Gerontology and Geriatric Medicine最新文献_第5页

Patient Autonomy Versus Intervention: Geriatric Care Dilemmas. 病人自主与干预：老年护理困境。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241276796

Zhongxi Gao

{"title":"Patient Autonomy Versus Intervention: Geriatric Care Dilemmas.","authors":"Zhongxi Gao","doi":"10.1177/23337214241276796","DOIUrl":"https://doi.org/10.1177/23337214241276796","url":null,"abstract":"Background: The ethical challenges faced by physicians when patients or their families refuse medical interventions are particularly complex in geriatric care. This manuscript explores the delicate balance between professional recommendations and patient autonomy, focusing on the nuanced decisions surrounding enteral nutrition in older patients. Methods: Two case studies are presented: a 99-year-old woman with a history of hypertension, diabetes, and coronary heart disease, and an 82-year-old man with Alzheimer's disease. Both cases involve the recommendation of a nasogastric tube for enteral nutrition, and the subsequent patient and family responses to this intervention. Results: In the first case, the patient and her family initially refused the tube due to personal beliefs and financial concerns, leading to a focus on psychological support and symptom management. The patient eventually agreed to the tube, but tragically passed away shortly after. In contrast, the second case resulted in the patient's family agreeing to the tube after a thorough discussion, leading to a successful recovery and the patient's ability to eat orally 6 months later. Conclusions: The cases underscore the importance of patient-centered care, clear communication, and empathy in geriatric medicine. They highlight the need for healthcare providers to respect patient autonomy, be aware of their own biases, and engage in open dialogue with patients and families. The manuscript advocates for a nuanced approach to medical ethics, where the patient's journey is guided with respect and care, honoring their wishes while striving for the best possible outcomes.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241276796"},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078278","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}

引用次数: 0

The Promise of Ecological Momentary Assessment to Improve Depression Management for Older Adults in Primary Care. 生态瞬间评估有望改善基层医疗机构对老年人抑郁症的管理。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241278538

Irina Mindlis, Thomas L Rodebaugh, Dimitris Kiosses, M Carrington Reid

{"title":"The Promise of Ecological Momentary Assessment to Improve Depression Management for Older Adults in Primary Care.","authors":"Irina Mindlis, Thomas L Rodebaugh, Dimitris Kiosses, M Carrington Reid","doi":"10.1177/23337214241278538","DOIUrl":"10.1177/23337214241278538","url":null,"abstract":"Among older adults, depression is a common, morbid, and costly disorder. Older adults with depression are overwhelmingly treated by primary care providers with poor rates of remission and treatment response, despite attempts to improve care delivery through behavioral health integration and care management models. Given one in 10 older adults in primary care settings meet criteria for depression, there is a pressing need to improve the efficacy of depression treatment among affected individuals. Measurement-based care (i.e., the incorporation of systematic measurement of patient outcomes into treatment) for depressed older adults in primary care has had poor uptake, which at least partly underlies the limited efficacy of depression treatments. In this perspective, we discuss the proposal that ecological momentary assessment (EMA) may increase uptake of measurement-based care for depression in primary care, enhance the quality of clinical depression data, and lead to improvements in treatment efficacy without adding to providers' burden. We describe key issues related to EMA implementation and application in routine settings for depressed older adults, along with potential pitfalls and future research directions.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241278538"},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082549","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}

引用次数: 0

Self-Perception of Mental Health and Exacerbated Social Inequalities Among Vulnerable Older Adults During the COVID-19 Pandemic in Brazil (2021-2023). 巴西 COVID-19 大流行期间（2021-2023 年）弱势老年人对心理健康的自我认知和加剧的社会不平等。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-27 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241274833

Letícia Perticarrara Ferezin, Rander Junior Rosa, Mônica Chiodi Toscano de Campos, Thaís Zamboni Berra, Heriederson Sávio Dias Moura, Ariela Fehr Tártaro, Murilo César do Nascimento, Natacha Martins Ribeiro, Juliana Soares Tenório de Araújo, Fernanda Bruzadelli Paulino da Costa, Reginaldo Bazon Vaz Tavares, Yan Mathias Alves, Titilade Kehinde Ayandeyi Teibo, Regina Celia Fiorati, Severina Alice da Costa Uchoa, Rosa Maria Pinheiro Souza, Ione Carvalho Pinto, Ricardo Alexandre Arcêncio

{"title":"Self-Perception of Mental Health and Exacerbated Social Inequalities Among Vulnerable Older Adults During the COVID-19 Pandemic in Brazil (2021-2023).","authors":"Letícia Perticarrara Ferezin, Rander Junior Rosa, Mônica Chiodi Toscano de Campos, Thaís Zamboni Berra, Heriederson Sávio Dias Moura, Ariela Fehr Tártaro, Murilo César do Nascimento, Natacha Martins Ribeiro, Juliana Soares Tenório de Araújo, Fernanda Bruzadelli Paulino da Costa, Reginaldo Bazon Vaz Tavares, Yan Mathias Alves, Titilade Kehinde Ayandeyi Teibo, Regina Celia Fiorati, Severina Alice da Costa Uchoa, Rosa Maria Pinheiro Souza, Ione Carvalho Pinto, Ricardo Alexandre Arcêncio","doi":"10.1177/23337214241274833","DOIUrl":"10.1177/23337214241274833","url":null,"abstract":"This study analyzes the self-perception of mental health of socially vulnerable elderly people during the COVID-19 crisis in Brazil. Conducted across all state capitals from February 2021 to October 2023, it included 366 participants living in various conditions such as camps, street situations, slums, and communities. The average age was 66.7 years, with a majority being male (59.0%), of Black or Brown race/color (62.3%), and earning below one minimum wage (36.6%). Findings revealed that older adults in street situations, experiencing psychological manifestations like sleep disturbances due to the pandemic, tended to assess their mental health more negatively. In contrast, older men of white race/color without such manifestations, and those practicing strategies like physical activity or relaxation, were less likely to perceive their mental health as poor. Addressing housing, implementing health strategies, and recognizing sample and regional complexities are crucial interventions for older adults in street situations.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241274833"},"PeriodicalIF":2.1,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082548","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}

引用次数: 0

Experience of Caregivers for Older Adults in Rural Ethiopia: Challenges and Available Social Support for Family Caregivers in Co-Residential Living Arrangement. 埃塞俄比亚农村老年人照顾者的经验：同居生活安排中家庭照顾者面临的挑战和可用的社会支持。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241273165

Kidus Yenealem Mefteh, Shambel Desale Gashaw, Tilahun Assefa Hailu, Seid Hassen Hussien

{"title":"Experience of Caregivers for Older Adults in Rural Ethiopia: Challenges and Available Social Support for Family Caregivers in Co-Residential Living Arrangement.","authors":"Kidus Yenealem Mefteh, Shambel Desale Gashaw, Tilahun Assefa Hailu, Seid Hassen Hussien","doi":"10.1177/23337214241273165","DOIUrl":"10.1177/23337214241273165","url":null,"abstract":"Family and kinship care is a common way of caring for older adults, particularly in rural Ethiopia, where institutional care arrangements are nonexistent. Moreover, the majority of studies on family caregivers of older adults were conducted in western cultures, which makes it difficult to understand family caregivers in the Ethiopian context. This study aims at exploring the experience of family caregivers for older adults in a co-residential setting. Specifically, it focuses on answering caregiving challenges and available social supports for family caregivers in a co-residential living arrangement. This study used a qualitative research method employing phenomenology to understand the lived experience of family caregivers for older adults in rural northwestern Ethiopia. Data were collected through a semi-structured interview with eight purposefully selected family caregivers of rural older adults. Regarding family caregivers's challenges and available social supports, four themes emerged from the collected data. These are economic challenges, the incongruence of older adult needs and caregiving capacity, work-caregiving conflict, work-social life conflict, and the presence of social support from different individuals and community-based institutions. In addition to strengthening caregiver support environments, it's critical to develop the capacity of family caregivers through training, economic support, and the integration of family caregivers with health extension workers.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241273165"},"PeriodicalIF":2.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074537","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}

引用次数: 0

Well-Being Outcomes from the Delivery of RASCALs, a Group Activity Intervention Using Nature-Focused Livestream Broadcasts. RASCALs 是一种利用以自然为重点的直播流进行小组活动干预的方法。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241273230

Rebecca L Mauldin, Megan R Westmore, Anna Tulloh, Keith A Anderson

引用次数: 0

Monkeypox Emergence Post-COVID: Insight into Egyptian Older Adult's Awareness, Concern, and Mental Health. COVID 后猴痘的出现：洞察埃及老年人的认识、关注和心理健康。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-20 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241273292

Fatma Magdi Ibrahim, Doaa Abd Elhameed Abd Elmawla, Safaa Mabrouk Abdel Aziz Elgarhy, Ateya Megahed Ibrahim, DoaaE Fadila

{"title":"Monkeypox Emergence Post-COVID: Insight into Egyptian Older Adult's Awareness, Concern, and Mental Health.","authors":"Fatma Magdi Ibrahim, Doaa Abd Elhameed Abd Elmawla, Safaa Mabrouk Abdel Aziz Elgarhy, Ateya Megahed Ibrahim, DoaaE Fadila","doi":"10.1177/23337214241273292","DOIUrl":"10.1177/23337214241273292","url":null,"abstract":"Aim: To identify Egyptian older adults' awareness, concerns, and mental health about the monkeypox outbreak. Background: In light of the ongoing COVID-19 pandemic, monkeypox disease is receiving more attention. The monkeypox virus outbreak has posed a global concern, especially to older adults with comorbidities. Natural disasters, and endemic affect older persons' mental health. Design: A cross-sectional descriptive design was followed. Methods: 254 older adults were recruited from three outpatient clinics using consecutive sampling using four tools. Results: 74.0% of older study participants were unaware of monkeypox. Gender, level of education, residence, worry about contracting monkeypox infection, and mental distress are predictors of awareness about monkeypox (p < .001). Worry of contracting monkeypox infection was common among female participants (p = .038), highly educated (p = .001), who had a low level of awareness and high level of mental distress (p = .001 for both). Conclusion: Awareness of monkeypox was associated with worry and mental distress. Gerontological nurses have a vital role in contacting older adults and providing care and education that decreases worry and preserves minds and feelings, improving their quality of life. Establishing a national strategic planning and crisis prevention framework to alleviate psychological distress and prevent mental health issues from deteriorating in this group is crucial.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241273292"},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019547","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}

引用次数: 0

Emergency Medical Service in the Elderly Population in Iran: A Cross-sectional Study Before and During the COVID-19 Pandemic. 伊朗老年人口中的紧急医疗服务：COVID-19 大流行之前和期间的横断面研究》。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-08-11 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241271908

Mohammadreza Sabbaghi, Kheizaran Miri, Mohammad Namazinia

引用次数: 0

Prevalence Rates of Diabetic Retinopathy and Undiagnosed Diabetes Among Delaware Nursing Home and Assisted Living Facility Residents. 特拉华州疗养院和生活辅助设施居民中糖尿病视网膜病变和未确诊糖尿病的患病率。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241260938

Robert B Å Andersson, Carlo Pelino, William A Monaco, Greta Bunin

{"title":"Prevalence Rates of Diabetic Retinopathy and Undiagnosed Diabetes Among Delaware Nursing Home and Assisted Living Facility Residents.","authors":"Robert B Å Andersson, Carlo Pelino, William A Monaco, Greta Bunin","doi":"10.1177/23337214241260938","DOIUrl":"10.1177/23337214241260938","url":null,"abstract":"Objectives: To determine the prevalence of diabetic retinopathy and undiagnosed diabetes among Delaware nursing home and assisted care facility residents. Methods: This cross-sectional study involved the statistical analysis of comprehensive eye examination records of 2,063 nursing home residents residing in 18 facilities and 4 assisted living facilities in Delaware from 2005 to 2009. Descriptive statistical analyses were conducted to identify the rates of retinal dot and blot hemorrhages and existing systemic diabetes diagnoses. Results: The mean age of nursing home and assisted care facility residents was 77 years (range 9-104), and 64.4% were over the age of 80. Most residents were female (61.1%) and white (72.5%). 3.6% of the 2,063 nursing home residents had blot or dot hemorrhages in one or both eyes. 32.8% had a type 1 or type 2 diabetes diagnosis. Of the ones with a positive dot and blot hemorrhage finding, 56.8% had a diagnosis of diabetes, and 43.2% did not. Discussion: There was a high prevalence of dot and blot hemorrhages without a systemic diagnosis of diabetes, indicating a need for regular eye care among residents.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241260938"},"PeriodicalIF":2.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876705","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}

引用次数: 0

Deep Sleep, Olfactory Loss, and Cognition in Early-stage Parkinson's Disease: Pilot Study Results. 帕金森病早期患者的深度睡眠、嗅觉丧失和认知能力：试点研究结果

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241262925

Vanessa M Young, Rebecca Bernal, Erin Pollet, Luis Serrano-Rubio, Carlos Gaona, Jayandra Jung Himali, Sudha Seshadri, David Andrés González, Mitzi M Gonzales

{"title":"Deep Sleep, Olfactory Loss, and Cognition in Early-stage Parkinson's Disease: Pilot Study Results.","authors":"Vanessa M Young, Rebecca Bernal, Erin Pollet, Luis Serrano-Rubio, Carlos Gaona, Jayandra Jung Himali, Sudha Seshadri, David Andrés González, Mitzi M Gonzales","doi":"10.1177/23337214241262925","DOIUrl":"10.1177/23337214241262925","url":null,"abstract":"Individuals with Parkinson's disease (PD) have a higher risk of developing dementia compared to age-matched controls. Rapid eye movement sleep behavior disorder (RBD) and hyposmia can influence symptoms severity. We report associations between polysomnography-assessed sleep architecture, olfactory identification, and cognition. Twenty adults with early-stage PD (mean age 69 ± 7.9; 25% female) completed cognitive assessments, the Brief Smell Identification Test (BSIT), and overnight in-clinic polysomnography. A global cognitive score was derived from principal component analysis. Linear regression models examined associations between sleep variables, BSIT performance, and cognition. Cognitive performance was compared between participants with and without RBD. Deep sleep attainment (β ± SE: 1.18 ± 0.45, p = .02) and olfactory identification (0.37 ± 0.12, p = .01) were associated with better cognition. Light sleep, REM sleep, arousal index, and sleep efficiency were not (all p > .05). Participants with RBD had significantly worse cognition (t-test = -1.06 ± 0.44, p = .03) compared to those without RBD; none entered deep sleep. Deep sleep attainment was associated with better memory (1.20 ± 0.41, p = .01) and executive function (2.94 ± 1.13, p = .02); sleep efficiency was associated with executive function (0.05 ± 0.02, p = .02). These findings suggest interrelationships between lack of deep sleep, hyposmia, and poorer cognition in PD, particularly among individuals with RBD. Assessing these markers together may improve early identification of high-risk individuals and access to interventions.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241262925"},"PeriodicalIF":2.1,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753371","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}

引用次数: 0

Physical Activity and Neuropsychological Functioning in Older Adults. 老年人的体育活动和神经心理功能。

IF 2.1

Gerontology and Geriatric Medicine Pub Date : 2024-06-20 eCollection Date: 2024-01-01 DOI: 10.1177/23337214241262924

Anna S Ord, Adrienne H Eldridge, David R Netz, Shannon G Kuschel, Jamie Holland, Theresa Long, Candace Dumas, Crista Glover, Morgan Schools, Rachel Stephens, Anna T Magnante, Scott W Sautter

{"title":"Physical Activity and Neuropsychological Functioning in Older Adults.","authors":"Anna S Ord, Adrienne H Eldridge, David R Netz, Shannon G Kuschel, Jamie Holland, Theresa Long, Candace Dumas, Crista Glover, Morgan Schools, Rachel Stephens, Anna T Magnante, Scott W Sautter","doi":"10.1177/23337214241262924","DOIUrl":"10.1177/23337214241262924","url":null,"abstract":"Research has identified a positive relationship between physical activity and neuropsychological functioning across the lifespan. The present study further examined the relationship between physical activity, depression, anxiety, and cognitive functioning in community-dwelling older adults (ages 65-96) who completed an outpatient neuropsychological evaluation (N = 526). Psychometrically sound and validated measures were used to assess depression, anxiety, and cognitive functioning. Analyses of covariance (ANCOVA) were conducted to examine differences between individuals who reported regularly engaging in physical activity and those who did not, after adjusting for demographic variables (age, education, and gender). Results indicated that physical activity was associated with better scores on measures of depression, anxiety, and cognitive functioning. Effect sizes for total scores on all measures were large, but there was a sizeable range of effect sizes (from small to large) for various cognitive domains. Smallest effect sizes were observed for subtests measuring language skills and visuospatial abilities, whereas largest effect sizes were seen in processing speed and memory. Results suggest that engaging in physical activity may be a beneficial non-pharmacological intervention for older adults. These findings underscore the importance of integrating physical activity programs in community and healthcare settings to foster mental and cognitive health in older populations.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":"10 ","pages":"23337214241262924"},"PeriodicalIF":2.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443744","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}

引用次数: 0