BMC Geriatrics最新文献

{"title":"The Psychoeducational Interventions: a valuable communication tool to support the caregiver of people with dementia.","authors":"Simona Cintoli, Luca L Tommasini, Eleonora Del Prete, Matilde Cerri, Roberto Ceravolo, Gloria Tognoni","doi":"10.1186/s12877-024-05562-5","DOIUrl":"https://doi.org/10.1186/s12877-024-05562-5","url":null,"abstract":"<p><strong>Background: </strong>informal caregivers of people with dementia are at greater risk of developing physical and mental health problems when compared to the general population: they often experience high levels of stress which can lead to a lowered sense of well-being, feelings of being burdened, depression and compromised physical health. The significant beneficial effects of Psychoeducational Interventions on the critical outcomes of caregiver burden and strain were considered sufficient to warrant a recommendation in favour of the intervention. The emergence of the COVID-19 pandemic has significantly increased the use internet-based interventions: this study describes the effectiveness of support program for informal caregivers of people with dementia internet-based and on-site conditions.</p><p><strong>Methods: </strong>A Psychoeducational Interventions program, consisting of 5 meetings every 2 weeks, has been structured. It aims to provide information and strategies for managing cognitive and psycho-behavioral symptoms in neurodegenerative diseases, as well as to develop effective communication skills and understanding of the caregiver's experience. Intervention formats include slides, video, group discussions and are always led by a psychologist. We assessed in 73 caregivers (33 internet-based and 40 on-site conditions) level of Behavioural and Psychological Symptoms of Dementia management, dementia awareness, social support, find leisure time, harmony with relative, stress, with Visual-Analogue Scale at the beginning of PI and at the end. During the pandemic period the protocol was adapted to be available online and subsequently proposed to caregivers belonging to the Cognitive Disorders and Dementia Centre.</p><p><strong>Results: </strong>in both modalities, internet-based and on-site condition, a statistically significant improvement was highlighted in all aspects (p < 0.05, for all p-value). Questionnaire on basic dementia knowledge was successfully completed at 100%. Also, participants reported a medium to high level of satisfaction with very limited dropouts (< 3%).</p><p><strong>Conclusions: </strong>The evidence from this pilot study indicated that caregiver support interventions in both conditions significantly improved several and important outcomes: they showed a significant effect in reducing caregiver strain and improving ability and knowledge. Indeed, Psychoeducational Interventions contribute to effective coping strategies to mitigate caregiver burden so they can continue to provide care for loved ones.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1004"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863115","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":"Quality of life and quality of care experience in Australian residential aged care: a retrospective cohort study of 1,772 residents.","authors":"Guogui Huang, Nasir Wabe, Magdalena Z Raban, Amy D Nguyen, S Sandun M Silva, Ying Xu, Julie Ratcliffe, Jyoti Khadka, Johanna I Westbrook","doi":"10.1186/s12877-024-05472-6","DOIUrl":"https://doi.org/10.1186/s12877-024-05472-6","url":null,"abstract":"<p><strong>Background: </strong>In April 2023, quality of life (QOL) and quality of care experience (QCE) indicators were introduced as mandatory indicators in Australian residential aged care (RAC) to measure and monitor wellbeing and consumer experience respectively. In this study, we used data for the initial four months after their introduction to describe QOL and QCE scores, explore related factors and assess variations by completion mode and facility.</p><p><strong>Methods: </strong>A retrospective cohort study using electronic data (Mar-Jun 2023) from 1,772 residents in 22 RAC facilities in metropolitan Sydney, Australia. QOL was measured by the Quality of Life-Aged Care Consumer (QOL-ACC) scale, and QCE by the Quality of Care Experience-Aged Care Consumer (QCE-ACC) scale, both through three completion modes: self, interviewer-facilitated and proxy completion. Propensity score matching was used to compare QOL/QCE differences by completion mode; multilevel ordinal logistic regression to investigate QOL-/QCE-related factors; and funnel plots to explore facility-level score variations.</p><p><strong>Results: </strong>Of 1,772 residents, 1,706 completed the QOL-ACC survey and 1,686 the QCE-ACC. The median score was 21 (interquartile range 18-24) for QOL and 23 (interquartile range 20-24) for QCE, both indicating 'excellent' outcomes. The leisure activities component of QOL, and social relationships and complaint lodging of QCE, were rated relatively lower than other dimensions. The scores of both indicators were significantly higher for self-completion versus other completion modes. Significant variation in QOL and QCE scores by facility were also observed, with seven and four facilities with lower-than-expected proportions of residents with 'excellent' or 'good' ratings of QOL and QCE, respectively. A longer length of stay (odd ratio [OR] = 0.70, 95% CI: 0.53-0.92 for ≥ 3 years of stay versus < 1 year of stay) and fall history (OR = 0.74, 95% CI: 0.60-0.91) were associated with lower QOL, while having a visual impairment (OR = 0.74, 95% CI: 0.55-0.99) and fall history (OR = 0.80, 95% CI: 0.64-0.99) were associated with lower QCE.</p><p><strong>Conclusion: </strong>We found high QOL and QCE across the 22 Australian RAC facilities. Enhancing residents' leisure activities, social relationships, and addressing specific needs (e.g., visual impairment and fall history) may enhance QOL and QCE.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1006"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863183","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":"Frailty assessment in geriatric trauma patients: comparing the predictive value of the full and a condensed version of the Fried frailty phenotype.","authors":"Joninah Braunschweig, Wei Lang, Gregor Freystätter, Christian Hierholzer, Heike A Bischoff-Ferrari, Michael Gagesch","doi":"10.1186/s12877-024-05594-x","DOIUrl":"https://doi.org/10.1186/s12877-024-05594-x","url":null,"abstract":"<p><strong>Background: </strong>Frailty is associated with multiple negative outcomes in geriatric trauma patients. Simultaneously, frailty assessment including physical measurements for weakness (grip strength) and slowness (gait speed) poses challenges in this vulnerable patient group. We aimed to compare the full 5-component Fried Frailty Phenotype (fFP) and a condensed model (cFP) without physical measurements, with regard to predicting hospital length of stay (LOS) and discharge disposition (DD).</p><p><strong>Methods: </strong>Prospective cohort study in patients aged 70 years and older at a level I trauma center undergoing frailty assessment by 5-component fFP (fatigue, low activity level, weight loss, weakness, and slowness). For the cFP, only fatigue, low activity level and weight loss were included. Co-primary outcomes were LOS and DD.</p><p><strong>Results: </strong>In 233 of 366 patients, information on all 5 frailty components was available (mean age 81.0 years [SD 6.7], 57.8% women) and included in our comparative analysis. Frailty prevalence was 25.1% and 3.1% by fFP and cFP, respectively. LOS did not differ significantly between frail and non-frail patients, neither using the fFP (p = .245) nor the cFP (p = .97). By the fFP, frail patients were 94% less likely to be discharged home independently (OR 0.06; 95% CI 0.007-0.50, p = .0097), while using cFP, none of the frail patients were discharged home independently.</p><p><strong>Conclusion: </strong>The fFP appears superior in identifying frail trauma patients and predicting their discharge destination compared with the condensed version. LOS in this vulnerable patient group did not differ by either frailty phenotype even if compared with those identified as non-frail.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1007"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863087","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":"Perspectives on managing innovation readiness in long-term care: a Q-methodology study.","authors":"Monique W van den Hoed, Ramon Daniëls, Audrey Beaulen, Jan P H Hamers, Job van Exel, Ramona Backhaus","doi":"10.1186/s12877-024-05572-3","DOIUrl":"https://doi.org/10.1186/s12877-024-05572-3","url":null,"abstract":"<p><strong>Background: </strong>The scarcity of resources in long-term care demands more than ever that organizations in this sector are prepared for innovation to ensure affordable access to care for older adults. Organizations that are innovation ready are more capable of implementing innovations. Therefore, a better understanding of how stakeholders view innovation readiness in long-term care can provide actionable strategies to enhance their innovative capacities. 'Innovation readiness' indicates the level of maturity of an organization to succeed in any type of innovation. Our study explored perspectives among stakeholders on what they consider important for organizations in long-term care for older adults to be innovation ready.</p><p><strong>Methods: </strong>Q-methodology, a mixed-methods approach, was used to investigate the perspectives of 30 stakeholders connected to long-term care for older adults in the Netherlands: academics, (top)management, innovation managers, client representatives, staff, and consultants. Stakeholders were asked to rank 36 statements on innovation readiness on importance. Statements were extracted from literature research and qualitative interviews. Thereafter in the post-interviews stakeholders explained their ranking and reflected on the statements. By-person factor analysis was used to identify clusters in the ranking data. Together with the qualitative data from follow-up interviews, these clusters were interpreted and described as perspectives of the stakeholders.</p><p><strong>Results: </strong>Four distinct perspectives were identified on what they consider important for innovation readiness in long-term care: (1) 'supportive role of management' (2) 'participation of the client (system) and employees' (3) 'setting the course and creating conditions' and (4) 'structuring decision-making, roles and responsibilities'. The 36 statements represented a complete overview of innovation readiness factors. No additional innovation factors to those previously identified in the literature emerged from the interviews.</p><p><strong>Conclusions: </strong>Stakeholders agree that all factors contributing to innovation readiness of long-term care organizations for older adults are accounted for. The variety of perspectives on what is most important shows there is no agreement among stakeholders about a fixed route toward innovation readiness. However, stakeholders suggested a temporal order of the innovation readiness factors, preferably starting with formulating the innovation ambition. This study's results could contribute to developing an assessment tool to deliver a structured approach for managers to assess the innovation readiness of their organization.</p><p><strong>Registration: </strong>The study received ethical approval on April 13, 2022 from the Medical Ethics Board of Zuyderland Medical Center in the Netherlands with the number METCZ20220036.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1017"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863181","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":"Exploring the reasons for self-administration medication errors among illiterate and low-literate community-dwelling older adults with polypharmacy: a qualitative study.","authors":"Nafiseh Ghassab-Abdollahi, Zahra Ghorbani, Narges Kheirollahi, Haidar Nadrian, Mina Hashemiparast","doi":"10.1186/s12877-024-05595-w","DOIUrl":"https://doi.org/10.1186/s12877-024-05595-w","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy and low literacy increase medication self-administration errors (MSEs) among older adults, adversely affecting both patients and healthcare systems through increased costs and reduced treatment efficacy.</p><p><strong>Objectives: </strong>This study explored the reasons for MSEs among illiterate and low-literate older adults with polypharmacy from the perspective of older adults, informal family caregivers, physicians, and pharmacists.</p><p><strong>Method: </strong>The qualitative study used a conventional content analysis approach from September 2022 to April 2023. Purposeful sampling was used to recruit participants for interviews.</p><p><strong>Results: </strong>The study included fifteen older adults, five caregivers, four physicians, and seven pharmacists. Seven main categories were extracted: 1) Age-related physical and cognitive changes, 2) Medication Mismanagement, 3) Inhibitor beliefs of proper medication use, 4) Caregiving challenges, 5) Deficiency in effective communication and education, 6) Health systems inefficiencies, 7) The challenges of producing, dispensing and obtaining medications.</p><p><strong>Conclusion: </strong>The origins of MSEs encompass a broad spectrum of factors, ranging from individual to systemic levels. Successful interventions for reducing errors will be those that take into account all aspects of error occurrence and strive to minimize them through a holistic approach. The findings highlight the importance of improving organizational health literacy strategies for older adults with limited literacy. Tailoring health information to the specific needs of older patients is crucial for addressing MSEs.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1010"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863041","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":"Catatonia-asossicated urinary retention in geriatric patients: a case series report.","authors":"Monica Parmar, Timothy Lau","doi":"10.1186/s12877-024-05544-7","DOIUrl":"https://doi.org/10.1186/s12877-024-05544-7","url":null,"abstract":"<p><strong>Background: </strong>Catatonia is an underdiagnosed neuropsychiatric condition, with only a few studies focusing on medical sequalae among elderly populations. Delayed treatment results in complications with high morbidity and mortality. Among elderly individuals, one such complication is urinary retention. Urinary retention can result in prolonged catheter use. In geriatric populations, prolonged use of catheters become particularly concerning and problematic as it can limit patient mobility, are potential sources for infection, and increase the risk for delirium. Catheter use has been independently associated with increased mortality in nursing home settings. Given the above risks and implications of catheter use, this case series describes clinical cases of catatonia-associated urinary retention specifically in older populations, whereby the use of electroconvulsive therapy (ECT) resulted in resolution of urinary retention concurrent with resolution of depressive and catatonic symptoms using validated scales.</p><p><strong>Case presentation: </strong>This study involved four patients ranging from 66-84 years old who met criteria for major depressive disorder and catatonia. At admission, Montgomery-Asberg Depression Rating Scale (MADRS) scores ranged from 40-56, indicating severe illness in all patients. All patients also met criteria for catatonia as measured by the Bush Francis Catatonia Rating Scale (BFCRS). During the admission, each patient experienced urinary retention as evidenced by post-void residual (PVR) bladder volumes ranging from 569-1400 mL. Medical workup was completed to exclude alternative causes for urinary retention. Each patient completed ECT treatment, ranging from 14-19 sessions which resulted in resolution of catatonia. All four patients were also noted to have PVR volumes ranging from 6-75 mL, thereby suggesting concurrent resolution of urinary retention. Posttreatment, the MADRS scores ranged from 3-16, indicating a mild or subthreshold index of illness. There was no recurrence of elevated post-void residual volumes, and therefore, all patients were discharged from hospital without the requirements of urinary catheter insertion.</p><p><strong>Conclusions: </strong>To our knowledge, there are no case reports that describe the concurrent resolution of catatonia, depressive symptoms and urinary retention simultaneously using validated scales throughout the ECT treatment course. Furthermore, there are no prior reports describing catatonia-related urinary retention specifically among a group of geriatric populations. Identifying and treating catatonia in a timely manner can reduce the complications associated with prolonged catheter use. There remains a gap in current research to describe if there exists any overlapping mechanisms and pathways to explain how ECT can treat catatonia, depression, and catatonia-associated urinary retention.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1014"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862771","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":"Clinical characteristics and intravitreal aflibercept outcomes in patients aged 90 years and older with neovascular age-related macular degeneration.","authors":"Feyzahan Uzun","doi":"10.1186/s12877-024-05596-9","DOIUrl":"https://doi.org/10.1186/s12877-024-05596-9","url":null,"abstract":"<p><strong>Background: </strong>Age-related macular degeneration (AMD) stands as the primary cause of visual impairment and blindness among the elderly population. Patients over 90 years comprise a unique demographic that may necessitate particular attention. The aim of this study was to examine the clinical characteristics and treatment outcomes in patients aged 90 years or older diagnosed with neovascular age-related macular degeneration (nAMD).</p><p><strong>Methods: </strong>The medical records of treatment-naive patients aged ≥ 90 years diagnosed with nAMD have been retrospectively reviewed in our clinic. The complete ophthalmic examination findings of the patients, along with optical coherence tomography and fundus fluorescein angiography records, as well as their adherence to treatment, and reasons for treatment discontinuation were noted. Clinical data following intravitreal injection loading dose and during the 1st and 2nd years of treatment were evaluated.</p><p><strong>Results: </strong>The average age of the 45 participants (25 females, 20 males) included in the study was 93.55 ± 5.2 years (range; 90-101). The mean best-corrected visual acuity at diagnosis, at the 4th month of treatment, and during the 1st and 2nd years were LogMAR 0.8, 0.5, 0.7 and 1.0, respectively. The most common reasons for missing appointments and completely discontinuing treatment were death and inability to attend appointments due to additional comorbidities.</p><p><strong>Conclusion: </strong>In the very elderly patient group, nAMD can lead to severe damage in the macula, and a decrease in visual acuity despite treatment is not uncommon. Close monitoring and support for treatment adherence are necessary for this group of patients.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1003"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862774","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 effect of sensory manipulation on the static balance control and prefrontal cortex activation in older adults with mild cognitive impairment: a functional near-infrared spectroscopy (fNIRS) study.","authors":"Guocai Xu, Mian Zhou, Jiangna Wang, Dewei Mao, Wei Sun","doi":"10.1186/s12877-024-05624-8","DOIUrl":"https://doi.org/10.1186/s12877-024-05624-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the modulatory role of prefrontal cortex (PFC) activity in older adults with mild cognitive impairment (MCI) when sensory cues were removed or presented inaccurately (i.e., increased sensory complexity) during sensory manipulation of a balance task. The research sheds light on the neural regulatory mechanisms of the brain related to balance control in individuals with MCI.</p><p><strong>Methods: </strong>21 older adults with MCI (male/female: 9/12, age: 71.19 ± 3.36 years) were recruited as the experimental group and 19 healthy older adults (male/female: 10/9, age: 70.16 ± 4.54 years) as the control group. Participants were required to perform balance tests under four standing conditions: standing on a solid surface with eyes open, standing on a foam surface with eyes open, standing on a solid surface with eyes closed, and standing on a foam surface with eyes closed. Functional Near-Infrared Spectroscopy (fNIRS) and force measuring platform are used to collect hemodynamic signals of the PFC and center of pressure (COP) data during the balance task, respectively.</p><p><strong>Results: </strong>Under the eyes open condition, significant Group*Surface interaction effects were found in the mean velocity of the COP (MVELO), the mean velocity in the medial-lateral (ML) direction (MVELO_ml) and the 95% confidence ellipse area of the COP (95%AREA-CE). Additionally, significant Group*Surface interaction effect was found in the left orbitofrontal cortex (L-OFC). The significant group effects were detected for three ROI regions, namely the left ventrolateral prefrontal cortex (L-VLPFC), the left dorsolateral prefrontal cortex (L-DLPFC), the right dorsolateral prefrontal cortex (R-DLPFC). Under the eyes closed condition, the significant Group*Surface interaction effects were found in root mean square (RMS), the RMS in the ML direction (RMS_ml) and the 95%AREA-CE. Additionally, significant group effects were detected for five ROI regions, namely R-VLPFC, the left frontopolar cortex (L-FPC), L-DLPFC, R-DLPFC and R-OFC.</p><p><strong>Conclusion: </strong>Our study emphasizes the role of the PFC in maintaining standing balance control among older adults with MCI, particularly during complex sensory conditions, and provides direct evidence for the role of the PFC during balance control of a clinically relevant measure of balance.</p><p><strong>Trial registration: </strong>ChiCTR2100044221, 12/03/2021.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1020"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863114","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":"Age- and sex-disaggregated disease burden among the older persons in India.","authors":"G Anil Kumar, Anamika Pandey, Sailesh Mohan, Dorairaj Prabhakaran, Rakhi Dandona","doi":"10.1186/s12877-024-05614-w","DOIUrl":"https://doi.org/10.1186/s12877-024-05614-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the context of the increasing number and proportion of population aged 60 years or more in India, it is imperative to understand their health needs for ensuring healthy ageing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we identified the top ten causes of disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) disaggregated by sex and age groups (60-64 years, 65-69 years, 70-74 years, 75-79 years, and ≥ 80 years) for India in 2019. We analysed the proportional contribution of individual causes to the total DALYs due to communicable diseases (CMNNDs), non-communicable diseases (NCDs), and injuries disaggregated by age and sex. We report the state-level heterogeneity in the crude DALY rate for CMNNDs, NCDs, and injuries for older persons disaggregated by sex. Additionally, we reviewed if the data capture of service delivery indicators on older persons were age- and sex-disaggregated in the Health and Wellness Centres (HWCs), and in the National Programs aimed at the Health Care for the Elderly (NPHCE), Prevention and Control of Non-communicable Diseases (NP-NCD), Control of Blindness and Visual Impairment (NPCBVI), Prevention & Control of Deafness (NPPCD), the Mental Health Program (NMPH), and the AYUSH Musculoskeletal Disorders Program (MSDP) within the context of disease burden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The older persons accounted for a total of 136.1 million DALYs (29.1% of the total DALYs) in 2019 of which 77.9% were from NCDs, 14.8% from CMNNDs, and 7.3% from injuries, and nearly two-thirds of DALYs were accounted by YLLs. In NCDs, cardiovascular diseases, chronic respiratory diseases, neoplasms, diabetes and kidney diseases, and musculoskeletal disorders accounted for nearly 80% of DALYs for both sexes. There were variations in the magnitude of disease burden by specific diseases and conditions between females and males, and by age groups within both sexes particularly for injuries and CMNNDs. Injuries accounted for more YLDs than YLLs, ranging between 5.9%-15.2% for females and 15.3%-17.3% for males, with the females having a higher contribution to total injury related DALYs due to falls as compared to the males (54.4% vs 36.6%), whereas the males had a higher contribution to total DALYs due to road injuries (33.8% vs 19.4%). There was substantial variation in the crude DALY rates of major disease groups by the two sexes across the states of India in 2019. The crude DALY rate for CMNNDs varied between 3.6 times -3.7 times between the states for females and males, respectively; NCDs varied between 1.3 times -1.9 times, and injuries varied 2.0 times -1.7 times. The capture of service utilisation indicators was not age- or sex-disaggregated in NPHCE, NPCBVI, NMHP, MSDP, and HWCs; sex-disaggregation was available in NP-NCD but not age-disaggregation; sex-disaggregated data wa","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1019"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862755","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":"Predictive value of a self-administered frailty screening questionnaire for the effectiveness of functional rehabilitation evaluated with the locomotor functional independence measure in a geriatric rehabilitation unit: a multicentre cohort study.","authors":"Jan Chrusciel, Ramatoulaye Ndoye, Biné-Mariam Ndiongue, Marie-Anne Fournier, Fariba Kabirian, Manon Pondjikli, Valentine Dutheillet-de-Lamothe, Gilles Berrut, Yves Rolland, Stéphane Sanchez","doi":"10.1186/s12877-024-05605-x","DOIUrl":"https://doi.org/10.1186/s12877-024-05605-x","url":null,"abstract":"<p><strong>Background: </strong>Patient Reported Outcome Measures (PROMs) are questionnaires that collect health data directly from the patient, without any intervention from a third party. The aim of rehabilitation units is to restore function. Functional gain can be evaluated with classic scales, such as the locomotor subscale of the Functional Independence Measure. This study aimed to assess the accuracy of a new self-assessment questionnaire pertaining to physical, sensory and cognitive ability (abbreviated SEPCO) for the prediction of functional prognosis in older patients admitted to a rehabilitation unit.</p><p><strong>Methods: </strong>In this multicentre observational study including patients admitted to 12 rehabilitation centres in France, all included patients completed the SEPCO on admission. Poor response to rehabilitation was defined as relative effectiveness < 40% on the evolution of the locomotor FIM subscale. Components of the questionnaire potentially associated with the outcome of rehabilitation were confirmed for inclusion upon expert review and summed to form an overall score. The final score had five components: the depression score of the HADS, the SOFRESC vision score, the SOFRESC balance score, the stress urinary incontinence subscale of the USP, and the EPICES socio-economic deprivation score. A logistic regression model adjusted for baseline characteristics assessed the performance of the SEPCO score to predict change in functional status, defined by the relative functional gain for the locomotion subscale of the Functional Independence Measure (FIM).</p><p><strong>Results: </strong>A total of 153 patients (mean age 79.2 ± 8.1 years, 72.5% women) were included. By multivariate analysis, a 5-scale SEPCO score ≥ 1.1 predicted worse functional improvement with an odds ratio (OR) of 2.575, 95% Confidence Interval (CI) 1.081 to 6.133, p = 0.03. Sensitivity for this threshold was 67.4% (95% CI 52.0-80.5%), with a specificity of 58.8% (95% CI 46.2-70.6%). Having a SEPCO ≥ 1.1 almost doubled the probability of poor response to rehabilitation (from 27.3 to 52.5%).</p><p><strong>Conclusion: </strong>The SEPCO score can predict poor functional gain from rehabilitation. Future studies should validate this score on an external cohort. The SEPCO could serve as a complement to the initial clinical evaluation performed by physicians, and assist physicians in setting each patient's rehabilitation goals.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1013"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863182","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}