Age and ageing最新文献

{"title":"Medication management information priorities of people living with dementia and their carers: a scoping review","authors":"Alexander J Clough, Danijela Gnjidic, Amanda J Cross, Natali Jokanovic, Karen Watson, Jacqueline Wesson, Stephanie Beshara, Justin Cheng, Mouna J Sawan","doi":"10.1093/ageing/afae200","DOIUrl":"https://doi.org/10.1093/ageing/afae200","url":null,"abstract":"Background People living with dementia and their carers often experience difficulties in effectively managing medications and have indicated they lack necessary support, information and guidance. Recognising the medication management information needs of this population is an important first step in addressing these issues. Objectives To identify the priorities for information on medication management expressed by people living with dementia and their carers. Methods A scoping review with systematic search was conducted from inception to 12 May 2023 for any original studies that reported the information needs of people living with dementia and their carers (informal, i.e. unpaid or within an existing relationship) regarding medication management. Two authors independently screened the abstracts, full-texts and extracted data. Study characteristics were described descriptively, and themes of information need were extracted using an iterative approach. Results Of the 11 367 records screened, 35 full-texts were included. All studies (n = 35) involved carers, with 17 also including people living with dementia. Most studies (n = 30) were conducted in the community and used qualitative methods (n = 32). Five major themes of information need were identified: critical medication information; medication effects; medication indication(s); disease progression and impact on medications; and safe and appropriate administration of medications. People living with dementia and their carers indicated they need more medication management information generally and want it simple, tailored and relevant. Conclusions This review highlights the key medication information priorities for people living with dementia and their carers and will help guide the provision of medication management guidance and development of new information resources.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236862","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":"Quality of life, pain and use of analgesic, anxiolytic and antidepressant medication, in people living in care homes.","authors":"Jemima T Collins, Lisa Irvine, Pip Logan, Katie Robinson, Erika Sims, Adam L Gordon","doi":"10.1093/ageing/afae196","DOIUrl":"10.1093/ageing/afae196","url":null,"abstract":"<p><strong>Background: </strong>People living in care homes often have problems with pain, anxiety and depression. Whether being on analgesia, anxiolytics or antidepressants has any bearing on pain severity and quality of life (QoL) in this population, requires further investigation.</p><p><strong>Objectives: </strong>(i) to examine the relationship between pain, anxiety and depression and medication use in care home residents and (ii) to compare those on medications to treat pain, anxiety and depression, and those who were not, and associations with pain severity and overall QoL.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomised controlled trial testing a falls prevention intervention in care homes. We recorded pain, anxiety and depression, QoL measurements and prescribed medication use.</p><p><strong>Results: </strong>In 1589 participants, the mean age was 84.7 years (±9.3 SD), 32.2% were male and 67.3% had a diagnosis of dementia. 54.3% and 53.2% of participants had some level of pain and anxiety or depression respectively, regardless of prescribed medication use. There was a direct association between pain severity and being on any analgesia, opioid analgesia, and antidepressants, but no associations between pain severity and use of paracetamol and anxiolytics. QoL was best for residents with no pain and not on any analgesia, anxiolytics or antidepressants and worst for those with moderate-extreme pain and taking at least two of these classes of medications.</p><p><strong>Conclusion: </strong>Many care home residents live with pain, anxiety and depression. Addressing residents' pain may also increase their quality of life, but using medication alone to reach this goal may be inadequate.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139037","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":"Trend and driving factors in burden of age-related macular degeneration in older adults aged 60-89 years: a global analysis over three decades.","authors":"Qin-Yu Ni, Meng-Yao Wu, Chen-Kai Zha, Yu Wen, Lan Zhong, Jing-Jing Ding, Xue-Yan Li, Li-Ming Tao, Zheng-Xuan Jiang, Fan Cao","doi":"10.1093/ageing/afae207","DOIUrl":"https://doi.org/10.1093/ageing/afae207","url":null,"abstract":"<p><strong>Background: </strong>To explore temporal trends and determine driving factors of age-related macular degeneration (AMD) burden in older adults aged 60-89 years at global, regional and national levels from 1990 to 2019.</p><p><strong>Methods: </strong>Prevalence and years lived with disability (YLDs) were extracted. Joinpoint regression analysis was adopted to calculate average annual percentage change and to identify the year with the most significant changes. Global trends were stratified by sex, age and sociodemographic index, and regional and national trends were explored. Decomposition analysis was conducted to determine what extent the forces of population size, age structure and epidemiologic change driving alterations of AMD burden.</p><p><strong>Results: </strong>Globally, prevalence rate slightly increased whereas YLDs rate decreased. The year 2005 marked a turning point where both prevalence and YLDs started to decline. Regionally, Western Sub-Saharan Africa had the highest prevalence and YLDs rates in 2019, with East Asia experiencing the most notable rise in prevalence from 1990 to 2019. Global decomposition revealed that the increased case number was primarily driven by population growth and ageing, and epidemiological change was only detected to lessen but far from offset these impacts.</p><p><strong>Conclusions: </strong>Although there was only slight increase or even decrease in prevalence and YLDs rates of AMD in older adults, the case number still nearly doubled, which may be primarily attributed to population growth and ageing, coupled with the emerging growing pattern of prevalence rate from 2015, collectively suggesting a huge challenge in control and management of AMD.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339436","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":"Editor's view-ageing in place.","authors":"Roy L Soiza","doi":"10.1093/ageing/afae206","DOIUrl":"https://doi.org/10.1093/ageing/afae206","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279120","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":"Visual field loss and falls requiring hospitalisation: results from the eFOVID study.","authors":"Siobhan Manners, Lynn B Meuleners, Jonathon Q Ng, Joanne M Wood, Bill Morgan, Nigel Morlet","doi":"10.1093/ageing/afae191","DOIUrl":"10.1093/ageing/afae191","url":null,"abstract":"<p><strong>Background: </strong>Visual fields are important for postural stability and ability to manoeuvre around objects.</p><p><strong>Objective: </strong>Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +.</p><p><strong>Methods: </strong>Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: -2 to -6 dB, moderate: -6.01 dB to -12 dB, severe < -12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders.</p><p><strong>Results: </strong>A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <-12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0-1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39-39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38-1.60) and diabetes (IRR 1.25, 95% CI 1.14-1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81-0.95) compared with those who did not have cataract surgery.</p><p><strong>Conclusion: </strong>The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124580","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":"Correction to: Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach.","authors":"","doi":"10.1093/ageing/afae203","DOIUrl":"10.1093/ageing/afae203","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131638","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 validation of a prognostic scoring system for 1-year mortality in older patients with hip fractures.","authors":"Yusei Katsuyama, Naoyuki Horie, Kengo Yoshii, Shinichiro Nakamura, Tomoki Saito, Kenji Takahashi","doi":"10.1093/ageing/afae195","DOIUrl":"10.1093/ageing/afae195","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures in older people result in increased mortality.</p><p><strong>Objective: </strong>We developed and validated an accurate and simple prognostic scoring system for hip fractures that can be used preoperatively.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Multicenter.</p><p><strong>Participants: </strong>Patients aged ≥65 years with hip fractures who underwent surgery between 2011 and 2021 were enrolled.</p><p><strong>Methods: </strong>The significant factors were determined with logistic regression analysis, and a scoring system was developed. The patients were classified into three groups, and a log-rank test was performed to evaluate 1-year survival rates. The model was internally and externally validated using the 5-fold cross-validation and data from another hospital, respectively.</p><p><strong>Results: </strong>We included 1026 patients. The analysis revealed eight significant prognostic factors: sex, body mass index, history of chronic heart failure and malignancy, activities of daily living (ADLs) before injury, hemoglobin and the prognostic nutritional index (PNI) at injury, and the American Society of Anesthesiologists Physical Status. The area under the receiver operating characteristic curve (AUC) after internal validation was 0.853. The external validation data consisted of 110 patients. The AUC of the model for the validation data was 0.905, showing outstanding discrimination. Sensitivity and specificity were 88.7% vs. 100% and 93.3% vs. 95.2% for the development and validation data, respectively.</p><p><strong>Conclusions: </strong>We developed and validated an accurate and simple prognostic scoring system for hip fractures using only preoperative factors. Our findings highlight PNI as an important predictor of prognosis in hip fracture patients.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124579","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":"New horizons in prediction modelling using machine learning in older people's healthcare research.","authors":"Daniel Stahl","doi":"10.1093/ageing/afae201","DOIUrl":"10.1093/ageing/afae201","url":null,"abstract":"<p><p>Machine learning (ML) and prediction modelling have become increasingly influential in healthcare, providing critical insights and supporting clinical decisions, particularly in the age of big data. This paper serves as an introductory guide for health researchers and readers interested in prediction modelling and explores how these technologies support clinical decisions, particularly with big data, and covers all aspects of the development, assessment and reporting of a model using ML. The paper starts with the importance of prediction modelling for precision medicine. It outlines different types of prediction and machine learning approaches, including supervised, unsupervised and semi-supervised learning, and provides an overview of popular algorithms for various outcomes and settings. It also introduces key theoretical ML concepts. The importance of data quality, preprocessing and unbiased model performance evaluation is highlighted. Concepts of apparent, internal and external validation will be introduced along with metrics for discrimination and calibration for different types of outcomes. Additionally, the paper addresses model interpretation, fairness and implementation in clinical practice. Finally, the paper provides recommendations for reporting and identifies common pitfalls in prediction modelling and machine learning. The aim of the paper is to help readers understand and critically evaluate research papers that present ML models and to serve as a first guide for developing, assessing and implementing their own.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279121","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":"Alcohol consumption and frailty risk: a dose-response meta-analysis of cohort studies.","authors":"Sepideh Soltani, Ahmad Jayedi, Seyedmojtaba Ghoreishy, Mahdieh Mousavirad, Samira Movahed, Maedeh Jabbari, Farzaneh Asoudeh","doi":"10.1093/ageing/afae199","DOIUrl":"10.1093/ageing/afae199","url":null,"abstract":"<p><strong>Background/aims: </strong>While previous studies suggest that light-to-moderate alcohol consumption may reduce the frailty risk, the dose-response relationship is still under question. To address the knowledge gap, we conducted a systematic review and dose-response meta-analysis of cohort studies to examine the association of alcohol consumption with the risk of both prefrailty and frailty in adults.</p><p><strong>Methods: </strong>We searched MEDLINE (Ovid), PubMed and Scopus to identify relevant cohort studies published before 8 May 2024. The dose-response meta-analysis was performed to investigate the associations between alcohol drinking and the risk of developing pre-frailty and frailty. We used random-effects models to calculate pooled relative risks (RR) with 95% CIs.</p><p><strong>Results: </strong>We included nine cohort studies with 64 769 participants and 15 075 cases, of which eight studies were rated to have a serious risk of bias as assessed by the ROBINS tool. Based on our analysis, each 12 g increase in alcohol intake did not appear to be associated with risks of prefrailty (RR: 1.08, 95% CI 0.89, 1.31; I2 = 91%, n = 3; GRADE = very low) and frailty (RR: 0.94, 95% CI 0.88, 1.00; I2 = 63%, n = 9; GRADE = low). The nonlinear dose-response meta-analysis indicates a slight inverse association with frailty risk up to an alcohol intake of 20 grams per day, beyond which an upward trend is observed.</p><p><strong>Conclusion: </strong>The inverse association found between moderate alcohol consumption and frailty risk appears to be stronger among older adults, which might be due to the lower and less popular alcohol consumption among older people than the general population. However, because this finding is based on low-quality evidence, more research is needed to develop specific dietary recommendations for alcohol consumption, particularly among young people.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279119","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":"Hip fracture has profound psychosocial impacts: a systematic review of qualitative studies.","authors":"Nicholas F Taylor, Made U Rimayanti, Casey L Peiris, David A Snowdon, Katherine E Harding, Adam I Semciw, Paul D O'Halloran, Elizabeth Wintle, Scott Williams, Nora Shields","doi":"10.1093/ageing/afae194","DOIUrl":"10.1093/ageing/afae194","url":null,"abstract":"<p><strong>Background: </strong>Hip fracture is a common and serious traumatic injury for older adults characterised by poor outcomes.</p><p><strong>Objective: </strong>This systematic review aimed to synthesise qualitative evidence about the psychosocial impact of hip fracture on the people who sustain these injuries.</p><p><strong>Methods: </strong>Five databases were searched for qualitative studies reporting on the psychosocial impact of hip fracture, supplemented by reference list checking and citation tracking. Data were synthesised inductively and confidence in findings reported using the Confidence in the Evidence from Reviews of Qualitative research approach, taking account of methodological quality, coherence, relevance and adequacy.</p><p><strong>Results: </strong>Fifty-seven studies were included. Data were collected during the peri-operative period to >12 months post fracture from 919 participants with hip fracture (median age > 70 years in all but 3 studies), 130 carers and 297 clinicians. Hip fracture is a life altering event characterised by a sense of loss, prolonged negative emotions and fear of the future, exacerbated by negative attitudes of family, friends and clinicians. For some people after hip fracture there is, with time, acceptance of a new reality of not being able to do all the things they used to do. There was moderate to high confidence in these findings.</p><p><strong>Conclusions: </strong>Hip fracture is a life altering event. Many people experience profound and prolonged psychosocial distress following a hip fracture, within a context of negative societal attitudes. Assessment and management of psychosocial distress during rehabilitation may improve outcomes for people after hip fracture.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139036","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}