Age and ageing最新文献

{"title":"Wisdom-inquiry science is essential for healthy longevity.","authors":"Colin Farrelly","doi":"10.1093/ageing/afaf073","DOIUrl":"https://doi.org/10.1093/ageing/afaf073","url":null,"abstract":"<p><p>Within a week of his 20 January 2025 inauguration, US President Donald J. Trump issued an order that froze all federal grants and loans, creating confusion and anxiety about the future of research and development in US biomedical science. The politicisation of science creates significant challenges not only for the researchers who depend on public funding to undertake their research, but also for the public understanding of why basic research is so important to the health and economic prosperity of the world's ageing populations. In 1944 US President Franklin D. Roosevelt wrote a letter to the director of the Office of Scientific Research and Development, Dr. Vannevar Bush, asking Bush how science and medicine could be best harnessed to win the war of science against disease. Bush's response, in his acclaimed 1945 book entitled Science, The Endless Frontier, detailed how 'scientific capital' determines the pace and shape of technological progress. The war against disease approach to public health and medicine has helped increase life expectancy, by reducing the prevalence of premature death, but it has also contributed to the increasing global healthspan-lifespan gap, which is nearly 10 years. Translational gerontology, and in particular the goal of developing geroprotective drugs that may help fortify the 'biological resilience' needed to increase healthy life expectancy, must become an integral part of a 'wisdom-inquiry' approach to public health and medicine if the aspiration of healthy longevity is to be realised this century.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750724","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}

{"title":"Sex and education differences in trajectories of physiological ageing: longitudinal analysis of a prospective English cohort study.","authors":"Mikaela Bloomberg, Andrew Steptoe","doi":"10.1093/ageing/afaf067","DOIUrl":"10.1093/ageing/afaf067","url":null,"abstract":"<p><strong>Background: </strong>Physiological age (PA) derived from clinical indicators including blood-based biomarkers and tests of physiological function can be compared with chronological age to examine disparities in health between older adults of the same age. Though education interacts with sex to lead to inequalities in healthy ageing, their combined influence on longitudinally measured PA has not been explored. We derived PA based on longitudinally measured clinical indicators and examined how sex and education interact to inform PA trajectories.</p><p><strong>Methods: </strong>Three waves of clinical indicators (2004/05-2012/13) drawn from the English Longitudinal Study of Ageing (ages 50-100 years) were used to estimate PA, which was internally validated by confirming associations with incident chronic conditions, functional limitations and memory impairment after adjustment for chronological age and sex. Joint models were used to construct PA trajectories in 8891 English Longitudinal Study of Ageing participants to examine sex and educational disparities in PA.</p><p><strong>Findings: </strong>Amongst the least educated participants, there were negligible sex differences in PA until age 60 (sex difference [men-women] age 50 = -0.6 years [95% confidence interval = -2.2 to 0.6]; age 60 = 0.4 [-0.6 to 1.4]); at age 70, women were 1.5 years (0.7-2.2) older than men. Amongst the most educated participants, women were 3.8 years (1.6-6.0) younger than men at age 50 and 2.7 years (0.4-5.0) younger at age 60, with a nonsignificant sex difference at age 70.</p><p><strong>Interpretation: </strong>Higher education provides a larger midlife buffer to physiological ageing for women than men. Policies to promote gender equity in higher education may contribute to improving women's health across a range of ageing-related outcomes.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New horizons in personality disorders-from neglect to necessity in geriatric care.","authors":"Richard C Oude Voshaar, Silvia D M van Dijk","doi":"10.1093/ageing/afaf066","DOIUrl":"https://doi.org/10.1093/ageing/afaf066","url":null,"abstract":"<p><p>Personality disorders, characterised by enduring and maladaptive patterns of behaviour, cognition and emotional regulation, affect 1 in 10 older adults. Personality disorders are frequently encountered in geriatric care considering their association with multimorbidity and increased health care utilisation. Patients with personality disorders often receive inadequate somatic health care due to (i) difficulties in expressing their actual symptoms and needs, (ii) challenging interactions with professionals, and (iii) non-compliance with medical treatment and lifestyle advice. Acknowledging personality disorders in geriatric care may improve treatment outcomes of somatic diseases. Since empirical evidence on personality diagnosis and treatment in older adults is scarce, we summarise future endeavours. First, the development of age-inclusive diagnostic tools should be prioritised to ensure comparability across age groups and facilitate longitudinal research over the lifespan. Second, evidence-based treatment approaches should be tailored to older people. Insight-oriented psychotherapies remain effective in later life considering sufficient level of introspection. Supportive and mediative therapies may better suit those with significant cognitive or physical impairments. Geriatric care models should be ideal for managing the complex needs of these patients when a consistent approach can be assured within the geriatric team as well as within the network considering the high level of interdisciplinary exchange needed. Third, considering the dynamic nature of personality disorders older adults should not be excluded from studies using novel technologies for real-time monitoring and personalised care. By addressing these gaps, the field can improve somatic treatment outcomes and uphold the dignity and well-being of older adults with personality disorders.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating reliable and clinically significant changes in health outcomes of a mindfulness-based cognitive defusion training program among older adults with mild cognitive impairment: a randomized controlled trial.","authors":"Yinxia Ren, Bei Wu, Chenxi Ge, Lulu Shi, Chen Zhang, Mengna Zhu, Dan Zhao, Lina Wang","doi":"10.1093/ageing/afaf069","DOIUrl":"10.1093/ageing/afaf069","url":null,"abstract":"<p><strong>Background: </strong>Recognizing perceived stress as a modifiable risk factor, mindfulness-based programs show promise for stress mitigation in older adults with mild cognitive impairment (MCI).</p><p><strong>Objective: </strong>To assess the efficacy of a mindfulness-based contextual cognitive defusion training (M-bCCDT) program on perceived stress and other health outcomes, and to examine the reliable and clinically significance of these improvements at individual-level among older adults with MCI.</p><p><strong>Design: </strong>A two-arm, assessor-blinded randomized controlled trial.</p><p><strong>Settings and participants: </strong>102 community-dwelling older adults with MCI.</p><p><strong>Methods: </strong>Participants were randomly allocated to either a M-bCCDT program (weekly 60-minute sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or health promotion classes. Measures of perceived stress, memory function, global cognitive function, psychomotor speed and mindfulness awareness were collected at baseline (T0), 8-week (T1) and 20-week (T2). Intervention effects were assessed at a group level (Generalized Estimating Equation, GEE) and individual level (Reliable and Clinically Significant Changes, RCSC).</p><p><strong>Results: </strong>The M-bCCDT program demonstrated significant interaction effects in perceived stress compared to the wait-list control group by GEE analysis (βT1 = -3.686, 95% CI [-5.397, -1.976]; βT2 = -7.608, 95% CI [-9.387, -5.829]). Furthermore, this program also showed significant efficacy in memory function, psychomotor speed and mindfulness awareness. RCSC indicated that 30 participants (59%) in the intervention group showed statistically significant improvement in perceived stress at 8-week, with 7 (14%) clinically significant. This increased to 38 (75%) with 20 (39%) clinically significant at 20-week. Secondary outcomes also showed statistically and clinically significant improvements over time, but no improvement in global cognitive function at the individual level.</p><p><strong>Conclusions: </strong>The M-bCCDT program positively impacted perceived stress and mindfulness awareness in older adults with MCI, facilitating the improvements in memory and psychomotor speed, with these benefits sustained for 20 weeks. It offers a systematic approach for community healthcare providers in MCI stress management.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and external validation of the electronic frailty index 2 using routine primary care electronic health record data.","authors":"Kate Best, Farag Shuweihdi, Juan Carlos Bazo Alvarez, Samuel Relton, Christina Avgerinou, Danielle Nimmons, Irene Petersen, Maria Pujades-Rodriguez, Simon Paul Conroy, Kate Walters, Robert M West, Andrew Clegg","doi":"10.1093/ageing/afaf077","DOIUrl":"10.1093/ageing/afaf077","url":null,"abstract":"<p><strong>Background: </strong>The electronic frailty index (eFI) is nationally implemented into UK primary care electronic health record systems to support routine identification of frailty. The original eFI has some limitations such as equal weighting of deficit variables, lack of time constraints on variables known to resolve and definition of frailty category cut-points. We have developed and externally validated the eFI2 prediction model to predict the composite risk of home care package; hospital admission for fall/fracture; care home admission; or mortality within one year, addressing the limitations of the original eFI.</p><p><strong>Methods: </strong>Linked primary, secondary and social care data from two independent retrospective cohorts of adults aged ≥65 in 2018 was used; the population of Bradford using the Connected Bradford dataset (development cohort, 78 760 patients) and the population of Wales, from the Secure Anonymised Information Linkage databank (external validation cohort, 660 417 patients). Candidate predictors included the original eFI variables, supplemented with variables informed by literature reviews and clinical expertise. The composite outcome was modelled using Cox regression.</p><p><strong>Results: </strong>In internal validation the model had excellent discrimination (C-index = 0.803, Nagelkerke's R2 = 0.0971) with good calibration (Calibration slope = 1.00). In external validation, the model had good discrimination (C-index = 0.723, Nagelkerke's R2 = 0.064), with some evidence of miscalibration (Calibration slope = 1.104).</p><p><strong>Conclusions: </strong>The eFI2 demonstrates robust prediction for key frailty-related outcomes, improving on the original eFI. Our use of novel methodology to develop and validate the eFI2 will advance the field of frailty-related research internationally, setting a new methodological standard.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24-Hour time use and cognitive performance in late adulthood: results from the Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE) study.","authors":"Audrey M Collins, Maddison L Mellow, Ashleigh E Smith, Lu Wan, Neha P Gothe, Jason Fanning, John M Jakicic, Chaeryon Kang, George Grove, Haiqing Huang, Lauren E Oberlin, Jairo H Migueles, M Ilyas Kamboh, Arthur F Kramer, Charles H Hillman, Eric D Vidoni, Jeffrey M Burns, Edward McAuley, Kirk I Erickson","doi":"10.1093/ageing/afaf072","DOIUrl":"https://doi.org/10.1093/ageing/afaf072","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study examined associations between 24-hour time-use composition (i.e. sleep, sedentary time, light physical activity and moderate-to-vigorous physical activity) and cognitive performance and explored whether demographic or genetic factors moderated these relationships.</p><p><strong>Methods: </strong>This analysis included baseline data from cognitively unimpaired older adults (n = 648) enrolled in the Investigating Gains in Neurocognition in an Intervention Trial of Exercise study. Time use was measured using wrist-worn triaxial accelerometers. Cognitive domains were determined using a confirmatory factor analysis from a comprehensive neuropsychological battery. Linear regression models tested associations between time-use composition and cognitive factors, adjusting for age, sex, education, body mass index, apolipoprotein E4 (APOE4) allele carriage and study site. Interaction terms evaluated moderation of time use by age, sex, education and APOE4 status. We also examined the theoretical impact of reallocating time between time-use behaviours on cognitive performance using compositional isotemporal substitution methods.</p><p><strong>Results: </strong>Time-use composition was associated with processing speed (F = 5.16, P = .002), working memory (F = 4.81, P = .003) and executive function/attentional control (F = 7.09, P < .001) but not episodic memory (F = 2.28, P = .078) or visuospatial function (F = 2.26, P = .081). Post hoc isotemporal substitution analyses found that significant associations were driven by time spent in moderate-to-vigorous physical activity (MVPA), with lesser amounts of MVPA associated with poorer cognitive performance. There was no evidence of moderation by any tested factors.</p><p><strong>Conclusions: </strong>Increasing or decreasing MVPA, at the expense of time spent in sleep, sedentary behaviour or light physical activity, may be related to individual variation in processing speed, executive function/attentional control and working memory in older adulthood.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778752","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}

{"title":"Predicting cardiovascular morbidity and mortality with SCORE2 (OP) and Framingham risk estimates in combination with indicators of biological ageing.","authors":"Anna Tirkkonen, Jonathan K L Mak, Johan G Eriksson, Pauliina Halonen, Juulia Jylhävä, Sara Hägg, Linda Enroth, Jani Raitanen, Iiris Hovatta, Tuija Jääskeläinen, Seppo Koskinen, Markus J Haapanen, Mikaela B von Bonsdorff, Laura Kananen","doi":"10.1093/ageing/afaf075","DOIUrl":"10.1093/ageing/afaf075","url":null,"abstract":"<p><strong>Background and objective: </strong>Previous research assessing whether biological ageing (BA) indicators can enhance the risk assessment of cardiovascular disease (CVD) outcomes beyond established CVD risk indicators, such as Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE2)/SCORE2-Older Persons (OP), is scarce. We explored whether BA indicators, namely the Rockwood Frailty Index (FI) and leukocyte telomere length (TL), improve predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators in general population of middle-aged and older CVD-free individuals.</p><p><strong>Methods: </strong>Data included 14 118 individuals from three population-based cohorts: TwinGene, Health 2000 (H2000), and the Helsinki Birth Cohort Study, grouped by baseline age (<70, 70+). The outcomes were incident CVD and CVD mortality with 10-year follow-up. Risk estimations were assessed using Cox regression and predictive accuracies with Harrell's C-index.</p><p><strong>Results: </strong>Across the three study cohorts and age groups: (i) a higher FI, but not TL, was associated with a higher occurrence of incident CVD (P < .05), (ii) also when considering simultaneously the baseline CVD risk according to FRS or SCORE2/SCORE2-OP (P < .05) (iii) adding FI to the FRS or SCORE2/SCORE2-OP model improved the predictive accuracy of incident CVD. Similar findings were seen for CVD mortality, but less consistently across the cohorts.</p><p><strong>Conclusions: </strong>We show robust evidence that a higher FI value at baseline is associated with an increased risk of incident CVD in middle-aged and older CVD-free individuals, also when simultaneously considering the risk according to the FRS or SCORE2/SCORE2-OP. The FI improved the predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators and demonstrated satisfactory predictive accuracy even when used independently.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fall prevention lessons from Australian Coroner’s Court cases about older adults: harnessing the prophylactic power of medico-legal findings","authors":"Jennifer Sarah Schulz-Moore, Paulo Henrique Silva Pelicioni","doi":"10.1093/ageing/afaf055","DOIUrl":"https://doi.org/10.1093/ageing/afaf055","url":null,"abstract":"Despite our existing knowledge about fall prevention, older adults are still falling, and some die from those falls. Much of this knowledge comes from work done with live patients. Coroners (who investigate sudden and unexpected deaths) offer fresh insights into preventive lessons for minimising falls in older adults. Coroners have a legal public health function to reduce preventable deaths. Their court investigations draw from documents, such as witness statements, police records, healthcare records and expert witness statements. The lessons gleaned from the rich coronial data could be incorporated into updated versions of the World Fall Guidelines. Despite the preventive power of coronial data, it is an under-researched and under-used source of prophylactic insights for fall prevention. Numerous preventive lessons have emerged from our ongoing study of Australian coroners’ cases about fatal falls in older adults living in residential care. Specifically, these prophylactic learnings involve equipment, legal and policy changes and systems-level adaptations. While recognising the robustness of the World Falls Guideline, the coronial examples studied were not described in the working group specific to them and could add value to preventing falls in aged-care facilities. The global interest in the ageing population calls for serious consideration of additional ways to glean fall prevention insights. It is time to recognise and harness the preventive power of coronial data to benefit older adults and our communities.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"19 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653455","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}

{"title":"Predictive factors of gait recovery after hip fracture: a scoping review","authors":"Cristina González de Villaumbrosia, Raquel Barba, Cristina Ojeda-Thies, Eulalia Grifol-Clar, Noelia Álvarez-Diaz, Teresa Álvarez-Espejo, Jose Manuel Cancio-Trujillo, Jesús Mora-Fernández, Teresa Pareja-Sierra, Raquel Barrera-Crispín, Alicia Calle-Egusquiza, Aina Capdevila-Reniu, Cristina Carrasco-Paniagua, Mª Carmen Cervera Díaz, Patricia Condorhuamán-Alvarado, Laura Cotano-Abad, Leonor Cuadra-Llopart, Verónica García-Cárdenas, Sofía González-Chávez, Luisa Alejandra Hernández-Sánchez, Beatriz Herrero-Pinilla, Jose López-Castro, Nuria Montero-Fernández, Angélica Muñoz-Pascual, Marta Muñoz-Vélez, Raquel Ortés-Gómez, Andrea Sáenz-Tejada, Javier Sanz-Reig, Sonia Torras-Cortada, Miriam Ramos Cortés, Pilar Sáez-López","doi":"10.1093/ageing/afaf057","DOIUrl":"https://doi.org/10.1093/ageing/afaf057","url":null,"abstract":"Objective This scoping review aimed to identify predictive factors influencing gait recovery post-hip fracture surgery among adults aged 65 and older. Design A systematic search of MEDLINE, Embase and CINAHL databases was conducted, focusing on studies assessing predictive factors of gait recovery within one month to one-year post-surgery. Two independent reviewers carried out study selection, quality assessment and data extraction using the Quality in Prognosis Studies Tool to gauge evidence levels. Results About 10,627 articles were initially identified. After duplicates were removed, 7665 were screened based on title and abstract, then 796 based on full text; 138 articles were finally included. The review identified a total of 77 predictive factors. However, just under half (34) of these were supported by studies with a low risk of bias. Higher-level evidence-supported factors were age, pre-fracture independence in daily activities, cognitive impairment, delirium, orthogeriatric multidisciplinary co-management, specific surgical interventions, allowing weight-bearing, comorbidities, nutritional status, rehabilitation treatments and polypharmacy. Conclusion The identified factors influencing gait recovery include both non-modifiable factors [such as younger age, pre-fracture independence in activities of daily living, absence of cognitive impairment, fewer comorbidities and lower anaesthetic risk] and modifiable factors, including rehabilitation treatments, organisational factors, absence of delirium, orthogeriatric co-management, surgical factors such as implant type and unrestricted weight-bearing, better nutritional status and strength, and reduced polypharmacy. We believe the latter should be prioritised in managing patients with hip fractures to achieve optimal recovery.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653454","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}

{"title":"Routine benign paroxysmal positional vertigo (BPPV) physiotherapy management: a feasibility study","authors":"Erin Dale Bicknell, Laura Ferguson, Alisha da Silva, Tiffany Theoharidis, Khyati Gohil, Jennifer Langford, Melissa Clarke, Anne McGann, Wendy Bower","doi":"10.1093/ageing/afaf039","DOIUrl":"https://doi.org/10.1093/ageing/afaf039","url":null,"abstract":"Background Benign paroxysmal positional vertigo (BPPV) is common in older adults with a falls history. The feasibility of routine physiotherapy management in subacute inpatients is not known. Objective Examine the feasibility of implementing routine BPPV physiotherapy management in older subacute inpatients and ascertain the proportion BPPV positive. Methods Subacute inpatients aged ≥50 years sustaining a fall within six months were assessed for BPPV. Feasibility was defined as &amp;gt;75% of eligible patients able to be assessed for BPPV. Implementation was also evaluated through surveys completed by study physiotherapists. Demographic, falls, medical history, frailty, functional mobility information and modified dizziness handicap inventory (DHI) versions were also collected. Results Overall, 67% of 447 eligible patients underwent BPPV assessment; 301 completed ≥ one BPPV assessment, 146 could not be assessed, most commonly due to physical limitation, cognition precluding assessment, declining assessment or discharged prior. Physiotherapists perceived BPPV management to be acceptable (88%), appropriate (90%) and feasible (76%) however constrained by patient-factors, time required and environmental barriers. BPPV was found in 6% of those assessed, with 35% reporting current dizziness or unsteadiness. Modified DHI scores were significantly higher in those BPPV positive (5-item P ≤ .001; 8-item P = .001). Conclusion BPPV management was not feasible in this population predominantly due to physical limitations and cognitive impairment. Physiotherapists perceive BPPV management as important but difficult amongst these patient-factors and competing clinical priorities. Subjective symptoms may not indicate BPPV risk, however, the 5-item DHI may identify need for individual assessment.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"90 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641088","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}