Aging Clinical and Experimental Research最新文献

{"title":"The prevalence of disability in older adults with multimorbidity: a meta-analysis","authors":"Jin Zhang,&nbsp;Yan Sun,&nbsp;Aiying Li","doi":"10.1007/s40520-024-02835-2","DOIUrl":"10.1007/s40520-024-02835-2","url":null,"abstract":"<div><h3>Background</h3><p>Disability is typically correlated with lower quality of life and decreased capacity for self-care. It has been demonstrated that multimorbidity is closely linked to a variety of unfavorable events, such as disability. Researchers are still figuring out how and to what extent co-morbidities impact disability, though. In order to fill up this gap, this study examines the prevalence and contributing variables of disability in older patients who have multimorbidity.</p><h3>Methods</h3><p>We conducted a systematic search of Pubmed, Cochrane Library, Web of Science, Embase, and CINAL databases for articles from their inception until September 2023. We selected co-morbid older adults aged &gt; 60 years and used the ADL scale or any scale that assesses disability as an assessment tool. We excluded literature that did not meet the criteria, and literature that could not be included in the data we needed. We extracted data from the included literature and calculated synthetic prevalence rates, ORs, and 95% confidence intervals.</p><h3>Results</h3><p>A total of 32 papers (71,135 older adults) were included in the study. The prevalence of disability among older patients with multimorbidity was around 34.9% (95% CI = 25.8-43.9%). Subgroup analysis showed higher rates of disability among comorbidities who were older, female, unmarried, and long-term users of health services. And the incidence of disability increased each year. Meanwhile, the regions of the United States, China, and Spain showed higher rates of disability.</p><h3>Conclusions</h3><p>Disability rates in older patients with multimorbidity are higher, thus it’s critical to focus on risk factors while fully accounting for regional variances.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02835-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment effect analysis of the Frailty Care Bundle (FCB) in a cohort of patients in acute care settings","authors":"Colum Crowe,&nbsp;Corina Naughton,&nbsp;Marguerite de Foubert,&nbsp;Helen Cummins,&nbsp;Ruth McCullagh,&nbsp;Dawn A. Skelton,&nbsp;Darren Dahly,&nbsp;Brendan Palmer,&nbsp;Brendan O’Flynn,&nbsp;Salvatore Tedesco","doi":"10.1007/s40520-024-02840-5","DOIUrl":"10.1007/s40520-024-02840-5","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention.</p><h3>Methods</h3><p>The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions.</p><h3>Results</h3><p>The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification.</p><h3>Conclusion</h3><p>The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02840-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Bimagrumab on body composition: a systematic review and meta-analysis","authors":"Mehmet Kanbay,&nbsp;Dimitrie Siriopol,&nbsp;Sidar Copur,&nbsp;Nuri Baris Hasbal,&nbsp;Mustafa Güldan,&nbsp;Kam Kalantar-Zadeh,&nbsp;Tania Garfias-Veitl,&nbsp;Stephan von Haehling","doi":"10.1007/s40520-024-02825-4","DOIUrl":"10.1007/s40520-024-02825-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Sarcopenia, a condition marked by progressive muscle mass and function decline, presents significant challenges in aging populations and those with chronic illnesses. Current standard treatments such as dietary interventions and exercise programs are often unsustainable. There is increasing interest in pharmacological interventions like bimagrumab, a monoclonal antibody that promotes muscle hypertrophy by inhibiting muscle atrophy ligands. Bimagrumab has shown effectiveness in various conditions, including sarcopenia.&lt;/p&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;p&gt;The primary objective of this meta-analysis is to evaluate the impact of bimagrumab treatment on both physical performance and body composition among patients diagnosed with sarcopenia.&lt;/p&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;p&gt;This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed, Ovid/Medline, Web of Science, and the Cochrane Library databases up to June 2024 using appropriate Medical Subject Headings (MeSH) terms and keywords related to bimagrumab and sarcopenia. Eligible studies were randomized controlled trials (RCTs) that assessed the effects of bimagrumab on physical performance (e.g., muscle strength, gait speed, six-minute walk distance) and body composition (e.g., muscle volume, fat-free body mass, fat body mass) in patients with sarcopenia. Data extraction was independently performed by two reviewers using a standardized form, with discrepancies resolved through discussion or consultation with a third reviewer.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;From an initial search yielding 46 records, we screened titles, abstracts, and full texts to include seven RCTs in our meta-analysis. Bimagrumab treatment significantly increased thigh muscle volume (mean difference [MD] 5.29%, 95% confidence interval [CI] 4.08% to 6.50%, P &lt; 0.001; moderate heterogeneity χ2 = 6.41, I2 = 38%, P = 0.17) and fat-free body mass (MD 1.90 kg, 95% CI 1.57 kg to 2.23 kg, P &lt; 0.001; moderate heterogeneity χ2 = 8.60, I2 = 30%, P = 0.20), while decreasing fat body mass compared to placebo (MD − 4.55 kg, 95% CI − 5.08 kg to − 4.01 kg, P &lt; 0.001; substantial heterogeneity χ2 = 27.44, I2 = 89%, P &lt; 0.001). However, no significant improvement was observed in muscle strength or physical performance measures such as gait speed and six-minute walk distance with bimagrumab treatment, except among participants with slower baseline walking speeds or distances.&lt;/p&gt;&lt;h3&gt;Discussion and conclusion&lt;/h3&gt;&lt;p&gt;This meta-analysis provides valuable insights into the effects of bimagrumab on sarcopenic patients, highlighting its significant improvements in body composition parameters but limited impact on functional outcomes. The observed heterogeneity in outcomes across studies underscores the need for cautious interpretation, considering variations in study populations, treatment durations, and outcome assessments. While bimagrumab shows promis","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40520-024-02825-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cMIND diet and hypertension among older adults in China: a nationwide survey","authors":"Yazhu Wang,&nbsp;Yu Zhang,&nbsp;Xinrong Zeng,&nbsp;Xiaobing Xian,&nbsp;Jingyu Chen,&nbsp;Tengfei Niu","doi":"10.1007/s40520-024-02842-3","DOIUrl":"10.1007/s40520-024-02842-3","url":null,"abstract":"<div><h3>Background</h3><p>Existing research indicates that the Mediterranean diet has a positive impact on preventing and treating hypertension. However, its specific effect on hypertension among elderly Chinese individuals is unclear.</p><h3>Aims</h3><p>The objective of this research was to explore the association between the Chinese version of the Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) diet and hypertension among elderly Chinese individuals, aiming to offer novel strategies for alleviating the burden of hypertension in this demographic.</p><h3>Methods</h3><p>In this study, we used cross-sectional data published in 2018 by the China Longitudinal Health and Longevity Survey (CLHLS) to develop a binary logistic regression model to investigate the correlation between cMIND diet and hypertension in a Chinese elderly population. Restricted cubic spline was used to test for linear associations, and further subgroup analyses were performed to test for interactions.</p><h3>Results</h3><p>In total, 7,103 older adults were included in the study, with a prevalence of hypertension of 39.0%. When the cMIND diet score was used as a continuous variable, a significant protective effect against hypertension was present (OR = 0.955, 95% CI:0.923–0.988, <i>p</i> = 0.008); when used as a categorical variable, this protective effect was still present at higher levels (compared to lower levels) of the cMIND diet (OR = 0.869, 95% CI: 0.760–0.995, <i>p</i> = 0.042).</p><h3>Discussion</h3><p>Although the Mediterranean diet has great potential to reduce the chance of hypertension, it should also consider the effect on the Chinese population. The results of this study provide new ways to reduce the disease burden of hypertension in Chinese older adults and improve quality of life in later life.</p><h3>Conclusion</h3><p>The cMIND diet can considerably reduce the risk of hypertension among older adults in China.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant-based index linked to fall risk in older Chinese adults: cross-sectional evidence from a national cohort","authors":"Fuli Yang,&nbsp;Junguo Jin,&nbsp;Jieliang Liu,&nbsp;Xiaoqi Lu,&nbsp;Huyi Jiang,&nbsp;Huixin Tan,&nbsp;Fenghua Zhou,&nbsp;Ping Zeng","doi":"10.1007/s40520-024-02838-z","DOIUrl":"10.1007/s40520-024-02838-z","url":null,"abstract":"<div><h3>Objectives</h3><p>Epidemiology showed that the falling incidences increased with advanced age, and recent findings found link between nutritional intake and risk of falls. Nevertheless, the relationship between different plant-based diets and the risk of falls in older adults remains unclear. Our investigation aimed to evaluate the correlation between various plant-based diet indices and the occurrence of falls.</p><h3>Design</h3><p>This study is a cross-sectional and post-hoc analysis from a national cohort study.</p><h3>Setting and participants</h3><p>We included individuals over 65 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) recruited in 2018 with information on falls and dietary assessments, finally 11,044 participants were eligible.</p><h3>Measurements</h3><p>Using food frequency questionnaire (FFQ), we calculated plant-based index scores categorized as unhealthy plant-based index (uPDI) and healthy plant-based index (hPDI). The primary outcome was falls obtained from questionnaire. Statistical analysis was performed utilizing logistic regression model to investigate the relationship between the plant-based diet indices and falls. We also used the subgroup analysis to investigate the interaction of falls and plant-based diet index (PDI) among different status and used the restricted cubic spline (RCS) curves to investigate the connection between the PDI scores and falls risk.</p><h3>Results</h3><p>Among 11,044 participants included in our study, a total of 2493 fall cases were observed. The logistic regression analysis revealed that the plant-based index related to falls. In the adjusted model, per 10-unit increment of hPDI has a significant decreased risk of falls (odd ratio [OR]: 0.85, 95% confidence interval [CI]: 0.79–0.91, P for trend &lt; 0.001) and per 10-unit increment in uPDI increased the risk of falls (OR: 1.21, 95% CI: 1.13–1.30, P for trend &lt; 0.001). We also revealed an interaction between smoking status and falls among the uPDI group (<i>P</i>_interaction = 0.012). Finally, we found that with plant-based index scores increased, the odds of falls among hPDI decreased (P for overall &lt; 0.001, P nonlinear = 0.0239), and the odds of falls among uPDI increased (P for overall &lt; 0.001, P nonlinear = 0.0332).</p><h3>Conclusion and implications</h3><p>We found significant association between the Plant-based diet index and the risk of falls, highlighting the key role of the consumption of nutritious <i>plant-based</i> foods on the risk of falls, which needed take into account in developing intervention and prevention strategies to decrease falls among older Chinese adults.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accident or intentional death? A case of certain uncertainty","authors":"Diego De Leo,&nbsp;Nicola Meda,&nbsp;Josephine Zammarrelli","doi":"10.1007/s40520-024-02834-3","DOIUrl":"10.1007/s40520-024-02834-3","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement of cognitive abilities in the occurrence of fractures in fallers aged 55 years or older: a cross-sectional study","authors":"Elpidio Attoh-Mensah,&nbsp;Kristell Pothier,&nbsp;Gilles Loggia,&nbsp;Remy Morello,&nbsp;Chantal Chavoix,&nbsp;Christian Marcelli","doi":"10.1007/s40520-024-02830-7","DOIUrl":"10.1007/s40520-024-02830-7","url":null,"abstract":"<div><h3>Background</h3><p>Both bone fragility and poor cognitive functions are known to contribute to fracture occurrence, but it remains unclear whether their contribution is independent of each other and which cognitive dysfunctions are most involved. This study aimed to clarify the involvement of various cognitive abilities in fall-related fractures among community-dwelling fallers aged 55 and over, and to determine whether poor cognitive abilities is a risk factor independent of bone fragility.</p><h3>Methods</h3><p>In a cross-sectional study, we collected sociodemographic and medical data, including bone mineral density (BMD), and performed cognitive and mobility assessments in 189 individuals with a history of fall in the previous year.</p><h3>Results</h3><p>Fallers with a fracture had poorer cognitive and mobility performance than non-injured fallers. Multivariate regressions revealed that cognition, BMD and other risk factors were independently associated with fracture among all participants (OR = 1.04, 95% CI = 1.01–1.08, <i>p</i> = 0.034 for completion time on part A of the Trail Making Test [TMT-A], and OR = 0.53, 95% CI = 0.33–0.84, <i>p</i> &lt; 0.001 for BMD), particularly in women (OR = 0.77, 95% CI = 0.60–0.98, <i>p</i> = 0.039 for backward digit span score, and OR = 0.43, 95% CI = 0.25–0.75, <i>p</i> = 0.001 for BMD).</p><h3>Conclusion</h3><p>Thus, poor cognition, especially poor processing speed and working memory, is associated with an increased risk of fracture in fallers, particularly in women, regardless of BMD or other fracture risk factors. Hence, an in-depth cognitive evaluation should enhance the detection of fallers at risk of fracture, particularly in the absence of signs of osteoporosis, and thus ensure the best possible prevention.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the vaccination campaign in a population of frail older outpatients affected by cognitive or endocrinological conditions: a pilot study in Italy","authors":"Nicola Veronese,&nbsp;Francesco Saverio Ragusa,&nbsp;Pascal Roberto Titone,&nbsp;Laura Vernuccio,&nbsp;Giuseppina Catanese,&nbsp;Maria Angela Randazzo,&nbsp;Mario Palermo,&nbsp;Giovanna Di Bella,&nbsp;Pasquale Mansueto,&nbsp;Ligia J. Dominguez,&nbsp;Mario Barbagallo","doi":"10.1007/s40520-024-02824-5","DOIUrl":"10.1007/s40520-024-02824-5","url":null,"abstract":"<div><p>Vaccination, particularly against pneumococcus and influenza, is a low-cost primary prevention, useful to avoid hard complications, particularly among frail older people. In this pilot study, we aimed to assess the effect of a strategy for influenza and pneumococcal vaccination for outpatients mainly affected by cognitive or endocrinological conditions, evaluating what could stimulate or demotivate vaccination among older people. This study was conducted during the 2023–2024 influenza season at the outpatient clinics in Palermo, Italy. A total 76 patients were included. More than half of the patients could be considered as pre-frail and about 20% frail, according to a comprehensive geriatric evaluation. Among patients, 46.05% received only vaccination against pneumococcus, 28.95% both vaccinations, and 25.0% only against influenza. Compared with the previous seasons, a 19.5% increase of influenza and 90.2% of pneumococcal vaccine uptake was observed. Side effects of vaccination were the main reason of the previous rejection, namely 76.9% for influenza and 53.8% for anti-pneumococcal vaccination. In conclusion, our study indicates how a new vaccination strategy in different settings could be feasible. Proposing influenza and pneumococcal vaccination for frail older outpatients could be an effective instrument to improve immunization coverage that is still low among older people.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the incident hypertension duration and cognitive performance in older adults: data from the NHANES 2011–2014","authors":"Chunlei Liu,&nbsp;Qi Li,&nbsp;Zhuqing Li,&nbsp;Li Wang,&nbsp;Che Wang,&nbsp;Xiaoyu Du,&nbsp;Wenjuan Song,&nbsp;Xiaotong Sun,&nbsp;Chengzhi Lu","doi":"10.1007/s40520-024-02836-1","DOIUrl":"10.1007/s40520-024-02836-1","url":null,"abstract":"<div><h3>Background</h3><p>Established evidences have demonstrated that hypertension was associated with the cognitive impairment. But the associations between the duration of hypertension exposure and cognitive performance are still inconclusive.</p><h3>Objectives</h3><p>The objective of this study was to assess the association between the duration of hypertension diagnosis and cognitive performance in older adults by the National Health and Nutrition Examination Survey (2011–2014).</p><h3>Methods</h3><p>To evaluate the relationship between the hypertension duration and cognitive performance, we conducted the logistic regression analysis. Furthermore, we also performed the Restricted cubic spline (RCS) analysis to assess the nonlinear relationship between the duration of exposure to hypertension and cognitive performance.</p><h3>Results</h3><p>Initially, total 19,931 participants were included in this study, and 2928 individuals were enrolled. With the increase of hypertension duration, more risk of cognitive impairment was observed in the Digit Symbol Substitution test (DSST) (OR = 1.012, 1.006–1.019), and a similar trend was observed in Animal Fluency test (AFT) (OR = 1.009,1.003–1.016). The RCS results showed that the hypertension duration pattern was linear associated with the risk of cognitive impairment in DDST (P for non–linearity = 0.758). Meanwhile, subgroups analysis of midlife hypertension, we revealed that linear association with the risk of cognitive impairment in DSST (P for non–linearity = 0.391) and CERAD (P for non–linearity = 0.849) among hypertension diagnose &lt; 55 years populations.</p><h3>Conclusion</h3><p>Collectively, our finding indicates that longer duration of exposure to hypertension worsens the cognition performance, especially for middle-aged hypertension.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons influencing the nurses’ prioritization process while preventing and managing delirium: findings from a qualitative study","authors":"Luisa Sist,&nbsp;Nikita Valentina Ugenti,&nbsp;Stefania Chiappinotto,&nbsp;Rossella Messina,&nbsp;Paola Rucci,&nbsp;Alvisa Palese","doi":"10.1007/s40520-024-02818-3","DOIUrl":"10.1007/s40520-024-02818-3","url":null,"abstract":"<div><h3>Background</h3><p>Nurses play an important role in the prevention and management of delirium episodes. However, some studies have reported that not all interventions recommended are applied due to time and resource constraints, resulting in patients receiving less care than required because other patients and/or interventions are prioritised. The concept of prioritization is part of the broader concept of decision-making as the ability to choose between two or more alternatives to ensure patient safety. Understanding the reasons influencing the prioritization process in patients at risk or with delirium may inform interventions to prevent and/or minimise the unfinished nursing care.</p><h3>Aim</h3><p>The purpose of this study was to explore the reasons that inform the prioritisation process among nurses when they are challenged to make decisions for patients at risk and with delirium.</p><h3>Methods</h3><p>A descriptive qualitative study performed according to the COnsolidated criteria for Reporting guidelines, in 2021. An intentional sample of nurses working full-time with older patients in medical, geriatric, and post-acute care facilities affiliated with the National Health System was involved. Semi-structured interviews were conducted and narratives thematic analysed.</p><h3>Results</h3><p>A total of 56 nurses (55.4% in internal medicine, 26.8% in geriatrics and 17.8% in post-acute/intermediate care) participated with an average age of 31.6 years. The reasons informing the prioritisation process while providing preventive or managerial interventions towards a patient at risk of or with delirium are set at three levels: (1) unit level, as reasons belong to the inadequacy of the ‘Environment’, the ‘Human Resources’, and the ‘Organisation and Work Processes’, (2) nurse’s level, as issues in ‘Competencies’ and ‘Attitudes’ possessed, and (3) patient level, due to the ‘Multidimensional Frailty’.</p><h3>Conclusion</h3><p>Nurses caring for patients at risk of and with delirium face several challenges in providing care. To prioritise preventive and managerial interventions, it is essential to implement multilevel and multifaced organizational and educational strategies.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}