Age and ageing最新文献_第9页

Correction to: Effects of osteoporosis treatment and multicomponent integrated care on intrinsic capacity and happiness among rural community-dwelling older adults: the Healthy Longevity and Ageing in Place (HOPE) randomised controlled trial. 修正：骨质疏松治疗和多成分综合护理对农村社区老年人内在能力和幸福感的影响：健康长寿和就地老龄化（HOPE）随机对照试验。

IF 6 2区医学

Age and ageing Pub Date : 2025-03-03 DOI: 10.1093/ageing/afaf071

引用次数: 0

Linking data to explore variation in care home prescribing: a helpful tool for starting conversations to enable change. 链接数据以探索养老院处方的变化：启动对话以实现变革的有用工具。

IF 6 2区医学

Age and ageing Pub Date : 2025-03-03 DOI: 10.1093/ageing/afaf061

Katy Jenks, Jennifer Kirsty Burton

引用次数: 0

Editor's view-political interference, assisted dying and multicomponent interventions. 编者的观点——政治干预、辅助死亡和多成分干预。

IF 6 2区医学

Age and ageing Pub Date : 2025-03-03 DOI: 10.1093/ageing/afaf065

Roy L Soiza

引用次数: 0

Correction to: The British Geriatrics Society's position on assisted dying. 更正：英国老年医学会对协助死亡的立场。

IF 6 2区医学

Age and ageing Pub Date : 2025-03-03 DOI: 10.1093/ageing/afaf059

引用次数: 0

Why we need to consider frailty in the assisted dying debate 为什么我们需要在辅助死亡的辩论中考虑脆弱

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-25 DOI: 10.1093/ageing/afaf028

Sarah A Hopkins, Annabel Price, Simon N Etkind

{"title":"Why we need to consider frailty in the assisted dying debate","authors":"Sarah A Hopkins, Annabel Price, Simon N Etkind","doi":"10.1093/ageing/afaf028","DOIUrl":"https://doi.org/10.1093/ageing/afaf028","url":null,"abstract":"Background Assisted dying/assisted suicide (AD/AS) is legal or decriminalised in several countries and Bills to legalise it are currently being considered by the UK and Scottish Parliaments. Older adults living with frailty make up an increasing proportion of those who die, yet the possible implications of AD/AS for these individuals are relatively unexplored. Here, we discuss some of these issues. Discussion Frailty complicates AD/AS in relation to eligibility because of ambiguity over whether frailty constitutes a terminal illness, challenges in accurately predicting prognosis, and difficulty determining reversibility of suffering. Frailty also blurs the distinction between terminal illness and disability, in contrast to the clear-cut language of current proposed legislation where those with a terminal illness are eligible, but those with disability are not. We discuss that decisions regarding AD/AS are often framed in terms of individual autonomy, whereas relational autonomy is the norm for many living with frailty, meaning that concerns regarding implicit coercion need careful consideration. Further, there is an established link between frailty and feeling a burden to others. There is an open question as to whether this, combined with persisting ageist attitudes in society, could influence decisions of people living with frailty about an assisted death. Conclusion The above issues make the place of frailty in proposed legislation on AD/AS uncertain. Further consideration is needed regarding eligibility, safeguards in the context of relational autonomy and for those who already feel a burden, and how to mitigate risks of further entrenching ableist and ageist attitudes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495157","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

We should not fear assisted dying 我们不应该害怕安乐死

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-25 DOI: 10.1093/ageing/afaf029

Rowan H Harwood

{"title":"We should not fear assisted dying","authors":"Rowan H Harwood","doi":"10.1093/ageing/afaf029","DOIUrl":"https://doi.org/10.1093/ageing/afaf029","url":null,"abstract":"The argument for allowing assisted dying (ad) is based on two principles: (i) respect for autonomy and (ii) adequate safeguards to avoid coercion or abuse. We should ensure that ad is accessible, equitable and regulated. It is wrong, without very good reason, to impose a set of beliefs on other people who do not hold those views. We should therefore not impose an obligation to go on living if an individual considers that it is associated with unwanted suffering, distress, dependency, indignity or cost. We should accept, and provide for, diversity and variation in people’s views on ad. The right to refuse life-prolonging therapies, or to have drugs to control distressing symptoms that incidentally shorten life, is well-established. The ethical distinction between these and ad is arguable. Worldwide, most people who choose to end their lives, are already close to death. Some people need protection from the possibility of their lives being ended when they did not intend or want it. However, older people are capable of making informed decisions on serious matters, with or without the support of others. To suggest otherwise is paternalistic and ageist. Multiple jurisdictions worldwide have developed and use effective safeguards. In these countries, ad is mostly welcomed and has not led to undue legal, social or human rights problems. Legal provision for ad is both desirable and necessary.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"12 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495170","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

Supporting older people through Hospital at Home care: a systematic review of patient, carer and healthcare professionals’ perspectives 通过家庭医院护理支持老年人：对患者、护理人员和卫生保健专业人员观点的系统审查

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-23 DOI: 10.1093/ageing/afaf033

Anita Wong, Claudia Cooper, Catherine J Evans, Mark James Rawle, Kate Walters, Simon Paul Conroy, Nathan Davies

{"title":"Supporting older people through Hospital at Home care: a systematic review of patient, carer and healthcare professionals’ perspectives","authors":"Anita Wong, Claudia Cooper, Catherine J Evans, Mark James Rawle, Kate Walters, Simon Paul Conroy, Nathan Davies","doi":"10.1093/ageing/afaf033","DOIUrl":"https://doi.org/10.1093/ageing/afaf033","url":null,"abstract":"Introduction Hospital at Home provides hospital-level type care at home, both remote and face-to-face by a multidisciplinary team of healthcare professionals. In practice, various different models are employed, but we do not know what older people, their family carers (carers) and healthcare professionals think of what works best for them. This review aimed to describe the various Hospital at Home models and synthesise literature exploring patient, carer and staff perspectives of Hospital at Home care for older people. Methods and analysis A systematic review of UK studies. Medline, Embase and CINAHL and grey literature were searched from 1991 to 2024, using predetermined inclusion and exclusion criteria; data were extracted from included papers. Tabulation, thematic grouping and concept mapping of themes were used to narratively synthesise the literature. Results Twenty studies met eligibility. Hospital at Home models included admission avoidance and early discharge. Studies were largely positive regarding Hospital at Home, with benefits including home familiarity, enabling person-centred care and shared decision-making and provision of family carer support. Challenges included staff accessibility, patient and carer anxieties regarding the safety of virtual wards, coordination across sectors and older people using technology. Conclusion Provision of holistic, accessible and continuous care for older people in Hospital at Home services facilitated patient and carer empowerment, dignity and autonomy. There are gaps in our understanding and evidence surrounding paid care workers and informal carers’ perspectives in UK settings, especially within rigorous Hospital at Home literature.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"209 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477570","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

Comparison of hospitalisation settings and exercise interventions in acute care: a systematic review and meta-analysis 住院环境和运动干预在急症护理中的比较：系统回顾和荟萃分析

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-21 DOI: 10.1093/ageing/afaf035

Paula Etayo-Urtasun, Mikel L Sáez de Asteasu, Mikel Izquierdo

{"title":"Comparison of hospitalisation settings and exercise interventions in acute care: a systematic review and meta-analysis","authors":"Paula Etayo-Urtasun, Mikel L Sáez de Asteasu, Mikel Izquierdo","doi":"10.1093/ageing/afaf035","DOIUrl":"https://doi.org/10.1093/ageing/afaf035","url":null,"abstract":"Background Inpatient hospitalisation is associated with adverse outcomes in older adults, including hospital-associated deconditioning. The hospital-at-home (HaH) model may promote physical activity. This systematic review and meta-analysis compares functional outcomes between inpatient and HaH settings and evaluates the efficacy of exercise interventions in both settings. Methods Systematic searches of PubMed, Scopus, Web of Science and ScienceDirect were conducted on 27 April 2024. Three distinct searches were performed: (i) studies comparing HaH and inpatient hospitalisation, (ii) trials evaluating inpatient exercise interventions and (iii) research on HaH exercise interventions. Two reviewers independently selected studies published from 2014 onwards using the PICOS framework and they assessed quality using PEDro scale. A meta-analysis was performed using a random effects model to analyse exercise interventions. This systematic review with meta-analysis was conducted according to PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024598286). Results Among the 9470 studies identified, nine studies comparing acute-care settings and 21 studies on exercise interventions (one in HaH) were included. Findings suggest that HaH may positively affect functional and cognitive outcomes. Inpatient exercise interventions significantly improved physical performance [standardised mean difference (SMD) = 0.42, 95% confidence interval (CI) = 0.12–0.72] and functional independence (SMD = 0.45, 95% CI = 0.14–0.77) at discharge. Conclusion HaH may contribute to preserving physical and cognitive status. Supervised exercise interventions during inpatient hospitalisation are safe and effective for improving older adults’ functional status, although further research in the HaH model is needed.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"19 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143462813","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

Utilisation of nursing home care before and after the 2015 Dutch national reform: an interrupted time series analysis 2015年荷兰国家改革前后养老院护理的利用：中断时间序列分析

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-04 DOI: 10.1093/ageing/afaf018

Janet L MacNeil Vroomen, Joost D Wammes, Bram Wouterse, Martin Smalbrugge, Terrence E Murphy

{"title":"Utilisation of nursing home care before and after the 2015 Dutch national reform: an interrupted time series analysis","authors":"Janet L MacNeil Vroomen, Joost D Wammes, Bram Wouterse, Martin Smalbrugge, Terrence E Murphy","doi":"10.1093/ageing/afaf018","DOIUrl":"https://doi.org/10.1093/ageing/afaf018","url":null,"abstract":"Background The Netherlands introduced abrupt, large-scale, long-term care (LTC) reforms in 2015 that promoted ageing-in-place. However, there has been no comprehensive population-level study evaluating how these reforms have impacted nursing home (NH) utilisation. This study examines the association between the 2015 reforms with national monthly rates of NH admissions and survival time amongst newly admitted older adults. Methods We analysed population data from Statistics Netherlands (2011–2019), conducting an interrupted time-series analysis to compare monthly NH admission rates before and after the 2015 reforms amongst adults aged 65 and older (N = 402 350). A Cox proportional hazards model was used to assess the reform’s impact on mortality risk amongst newly admitted residents. Results The adjusted NH admission rate before the reform was 88.80 per 100 000 older adults (95% CI (confidence interval): 82.36–95.83), compared to 69.82 per 100 000 after the reform (95% CI: 65.91–73.78), indicating a significant reduction (incident rate ratio: 0.80, 95% CI: 0.74–0.86). Over a 3-year follow-up, the average survival time for those admitted after the reform was 608 days (95% CI: 608.72–610.74), compared to 622.52 days (95% CI: 620.59–624.45) for those admitted before the reform. The reform was associated with a slightly increased mortality risk (hazard ratio: 1.05, 95% CI: 1.02–1.07). Conclusions The 2015 Dutch LTC reform is associated with a reduction in national NH admissions and a decrease in average survival time of 2 weeks.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"41 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125381","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

Deprescribing in cognitively vulnerable older people: development and validation of STOPPCog criteria 认知脆弱老年人的处方解除：STOPPCog标准的制定和验证

IF 6.7 2区医学

Age and ageing Pub Date : 2025-02-04 DOI: 10.1093/ageing/afaf014

Siobhan McGettigan, Denis Curtin, Denis O’Mahony

{"title":"Deprescribing in cognitively vulnerable older people: development and validation of STOPPCog criteria","authors":"Siobhan McGettigan, Denis Curtin, Denis O’Mahony","doi":"10.1093/ageing/afaf014","DOIUrl":"https://doi.org/10.1093/ageing/afaf014","url":null,"abstract":"Objective To validate STOPPCog, a list of explicit criteria for potentially inappropriate medication use in cognitively vulnerable older adults. Design A Delphi consensus survey of an expert panel comprising academic geriatricians, old age psychiatrists, general practitioners, and clinical pharmacists. Setting Ireland. Subjects Nine panellists. Methods STOPPCog criteria were initially created by the authors based on clinical experience and literature appraisal. Criteria were organised according to drug/drug class. Using Delphi consensus methodology, panellists ranked their agreement with each criterion on a 5-point Likert scale and provided written feedback. Criteria with a median value of 1 or 2 (strongly agree/agree) and a 25th centile value of ≤2 were included in the final list. Results All panellists completed two Delphi consensus validation rounds. Twenty-five criteria were proposed initially, twenty were accepted. One criterion was rejected (multi-vitamin supplements), and four criteria were rephrased (two of these were combined to one criterion for greater clarity). The final list comprised 23 criteria that are arranged in six subgroups i.e. (i) drugs with anticholinergic properties taken daily; (ii) drugs with sedative properties taken daily; (iii) drugs that may exacerbate psychotic symptoms in patients with alpha-synuclein pathology; (iv) drugs used for chronic pain; (v) drugs without proven efficacy for dementia taken daily; (vi) drugs that are of no proven benefit in advanced stage dementia i.e. clinical dementia rating of 3.0 where palliation may be appropriate. Conclusion STOPPCog comprises 23 criteria relating to medications that are potentially inappropriate in cognitively vulnerable older adults. STOPPCog may assist physicians in deprescribing medications in this patient population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"80 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125379","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