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Natural history of lower urinary tract symptoms and voiding parameters in ageing men with 5-year follow-up-the concord health and ageing in men project (CHAMP). 康科德男性健康与老龄化项目(CHAMP) 5年随访中老年男性下尿路症状和排尿参数的自然病史
IF 6 2区 医学
Age and ageing Pub Date : 2025-03-28 DOI: 10.1093/ageing/afaf078
Giovanni Losco, Lewis Chan, Rachel Esler, Vasi Naganathan, Fiona Blyth
{"title":"Natural history of lower urinary tract symptoms and voiding parameters in ageing men with 5-year follow-up-the concord health and ageing in men project (CHAMP).","authors":"Giovanni Losco, Lewis Chan, Rachel Esler, Vasi Naganathan, Fiona Blyth","doi":"10.1093/ageing/afaf078","DOIUrl":"10.1093/ageing/afaf078","url":null,"abstract":"<p><strong>Background: </strong>Natural history of voiding parameters with age is poorly understood. We aim to understand both subjective and objective lower urinary tract parameters in older men over 5 years.</p><p><strong>Methods: </strong>The Concord Health and Ageing in Men Project is a prospective cohort study of older men, involving 1705 men aged 70 years and over living in Sydney, Australia. Men were assessed at 0, 2 and 5 years. Demographic information, medical history, International Prostate Symptom Score (IPSS), flow rate and post-void volume were collected at three timepoints.</p><p><strong>Results: </strong>A total of 1705 men aged 70-97 years participated. At 2 and 5 year follow-up, 1367 and 940 men presented for assessment. Mean IPSS was 7.35 at baseline, 6.96 at 2 years (P = .9) and 7.18 at 5 years (P = .30). Mean flow rate at baseline was 15.0 ml/s, 14.6 ml/s at 2 years (P = .001) and 15.3 ml/s at 5 years (P = .42). Adjusting for age at baseline, the change in flow over 5 years was not significant (P = .93). Mean post-void residual was 72.4 ml at baseline, 84.0 ml at 2 years (P = .003) and 93.2 ml at 5 years (P = .001). Men with residual volume >200 ml at baseline had no significant change in residual over 5 years (P = .51).</p><p><strong>Conclusions: </strong>Urinary symptoms and voiding parameters remain stable over 5 years. Men with elevated post-void volume did not deteriorate significantly. Conservative management of lower urinary tract symptoms appears a reasonable strategy in older men.</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/PMC11972631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794365","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}
引用次数: 0
Fall prevention lessons from Australian Coroner’s Court cases about older adults: harnessing the prophylactic power of medico-legal findings 从澳大利亚验尸法庭关于老年人的案例中预防跌倒的经验教训:利用医学-法律发现的预防力量
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-18 DOI: 10.1093/ageing/afaf055
Jennifer Sarah Schulz-Moore, Paulo Henrique Silva Pelicioni
{"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}
引用次数: 0
Predictive factors of gait recovery after hip fracture: a scoping review 髋部骨折后步态恢复的预测因素:范围回顾
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-18 DOI: 10.1093/ageing/afaf057
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
{"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}
引用次数: 0
Routine benign paroxysmal positional vertigo (BPPV) physiotherapy management: a feasibility study 常规良性阵发性位置性眩晕(BPPV)物理治疗管理的可行性研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-18 DOI: 10.1093/ageing/afaf039
Erin Dale Bicknell, Laura Ferguson, Alisha da Silva, Tiffany Theoharidis, Khyati Gohil, Jennifer Langford, Melissa Clarke, Anne McGann, Wendy Bower
{"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}
引用次数: 0
Association of low bone mineral density and dementia in older women: insights from the Longevity Improvement and Fair Evidence Study 老年妇女低骨密度与痴呆的关系:来自寿命改善和公平证据研究的见解
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-18 DOI: 10.1093/ageing/afaf058
Kengo Kawaguchi, Megumi Maeda, Fumiko Murata, Yasuharu Nakashima, Haruhisa Fukuda
{"title":"Association of low bone mineral density and dementia in older women: insights from the Longevity Improvement and Fair Evidence Study","authors":"Kengo Kawaguchi, Megumi Maeda, Fumiko Murata, Yasuharu Nakashima, Haruhisa Fukuda","doi":"10.1093/ageing/afaf058","DOIUrl":"https://doi.org/10.1093/ageing/afaf058","url":null,"abstract":"Background Both osteoporosis and dementia have emerged as important public health challenges in Japan’s aging population. This study aimed to investigate the impact of low bone mineral density (BMD) on the subsequent risk of dementia in older Japanese women aged ≥65 years, given the overlapping demographics of individuals affected by these two conditions. Methods This cohort study was conducted using osteoporosis screening data and insurance claims data from a municipality. We identified 8618 women (median age: 73 years) who underwent osteoporosis screening between April 2019 and March 2021. Participants with a BMD &amp;lt;80% of the young adult mean were assigned to a low-BMD group (n = 2297), whereas those with a BMD ≥80% were assigned to a control group (n = 6321). The study outcomes were new-onset all-cause dementia and Alzheimer’s disease (AD). To estimate the risk of low BMD on these outcomes, we constructed Cox proportional hazards models that adjusted for covariates (age, care needs, year of cohort entry, comorbidities and medications) using inverse probability of treatment weighting. Results The low-BMD group had a significantly higher risk of developing both all-cause dementia (adjusted hazard ratio: 1.58, 95% confidence interval: 1.20–2.08) and AD (1.61, 1.11–2.36) than the control group over approximately 30 months of follow-up. Conclusion These findings suggest that low BMD is associated with medium-term onset of dementia. Osteoporosis screenings could be useful not only for the secondary prevention of osteoporosis, but also for the primary prevention of dementia.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653459","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
Developing an integrated care conceptual framework for older adults with multimorbidity within china’s integrated delivery system 在中国综合服务体系中为多病老年人制定综合护理概念框架
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-17 DOI: 10.1093/ageing/afaf060
Jingjie Wu, Jing Shao, Dandan Chen, Erxu Xue, Yujia Fu, Hui Zhang, Qinhong Xu, Chunbo Liu, Zhihong Ye
{"title":"Developing an integrated care conceptual framework for older adults with multimorbidity within china’s integrated delivery system","authors":"Jingjie Wu, Jing Shao, Dandan Chen, Erxu Xue, Yujia Fu, Hui Zhang, Qinhong Xu, Chunbo Liu, Zhihong Ye","doi":"10.1093/ageing/afaf060","DOIUrl":"https://doi.org/10.1093/ageing/afaf060","url":null,"abstract":"Background The definition of China’s integrated delivery system remains abstract since it was proposed in 2021, lacking detailed clarification on essential concepts such as specific contents and main providers of services for older adults with multimorbidity. Aim To develop an integrated care conceptual framework for older adults with multimorbidity within China’s integrated delivery system. Methods A scoping review, semi-structured interviews and a modified e-Delphi study were used to explore specific contents of integrated care for older adults with multimorbidity. A social network analysis was conducted to identify healthcare providers with the greatest potential to play a central role in the integrated care for older adults with multimorbidity. Finally, an integrated care conceptual framework was established based on specific contents and main providers. Results The center of the framework represents the people-centered and need-oriented connotation of China’s integrated delivery system. The first circle reflects three significant characteristics of the integrated delivery system, namely care comprehensiveness, care coordination, and care continuity. The second circle includes main providers of integrated care, which are expected to play a central role in professional collaboration and information diffusion. The outermost circle consists of specific contents of integrated care, including clinical practice, human workforce, organisational collaboration, information technology, regulations and policies. Conclusion The framework derived from this study is expected to promote the understanding and implementation of integrated care for older adults with multimorbidity within the Chinese context. The service content of integrated care related to clinical practice also offers valuable references for other countries.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641087","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
Failure to improve—identifying risk factors for poor functional recovery following chronic subdural hematoma surgery 未能改善-识别慢性硬膜下血肿手术后功能恢复不良的危险因素
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-17 DOI: 10.1093/ageing/afaf056
Rahul Raj, Pihla Tommiska, Teemu Luoto, Ville Leinonen, Timo Koivisto, Sami Tetri, Jussi Posti, Kimmo Lönnrot
{"title":"Failure to improve—identifying risk factors for poor functional recovery following chronic subdural hematoma surgery","authors":"Rahul Raj, Pihla Tommiska, Teemu Luoto, Ville Leinonen, Timo Koivisto, Sami Tetri, Jussi Posti, Kimmo Lönnrot","doi":"10.1093/ageing/afaf056","DOIUrl":"https://doi.org/10.1093/ageing/afaf056","url":null,"abstract":"Background Chronic subdural hematoma (CSDH) is a common condition among older people living with frailty. Outcome after surgery is generally good, but there is a significant proportion of patients who do not benefit from surgery. This study aimed to identify predictors of failure to improve functional outcomes after CSDH surgery. Methods This is a post-hoc analysis of the nationwide FINISH trial, which enrolled 589 adult patients undergoing burr-hole drainage for symptomatic CSDH during 2020–22. Functional outcome was assessed using the modified Rankin Scale (mRS). Failure to improve was defined as unchanged or worsened mRS at 6 months compared to preoperative mRS. Multivariable logistic regression was used to identify factors associated with failure to improve. Results Of the 568 patients with available mRS data at 6 months, 20% (n = 115) showed no improvement in mRS between the preoperative and 6-month period. Factors associated with failure to improve included pre-existing dementia (OR 2.62, 95% CI 1.21–5.66), use of a walker (OR 3.19, 95% CI 1.64–6.23), smaller hematoma width (OR 0.96, 95% CI 0.93–0.99), and lesser midline shift (OR 0.91, 95% CI 0.86–0.97). Despite this, 88% of patients had stable or improved residence status, and 85% maintained or improved mobility. Conclusion A substantial proportion of surgically treated CSDH patients do not improve in functional status. Dementia was a significant predictor of poor outcomes. Future research should focus to better identify patients at risk of poor outcomes in order to avoid overtreatment and explore possible alternative treatment strategies.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641060","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
Best practice in the use of middle meningeal artery embolisation for chronic subdural haematoma 应用脑膜中动脉栓塞治疗慢性硬膜下血肿的最佳实践
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-16 DOI: 10.1093/ageing/afaf054
Frances Rickard, Mark Backhouse, Alexandra Langberg, Alex Mortimer, Adam Willliams, Anthony Cox, Crispin Wigfield, David Shipway
{"title":"Best practice in the use of middle meningeal artery embolisation for chronic subdural haematoma","authors":"Frances Rickard, Mark Backhouse, Alexandra Langberg, Alex Mortimer, Adam Willliams, Anthony Cox, Crispin Wigfield, David Shipway","doi":"10.1093/ageing/afaf054","DOIUrl":"https://doi.org/10.1093/ageing/afaf054","url":null,"abstract":"Chronic subdural haematoma (cSDH) is a common neurosurgical disorder in older people and projected to become the most common cranial neurosurgical pathology by 2030. Incidence of cSDH has risen in recent years as a consequence of improved access to brain imaging, and the increased prescribing of antithrombotic medication for both primary and secondary prevention of vascular disease. Chronic SDH typically presents with an insidious onset of broad-ranging symptoms including impaired cognition, gait, balance and mobility, often with headache. It progresses to more fulminant symptoms of hemiplegia, dysphasia and eventually coma. Although the established standard of care for clearly symptomatic cSDH is burr hole trephination, Middle Meningeal Artery Embolisation (MMAE) has emerged as a minimally invasive treatment option for some patients with cSDH. This is a rapidly evolving field: recently published randomised control trials have provided an evidence-base supporting the use of MMAE not only as an adjunct to burr hole trephination, but also in patients in whom trephination is contraindicated, or in patients with mild symptomatology who are not considered appropriate for immediate burr hole trephination. This article provides practical, real-world guidance on current best practice based on our experience and the published evidence available to date. We use case studies and treatment algorithms from the UK’s highest volume MMAE centre to illustrate collaborative care pathways for patients with cSDH between neurosurgery, interventional neuroradiology and trauma geriatricians.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"25 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653456","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 effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial 围手术期认知训练对老年全髋关节置换术患者术后谵妄的影响:一项前瞻性随机试验
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-09 DOI: 10.1093/ageing/afaf020
Ting Lia, Chang Yua, Feng Lv, Zhen Feng, Yan Hou, Li Ren, Ping Li
{"title":"The effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial","authors":"Ting Lia, Chang Yua, Feng Lv, Zhen Feng, Yan Hou, Li Ren, Ping Li","doi":"10.1093/ageing/afaf020","DOIUrl":"https://doi.org/10.1093/ageing/afaf020","url":null,"abstract":"Objective This study investigated whether cognitive training (CT) ameliorates postoperative delirium (POD) in older patients undergoing total hip and knee arthroplasty. Methods This clinical trial was conducted from 18 February to 10 July 2023 and included individuals aged 60–79 who underwent elective total hip and knee arthroplasties with surgery durations ≤3 hours under general anaesthesia. Patients with preoperative cognitive dysfunction and dementia were excluded. The incidence of POD was compared between the CT and routine care (RC) groups as the primary outcome. Secondary outcomes included adverse events, postoperative pain within 48 hours, and POD characteristics. Results In this study, 122 individuals were divided into two groups. The overall incidence of POD was 8.2% (10 out of 122), with no significant difference between the two groups (9.8% for CT group vs. 6.6% for RC group; P = .509). Secondary outcomes also showed no significant difference between the two groups. The training time was less, and the compliance rate was poor in the CT group (4.0%). Nonetheless, the results revealed a significant difference in POD rates among CT subgroups, and a robust correlation was identified between CT sessions lasting less than the median duration of 12 minutes and the incidence of POD (P = .043). Conclusion The incidence of POD in older patients undergoing total hip or knee arthroplasty may not be mitigated by CT. As POD was exclusively observed in patients with fewer CT sessions, it suggests that the compliance-recommended CT sessions may contribute to the POD.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"116 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583084","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
Common occurrence of atrophic gastritis in an ageing non-hospitalised population: an autopsy study 萎缩性胃炎在老年非住院人群中的常见发生:尸检研究
IF 6.7 2区 医学
Age and ageing Pub Date : 2025-03-05 DOI: 10.1093/ageing/afaf047
Pekka Karhunen, Sari Tuomisto, Sirkka Goebeler, Mika Martiskainen, Eloise Kok
{"title":"Common occurrence of atrophic gastritis in an ageing non-hospitalised population: an autopsy study","authors":"Pekka Karhunen, Sari Tuomisto, Sirkka Goebeler, Mika Martiskainen, Eloise Kok","doi":"10.1093/ageing/afaf047","DOIUrl":"https://doi.org/10.1093/ageing/afaf047","url":null,"abstract":"Background Atrophic gastritis—the end stage of chronic gastritis—is an asymptomatic disease due to Helicobacter pylori infection causing decreased vitamin B12 and folate absorption, which may lead to severe haematological and neuropsychological disorders including Alzheimer’s disease. The diagnosis requires endoscopy and biopsies from symptomatic patients, explaining why its true prevalence in the population is not well-known. Objective We aimed to evaluate the prevalence of various stages of chronic gastritis in an autopsy series most closely representing the general population. Subjects and Methods Gastric mucosa samples were collected prospectively from out-of-hospital deaths included in the Tampere Sudden Death Study (n = 70, mean age 63, age range 22–91 years). Antrum and corpus samples were stained with a H. pylori antibody and staged histopathologically. Results Chronic gastritis with or without atrophic changes was detected in 40% of the cases. The proportion of healthy mucosa decreased age-dependently from 71.4% among individuals aged &amp;lt;50 years to 43.5% among the oldest individuals (&amp;gt;70 years), and that of chronic non-atrophic gastritis from 21.4% to 8.7%. In contrast, the prevalence of atrophic gastritis was 27.1% and increased in the age groups from 7.1% to 47.8% (P = .019) among the oldest individuals, showing a strong association (P &amp;lt; .0001) with H. pylori immunopositivity. Conclusions Atrophic gastritis is a common feature of the ageing stomach, which is observed in every second individual aged 70+ years, showing a strong association with H. pylori immunopositivity. Atrophic gastritis may be a more common risk factor in old age for diseases associated with low serum B12 and folate levels than has been previously known.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"32 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546485","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}
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