Canadian Geriatrics Journal最新文献

{"title":"The Association Between the Presence of Medical Care and Resident Outcomes in Canadian Nursing Homes: a Retrospective Cross-Sectional Analysis.","authors":"Krittika Bali, Adrian Wagg, Ruth Murphy, Andrea Gruneir","doi":"10.5770/cgj.27.709","DOIUrl":"10.5770/cgj.27.709","url":null,"abstract":"<p><p>The quality of medical care provided to older residents in nursing homes may depend upon available staffing models; this study examined the relationship between physician and nurse practitioner (NP) presence, care involvement, and resident outcomes. The secondary analysis of data collected in the Translating Research in Elder Care (TREC) study during 2019-20 included items on daily presence of physicians and NPs on units, physician involvement in care planning, and ability to contact physician or NP when necessary linked to routinely collected Resident Assessment Instrument-Minimum Data Set version 2.0 data. Eight logistic regression models tested the association between measures of staffing involvement and each outcome (antipsychotic use without indication (APM), physical restraint use, hospital transfers, and polypharmacy). The sample consisted of 10,888 residents across 320 care units in 90 facilities. Of the units, 277 (86%) reported a physician or NP visited daily, 160 (72.1%) reported that the physician was involved in care planning, and 318 (99%) units reported that the physician or NP could be reached when needed. Following adjustment for multiple confounding variables, there were no statistically significant associations between presence/involvement of medical professionals and resident outcomes (for example, physician or NP presence on the unit and hospitalization transfers [AOR=1.17, 95% CI: 0.46-3.10] or polypharmacy [AOR=1.37, 95% CI: 0.64-2.93]). We found non-significant associations between medical staff presence and involvement and selected resident outcomes, suggesting either the presence of many unaccounted for confounding inter-related resident-care provider variables or underlying insensitivity of the available data.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 3","pages":"317-323"},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and Language Performance in Healthy Aging, Stroke and Neurodegenerative Conditions: a Scoping Review.","authors":"Roya Khalili, Eva Kehayia, Marc Roig","doi":"10.5770/cgj.27.707","DOIUrl":"10.5770/cgj.27.707","url":null,"abstract":"<p><strong>Background: </strong>While the benefits of exercise on cognitive functions have already been reviewed, little is known about the impact of exercise on language performance. This scoping review was conducted to identify existing evidence on exercise-induced changes in language performance in healthy aging individuals and adults with stroke or neurodegenerative conditions.</p><p><strong>Methods & results: </strong>Using the Arksey and O'Malley framework, 29 studies were included. Eleven studies in healthy aging indicated enhanced language performance, with 72.72% having significant improvement in semantic/phonological Verbal Fluency (VF) following exercise. Among 18 studies on older adults with stroke or neurodegenerative conditions, 11 reported better language performance, with 44.44% having significant improvement in picture naming/description and semantic/phonological VF by exercise. The seven remaining studies reported no significant change in language performance in persons with stroke or neurodegenerative conditions.</p><p><strong>Conclusion: </strong>Overall, exercise interventions showed improvement in language performance in healthy aging, while selective enhancement was shown for language performance in persons with either stroke or neurodegenerative conditions.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 3","pages":"324-344"},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Level, Motivation and Barriers to Participate in Physical Activity among Geriatric Population at Ahmedabad City, India: An Epidemiological Factsheet.","authors":"Viral R Dave, Neel B Desai, Vasu Rathod","doi":"10.5770/cgj.27.751","DOIUrl":"10.5770/cgj.27.751","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the level of physical activity among geriatric population, to determine the motivating factors for being active and identifying barriers that prevent participants from engaging in physical activity.</p><p><strong>Methods: </strong>A community-based cross-sectional study was carried out at one of the wards within Ahmedabad city following multi-stage random sampling. The calculated sample size was 230. A pre-designed, validated, short version International Physical Activity Questionnaire (IPAQ) and Behaviour Regulation in Exercise Questionnaire (BREQ-3) were used for data collection by personal interview. From selected sampling-frame, geriatric people residing in every 5th household were interviewed after obtaining oral informed consent following simple-random sampling.</p><p><strong>Results: </strong>Of total 230 study participants, 67 (29.13%) were physically active (cumulative for Category 2 and Category 3), while the remaining 163 (70.87%) were found physically inactive (i.e., minimally active [Category 1]). Motivational scores, particularly in identified regulation, showed higher median scores across subdomains of the BREQ-3. Amotivation exhibited a strong negative correlation with physical activity, while intrinsic regulation displayed a strong positive correlation.</p><p><strong>Conclusion: </strong>More than two-third of study participants were physically inactive. Level of educational status, type of previous occupation involved, presence of addiction, BMI, electronic device usage duration per day and presence of chronic illness were statistically significant determinants to decide involvement of elderly people in category of physical activity. Amotivation, external and introjected regulation had negative correlation with physical activity, while intrinsic regulation and RAI (Relative Autonomy Index) showed positive correlation with physical activity. None of the behavioural regulators had statistically significant association with category of physical activity.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 3","pages":"299-306"},"PeriodicalIF":1.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning Towards a Virtual Falls Prevention Program for Frail Seniors: Learning from the Experiences of Older Adults During the COVID-19 Pandemic.","authors":"Sophie M Weiss, Csilla Kalocsai, Barbara Liu, Mireille Norris","doi":"10.5770/cgj.27.722","DOIUrl":"10.5770/cgj.27.722","url":null,"abstract":"<p><strong>Background: </strong>The literature to date is unable to clearly characterize the appropriateness of virtual care for falls prevention services from the patient perspective. In response to COVID-19, the Falls Prevention Program (FPP) at Sunnybrook Health Sciences Centre was modified to include virtual components. We set out to uncover the experiences of this unique older-adult patient population to inform FPP quality improvement and appropriate incorporation of technology post-pandemic.</p><p><strong>Methods: </strong>FPP patients during the COVID-19 pandemic (February 2020 - February 2022) and their primary caregivers met inclusion criteria. Out of 18 eligible patients, 10 consented to participate in 20-minute, semi-structured telephone interviews conducted and transcribed by the first author. Inductive coding followed by theme generation occurred through collaborative analysis.</p><p><strong>Results: </strong>The participants (n=10) were 60% female, mean age 84 years (SD 5.8), 60% living alone, and 70% university educated. We generated three main themes: 1) First Steps First, revealed a common desire for physical and mental support and the perceived essentials of a successful FPP highlighting the importance of program length and individualized attention; 2) Overcoming Obstacles, highlighted participants' experiences overcoming barriers with technology in the context of an isolating pandemic; and 3) Advancing Care Post-Pandemic, elaborated on the appropriateness of virtual care and delved into the importance of program personalization.</p><p><strong>Conclusion: </strong>The interviewed older adults revealed agreement on the FPP's necessity and the importance of increasing program length, one-on-one interaction, and program flexibility for unique patient needs. Incorporating virtual assessment prior to in-person exercises was largely favoured and should be considered as an appropriate use of technology post-pandemic.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"141-151"},"PeriodicalIF":1.6,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Measuring the Use of End-of-Life Symptom Relief Medications in Long-Term Care Homes-a Qualitative Study.","authors":"Rhiannon L Roberts, Christina Milani, Colleen Webber, Shirley H Bush, Kaitlyn Boese, Jessica E Simon, James Downar, Amit Arya, Peter Tanuseputro, Sarina R Isenberg","doi":"10.5770/cgj.27.765","DOIUrl":"https://doi.org/10.5770/cgj.27.765","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.5770/cgj.27.712.].</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"267"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Alternate Level of Care Status Designation: a Case-Control Study and Model to Optimize Care Trajectories.","authors":"Marianne Lamarre, Myriam Daignault, Vincent Weng-Jy Cheung, Marie-France Forget, Quoc Dinh Nguyen","doi":"10.5770/cgj.27.697","DOIUrl":"10.5770/cgj.27.697","url":null,"abstract":"<p><strong>Background: </strong>As health-care demand is growing, our health-care system will require the optimization of the care trajectories. Patients with an alternate level of care (ALC) status could be a target for flow optimization. We aimed to characterize ALC patients and risk factors for ALC status, and to propose an integrated model to analyze the trajectory of ALC patients and discuss solutions to reduce their burden.</p><p><strong>Methods: </strong>A case-control design was used to compare 60 ALC and 60 non-ALC patients admitted to the geriatric unit of the Centre hospitalier de l'Université de Montréal in 2021, collecting medical and sociodemographic data. Based on our model, univariate statistical analyses were computed to compare groups and identify risk factors for ALC status.</p><p><strong>Results: </strong>ALC patients were less independent (22% performed five to six activities of daily living vs. 43%, <i>p</i> = .03). Both groups were comparable in terms of mobility and neurocognitive disorders. ALC patients were more likely to receive a new diagnosis of a neurocognitive disorder or new behavioural or psychological symptoms (37% vs. 15%, <i>p</i> = .008). Up to 25% of ALC patients were admitted despite presenting no active medical condition (vs. 3% of non-ALC patients, <i>p</i> = .002).</p><p><strong>Conclusions: </strong>The optimization of the care trajectory of ALC patients is mainly based on pre-hospital and post-hospital factors. A proportion of ALC admissions might be avoidable with additional investment in home care resources and relocation procedures. Fluidity of ALC trajectory may benefit from improved orientation at discharge procedures. Full optimization of ALC trajectories requires a systemic understanding of the health-care system.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"152-158"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance Training with Instability Does Not Hamper Total Training Volume and Muscle Strength Gains in Older Adults: a Secondary Analysis from REI Study.","authors":"Yslaíny Araújo Silva, Bruno Remígio Cavalcante, Letícia Bojikian Calixtre, Milena Lucilla Lacio Tomaz, Mariana Ferreira de Souza, Ana Carolina Rodarti Pitangui, Rodrigo Cappato de Araújo","doi":"10.5770/cgj.27.730","DOIUrl":"10.5770/cgj.27.730","url":null,"abstract":"<p><strong>Background: </strong>Resistance training with instability (REI) emerged as a promising training modality for older adults aiming to counteract age-related changes.</p><p><strong>Objectives: </strong>We compared the effects of 12 weeks of REI and traditional resistance exercise (RE) on muscle strength in older adults with cognitive impairment. We further explored if total training volume (TTV) significantly differs among training groups.</p><p><strong>Methods: </strong>This is a secondary analysis of the REI study. Participants were randomly assigned to REI (n=22) or RE (n=23). RE protocol involved moderate-intensity, free-weight, and machines-based resistance exercises (3 sets, 10-15 repetitions). REI received a similar training protocol, in which exercises were simultaneously performed with instability/unstable devices (e.g., squat exercise under a foam pad or Bosu^® ball). Maximal isometric strength and isokinetic parameters were assessed at baseline and after completion of a 12-week intervention through a hydraulic handgrip and isokinetic dynamometer, respectively. TTV (sets × repetitions × load) was computed based on external training load over the 12 weeks.</p><p><strong>Results: </strong>No differences were observed between groups (<i>p</i>=.35) after the intervention. Over 12 weeks, REI and RE improved isometric handgrip strength (<i>p</i><.001) and isokinetic performance (<i>p</i>=.04). We also did not find differences in the TTV between training groups (<i>p</i>=.28).</p><p><strong>Conclusion: </strong>We demonstrated that both REI and RE training induced similar gains in muscle strength. Combining unstable surfaces/instability devices did not hamper TTV, which may have clinical applications in the context of exercise for older adults.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"133-140"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Dementia Doesn't Mean That Life Doesn't Have More Wonderful Things Ahead\": A Qualitative Study Evaluating a Canadian Dementia Support Services Program.","authors":"Mallorie T Tam, Susanna Martin, Yu Fei Jiang, Angela Machado, Julie M Robillard","doi":"10.5770/cgj.27.698","DOIUrl":"10.5770/cgj.27.698","url":null,"abstract":"<p><strong>Background: </strong>Community support programs can improve quality of life for people living with dementia and their care partners. Important to the successful implementation of such programs is close engagement with end-users to gain a better understanding of their needs. This study describes the perspectives of people living with dementia, care partners, and health-care providers on the First Link^® dementia support program provided by the Alzheimer Society of British Columbia (ASBC).</p><p><strong>Methods: </strong>Following a large-scale survey (N=1,164), semi-structured interviews were conducted with participants to explore in greater detail the different needs and themes that emerged from the first phase of the study. The interviews explored: 1) experiences with the program; 2) future planning; 3) meaning of independence; and 4) impact of the program on emotional and physical well-being.</p><p><strong>Results: </strong>A total of 48 participants were interviewed in this study. Knowledge and education were key factors that helped participants manage the impact of dementia. Learning about dementia, the experiences of others, strategies on how to manage symptoms, what to plan for in the future, and how to access different services in the community, was tied to increased feelings of confidence and comfort, and decreased stress. Participants also provided suggestions for improvement of the First Link^® dementia program such as further embedding the program into the patient journey, providing more services in remote areas, providing education for health-care providers, and increasing awareness of the program.</p><p><strong>Conclusion: </strong>By emphasizing the lived experiences and needs of those living with dementia and their caregivers, this work will inform future research-based program evaluations globally and, in turn, improve the existing services to support people living with-and impacted by-dementia.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"116-125"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subspecialty Selection and Fellowship Training Satisfaction among American and Canadian Geriatric Psychiatry Fellows.","authors":"Jeanne Sansfaçon, Karin Cinalioglu, Sara G Gloeckler, Matt Kern, Brandon C Yarns, Myriam Lesage, Jaimie Hunter, Soham Rej","doi":"10.5770/cgj.27.733","DOIUrl":"10.5770/cgj.27.733","url":null,"abstract":"<p><p>The Geriatric Psychiatry Fellowship Subspecialty survey aimed to identify key motivating factors associated with choosing geriatric psychiatry as a career, and to assess training satisfaction among geriatric psychiatry fellows/residents in Canada and the United States. American and Canadian geriatric psychiatry program directors were asked to distribute an online survey to their fellows. Descriptive statistics for quantitative items and Mann-Whitney U tests were performed to assess for differences by country of training. Thirty-one geriatric psychiatry fellows completed the survey. The most important motivating factors for pursuing a career in geriatric psychiatry were found to be \"working with patients and families\", \"working in an interdisciplinary environment\", and \"intellectual stimulation\". Fellows' overall training satisfaction was high, with American fellows more satisfied than Canadian residents (<i>p</i> = .047) on average, especially with regard to biomedical aspects of training (<i>p</i> = .01).</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"178-182"},"PeriodicalIF":1.6,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Memory Support System in French: a Pilot Study.","authors":"Octavio A Santos, Johanna Fievre, Lisa Sweet, Frank Knoefel, Neil Thomas","doi":"10.5770/cgj.27.723","DOIUrl":"10.5770/cgj.27.723","url":null,"abstract":"<p><p>Mild cognitive impairment (MCI) confers a higher risk of developing dementia. While largely preserved, instrumental activities of daily living (IADLs) may be affected to varying degrees by MCI. The Memory Support System (MSS) is a curriculum and calendar/note-taking system that has proven effective in sustaining independence in IADLs for individuals with MCI and in protecting mood among care partners. Until recently, the MSS has only been utilized among English- and Spanish-speaking samples. This study investigated the use of a translated and culturally adapted MSS in four French-speaking, community-dwelling participants with MCI and their support partners. Measures of treatment adherence, daily function, self-efficacy for memory, quality of life, mood, anxiety, and caregiver burden were assessed at baseline, treatment end, and eight-week follow-up. By treatment end and follow-up, participants with MCI showed improvement in adherence to the MSS calendar, IADLs, everyday abilities requiring memory and planning, self-efficacy, depression and anxiety symptoms, and quality of life. Care partners showed improvement in quality of life and depressive symptoms, while their caregiver burden and anxiety symptoms generally remained unchanged. Findings suggest that, with appropriate training, Francophones with MCI can and will use the MSS, and that MSS training may contribute to daily functioning and aspects of participant and care partner well-being.</p>","PeriodicalId":56182,"journal":{"name":"Canadian Geriatrics Journal","volume":"27 2","pages":"168-177"},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201362","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}