abstract":"<strong>Background</strong> Sarcopenia, a prevalent and serious condition among community older adults, often remains unnoticed. The use of systematic screening has the potential to enhance detection rates; however, there is currently no consensus on the most effective approach. This study ai med to assess the diagnostic test accuracy of five simple sarcopenia screening tools and determine which test has the highest accuracy.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630003","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":"Relationship-centred care for people living with dementia in care homes","authors":"Elizabeth Gillen, Deborah Edwards, Seren Roberts, Nia Davies, Isobel Davies, Jane Harden","doi":"10.1101/2024.04.15.24305839","DOIUrl":"https://doi.org/10.1101/2024.04.15.24305839","url":null,"abstract":"Dementia is a progressive degenerative disease, typically affecting older adults for which there is currently no cure. Dementia is characterised by progressive impairment to several cognitive functions including memory and orientation, practical abilities and mood changes, all of which can impact personality and social relationships. The theory of social death has been explored for people living with dementia as the ability to maintain social interactions are threatened leading to a loss of social identity and exclusion and withdrawal from the wider community.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"221 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623121","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":"Developing multifactorial dementia prediction models using clinical variables from cohorts in the US and Australia","authors":"Caitlin A Finney, David A Brown, Artur Shvetcov, Alzheimers Disease Neuroimaging Initiative, Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing","doi":"10.1101/2024.03.12.24304189","DOIUrl":"https://doi.org/10.1101/2024.03.12.24304189","url":null,"abstract":"INTRODUCTION\u0000Existing dementia prediction models using non-neuroimaging clinical measures have been limited in their ability to identify disease. This study used machine learning to re-examine the diagnostic potential of clinical measures for dementia. METHODS\u0000Data was sourced from the Australian Imaging, Biomarkers, and Lifestyle Flagship Study of Ageing (AIBL) and the Alzheimers Disease Neuroimaging Initiative (ADNI). Clinical variables included 21 measures across medical history, hematological and other blood tests, and APOE genotype. Tree-based machine learning algorithms and artificial neural networks were used. RESULTS\u0000APOE genotype was the best predictor of dementia cases and healthy controls. Our results, however, demonstrated that there are limitations when using publicly accessible cohort data that may limit the generalizability and interpretability of such predictive models.\u0000DISCUSSION\u0000Future research should examine the use of routine APOE genetic testing for dementia diagnostics. It should also focus on clearly unifying data across clinical cohorts.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140126191","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":"A novel scale for assessing caregiving competence in family caregivers of persons with dementia","authors":"Ippei Suganuma, Noriyuki Ogawa, Kenji Kamijou, Aki Nakanishi, Ippei Kawasaki, Keisuke Itotani, Shinichi Okada","doi":"10.1101/2024.03.10.24304060","DOIUrl":"https://doi.org/10.1101/2024.03.10.24304060","url":null,"abstract":"The aging of family caregivers and the challenges of long-distance caregiving attributed to the increase in the number of elderly individuals living alone have raised concerns about dementia caregiving in Japan. Additionally, with the shifts in family dynamics due to declining birth rates and an extended average lifespan, adapting support strategies for family caregivers is necessary. Thus, it is necessary to measure the caregiving competence of family caregivers early and effectively. However, a comprehensive caregiving competence scale tailored to dementia, including aspects such as caregiving burden, affirmation, and coping, is lacking. Therefore, this study aimed to develop a Caregiving Competence Scale for Dementia (CCSD) for primary family caregivers caring for individuals with dementia. This study focused on primary family caregivers caring for individuals with cognitive impairment and various degrees of dementia. The initial version of the CCSD was developed, and a questionnaire survey was conducted to validate its structural validity and reliability. A total of 150 participants were included in the analysis. The exploratory factor analysis identified five factors with 27 items: Factor 1: “Positive Emotions and Awareness,” Factor 2: “Presence or Absence of Consultation Partners and Family Support,” Factor 3: “Caregiving Burden and Coping Skills,” Factor 4: “Dementia Literacy,” and Factor 5: “Engagement and Emotional Control.” The confirmatory factor analysis revealed a good model fit (comparative fit index = 0.905 and root mean square error of approximation = 0.072). The overall Cronbach’s alpha coefficient for the scale was 0.892. The CCSD, comprising 27 items covering five factors, has been successfully developed as a measurement scale. Measuring caregiving competence contributes to developing targeted support strategies for primary family caregivers and facilitating appropriate interventions.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140126186","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":"The association between delirium and falls in older adults in the community: a systematic review","authors":"Charlotte Eost-Telling, Lucy McNally, Yang Yang, Chunhu Shi, Gill Norman, Saima Ahmed, Brenda Poku, Annemarie Money, Helen Hawley-Hague, Susan D Shenkin, Chris Todd, Emma R.L.C. Vardy","doi":"10.1101/2024.03.12.24303708","DOIUrl":"https://doi.org/10.1101/2024.03.12.24303708","url":null,"abstract":"Objective: Systematically review and critically appraise evidence for the association between delirium and falls in community-dwelling adults aged 60 years and above\u0000Methods: We searched EMBASE, MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and Evidence-Based Medicine Reviews (EBMR) databases in April 2023. Standard methods were used to screen, extract data, assess risk of bias (using Newcastle Ottawa scale), provide a narrative synthesis and where appropriate conduct meta-analysis.\u0000Results: We included eight studies, with at least 3505 unique participants. Five found limited evidence for an association between delirium and subsequent falls: one adjusted study showed an increase in falls (RR 6.66;95% CI 2.16-20.53) but the evidence was low certainty. Four non-adjusted studies found no clear effect. Three studies (one with two subgroups treated separately) found some evidence for an association between falls and subsequent delirium: meta-analysis of three adjusted studies showed an increase in delirium (pooled OR 2.01; 95%CI 1.52-2.66), one subgroup of non-adjusted data found no clear effect. Number of falls and fallers were reported in the studies. Four studies and one subgroup were at high risk of bias and one study had some concerns. Conclusions: We found limited evidence for the association between delirium and falls. More methodologically rigorous research is needed to understand the complex relationship, establish how and why this operates bi-directionally and identify potential modifying factors involved. We recommend the use of standardised assessment measures for delirium and falls. Clinicians should be aware of the potential relationship between these common presentations.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140129664","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":"Effectiveness of tele-exercise on muscle function and physical performance in older adults for preventing sarcopenia: A protocol for systematic review","authors":"YA SHI, Emma Stanmore, Lisa McGarrigle, Chris Todd","doi":"10.1101/2024.03.06.24303856","DOIUrl":"https://doi.org/10.1101/2024.03.06.24303856","url":null,"abstract":"Introduction Sarcopenia is characterized by the progressive weakening of muscle function that occurs with age. This condition frequently leads to frailty, disability, and even death. Research on sarcopenia prevention is growing. Tele-exercise intervention is increasingly gaining attention in this field, with the rapid advancement of the Internet and the influence of the COVID-19. However, there is a lack of empirical support for its effectiveness. Our study aims to assess the effect of tele-exercise on sarcopenia in older persons, specifically focusing on its ability to improve muscle strength, muscle mass and physical performance.\u0000Methods and analysis Searching will be performed in the following eleven databases (Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, WOS, Scopus, CBM, CNKI, WANFANG, VIP) for published trials and two trial registries (Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform) for unpublished trials. Google Scholar will be utilized to find grey literatures. The criterion of inclusion will be clinical trials involving tele-exercise interventions in older adults diagnosed with sarcopenia (possible, confirmed, or severe sarcopenia). For data synthesis, we will utilize a summary table to show the major characteristics of selected trials and a summary graph to demonstrate the risk of bias using RoB 2 in each trial, which will be further discussed in a narrative synthesis. The possibility of meta-analysis for quantitative data will be assessed according to the homogeneity analysis of the trials, using the methods of fixed or random effects model. If meta-analysis is possible, subgroup analysis and sensitivity analysis will be performed as well. Publication bias will be assessed through the use of the funnel plot and Egger's linear regression test when an adequate number of trials are available. Finally, the GRADE approach will be used to classify the certainty of evidence body into four categories (high, moderate, low, and very low). Ethics and dissemination The findings of the systematic review will be shared through publishing in a peer-reviewed journal and presentation at appropriate conferences. Since we will not be utilizing specific patient data, ethical approval is unnecessary.\u0000PROSPERO registration number CRD42024516930","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140056746","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":"Relation of frailty with depression among Colombian COPD adults aged over 60 years","authors":"Adalberto Campo-Arias, John Carlos Pedrozo-Pupo, Carmen Cecilia Caballero-Dominguez","doi":"10.1101/2024.02.29.24303577","DOIUrl":"https://doi.org/10.1101/2024.02.29.24303577","url":null,"abstract":"Introduction: Frailty and depression risk are common in older adults undergoing chronic obstructive pulmonary disease (COPD) treatment. However, little is known about this association in people with COPD residing in low- and middle-income countries. The study aimed to o establish the relationship between frailty and depression among ambulatory adults over 60 years with COPD in Santa Marta, Colombia.\u0000Methods: A cross-sectional study was designed in which consecutive patients from the pulmonology outpatient clinic were invited to participate. Frailty was quantified with the FiND (Frail Non-Disabled [FiND] Screening Tool) [Cronbach's alpha 0.65] and depression with the Primary Care Screening Questionnaire for Depression (PSQD) [Cronbach's alpha 0.73].\u0000Results: Three-hundred forty-nine patients with COPD between 60 and 98 years participated (M=75.6, SD=8.4), 61.9% were males, and 19.8% presented a C or D combined evaluation. Two hundred eighty-six patients (76.8%) presented frailty with and without mobility disability, and 31.2% presented depression. The relationship of frailty with depression remained significant, even after adjusting for confounding variables (OR=2.80, 95%CI 1.42-5.51).\u0000Conclusions: Frailty and depression are significantly associated after adjusting for confounding variables. More studies are welcome.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140019298","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":"Exploring the power of structural brain MRI and clinical measures in predicting AD neuropathology: a machine learning approach","authors":"Farooq Kamal, Cassandra Morrison, Michael D. Oliver, Mahsa Dadar","doi":"10.1101/2024.02.28.24303519","DOIUrl":"https://doi.org/10.1101/2024.02.28.24303519","url":null,"abstract":"Importance: Vascular and structural brain changes are increasingly recognized for their role in cognitive decline and progression of neurodegenerative conditions including Alzheimer's disease (AD). Despite advances in imaging technologies, the exact contribution of these brain changes to disease processes remains a subject of ongoing research. Objective: To apply machine learning techniques to determine critical features of AD-related neuropathologies in vivo. Main Outcomes and Measures: A total of 127 participants (95 females, mean age=87.3) from the RUSH dataset and 65 participants (17 females, mean age=79.0) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were included. In the RUSH dataset, machine learning models were applied towards feature selection of MRI, clinical, and demographic data to identify the best performing set of variables that could predict neuropathology outcomes (e.g., Braak neurofibrillary tangle stage, neurofibrillary tangle burden; NFT). The best-performing neuropathology predictors using the top seven MRI, clinical, and demographic features were then validated in ADNI to compare results and ensure that the feature selection process did not lead to overfitting. For continuous measures, gradient boosting, bagging, support vector regression, and linear regression were implemented. For binary outcomes, logistic regression, gradient boosting, support vector machine, and bagging classifiers were utilized. Results: Applying feature ranking methods using similar information criteria, four machine learning models consistently ranked white matter hyperintensity (WMHs), gray matter (GM), and white matter (WM) volumes as important features in predicting all neuropathology measures. In the RUSH dataset, prediction accuracy was highest for Braak stage, NFT, and tangles (i.e., cross-validated correlation between actual measures and predictions was above 0.8). The best-performing model achieved r=0.83 (RMSE=0.50) in predicting tangles. The best-performing binary classifier achieved 82% accuracy, 86% sensitivity, and 78% specificity in predicting NIA-Reagan (measure of neurofibrillary tangles and neuritic plaques). Similar results were observed in the ADNI dataset. Conclusion and Relevance: These results highlight the efficacy of machine learning models, particularly when incorporating structural MRI features (e.g., GM, WM) alongside WMHs, in accurately predicting AD neuropathology. The use of machine learning may prove beneficial in early detection of AD pathology.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140007456","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":"The dimensionality of the Death Anxiety Inventory-Revised in Colombian-aged adults","authors":"Adalberto Campo-Arias, Monica Reyes-Rojas, Guillermo Augusto Ceballos-Ospino","doi":"10.1101/2024.02.27.24303479","DOIUrl":"https://doi.org/10.1101/2024.02.27.24303479","url":null,"abstract":"The Death Anxiety Inventory-Revised (DAI-R) is a relatively new instrument to quantify anxiety about death in different contexts. However, the dimensionality in the elderly population is unknown. The study aimed to corroborate the dimensionality of the DAI-R among Colombian-aged adults. A psychometric study was conducted with the participation of 100 aged adults (M=68.82, SD=4.82; 52% were male gender). This scale has 17 items, grouped into four dimensions or factors, and a dichotomous answer pattern. Dimensionality was tested using confirmatory factor analysis (CFA), and goodness-of-fit indicators were computed. The CFA showed unacceptable goodness-of-fit indicators, and the four-dimensional structure of the DAI-R was rejected. In conclusion, the DAI-R has an unsatisfactory four-dimensional structure among Colombian-aged adults. Further research should corroborate this finding with a large sample size.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140003111","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":"Digital Health Technologies for Metabolic Disorders in Older Adults: A Scoping Review Protocol","authors":"Panitda Huynh, Elgar Fleisch, Michael Braendle, Tobias Kowatsch, Mia Jovanova","doi":"10.1101/2024.02.26.24303372","DOIUrl":"https://doi.org/10.1101/2024.02.26.24303372","url":null,"abstract":"Introduction:\u0000Metabolic disorders (type 2 diabetes, insulin resistance, hyperglycemia, obesity, hyperlipidemia, hypertension, nonalcoholic fatty liver disease, and metabolic syndrome) are leading causes of mortality and disability worldwide and disproportionately affect older adults relative to those younger. Digital health technologies (DHTs), such as patient monitoring, digital diagnostics, and digital therapeutics, emerge as promising tools for navigating health in day-to-day life. However, their role in targeting metabolic disorders, particularly among a key demographic of older adults, is not yet fully understood. Thus, this work aims to scope the use of DHTs in managing metabolic health disorders among older adults. Methods and Analysis:\u0000We will conduct a scoping review following the recommended framework by Arksey and O'Malley (1). Our search will focus on three primary concepts: metabolic disorders, DHTs, and older adults. We plan to search five online databases (Cochrane, Embase, PubMed, Scopus, and Web of Science) to identify original research articles published between January 2014 and January 2024. Two reviewers will independently screen articles for inclusion based on predetermined criteria, and a separate reviewer will resolve conflicts. Data will be extracted using a standardized form, and the findings will be synthesized and reported qualitatively and quantitatively. Ethics and dissemination.\u0000No ethics approval is required for this protocol and scoping review, as data will be used only from published studies with appropriate ethics approval. Results will be disseminated in a peer-reviewed publication.\u0000This protocol has been preregistered on OSF Repository at: https://osf.io/9s8fm.","PeriodicalId":501025,"journal":{"name":"medRxiv - Geriatric Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979018","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}