OBM geriatrics最新文献

{"title":"Take a Seat for Yoga with Seniors: A Scoping Review","authors":"Diana Veneri, M. Gannotti","doi":"10.21926/obm.geriatr.2202197","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2202197","url":null,"abstract":"Chair yoga is a specific form of yoga practiced while seated on a chair, or standing using a chair for support; this adaptation allows those with impaired standing ability to practice safely. The purpose of this scoping review was to analyze the published literature regarding the use of chair/adapted yoga with older adults. Two researchers performed the review. Data sources: PubMed Central, CINAHL, Medline Full Text, Nursing and Allied Health, SPORT discus and TRIP were accessed. Study selection: Inclusion criteria included pre-test/post-test studies with a yoga intervention for older adults using a chair. Exclusion criteria were studies with seated exercise interventions not specific to yoga, mindfulness or breathing techniques with no physical activity, yoga with no use of a chair, not specific to older adults and reviews. The search strategy was performed by two reviewers. Data extraction: Covidence, a systematic review production tool, was utilized to aid article analysis. Data synthesis: Summation of study type, sample, dosing, intervention type, setting, outcome domains and results were included. Of the 3147 studies initially identified, 75 met the inclusion criteria. This review included 32 RCTs, 11 quasi-experimental, 21 cohort, nine qualitative studies and 2 case-series studies. Most studies reported affective and psychomotor domains of learning (n = 51) and favored chair/adapted yoga as an intervention over the control. A few studies included a second intervention. Twenty two of the 75 studies were focused on community dwelling older adults, followed by participants with orthopedic diagnoses (n = 16), and cognitive impairment (n = 9). The quality of literature supporting chair/adapted yoga is fairly substantial for both community dwelling and those with certain physical and cognitive diagnoses. It is recommended that this intervention continue to be utilized and studied.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43672949","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 CITIDEMAGE Study: Combined Treatment with a Cholinergic Precursor in Dementia Patients","authors":"P. Gareri, A. Cotroneo, G. Orsitto, N. Veronese, Salvatore Putignano","doi":"10.21926/obm.geriatr.2201193","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201193","url":null,"abstract":"Certain previous studies have demonstrated the benefits of the addition of citicoline, a cholinergic precursor, to acetylcholinesterase inhibitors (AchEIs) or memantine in patients with Alzheimer’s disease (AD). The present study showed the effectiveness of oral citicoline plus AchEIs plus memantine in outpatients with AD. This was a retrospective case-control study involving 169 patients aged 65 years old or older having AD (mean age: 78.7 ±4.9 years). In addition, 84 patients were treated with AchEIs plus memantine plus citicoline 1 g/day given orally (group A), and 85 patients were treated with AchEIs plus memantine (group B). In both groups, memantine and AchEIs were used at the highest dosage tolerated. Tests were administered at baseline (T0), after 6 (T1), and 12 months (T2) and included MMSE, ADL, IADL, NPI, CIRS, GDS-short form, the EuroQoL, and the Sleep questionnaire. The primary outcomes were the effects of combined treatment versus AchEIs plus memantine on cognitive functions assessed by MMSE. The secondary outcomes were possible side effects of treatment in both groups, the influence on daily life functions, behavioral symptoms, quality of life, and sleep. Patients in group A showed a mild increase in MMSE at 6 (15.85 ±2.86 vs. 16.39 ±2.93) and 12 months (16.39 ±2.93 vs. 16.43 ±3.08). On comparing the two groups, the difference in MMSE score was significant, both at T1 (p = 0.003) and T2 (p = 0.011). Moreover, a significant improvement in GDS and EuroQoL scores was observed. No differences in secondary outcomes, including side effects, were observed between the two groups. This study strengthens the role of citicoline plus AchEIs plus memantine in patients with AD.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49209582","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 Role of General Medicine in the Evaluation of Frailty in the Elderly Population: Definition of a Standardized Instrument for the Correct Framing of Frailty and Comparison with Currently Existing Instruments for Stratification of Clinical Risk","authors":"F. Robusto, Giovanni Colucci, M. Zamparella, Enrico Maria Pellegrini, Brigida Martucci, P. Iacovazzo, Enza Colucci, M. Minardi, C. Giliberti, V. Bossone, V. Lepore, Stefano Ivis","doi":"10.21926/obm.geriatr.2201192","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201192","url":null,"abstract":"Frailty is a chronic condition that increases the vulnerability to stressogenic factors and prevents the patient from returning to the preceding condition of homeostasis. This increases the risk of negative outcomes and progressively brings the patient toward disability, leading to higher use of healthcare resources. Clinical risk stratification systems can generally be useful for identifying frail patients from the standpoint of a healthcare system, though General Practitioners (GPs) assume a key and irreplaceable role in the definition and correct diagnosis of frailty. This study developed a standardized instrument (called SVaFra) for the definition of frailty in the elderly population in a general medicine setting and compared it with a few clinical risk stratification tools that have already been validated and are in wide use. In addition, the impact of the application of SVaFra on healthcare outcomes was evaluated. A scientific board composed of experienced GPs, biomedical engineers, and other healthcare professionals, involved in the management of patients suffering from frailty, developed a framework in the form of a questionnaire for the evaluation of frailty by creating four principal groupings of the components that characterize it (clinical complexity, disability, family environment, and management complexity). An observational study, involving 98 GPs from four Italian regions who filled out the questionnaire, was then developed. The doctors were asked to provide a judgment for the four frailty components and the overall frailty. Additionally, a cohort of patients was stratified by applying Charlson Comorbidity Index (CCI) and Drug Derived Complexity Index (DDCI) to administrative databases. The utilization of healthcare resources in the year following the administration of the SVaFra framework with this population was compared with a control group with similar clinical or demographic characteristics. A total of 1,305 frail geriatric patients were identified (males 36.0%; mean age 83.1 ±8.52 years). Regarding the four principal areas used by the GPs to formulate a frailty judgment, the clinical categorization “moderate-severe” was most frequently noted (57.0%). The GPs then specified the following most frequent pathologies: arterial hypertension (76.4%), congestive heart failure (31.5%), dementia (30.7%), diabetes (29.9%), cardiac arrhythmia (27.6%), major depression (25.2%), stroke (22.0%), respiratory insufficiency (22.0%), chronic renal insufficiency (12.6%), management complexity (48.3%), disability (43.2%), and family environment (23.8%). For 165 subjects (12.6%), the GPs expressed an overall frailty judgment of “severe” based on management complexity and disability. Record linkage with administrative databases was possible in 102 cases. The presence of a CCI score of >0 was recorded in only 20 (15.3%) patients identified as frail by GPs, while high DDCI scores were recorded for 88 (86.3%) patients. As for the utilization of healt","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42588508","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":"Adjustment for Covariates of Major Depressive Episodes among Men and Women Aged 65 Years Old and Older","authors":"Areen O` mary, T. Chambers","doi":"10.21926/obm.geriatr.2104185","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2104185","url":null,"abstract":"The current study aimed to examine if sex can significantly predict risk for lifetime major depressive episodes among adults aged 65 and older with and without adjustment for covariate variables of race, education, marital status, health, and poverty. Secondary data was obtained from the National Survey on Drug Use and Health public-use data file to achieve study goals. The study participants were males and females aged 65 years or older. The unweighted sample included 3,969 adults aged 65 years or older, representing a weighted population size of 50,986,065.86 in the US. Lifetime major depressive episode.The study findings confirmed that sex could significantly predict risk for lifetime major depressive episodes among adults aged 65 or older with and without adjustment for health determinants of race, education, marital status, health, and poverty. Four of the five variables, including race, education, health, and poverty, were significant once as covariate variables adjusted for and once as predictor variables. In contrast, marital status was insignificant both as a covariate and a predictor variable. Close attention is required to the adults aged 65 or older at risk for lifetime major depressive episode diagnosis, particularly women, to meet their unique needs.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49623332","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":"Living in an Age of Longevity: Enduring Insights and Perspectives for Embarking on a Quest for Health and Well-Being in Later Life","authors":"T. Seedsman","doi":"10.21926/obm.geriatr.2201195","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2201195","url":null,"abstract":"While increases in life expectancy along with extended longevity can be seen as a success story, there remains the central issue surrounding the health and quality of life for increasing numbers of older people. As populations live longer the idea that older people should be empowered to remain active and productive citizens will be paramount. Questions concerning the meaningfulness, purpose and desirability of living longer present an existential challenge for all and sundry. It is clear, that the speed of population aging has made many existing policies, support services and social structures obsolete and thereby societies worldwide will need to face the profound challenges of rethinking aging and old age in wholly different ways. The need to combat ageism including a re-conceptualization of successful aging is seen to be a critical undertaking to promote healthy and productive aging. In particular, understanding the lived experiences of older people warrants deeper focus surrounding the complex interconnections between agency, social structures and quality of life. Insights and perspectives on human finitude, resilient aging, and self-care are offered for the purpose of highlighting their prospective associations with health outcomes in later life. Human longevity presents new realities demanding serious collaborative conversations on heterogeneity, equity and social justice in the context of a rights-based approach to aging policy.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41858524","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 Safety of Oral Telomerase Activator in UV-Induced Skin Cancer with A Review of Telomerase in Aging and Skin Carcinogenesis","authors":"K. Burke, Xueyan Zhou, Yongyin Wang, Huachen Wei","doi":"10.21926/obm.geriatr.2104184","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2104184","url":null,"abstract":"The supplement telomerase activator TA-65 (purified from Astragalus membranaceus) has been shown to retard cellular senescence, boost the aging immune system, and retard age-related symptoms. Lengthened telomeres retard aging, but because cancers often maintain longevity by lengthening telomeres, dietary telomerase activator might possibly increase tumorigenesis. This study investigated whether oral TA-65 effects the timing of onset and/or the incidence of skin cancers induced by UVB-irradiation and whether that possible effect is different if the oral supplementation is begun only after tumors are first detected clinically or if supplementation is begun before initiation of tumors as well as during and after the inciting UVB exposure. Three groups of ten Skh:1 hairless, nonpigmented mice exposed to UVB for twenty weeks were given (1) no supplementation, (2) TA-65 supplementation starting when the first UV-induced skin cancers were clinically observed, after which the UV exposure was terminated, and (3) TA-65 supplementation before, during, and after UV exposure (as more tumors subsequently appeared). Except for two time points when Group 3 had borderline or statistically more tumors ≥ 2mm per mouse, overall, there was no statistically significant difference in the time of onset, the incidence, or the tumor load of skin cancers with TA-65 with either timing, confirming the safety of this anti-aging supplement in this model of the most frequent human malignancy.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48632530","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":"Cisplatin-Based Neoadjuvant Chemotherapy for Elderly Patients with Muscle-Invasive Bladder Cancer: Is It Feasible?","authors":"C. Dumont, Madeleine Lefèvre, Quiterie Aussedat, Pierre Reignier, A. Masson-Lecomte, E. Xylinas, H. Gauthier, V. Fossey-Diaz, A. Arégui, S. Culine","doi":"10.21926/obm.geriatr.2104183","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2104183","url":null,"abstract":"Cisplatin-based neoadjuvant chemotherapy (C-NAC) has been the standard of care in localized muscle-invasive bladder cancer (MIBC). However, the feasibility and benefit of C-NAC in elderly patients remain uncertain since this population has always been underrepresented in pivotal trials and is often barred from chemotherapy in routine practice because of their perceived frailty. Therefore, in order to evaluate the effectiveness of C-NAC in elderly patients with MIBS, we retrospectively reviewed the medical files of patients (cT2-4, N0-3, and M0) treated at our institution and aged 75 or older at the time of the first chemotherapy cycle. From May 2012 to March 2020, 51 patients aged 75 to 90 received C-NAC. Among them, 38 patients received methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) and 13 patients received gemcitabine and cisplatin (GC). In this study, the primary endpoint was the feasibility of C-NAC, evaluated as the percentage of patients who underwent at least four chemotherapy cycles. Overall feasibility of a complete four-cycle chemotherapy course was 75% (dose-dense MVAC [dd-MVAC]: 76%; GC: 69%). Incidence of grade 3-4 adverse events was 57%, mostly driven by hematological toxicity from dd-MVAC, and the incidence of febrile neutropenia was 6%. These results indicate the feasibility of C-NAC in elderly patients without any contraindication to cisplatin. A coordinated multidisciplinary approach, including a geriatric oncologist, may help to identify patients at increased risk for chemotherapy-induced toxicity, especially in patients aged 85 or older.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45341044","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":"An Overview of Osteoporosis Management","authors":"Nathan S. Jiang, Byron Newton, X. Jiang","doi":"10.21926/obm.geriatr.2104181","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2104181","url":null,"abstract":"Osteoporosis is one of the most common disorders around the world. Osteoporotic fracture especially hip fracture are associated with an increased mortality rate in elders. However, elders with osteoporosis or at high risk of fractures remain largely underdiagnosed and undertreated. The screening, diagnosis, and treatment of osteoporosis must be improved to maintain pace with its fast-growing prevalence. This review will cover risk factors of osteoporosis, screening and diagnosis tools, newfound advancements, current medical treatments including options for special populations of concern, and future research directions.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47137984","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":"Men's Bones Matter Too, a Cross Sectional Study Examining Bone Health among Men with Intellectual Disability in Ireland.","authors":"Éilish A Burke, R. Carroll, Angela W. Ding, Melisa Yaman, J. Walsh, P. McCallion, M. McCarron","doi":"10.21926/obm.geriatr.2104182","DOIUrl":"https://doi.org/10.21926/obm.geriatr.2104182","url":null,"abstract":"Globally between 30-40% of all osteoporotic fractures occur among men, with a quarter of all hip fractures, the most serious complication of osteoporosis, occurring in men. Among men of 50 years of age or older, osteoporotic fracture risk reaches an alarming 20%. What is of great concern is that associated mortality is greater among men when compared with women. For hip fractures specifically, mortality for men is two to three times that in women which may be attributed to the fact that osteoporosis is often considered a “women’s disease”. Of great concern is that there is a paucity of bone health investigation among men with intellectual disability. In the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing, objective bone status of 244 men was measured using a quantitative ultrasound. Participant’s also self-reported doctor’s diagnosis of health conditions including osteoporosis, medication and fracture history with the assistance of key workers/family. Ethical approval for the study was obtained from the Faculty of Health Sciences Trinity College and all participating service providers. Overall, 70.9% of men presented with poor bone health, with 57.8% taking at least one medication that contributed to osteoporosis/osteopenia. Men had a high prevalence of fracture (21.7%) despite this less than 18% had attended bone health screening. In light of these findings, it is time for the spotlight to focus on men’s bone health and for healthcare professionals to realise how ‘at risk’ of osteoporosis are men with intellectual disability. Projections place men on a trajectory of continuous increased risk of fracture in comparison to women.","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41439538","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":"Promoting Quality of Life in Advanced Dementia Care: Reading Buddies Program as Service-learning.","authors":"Scott A Trudeau, Megan E Gately","doi":"10.21926/obm.geriatr.2102169","DOIUrl":"10.21926/obm.geriatr.2102169","url":null,"abstract":"<p><p>The Reading Buddies Program was developed as a service-learning component of an Occupational Therapy Practice with Older Adults course as a collaboration between Tufts University and the VA Bedford Health Care System. The purpose of this service-learning program was to challenge graduate students' implicit biases and improve communication skills when working with older adults with significant cognitive impairments. Through this collaboration, occupational therapy students provided individualized, activity-based care to Veterans with advanced dementia. In this qualitative study, a total of 55 guided reflection papers submitted by students were analyzed using NVivo. Four major themes emerged: \"I was a fish out of water,\" \"I finally took a risk,\" \"And then I thought, maybe I should give myself a little credit,\" and, \"I am still experimenting with how I feel,\" illustrating student outcomes and perceived benefits of participation in the Reading Buddies Program. Each theme reflected the development of clinical reasoning which was the targeted impact. Outcomes confirm service-learning as an effective tool and suggest further use for academic programs, emphasizing the potential of creative partnerships to meet educational goals while providing valuable programming to vulnerable populations.</p>","PeriodicalId":74332,"journal":{"name":"OBM geriatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39565049","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}