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Palliative care in nursing homes: building the evidence base 疗养院的姑息治疗:建立证据基础
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-11-08 DOI: 10.1093/ageing/afag247
{"title":"Palliative care in nursing homes: building the evidence base","authors":"","doi":"10.1093/ageing/afag247","DOIUrl":"https://doi.org/10.1093/ageing/afag247","url":null,"abstract":"<span class=\"paragraphSection\">older peoplenursing homespalliative carecare homes</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149368417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eight-week omega-3 polyunsaturated fatty acid supplementation alters but does not attenuate exercise-induced muscle damage in older adults: a randomised controlled trial 一项随机对照试验:8周补充omega-3多不饱和脂肪酸可以改变但不能减轻老年人运动引起的肌肉损伤
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-11-06 DOI: 10.1093/ageing/afag323
{"title":"Eight-week omega-3 polyunsaturated fatty acid supplementation alters but does not attenuate exercise-induced muscle damage in older adults: a randomised controlled trial","authors":"","doi":"10.1093/ageing/afag323","DOIUrl":"https://doi.org/10.1093/ageing/afag323","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Background</div>Exercise-induced muscle damage (EIMD) serves as a model to study muscle plasticity and recovery. Exercise recovery declines with age, and while omega-3 polyunsaturated fatty acids (n-3 PUFA) exhibit inconsistent effects in younger adults, the effect in older adults is unknown.<div class=\"boxTitle\">Methods</div>In a double-blind, randomised, placebo-controlled trial, 43 healthy, older women and men (65-85 years) ingested 5 mL of n-3 PUFA algae oil (2 g PUFA) or placebo for eight weeks. After eight weeks participants performed a bout of 10 × 10 eccentric-emphasised leg extensions. Outcome measures included quadriceps maximal voluntary contraction (MVC), muscle soreness, creatine kinase (CK) and inflammation (Interleukin-6, high-sensitive C-reactive protein; CRP) assessed at baseline and post-exercise.<div class=\"boxTitle\">Results</div>EIMD symptoms such as muscle soreness and function were modest and consistent with previous reports in older adults. Overall, n-3 PUFA supplementation did not improve functional recovery. However, a borderline greater MVC loss was observed in the n-3 PUFA group (time × group: <span style=\"font-style: italic;\">P</span> = .064), which resulted from significantly lower MVC in the n-3 PUFA group at 24 h (difference: −10.9%, 95%CI: −21.4;−0.40%, <span style=\"font-style: italic;\">P</span> = .042) and at 72 h (difference: −9.80, 95%CI: −18.3;−1.27, <span style=\"font-style: italic;\">P</span> = .025) post-exercise compared to the placebo. No significant overall group differences were observed for CK, interleukin-6, CRP, but CK concentrations significantly increased from baseline at 24 h post-exercise in the placebo group (change: +81.1%, 95%CI:10.5;152%, <span style=\"font-style: italic;\">P</span> = .014). Habitual physical activity and sex emerged as significant moderators of molecular recovery in an exploratory analysis.<div class=\"boxTitle\">Conclusion</div>n-3 PUFA supplementation did not improve functional recovery, but different molecular response patterns were observed. Habitual physical activity and sex may be determinants of post-exercise response; this exploratory finding warrants confirmation in larger studies.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149360214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The trajectories of comprehensive capacity of bedridden older people based on latent growth mixture models: a longitudinal study 基于潜在生长混合模型的卧床老年人综合能力轨迹:一项纵向研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-11-06 DOI: 10.1093/ageing/afag327
{"title":"The trajectories of comprehensive capacity of bedridden older people based on latent growth mixture models: a longitudinal study","authors":"","doi":"10.1093/ageing/afag327","DOIUrl":"https://doi.org/10.1093/ageing/afag327","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Background</div>Bedridden older people generally have poor comprehensive capacity and are prone to multi-system complications including pressure injuries and lower limb venous thrombosis, imposing heavy caregiving and financial burdens and severely affecting their health.<div class=\"boxTitle\">Objective</div>To identify distinct trajectories of ability in bedridden older people and characteristics distinguishing the trajectories, while assessing the prognostic value of these trajectories for early risk identification of pressure injury and deep-vein thrombosis (DVT).<div class=\"boxTitle\">Participants</div>Two hundred twenty six bedridden older people aged 65 years and above from two nursing homes in China.<div class=\"boxTitle\">Methods</div>Patients were required 5 assessments during 1-year follow-up period. Latent Growth Mixture Modelling identified distinct trajectories, multinomial logistic regression identified characteristics distinguishing the trajectories and generalised estimating equations evaluated associations between trajectories and pressure injury and DVT.<div class=\"boxTitle\">Results</div>There are three distinct trajectories of comprehensive capacity among bedridden older people, including severe impairment with stable type (63.5%); moderate impairment with slowly deteriorating type (16.3%); moderate-to-severe impairment with fluctuating type (20.2%). Characteristics distinguishing the trajectories were tooth loss, hypertension, indwelling gastric tube and dysphagia. Compared with the severe impairment stable type, the other two groups had higher pressure injury risk; the moderate impairment with slowly deteriorating type also had higher DVT risk.<div class=\"boxTitle\">Conclusions</div>Capacity trajectories of bedridden older people are heterogeneous. Nurses may want to focus on those with tooth loss, hypertension, indwelling gastric tube and dysphagia to deliver targeted care. These trajectories are significantly associated with pressure injury and deep vein thrombosis risks. Their identification enables earlier risk stratification and more targeted prevention.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149360204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Profiling perceived knowledge, relevance and interest across geriatric topics of health and social care professionals: multinational electronic cross-sectional survey 对卫生和社会保健专业人员的老年主题的感知知识、相关性和兴趣进行分析:跨国电子横断面调查
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-11-01 DOI: 10.1093/ageing/afag317
{"title":"Profiling perceived knowledge, relevance and interest across geriatric topics of health and social care professionals: multinational electronic cross-sectional survey","authors":"","doi":"10.1093/ageing/afag317","DOIUrl":"https://doi.org/10.1093/ageing/afag317","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Background</div>Interprofessional training is essential for high-quality care of older adults. Despite widespread recognition of its importance, evidence on perceived geriatric competence remains limited to studies on single countries or professions.<div class=\"boxTitle\">Methods</div>Secondary analysis of a COST Action multinational multilingual web-based survey (PROmoting GeRiAtric Medicine in countries where it is still eMergING, PROGRAMMING) conducted across the 27 European Union Member States (EU-27) and non-EU-27 countries between 9 October 2023 and 5 June 2024. Four thousand seven hundred eighty-eight professionals from 10 core health and social care groups were included. We explored perceived Knowledge, Relevance and Interest across seven domains required for comprehensive geriatric assessment: frailty, falls and mobility, delirium, depression, mild cognitive impairment and dementia screening, nutritional assessment and malnutrition, polypharmacy and deprescribing. Student’s <span style=\"font-style: italic;\">t</span> test; one-way analysis of variance, hierarchical clustering and latent class analysis were used to identify interprofessional differences and shared patterns across professions.<div class=\"boxTitle\">Results</div>Mean age was 42.4 years (SD 11.9); 3432 (71.7%) were women; 2893 (60.4%) worked in EU-27 countries. Interprofessional differences were observed across all topics. Physiotherapists led in falls and mobility (mean 4.21, SD 0.75), pharmacists in polypharmacy and deprescribing (mean 3.51, SD 1.07), and psychologists/psychotherapists in depression (mean 3.96, SD 0.82). A medical doctors–nurses–pharmacists cluster emerged for Knowledge and Interest; 34.4% pharmacists fell in the low relevance class. Social workers and speech and language therapists showed a low Knowledge–high Interest mismatch. EU-27 professionals reported higher scores than non-EU-27 professionals across most topics (<span style=\"font-style: italic;\">P</span> &lt; .001).<div class=\"boxTitle\">Conclusions</div>Perceived knowledge, relevance and interest showed substantial variation across professions and regions, while revealing shared professional profiles. This may inform team-based interprofessional education.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149305012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Attitudes of people living with dementia and their carers towards the use of generative artificial intelligence to inform structured medication reviews 痴呆症患者及其护理人员对使用生成式人工智能为结构化药物审查提供信息的态度
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-11-01 DOI: 10.1093/ageing/afag320
{"title":"Attitudes of people living with dementia and their carers towards the use of generative artificial intelligence to inform structured medication reviews","authors":"","doi":"10.1093/ageing/afag320","DOIUrl":"https://doi.org/10.1093/ageing/afag320","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Background</div>Polypharmacy is common in people living with dementia (PLwD) and associated with adverse outcomes. Although Structured Medication Reviews (SMRs) are recommended to optimise medication regimens, their delivery is often constrained by limited resources. Artificial intelligence (AI) may support SMRs, yet little is known about how it is perceived by PLwD and their carers. This study explored their experiences of polypharmacy, views on SMRs and attitudes towards use of AI tools in SMRs.<div class=\"boxTitle\">Methods</div>Semi-structured interviews with 12 PLwD experiencing polypharmacy and two focus groups with 14 carers were conducted via Microsoft Teams or telephone and analysed using Reflexive Thematic Analysis.<div class=\"boxTitle\">Results</div>Two themes were constructed: participants’ perspectives on meaningful SMRs, and embracing AI while preserving patient safety and the human touch. Participants described challenges in managing polypharmacy, with carers playing a central role in supporting adherence and monitoring side effects. Experiences of SMRs varied. SMRs were most valued when clinicians were empathetic and able to offer personalised guidance. Participants viewed AI use in SMRs positively, provided that such tools were well validated and used to assist rather than replace healthcare professionals. AI was also seen as potentially reducing administrative burden and supporting more person-centred care. However, some had concerns regarding patient safety and data security, highlighting the need for appropriate regulation and human oversight.<div class=\"boxTitle\">Conclusion</div>Participants were supportive of AI use in SMRs, despite concerns about safety, data security and disclosure of AI use, and emphasised the importance of patient-clinician interactions and lived experience involvement in AI tool development.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"63 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149305015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New horizons in adaptive capacity and heat-related health in older people: integrating frailty, energy insecurity and social resources 老年人适应能力和与热有关的健康的新视野:综合虚弱、能源不安全和社会资源
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-10-31 DOI: 10.1093/ageing/afag315
{"title":"New horizons in adaptive capacity and heat-related health in older people: integrating frailty, energy insecurity and social resources","authors":"","doi":"10.1093/ageing/afag315","DOIUrl":"https://doi.org/10.1093/ageing/afag315","url":null,"abstract":"<span class=\"paragraphSection\">Extreme heat is a major environmental threat to healthy ageing, with older people experiencing the highest rates of heat-related morbidity and mortality. Although age-related physiological changes, multimorbidity and frailty remain key determinants of heat susceptibility, climate change, social inequalities and energy insecurity are reshaping the conditions in which older people experience and respond to thermal stress. This narrative New Horizons review integrates evidence identified through a structured, non-systematic search of peer-reviewed literature and relevant institutional reports across geriatric medicine, environmental health and climate science. It examines how frailty, intrinsic capacity, housing, energy affordability and social frailty influence the ability of older people to recognise risk, access protection and respond effectively to extreme heat. Particular attention is given to energy insecurity and summer cooling poverty, through which limited access to affordable household energy may undermine resilience. Ageing models primarily characterise individual vulnerability and functioning within the environment, whereas climate vulnerability models organise risk around exposure, sensitivity and adaptation; we use adaptive capacity to connect these perspectives by asking whether personal and contextual resources can be mobilised for protection. It may provide a conceptual basis for developing and subsequently validating a heat-adapted comprehensive geriatric assessment and for informing targeted prevention and climate adaptation policies for ageing populations.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"34 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149304248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The experience of family caregivers when their loved one is home hospitalized: a mixed methods analysis of a randomized controlled trial. 当他们所爱的人在家住院时,家庭照顾者的经验:随机对照试验的混合方法分析。
IF 7.4 2区 医学
Age and ageing Pub Date : 2026-10-31 DOI: 10.1093/ageing/afag318
Ryan C L Brewster, Meghna Desai, Sarah Findeisen, Stephanie Blitzer, Michelle Grinman, Mitchell Wicker, Scott Harrison, Steven Amrhein, Mary Barthel, David M Levine
{"title":"The experience of family caregivers when their loved one is home hospitalized: a mixed methods analysis of a randomized controlled trial.","authors":"Ryan C L Brewster, Meghna Desai, Sarah Findeisen, Stephanie Blitzer, Michelle Grinman, Mitchell Wicker, Scott Harrison, Steven Amrhein, Mary Barthel, David M Levine","doi":"10.1093/ageing/afag318","DOIUrl":"https://doi.org/10.1093/ageing/afag318","url":null,"abstract":"<p><strong>Background: </strong>Home hospital has been shown to achieve comparable, if not better, clinical and patient-centred outcomes compared to brick-and-mortar (BAM) hospitalisation. Family caregivers (FCs) play an essential role in delivering home hospital care; however, their perceptions towards the home hospital model remain an active area of inquiry, particularly in rural settings.</p><p><strong>Methods: </strong>We conducted a mixed methods analysis of FCs of patients participating in a multicenter randomised controlled trial of rural home hospital in the USA and Canada. We compared pre- and post-intervention burden among home hospital and BAM caregivers with the Zarit Burden Interview-12 (ZBI-12) scale (n = 20 home hospital, n = 10 BAM). We conducted semi-structured qualitative interviews with home hospital caregivers (n = 19). Qualitative data were coded and analysed using thematic analysis to construct core themes and subthemes.</p><p><strong>Results: </strong>There was no significant difference in median ZBI-12 scores between home hospital and BAM at admission (4 interquartile range [IQR 2-9.3] vs 5 [IQR 0.3-9.3]; P = .723), discharge (6 [3.3-8] vs 7.5 [2.5-11.8], P = .309), or change from admission to discharge (0 [-2.5 to 3] vs 1.5 [0-3.5]; P = .269). Our qualitative analysis revealed three central themes: (i) The caregiving experience was positively shaped by strong communication and shared decision-making with the care team; (ii) Caregivers described receiving high-quality home hospital care, particularly surrounding patient-centeredness and technology; and (iii) Home hospital was perceived to offer greater flexibility, comfort and psychosocial support compared to BAM hospitalisation.</p><p><strong>Conclusion: </strong>Home hospital provides numerous benefits for FCs without increasing perceived burden; further work is needed to establish potential supports to optimise their experience.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 11","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149340344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From fall experiences to patient-reported data in community fall-risk screening: a multiperspective qualitative study 从跌倒经历到社区跌倒风险筛查中患者报告的数据:一项多视角定性研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-10-28 DOI: 10.1093/ageing/afag316
{"title":"From fall experiences to patient-reported data in community fall-risk screening: a multiperspective qualitative study","authors":"","doi":"10.1093/ageing/afag316","DOIUrl":"https://doi.org/10.1093/ageing/afag316","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Background</div>Falls are an important public health problem among community-dwelling older adults. Patient-reported fall experiences are important for community fall-risk screening, but how these experiences become screening data remains poorly understood.<div class=\"boxTitle\">Methods</div>We conducted a multiperspective qualitative study in community health centres and surrounding communities in Xi’an, China. Community-dwelling older adults, family caregivers and primary healthcare workers were recruited using purposive and maximum-variation sampling. Semi-structured interviews were analysed using reflexive thematic analysis and cross-group comparison.<div class=\"boxTitle\">Results</div>A total of 47 participants were interviewed, including 23 community-dwelling older adults, 11 family caregivers and 13 primary healthcare workers. We identified a 6-link process through which fall experiences became patient-reported data: renaming, recalling, weighing before expression, reprocessing within the family, community inquiry and data completion and reshaping through feedback. These links were explained by three themes and nine subthemes. Fall experiences were filtered through everyday definitions, normalisation of near-falls and ageing and memory reconstruction based on life anchors and consequences. Reporting willingness was negotiated through autonomy, identity, family relationships, fear of troubling others and service expectations. Once information entered community screening, oral accounts were summarised in structured records, interpreted through professional judgement and further reshaped by feedback from services.<div class=\"boxTitle\">Conclusion</div>Patient-reported fall data are shaped by more than recall alone. They are also influenced by interpretation, family interaction, screening practices, documentation and feedback. Screening may be improved through understandable questions, documentation of near-falls and uncertainty and clearer links between reported information and follow-up services.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"13 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149281943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recent research on vaccines for older adults 最近对老年人疫苗的研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-10-26 DOI: 10.1093/ageing/afag313
{"title":"Recent research on vaccines for older adults","authors":"","doi":"10.1093/ageing/afag313","DOIUrl":"https://doi.org/10.1093/ageing/afag313","url":null,"abstract":"<span class=\"paragraphSection\">Vaccination is increasingly recognised as a cornerstone of healthy ageing and geriatric care, extending beyond the prevention of infectious disease to potentially influence broader health outcomes. This Commentary article commemorates the launch of <span style=\"font-style: italic;\">Age and Ageing</span>’s vaccines collection by highlighting key vaccine-related research published in the journal. It focuses on vaccine uptake, effectiveness and emerging research priorities for older adults. Uptake of recommended vaccines, including influenza, COVID-19, respiratory syncytial virus and pneumococcal vaccines, remains variable internationally and is challenged by vaccine hesitancy. Successful vaccination programmes combine healthcare professional education, centralised reminder systems and easy access to vaccination services. Studies involving care-home residents demonstrated that COVID-19 vaccines provided substantial protection against infection and, particularly, mortality, although effectiveness declines over time and is influenced by immunosenescence. Immunological studies reveal weaker vaccine responses among infection-naïve older adults, supporting the importance of booster programmes and strategies to enhance immunity. Emerging evidence also suggests that interventions such as probiotics may improve vaccine immunogenicity, although further high-quality trials are required. Beyond infection prevention, observational data indicate that several vaccines, may be associated with a reduced risk of dementia, particularly vascular dementia, though causal relationships remain unproven. Looking forward, greater inclusion of frail older adults and care home residents in vaccine trials is essential to strengthen the evidence base. Future research should support the development of novel vaccines, improve preparedness for future pandemics and optimise vaccination strategies to maximise healthy ageing and preserve function in later life.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"10 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic review and meta-analysis of impact of ‘Vascular Geriatrics’ interventions on short-term outcomes for vascular surgery inpatients “血管老年病学”干预对血管外科住院患者短期预后影响的系统回顾和荟萃分析
IF 6.7 2区 医学
Age and ageing Pub Date : 2026-10-25 DOI: 10.1093/ageing/afag311
{"title":"Systematic review and meta-analysis of impact of ‘Vascular Geriatrics’ interventions on short-term outcomes for vascular surgery inpatients","authors":"","doi":"10.1093/ageing/afag311","DOIUrl":"https://doi.org/10.1093/ageing/afag311","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Introduction</div>Vascular surgeons are treating more older, frail and multimorbid patients. Integrated care models including both surgeons and geriatricians have improved peri-operative outcomes in orthopaedics. This meta-analysis investigated the impact of ‘Vascular Geriatrics’ services on short-term outcomes for vascular surgery inpatients.<div class=\"boxTitle\">Methods</div>PubMed, Scopus, Embase and recent conference abstracts were searched for studies of all methodologies comparing outcomes before and after the introduction of ‘Vascular Geriatrics’ service. Risk of bias was assessed using Methodological Index for Non-Randomised Studies criteria for non-randomised studies and Risk of Bias Tool (Version Two) tool for randomised. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations analysis. Meta-analyses compared the relative risks of inpatient mortality, complications, discharge to home and 30-day readmission using a random-effects model. Length of stay (LOS) in days was compared using mean difference.<div class=\"boxTitle\">Results</div>Eight studies with 2441 patients were included. Models included outpatient pre-operative comprehensive geriatric assessment, inpatient geriatric liaison service and geriatrician-surgeon co-management. ‘Vascular Geriatrics’ was associated with a lower risk of inpatient mortality (RR 0.65, 95% CI 0.46–0.9, <span style=\"font-style: italic;\">P</span> = .010), cardiac complications (RR 0.35, 95% CI 0.19–0.62, <span style=\"font-style: italic;\">P</span> &lt; .001) and infective complications (RR 0.48, 95% CI 0.38–0.63, <span style=\"font-style: italic;\">P</span> &lt; .001). Delirium risk was reduced but not significantly (RR 0.58, 95% CI 0.25–1.34, <span style=\"font-style: italic;\">P</span> = .20). There was no association in LOS (<span style=\"font-style: italic;\">P</span> = .37), discharge to home (<span style=\"font-style: italic;\">P</span> = .55) or 30-day readmission risk (<span style=\"font-style: italic;\">P</span> = .64).<div class=\"boxTitle\">Conclusions</div>Though study quality was poor, formalised geriatric involvement was associated with a decreased risk of adverse peri-operative outcomes in vascular patients compared to traditional care models. Further studies are needed to investigate the most effective design of geriatrician–surgeon partnership.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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