Age and ageing最新文献

{"title":"Editor's view-electronic frailty index 2: the sequel.","authors":"Roy L Soiza","doi":"10.1093/ageing/afaf127","DOIUrl":"https://doi.org/10.1093/ageing/afaf127","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092576","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":"The use and effect of virtual reality as a non-pharmacological intervention for behavioural and psychological symptoms of dementia: a systematic review and meta-analysis.","authors":"Li-Chin Wang, Amy Montgomery, Peter Smerdely, Olivia Paulik, Cherie Barton, Elizabeth Halcomb, Heidi Hoi Ying Hui, Carolyn Pieri, Maria Rios Lopez, Judeil Teus, Gemma McErlean","doi":"10.1093/ageing/afaf117","DOIUrl":"10.1093/ageing/afaf117","url":null,"abstract":"<p><strong>Background: </strong>Behavioural and psychological symptoms of dementia (BPSD) are complex neuropsychiatric symptoms that contribute to caregiver strain, increased rates of institutionalisation and reduced quality of life. Virtual reality (VR) has gained interest as a non-pharmacological approach to potentially reduce BPSD severity.</p><p><strong>Objective: </strong>This review sought to synthesise evidence on the effectiveness of VR in reducing BPSD severity, while exploring its acceptability, safety, and optimal dosage in dementia care.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, CINAHL and SCOPUS were searched for randomised and quasi-experimental trials assessing VR's effect on BPSD. JBI critical appraisal checklists were used to assess methodological quality. Findings were presented narratively, with meta-analysis performed on a subset of BPSD symptoms where data were available.</p><p><strong>Results: </strong>Of the ten included studies, four found no significant change in overall BPSD. Mixed findings were observed for individual BPSD symptoms. Meta-analysis showed a significant reduction in depressive symptoms (mean diff -0.38, P= .026) and no reduction in agitation (mean diff 1.87, P = .2). Two studies reported reduced aggression and mixed findings were found for anxiety. Reduced apathy was observed in one study following each VR session and during the session in another. VR was generally well-accepted with few side effects reported.</p><p><strong>Conclusion: </strong>VR appears to be an acceptable non-pharmacological intervention for BPSD reduction. However, the limited available studies, methodological variations and quality issues suggest the need for future larger-scale research to confirm its efficacy and effectiveness.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956216","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":"Resident funding and care home quality: a retrospective observational analysis of the impact of the two-tier care system in England.","authors":"Anders Bach-Mortensen,Benjamin Goodair,Michelle Degli Esposti,Christine Corlet Walker","doi":"10.1093/ageing/afaf100","DOIUrl":"https://doi.org/10.1093/ageing/afaf100","url":null,"abstract":"BACKGROUNDAdult social care in England operates in a two-tier system of self-funded and state-funded residents. It is unclear, however, whether resident funding source impacts care home quality.METHODSWe conducted a nationwide retrospective observational analysis of care homes in England (n = 28 239 Provider Information Return entries for 14 444 care homes, representing ~367 653 residents), 2021-23, to examine the relationship between resident funding (self- or state-funded) and care home quality (inspection ratings by the industry regulator). We linked data from the Care Quality Commission's Provider Information Return to inspection ratings, area deprivation, and care home and resident characteristics. We modelled a series of logistic regressions, incorporating interaction terms to investigate the interrelationships between ownership (for-profit, third sector, public) and area deprivation.FINDINGSCare homes with more self-funded residents were more likely to have better inspection ratings [odds ratio for each percentage of self-funded residents: 1.01, 95% confidence interval (CI) 1.008-1.012, P < .001]. The effect of self-funded residents on care quality was largest amongst for-profit homes and not statistically significant for third sector and public homes. For homes without self-funders, third sector and public providers were 14.0 (95% CI: 10.1-17.8, P < .001) and 6.9 (95% CI: 4.1-9.7, P < .001) percentage points more likely to be rated higher than for-profit homes.CONCLUSIONSThe quality of for-profit care homes is strongly influenced by the proportion of self-funded residents, whilst third and public sector homes provide consistent care regardless of resident funding source. This strongly impacts care equity for residents nationwide, as the concentration of self-funders is largely determined by area wealth.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921094","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":"Advancing frailty identification in UK primary care with eFI2: are we there yet?","authors":"Roman Romero-Ortuno, Victoria Louise Keevil","doi":"10.1093/ageing/afaf111","DOIUrl":"https://doi.org/10.1093/ageing/afaf111","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961231","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":"What is the role of specialist palliative care in the management of home-based people dying from non-malignant conditions?","authors":"Geoffrey K Mitchell","doi":"10.1093/ageing/afaf112","DOIUrl":"https://doi.org/10.1093/ageing/afaf112","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961021","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":"The uncertainties and questions of care home residents, relatives and staff as a basis for evidence-based improvement and research.","authors":"Reena Devi, Kirsty Jayne Haunch, Elizabeth Helen Graham, Alys Wyn Griffiths, Gary Hodge, Andrew Clegg, Maria Drummond, Anne Forster, Susie Pearce, Karen Spilsbury, Carl Thompson","doi":"10.1093/ageing/afaf125","DOIUrl":"https://doi.org/10.1093/ageing/afaf125","url":null,"abstract":"<p><strong>Background: </strong>Research in long-term residential care settings (or care homes) for older people should address questions and uncertainties that matter most for those receiving and delivering care. Whether research does this effectively is unclear. In part, because the uncertainties and questions of key stakeholders are unmapped.</p><p><strong>Objective: </strong>To capture and prioritise the uncertainties of older people living in care homes, their relatives and staff.</p><p><strong>Methods: </strong>A three-phase mixed-methods study: (i) gathering uncertainties, (ii) data analysis and (iii) prioritisation. Phase 1 used interviews to gather uncertainties from residents (n = 14), relatives (n = 10) and staff (n = 44). In phase 2, uncertainties were coded using thematic inductive analysis, represented as 'foreground' (necessitating research) or 'background' (not needing research) questions, and a prioritisation tool developed. The tool included optional open-text responses, capturing new questions fitting (and additional detail around) the existing subthemes. During phase 3, the prioritisation tool was completed by residents (n = 95), relatives (n = 85) and staff (n = 158).</p><p><strong>Results: </strong>319 uncertainties were identified: 274 foreground (research-based) and 45 background (fact-based) questions. Six broad and 38 subthemes were developed. Broad themes included (i) communal living, (ii) health and care services, (iii) resident care, (iv) residents' health and well-being, (v) residents' daily life and (vi) care home staff. Priority subthemes included enjoy living with others, dignity and respect, support with emotions, meaningful activities, and staff recruitment and retention.</p><p><strong>Conclusion: </strong>This is the first study of care home prioritised uncertainties informed by residents, relatives and staff. The uncertainty-based questions represent important targets for care home research and practice improvement.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148867","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":"Editing geriatric medicine journals: perspectives from the editors-in-chief of Age and Ageing, European Geriatric Medicine and the Journal of the American Geriatrics Society.","authors":"Roy L Soiza,Alfonso J Cruz Jentoft,Joseph G Ouslander","doi":"10.1093/ageing/afae294","DOIUrl":"https://doi.org/10.1093/ageing/afae294","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"38 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914852","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":"Low gait speed is better than frailty and sarcopenia at identifying the risk of disability in older adults","authors":"Aline Fernanda de Souza, Dayane Capra de Oliveira, Paula Camila Ramírez, Roberta de Oliveira Máximo, Mariane Marques Luiz, Maicon Luís Bicigo Delinocente, Andrew Steptoe, Cesar de Oliveira, Tiago da Silva Alexandre","doi":"10.1093/ageing/afaf104","DOIUrl":"https://doi.org/10.1093/ageing/afaf104","url":null,"abstract":"Objective To compare frailty, sarcopenia and their respective components to determine which is more effective in identifying the risk of disability in basic and instrumental activities of daily living (BADL and IADL, respectively). Methods A longitudinal study involving 3,637 individuals without disabilities concerning BADL and 3,696 individuals without disabilities regarding IADL at baseline. Frailty was defined using the phenotype. Sarcopenia was determined according to the criteria proposed by the EWGSOP2: low strength (grip strength &amp;lt;27 kg for men and &amp;lt;16 kg for women), low skeletal muscle mass index (&amp;lt;9.36 kg/m2 for men and &amp;lt;6.73 kg/m2 for women) and low physical performance (gait speed ≤0.8 m/s). In addition to the complete constructs, each component was assessed. Poisson mixed models were utilised, with the outcome identified as incident cases of disability over 8 years, adjusted for covariates. Results: Pre-frailty was associated with a 17% and 18% annual increase in the risk of disability for BADL and IADL, respectively. These figures were 27% and 28% for individuals classified as frail. Sarcopenia was not associated with an increased risk of disability. Amongst the components of frailty and sarcopenia, low physical performance, assessed by gait speed ≤0.8 m/s, was the most effective for identifying the risk of disability (12% per year for BADL and 14% per year for IADL). Conclusion In clinical practice, low physical performance (gait speed ≤0.8 m/s) may be the preferred tool for screening the risk of functional decline in older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"37 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866181","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":"Development of a core outcome set for clinical trials targeting interventions aiming to improve adherence to appropriate polypharmacy in older people—an international consensus study","authors":"Hanadi Al Shaker, Heather Barry, Carmel Hughes","doi":"10.1093/ageing/afaf102","DOIUrl":"https://doi.org/10.1093/ageing/afaf102","url":null,"abstract":"Background Medication non-adherence is prevalent in older people taking polypharmacy. Several interventions have been employed to improve adherence in this population. However, inconsistencies in outcomes have impeded comparisons of findings. Accordingly, this work aimed to develop a core outcome set (COS) for use in trials aiming to improve adherence to appropriate polypharmacy in older people. Methods A group of stakeholders, including academics, journal editors, healthcare professionals (HCPs) and public participants, evaluated 13 outcomes compiled from the literature in a Delphi study using a nine-point Likert scale ranging from 1 to 9, where higher scores (7–9) indicated critical importance and lower scores (1–3) unimportance. The resultant Delphi consensus list was discussed and voted on (yes: critical and no: unimportant) in two online nominal group technique (NGT) meetings. The NGT followed a five-stage approach: introduction, silent generation, round-robin, clarification and voting. An outcome was included if ≥80% of participants scored it critical and ≤ 15% scored it as unimportant. Results Of the 13 outcomes originally presented to participants, consensus was achieved to include six outcomes in the COS after the Delphi study (Round 1, n = 57; Round 2, n = 53; Round 3, n = 50, where ‘n’ represents participant numbers) and the NGT meetings (n = 10) comprising medication adherence across multiple medications, treatment burden, health-related quality of life (HRQoL), healthcare utilisation (HCU), adverse events and side effects (AEs and SEs) and cost-effectiveness. Conclusion This COS should be used in intervention studies focusing on improving adherence to appropriate polypharmacy in older people. Future work should identify outcome measurement instruments to be used alongside the COS.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"7 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866175","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":"Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study","authors":"Shuomin Wang, Qianyuan Li, Jianzhong Hu, Qirong Chen, Shanshan Wang, Qian-Li Xue, Chongmei Huang, Hongyu Sun, Minhui Liu","doi":"10.1093/ageing/afaf101","DOIUrl":"https://doi.org/10.1093/ageing/afaf101","url":null,"abstract":"Background Chronic conditions often co-occur in specific disease patterns. Certain chronic diseases contribute to incident frailty or cognitive impairment (CI), but the associations of multimorbidity patterns and the order of frailty and CI occurrence remain unclear. Objectives To determine multimorbidity patterns amongst older adults and their associations with the order of frailty and CI occurrence. Design Prospective cohort study. Methods Using data from National Health and Aging Trends Study, 7522 community-dwelling participants were included and followed up for four years. Latent class analysis was conducted to identify multimorbidity patterns with clinical meaningfulness. Fine and Grey competing risks models were used to examine the associations between multimorbidity patterns and different orders of frailty and CI occurrence (frailty-first, CI-first, frailty-CI co-occurrence). Results Four multimorbidity patterns were identified: cardiometabolic, osteoarticular, cancer-dominated and psychiatric/multisystem pattern. Compared to non-multimorbidity, all four multimorbidity patterns were associated with a higher risk of developing frailty-first, but not developing CI-first. Specifically, the psychiatric/multisystem pattern had the highest risk of developing frailty-first ( Sub-distribution hazard ratios [SHR] = 3.74, 95% confidence intervals = 2.96, 4.71), followed by osteoarticular pattern (SHR = 2.53, 95% CI = 1.98, 3.22) and cardiometabolic pattern (SHR =2.41, 95% confidence intervals = 1.96, 2.98). In addition, only participants from psychiatric/multisystem and cardiometabolic pattern showed a higher risk of frailty-CI co-occurrence. Conclusions Our findings highlight the etiological heterogeneity between physical frailty and CI. Clinician should be aware of multimorbidity clusters and thus provide more effective strategies for comorbid older adults to prevent the onset of these two geriatric syndromes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"21 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866183","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}