Aging Clinical and Experimental Research最新文献

{"title":"Intrinsic capacity and recent falls in adults 80 years and older living in the community: results from the ilSIRENTE Study","authors":"Stefano Cacciatore,&nbsp;Emanuele Marzetti,&nbsp;Riccardo Calvani,&nbsp;Anna Picca,&nbsp;Sara Salini,&nbsp;Andrea Russo,&nbsp;Matteo Tosato,&nbsp;Francesco Landi","doi":"10.1007/s40520-024-02822-7","DOIUrl":"10.1007/s40520-024-02822-7","url":null,"abstract":"<div><h3>Background</h3><p>Falls in older adults significantly impact overall health and healthcare costs. Intrinsic capacity (IC) reflects functional reserve and is an indicator of healthy aging.</p><h3>Aims</h3><p>To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study.</p><h3>Methods</h3><p>The Minimum Data Set for Home Care (MDS−HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0−100).</p><h3>Results</h3><p>The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (&lt; 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94–0.98, <i>p</i> &lt; 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94–0.98, <i>p</i> &lt; 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93–0.99, <i>p</i> = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16–0.60, <i>p</i> &lt; 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15–0.59, <i>p</i> &lt; 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16–0.82, <i>p</i> = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97–0.99, <i>p</i> &lt; 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96–0.99, <i>p</i> &lt; 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96–0.99, <i>p</i> &lt; 0.001).</p><h3>Discussion</h3><p>This is the first study using an MDS−HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain.</p><h3>Conclusions</h3><p>Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911306","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":"Comparison of functional performance outcomes between oral patented crystalline glucosamine sulfate and platelet-rich plasma among knee osteoarthritis patients: a propensity score matching analysis","authors":"Chavarin Amarase,&nbsp;Aree Tanavalee,&nbsp;Srihatach Ngarmukos,&nbsp;Chotetawan Tanavalee,&nbsp;Nonn Jaruthien,&nbsp;Pakpoom Somrak,&nbsp;Saran Tantavisut","doi":"10.1007/s40520-024-02814-7","DOIUrl":"10.1007/s40520-024-02814-7","url":null,"abstract":"<div><h3>Background</h3><p>Among the medications used to treat knee osteoarthritis (OA), oral patented crystalline glucosamine sulfate (pCGS) and platelet-rich plasma (PRP) have become popular alternatives to painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs). Although studies have shown that pCGS and PRP improve clinical outcomes, no study has compared outcomes between these optional treatments. We compared functional performance outcomes from baseline to the 1-year follow-up (FU) between oral pCGS and PRP in patients with knee OA.</p><h3>Materials and methods</h3><p>Three hundred eighty-two patients receiving oral pCGS and 122 patients receiving PRP injections were enrolled for a review of functional performance outcomes, including a five-time sit-to-stand test (5xSST), time up-and-go test (TUGT), and 3-minute walk distance test (3MWDT). The patients were followed up for one year. The pCGS group received 1500 mg daily, whereas the PRP group received 2 cycles of intra-articular injections at week 0 and week 6. Using propensity score matching based on age, sex, height, weight, BMI, and Kellgren and Lawrence (KL) classification, all three functional performance outcomes were compared between the baseline (pretreatment), 6-week, 12-week, 24-week, and 1-year FUs.</p><h3>Results</h3><p>With a ratio of 2:1 (pCGS: PRP), 204 patients in the pCGS group were matched with 102 patients in the PRP group. Compared with the baseline levels, the PRP group showed significant improvements in 5xSST and TUGT outcomes from 6 weeks and significant improvements in 3MWDT outcomes from 12 weeks, whereas the pCGS group showed significant improvements in TUGT outcomes from 6 weeks and significant improvements in 5xSST and 3MWDT outcomes from 12 weeks. At the 24-week and 1-year FU, both groups showed significant improvements in all three functional performance tests without adverse events.</p><h3>Conclusions</h3><p>Although the PRP group showed faster improvements in 5xSST outcomes at six weeks, from the 12-week to 1-year FU, both the pCGS and PRP groups showed significant improvements in 5xSST, TUGT, and 3MWDT outcomes. As the use of PRP is more complicated and invasive than the use of oral pCGS, the benefits and drawbacks of selecting PRP over pCGS in knee OA treatment should be examined.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911305","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":"Recommendations for the optimal use of bone forming agents in osteoporosis","authors":"Nicola Veronese,&nbsp;Karine Briot,&nbsp;Nuria Guañabens,&nbsp;Ben Hur Albergaria,&nbsp;Majed Alokail,&nbsp;Nasser Al-Daghri,&nbsp;Angie Botto-van Bemden,&nbsp;Olivier Bruyère,&nbsp;Nansa Burlet,&nbsp;Cyrus Cooper,&nbsp;Elizabeth M. Curtis,&nbsp;Peter R. Ebeling,&nbsp;Philippe Halbout,&nbsp;Eric Hesse,&nbsp;Mickaël Hiligsmann,&nbsp;Bruno Muzzi Camargos,&nbsp;Nicholas C. Harvey,&nbsp;Adolfo Diez Perez,&nbsp;Régis Pierre Radermecker,&nbsp;Jean-Yves Reginster,&nbsp;René Rizzoli,&nbsp;Heide Siggelkow,&nbsp;Bernard Cortet,&nbsp;Maria Luisa Brandi","doi":"10.1007/s40520-024-02826-3","DOIUrl":"10.1007/s40520-024-02826-3","url":null,"abstract":"<div><p>Bone forming agents, also known as anabolic therapies, are essential in managing osteoporosis, particularly for patients at very high-risk of fractures. Identifying candidates who will benefit the most from these treatments is crucial. For example, this group might include individuals with severe osteoporosis, multiple vertebral fractures, a recent fragility fracture or those unresponsive to antiresorptive treatments. Definitions of patients with a very high fracture risk vary across nations, are often based on fracture history, bone mineral density (BMD), and/or fracture risk calculated by FRAX® or other algorithms. However, for very high-risk patients, anabolic agents such as teriparatide, abaloparatide, or romosozumab are commonly recommended as first-line therapies due to their ability to stimulate new bone formation and improve bone microarchitecture, offering significant benefits in rapid fracture reduction over antiresorptive therapies. The cost-effectiveness of these agents is a critical consideration for decision-makers. Despite their higher costs, their effectiveness in significantly reducing fracture risk and improving quality of life can justify the investment, especially when long-term savings from reduced fracture rates and associated healthcare costs are considered. Additionally, after completing a course of anabolic therapy, transitioning to antiresorptive agents like bisphosphonates or denosumab is crucial to maintain the gains in bone density and minimize subsequent fracture risks. This sequential treatment approach ensures sustained protection and optimal resource utilization. In summary, the effective use of bone forming agents in osteoporosis requires a comprehensive strategy that includes accurate patient identification, consideration of cost-effectiveness, and implementation of appropriate sequential treatments, ultimately maximizing patient outcomes and healthcare efficiency.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905551","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":"Respond to the editor regarding “The investigation of effect on foot plantar massage on functional recovery in older adults with general surgery, randomized clinical trial”","authors":"Asuman Saltan,&nbsp;Selda Mert,&nbsp;Önder Topbaş,&nbsp;Beyza Aksu","doi":"10.1007/s40520-024-02801-y","DOIUrl":"10.1007/s40520-024-02801-y","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905552","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":"Editor’s note: Climate change and health in aging populations","authors":"Nicola Veronese","doi":"10.1007/s40520-024-02832-5","DOIUrl":"10.1007/s40520-024-02832-5","url":null,"abstract":"","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905587","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":"How to compensate for frailty? The real life impact of geriatric co-management on morbi-mortality after colorectal cancer surgery in patients aged 70 years or older","authors":"A. Pille,&nbsp;H. Meillat,&nbsp;C. Braticevic,&nbsp;B. Lelong,&nbsp;F. Rousseau,&nbsp;M. Cecile,&nbsp;L. Tassy","doi":"10.1007/s40520-024-02752-4","DOIUrl":"10.1007/s40520-024-02752-4","url":null,"abstract":"<div><p>In Europe, CRC is the second most common cause of cancer death, and surgery remains the mainstay curative treatment. Age and frailty are associated with an increased risk of postoperative morbidity and 1-year mortality. Chronological age is not sufficient to assess the risk of postoperative complications. The CGA has been developed to better identify frail patients. Geriatric co-management have been developed to optimize the post-operative outcomes. We analyzed the real-life of geriatric co-management within an ERAS program on surgical outcomes at 90 days and oncologic outcomes at 1 year in patients aged 70 years or older after surgery for CRC. This was a retrospective study based on a prospective cohort. Fifty-one patients with a G8 score ≤ 14 were referred to geriatricians for preoperative CGA (Frail Group). They were compared with 151 patients with a G8 score ≥ 15 (Robust Group). In the Frail Group, patients were significantly older with more comorbidities than the patients in the Robust Group. Oncologic characteristics, treatments and global post-operative outcomes were comparable between the two groups. One year after surgery mortality and recurrence rates were similar between the two groups. Our study suggests that geriatric co-management is feasible and contributes to the reduction of postoperative morbimortality. Moreover, performing the CGA after G8 score screening and completion of geriatric interventions resulted in similar 90-day postoperative outcomes, in frail patients than in robust patients. Our results confirmed the benefit of geriatric co-management, involving G8 screening, CGA, and ERAS, for frail older patients undergoing surgery for CRC.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905588","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":"Associations of 24-hour movement behaviors with depressive symptoms in rural-dwelling older adults: a compositional data analysis","authors":"Tong Zhao,&nbsp;Rui Liu,&nbsp;Qi Han,&nbsp;Xiaolei Han,&nbsp;Juan Ren,&nbsp;Ming Mao,&nbsp;Jie Lu,&nbsp;Lin Cong,&nbsp;Yongxiang Wang,&nbsp;Shi Tang,&nbsp;Yifeng Du,&nbsp;Chengxuan Qiu","doi":"10.1007/s40520-024-02827-2","DOIUrl":"10.1007/s40520-024-02827-2","url":null,"abstract":"<div><h3>Background</h3><p>We aimed to explore the association of sleep duration with depressive symptoms among rural-dwelling older adults in China, and to estimate the impact of substituting sleep with sedentary behavior (SB) and physical activity (PA) on the association with depressive symptoms.</p><h3>Methods</h3><p>This population-based cross-sectional study included 2001 rural-dwelling older adults (age ≥ 60 years, 59.2% female). Sleep duration was assessed using the Pittsburgh Sleep Quality Index. We used accelerometers to assess SB and PA, and the 15-item Geriatric Depression Scale to assess depressive symptoms. Data were analyzed using restricted cubic splines, compositional logistic regression, and isotemporal substitution models.</p><h3>Results</h3><p>Restricted cubic spline curves showed a U-shaped association between daily sleep duration and the likelihood of depressive symptoms (<i>P</i>-nonlinear &lt; 0.001). Among older adults with sleep duration &lt; 7 h/day, reallocating 60 min/day spent on SB and PA to sleep were associated with multivariable-adjusted odds ratio (OR) of 0.81 (95% confidence interval [CI] = 0.78–0.84) and 0.79 (0.76–0.82), respectively, for depressive symptoms. Among older adults with sleep duration ≥ 7 h/day, reallocating 60 min/day spent in sleep to SB and PA, and reallocating 60 min/day spent on SB to PA were associated with multivariable-adjusted OR of 0.78 (0.74–0.84), 0.73 (0.69–0.78), and 0.94 (0.92–0.96), respectively, for depressive symptoms.</p><h3>Conclusions</h3><p>Our study reveals a U-shaped association of sleep duration with depressive symptoms in rural older adults and further shows that replacing SB and PA with sleep or vice versa is associated with reduced likelihoods of depressive symptoms depending on sleep duration.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905586","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":"Predictors of the onset of low handgrip strength in Europe: a longitudinal study of 42,183 older adults from 15 countries","authors":"Rizwan Qaisar,&nbsp;M. Azhar Hussain,&nbsp;Fabio Franzese,&nbsp;Asima Karim,&nbsp;Firdos Ahmad,&nbsp;Atif Awad,&nbsp;Abeer A. Al-Masri,&nbsp;Shaea A. Alkahtani","doi":"10.1007/s40520-024-02800-z","DOIUrl":"10.1007/s40520-024-02800-z","url":null,"abstract":"<div><h3>Objectives</h3><p>A low handgrip strength (HGS) is a significant risk factor for multiple diseases. However, most relevant studies investigate the complications of a low HGS, while the risk potential of causative factors of low HGS remain poorly characterized.</p><h3>Methods</h3><p>We investigated the potentials of quality of life, depression, dyslipidaemia, diabetes mellitus, cancer, Alzheimer’s disease, stroke, frailty, and difficulties performing daily activities in predicting low HGS (≤ 27 kg for men, ≤ 16 kg for women) in European older adults aged 50 or above from 15 countries (n = 42,183). All data was collected from four successive waves of survey of health, ageing, and retirement in Europe (SHARE) conducted between 2013 and 2020. Logistic models are applied, and estimated effects are presented as odds ratios and probabilities.</p><h3>Results</h3><p>Collectively, 3016 participants (men; n = 1395; 7.38%, women; n = 1621, 6.97%) developed low HGS during the 6.5 years study period. After adjusting for covariables, we identified an advancing age (1.6–48.1% points higher risk of low HGS), male gender (1.0%-point higher risk of low HGS), lower quality of life (1.6%-point higher), and stroke (1.5%-points) as significant risk factors for low HGS. We also found a dose-dependent association of Euro-D depression scores with the risk of low HGS, as the higher scores were associated with between 0.6- and 2.3%-points higher risk of developing low HGS than participants without depression. Among physical performance indicators, difficulty climbing stairs (2.0%-points higher low HGS risk) or rising from a chair (0.7%-points) were significantly associated with developing low HGS. Lastly, frailty (0.9%-points higher risk of low HGS) and the fear of falling down (1.6%-points higher risk) also increased the risk of developing low HGS.</p><h3>Conclusion</h3><p>Altogether, we report several risk factors for developing low HGS. Our observations may help evaluating and monitoring high-risk population for developing low HGS in pre-clinical settings.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896492","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":"Extremity fractures, attempted suicide, blood transfusion and thromboembolic events are independent risk factors for a prolonged hospital stay in severely injured elderly","authors":"Philipp Störmann,&nbsp;Jason A. Hörauf,&nbsp;Ramona Sturm,&nbsp;Lara Zankena,&nbsp;Jonin Serafin Zumsteg,&nbsp;Rolf Lefering,&nbsp;Ingo Marzi,&nbsp;Hans-Christoph Pape,&nbsp;Kai Oliver Jensen,&nbsp;TraumaRegister DGU","doi":"10.1007/s40520-024-02817-4","DOIUrl":"10.1007/s40520-024-02817-4","url":null,"abstract":"<div><h3>Methods</h3><p>Due to demographic change, the number of polytraumatized geriatric patients (&gt; 64 years) is expected to further increase in the coming years. In addition to the particularities of the accident and the associated injury patterns, prolonged inpatient stays are regularly observed in this group. The aim of the evaluation is to identify further factors that cause prolonged inpatient stays.</p><p>A study of the data from the TraumaRegister DGU® from 2016–2020 was performed. Inclusion criteria were an age of over 64 years, intensive care treatment in the GAS-region, and an Injury Severity Score (ISS) of at least 16 points. All patients who were above the 80th percentile for the average length of stay or average intensive care stay of the study population were defined as so-called long-stay patients. This resulted in a prolonged inpatient stay of &gt; 25 days and an intensive care stay of &gt; 13 days. Among other, the influence of the cause of the accident, injury patterns according to body regions, the occurrence of complications, and the influence of numerous clinical parameters were examined.</p><h3>Results</h3><p>A total of 23,026 patients with a mean age of 76.6 years and a mean ISS of 24 points were included. Mean ICU length of stay was 11 ± 12.9 days (regular length of stay: 3.9 ± 3.1d vs. prolonged length of stay: 12.8 ± 5.7d) and mean inpatient stay was 22.5 ± 18.9 days (regular length of stay: 20.7 ± 15d vs. 35.7 ± 22.3d). A total of n = 6,447 patients met the criteria for a prolonged length of stay. Among these, patients had one more diagnosis on average (4.6 vs. 5.8 diagnoses) and had a higher ISS (21.8 ± 6 pts. vs. 26.9 ± 9.5 pts.)</p><p>Independent risk factors for prolonged length of stay were intubation duration greater than 6 days (30-fold increased risk), occurrence of sepsis (4x), attempted suicide (3x), presence of extremity injury (2.3x), occurrence of a thromboembolic event (2.7x), and administration of red blood cell concentrates in the resuscitation room (1.9x).</p><h3>Conclusions</h3><p>The present analysis identified numerous independent risk factors for significantly prolonged hospitalization of the geriatric polytraumatized patient, which should be given increased attention during treatment. In particular, the need for a smooth transition to psychiatric follow-up treatment or patient-adapted rehabilitative care for geriatric patients with prolonged immobility after extremity injuries is emphasized by these results.</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896491","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":"A transitional care program in a technologically monitored in‐hospital facility reduces the length of hospital stay and improves multidimensional frailty in older patients: a Randomized Clinical Trial","authors":"Alberto Pilotto,&nbsp;Wanda Morganti,&nbsp;Marina Barbagelata,&nbsp;Emanuele Seminerio,&nbsp;Simona Morelli,&nbsp;Romina Custureri,&nbsp;Simone Dini,&nbsp;Barbara Senesi,&nbsp;Camilla Prete,&nbsp;Gianluca Puleo,&nbsp;Carlo Berutti Bergotto,&nbsp;Francesco Vallone,&nbsp;Carlo Custodero,&nbsp;Antonio Camurri,&nbsp;The PRO‐HOME Project Investigators Group","doi":"10.1007/s40520-024-02821-8","DOIUrl":"10.1007/s40520-024-02821-8","url":null,"abstract":"<div><h3>Background</h3><p>Longer length of hospital stay (LOS) negatively affects the organizational efficiency of public health systems and both clinical and functional aspects of older patients. Data on the effects of transitional care programs based on multicomponent interventions to reduce LOS of older patients are scarce and controversial.</p><h3>Aims</h3><p>The PRO‐HOME study aimed to assess the efficacy in reducing LOS of a transitional care program involving a multicomponent intervention inside a technologically monitored in‐hospital discharge facility.</p><h3>Methods</h3><p>This is a Randomized Clinical Trial on 60 patients (≥65 years), deemed stable and dischargeable from the Acute Geriatrics Unit, equally assigned to the Control Group (CG) or Intervention Group (IG). The latter underwent a multicomponent intervention including lifestyle educational program, cognitive and physical training. At baseline, multidimensional frailty according to the Multidimensional Prognostic Index (MPI), and Health‐Related Quality of Life (HRQOL) were assessed in both groups, along with physical capacities for the IG. Enrolled subjects were evaluated after 6 months of follow‐up to assess multidimensional frailty, HRQOL, and re‐hospitalization, institutionalization, and death rates.</p><h3>Results</h3><p>The IG showed a significant 2‐day reduction in LOS (median days IG = 2 (2–3) vs. CG = 4 (3–6); <i>p</i> &lt; 0.001) and an improvement in multidimensional frailty at 6 months compared to CG (median score IG = 0.25(0.25–0.36) vs. CG = 0.38(0.31–0.45); <i>p</i> = 0.040). No differences were found between the two groups in HRQOL, and re‐hospitalization, institutionalization, and death rates.</p><h3>Discussion</h3><p>Multidimensional frailty is a reversible condition that can be improved by reduced LOS.</p><h3>Conclusions</h3><p>The PRO‐HOME transitional care program reduces LOS and multidimensional frailty in hospitalized older patients.</p><p><i>Trial registration</i>: ClinicalTrials.gov n. NCT06227923 (retrospectively registered on 29/01/2024).</p></div>","PeriodicalId":7720,"journal":{"name":"Aging Clinical and Experimental Research","volume":"36 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892702","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}