BMC Geriatrics最新文献

{"title":"Polypharmacy and anticholinergic burden scales in older adults: a cross-sectional study among psychiatric outpatients in a tertiary care hospital.","authors":"Manjunath Bidarolli, Biswadeep Das, Vikram Singh Rawat, Sachin Manocha, Hannah Theresa Sony, Akash Agnihotri, Mahima Gupta, Franklin Agera","doi":"10.1186/s12877-024-05584-z","DOIUrl":"10.1186/s12877-024-05584-z","url":null,"abstract":"<p><strong>Introduction: </strong>Mental disorders are prevalent among older adults, often leading to the use of multiple medications, many with anticholinergic properties. Polypharmacy, common in this population, is a major contributor to anticholinergic burden, which is linked to cognitive and physical decline. This study investigates the relationship between polypharmacy and anticholinergic burden across seven anticholinergic burden scales in elderly patients attending the psychiatric outpatient.</p><p><strong>Methods: </strong>Study was conducted at a psychiatry outpatient clinic at All India Institute of Medical Sciences, Rishikesh, India, from December 2021 to March 2023. Elderly patients (aged ≥ 60 years) who were on at least one psychotropic medication and had a primary working diagnosis of psychiatric illness were included. All psychotropic medications, including antidepressants, antipsychotics, mood stabilizers, and hypnotics, were evaluated. Anticholinergic burden scales were calculated by the respective tools. Univariate analysis was adopted to determine the factors that may affect polypharmacy.</p><p><strong>Results: </strong>Study included 1165 elderly patients aged ≥ 60 years. The prevalence of polypharmacy was 20.43% (n = 238). Clonazepam (n = 364, 17.28%), escitalopram (n = 197, 9.35%), metformin (n = 165, 7.83%), sertraline (n = 141, 6.69%), mirtazapine (n = 129, 6.12%), and lorazepam (n = 110, 5.22%) were among the most frequently prescribed anticholinergic drugs. Univariate analysis demonstrated that all anticholinergic risk assessment scales were closely correlated with polypharmacy, with the strongest association observed for the Anticholinergic Load Scale (ALS) (Odds Ratio = 4.3; p < 0.001). Polypharmacy was also positively associated with adverse drug reactions (Odds Ratio = 1.81; 95% Confidence Interval = 1.27-2.56).</p><p><strong>Conclusion: </strong>The anticholinergic burden in this cohort of elderly psychiatry patients was high, with 95.1% (n = 1108) experiencing a significant burden. Adverse drug events and anticholinergic burden scales were positively associated with polypharmacy, with a stronger correlation between polypharmacy and ALS scores than with other anticholinergic burden scales in older adults.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"43"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mobile-based multidomain lifestyle intervention using Cognitive Evergreenland for older adults with subjective cognitive decline: a feasibility study.","authors":"Rong Lin, Yuanjiao Yan, Zhili Chen, Chenshan Huang, Junyu Zhao, Mingfeng Chen, Hong Li","doi":"10.1186/s12877-025-05684-4","DOIUrl":"10.1186/s12877-025-05684-4","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a growing public health issue. Non-drug interventions targeting individuals before the onset of overt cognitive decline may be effective. Subjective cognitive decline (SCD) is present in > 50% of older adults and associated with progression to dementia. Here, we tested the compliance and effectiveness of a Multidomain Lifestyle Intervention Program using the mini-program, Cognitive Evergreenland, (MLIP-CE), based on the Health Action Process Approach model to support home-based intervention in older adults with SCD.</p><p><strong>Methods: </strong>Cognitive Evergreenland was designed to improve cognitive reserve and maintain brain function in people at high risk of dementia and included: cognitive stimulation, cognitive training, health education, vascular risk monitoring, social support, and functional assessment, among other features. This was an exploratory trial designed to examine participant compliance with the mobile lifestyle intervention and its effectiveness, as well as changes in health-related indicators and cognitive function of older adults with SCD from baseline to 12 and 24 weeks post-intervention.</p><p><strong>Results: </strong>The retention rate for MLIP-CE was 90.2% (37/41). Mean participant age was 70.93 ± 6.91 years, 73.2% of participants were female, and mean Montreal Cognitive Assessment score was 24.51 ± 2.87. Throughout the 24 weeks of the prescribed intervention, app usage remained consistently high, with over 92% of participants using the mini-program at least once a week and successfully completing corresponding health management tasks. In terms of average usage, cognitive training emerged as the most frequently used functional module (95.73%), closely followed by health education (95.02%). The health behavior levels of older adults with SCD, measured in terms of ability, opportunity, and motivation, were significantly increased relative to baseline (p < 0.001). Regarding cognitive function, Mini-Mental State Examination scores were significantly improved post-intervention, with a moderate effect size (Hedges' g = 0.60).</p><p><strong>Conclusions: </strong>These findings suggest that MLIP-CE, which was designed based on a theoretical framework, has potential for implementation, and support ongoing research into use of MLIP-CE for individuals at high risk of SCD or other dementia conditions.</p><p><strong>Trial registration: </strong>The trial was prospectively registered at the Chinese Clinical Trials Registry with the registration number ChiCTR2200058665 on 13 April 2022.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"41"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time travel of older people through virtual reality: a qualitative study.","authors":"Leyla Muslu, Zeynep Karakuş, Ercan Asï, Rabia Bayindir, Zeynep Özer","doi":"10.1186/s12877-025-05699-x","DOIUrl":"10.1186/s12877-025-05699-x","url":null,"abstract":"<p><strong>Background: </strong>Innovative technologies such as virtual reality may improve physical and cognitive functions in older people. While there are some experimental studies on virtual reality, qualitative studies related to the virtual reality experiences of older people are limited in the literature. This study aims to describe older people's perceptions about their experiences regarding virtual reality.</p><p><strong>Methods: </strong>The study has qualitative descriptive design. The data were collected through semi-structured individual interviews with older people (n = 37). The interviews were conducted during a two-months period, from February to March 2022. Thematic and descriptive analysis was used to analyse data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.</p><p><strong>Results: </strong>Four themes and 15 sub-themes were identified from the interviews. The themes were (a) time travel through virtual reality, (b) comparing the past and present through virtual reality, (c) benefits of virtual reality, and (d) the meaning of virtual reality.</p><p><strong>Conclusions: </strong>This study provides in-depth information about the views of older people regarding the virtual reality experience. The study revealed that older people had positive experiences with virtual reality and showed that it has the potential to be useful in elderly care. In the study, virtual reality also enabled older people to have a time-traveling experience. It is recommended that virtual reality should be integrated into the care of older people by nurses and healthcare professionals.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"42"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living Lab Dementia: process evaluation of an academic-practice partnership in German long term care for people living with dementia - study protocol.","authors":"Andrea Leinen, Felix Bühler, Sascha Köpke, Mareike Löbberding, Gabriele Meyer, Helga Schneider-Schelte, Stefan Wilm, Anja Bieber, Martin N Dichter","doi":"10.1186/s12877-024-05649-z","DOIUrl":"10.1186/s12877-024-05649-z","url":null,"abstract":"<p><strong>Background: </strong>Living Labs, as a type of academic-practice partnerships, possess the potential to transform care and research into a participatory partnership and narrow the research-practice gap to improve evidence-based and Person-centred care. Given the lack of systematic investigations of Living Labs in healthcare, we will establish a dementia-specific academic-practice partnership (Living Lab Dementia) in Germany and conduct a process evaluation. The aim of this study is to gain insights into the intervention itself (mechanisms of impact) and its implementation process (degree of implementation, barriers, and facilitators).</p><p><strong>Methods: </strong>This process evaluation of the multi-center research project PraWiDem (German acronym for linking professional nursing practice and research in dementia) will be conducted applying a convergent mixed methods design and will be based on the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. The intervention is presented in a logic model which describes relevant basic theoretical assumptions, intervention components, implementation aspects, mechanisms of impact, relevant outcomes, and the context in which the intervention is delivered. Data will be collected before the intervention (T₀), during the intervention period, and at follow-up after 18 months (T₁). Qualitative data will be collected through semi-structured interviews and focus groups. Quantitative data sources will be process documents and questionnaires.</p><p><strong>Discussion: </strong>Our study will provide important insights into the Living Lab Dementia intervention and its implementation processes. The results of this evaluation will contribute to the refinement of the intervention and its implementation processes, and will enable to measure the impact of these processes in future studies.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"40"},"PeriodicalIF":3.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on which health settings geriatricians should staff: a qualitative study of patients, care providers and health administrators.","authors":"Eric Kai-Chung Wong, Andrea C Tricco, Wanrudee Isaranuwatchai, David M J Naimark, Sharon E Straus, Joanna E M Sale","doi":"10.1186/s12877-025-05691-5","DOIUrl":"10.1186/s12877-025-05691-5","url":null,"abstract":"<p><strong>Background: </strong>With a shortage of geriatricians and an aging population, strategies are needed to optimise the distribution of geriatricians across different healthcare settings (acute care, rehabilitation and community clinics). The perspectives of knowledge users on staffing geriatricians in different healthcare settings are unknown. We aimed to understand the acceptability and feasibility (including barriers and facilitators) of implementing a geriatrician-led comprehensive geriatric assessment (CGA) in acute care, rehabilitation, and community clinic settings.</p><p><strong>Methods: </strong>A qualitative description approach was used to explore the experience of those implementing (administrative staff), providing (healthcare providers), and receiving (patients/family caregivers) a geriatrician-led CGA in acute care, rehabilitation and community settings. Semi-structured interviews were conducted in Toronto, Canada. The theoretical domains framework and consolidated framework for implementation research informed the interview guide development. Analysis was conducted using a thematic approach.</p><p><strong>Results: </strong>Of the 27 participants (8 patients/caregivers, 9 physicians, 10 administrators), the mean age was 53 years and 14 participants (52%) identified as a woman (13 [48%] identified as a man). CGAs were generally perceived as acceptable but there was a divergence in opinion about which healthcare setting was most important for geriatricians to staff. Acute care was reported to be most important by some because no other care provider has the intersection of acute medicine skills with geriatric training. Others reported that community clinics were most important to manage geriatric syndromes before hospitalization was necessary. The rehabilitation setting appeared to be viewed as important but as a secondary setting. Facilitators to implementing a geriatrician-led CGA included (i) a multidisciplinary team, (ii) better integration with primary care, (iii) a good electronic patient record system, and (iv) innovative ways to identify patients most in need of a CGA. Barriers to implementing a geriatrician-led CGA included (i) lack of resources or administrative support, (ii) limited team building, and (iii) consultative model where recommendations were made but not implemented.</p><p><strong>Conclusions: </strong>Overall, participants found CGAs acceptable yet had different preferences of which setting to prioritise staffing if there was a shortage of geriatricians. The main barriers to implementing the geriatrician-led CGA related to lack of resources.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"39"},"PeriodicalIF":3.4,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity, Vitamin D, and all-cause/cardiovascular mortality: a prospective study in older Chinese adults.","authors":"Mingrui Chen, Ling Cheng, Sisi Yang, Yan Zhang","doi":"10.1186/s12877-025-05687-1","DOIUrl":"https://doi.org/10.1186/s12877-025-05687-1","url":null,"abstract":"<p><strong>Background: </strong>Physical activity was associated with the risk of all-cause and cardiovascular mortality. However, little is known about older adults, especially those aged over 80 years.</p><p><strong>Methods: </strong>2863 older adults in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were enrolled. Physical activity score was used to evaluate the physical activity. Serum 25-hydroxyvitamin D and demographic characteristics were collected at baseline. We used multivariable-adjusted Cox regression models and stratified analysis to determine the association between physical activity, vitamin D and all-cause/cardiovascular mortality. Mediation analysis was performed to evaluate the mediating effect of vitamin D between physical activity and all-cause/cardiovascular mortality.</p><p><strong>Results: </strong>The median age of this population was 87 years, and 70.27% were the oldest-old (age ≥ 80 years). We observed a tendency for a higher vitamin D concentration in participants with higher physical activity score levels. Both physical activity and vitamin D levels were inversely associated with all-cause and cardiovascular mortality in all participants. Between physical activity and all-cause/cardiovascular mortality, the mediation proportions of vitamin D were 7.76% (P < 0.001) and 4.13% (P < 0.001), respectively. The mediating effect of vitamin D remained all significant in various types of physical activities. Furthermore, vitamin D accounted for a greater mediating proportion in the physical activities of housework and raising domestic animals/pets.</p><p><strong>Conclusions: </strong>Physical activity could reduce the risk of all-cause/cardiovascular mortality and was mediated by vitamin D in older Chinese adults.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"38"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective comparison of cortical bone trajectory and pedicle screw in lumbar fusion for patients over 80, including sagittal balance: a single-center study.","authors":"Giwuk Jang, Seungjun Ryu, Sanghoon Lee, Jeong-Yoon Park, Dong-Ah Shin, Hoyeol Zhang","doi":"10.1186/s12877-024-05590-1","DOIUrl":"https://doi.org/10.1186/s12877-024-05590-1","url":null,"abstract":"<p><strong>Background: </strong>Comparative studies of posterior lumbar interbody fusion with cortical bone trajectory and pedicle screw in older patients, particularly in those aged ≥ 80 years, are rare. This study aimed to retrospectively analyze the clinical and surgical outcomes following posterior lumbar interbody fusion with pedicle screw fixation compared to cortical bone trajectory in patients aged ≥ 80 years with degenerative lumbar spine disease.</p><p><strong>Methods: </strong>We included 68 patients aged ≥ 80 years who underwent degenerative lumbar spinal surgery at our spine center between January 2011 and December 2020. Of these 68 patients, 24 and 44 underwent posterior lumbar interbody fusion with cortical bone trajectory and pedicle screw, respectively.</p><p><strong>Results: </strong>The Visual Analog Scale for back pain was significantly lower in the cortical bone trajectory group than in the pedicle screw group at 6 months postoperatively (P = 0.049). The Oswestry Disability Index was significantly lower in the cortical bone trajectory group than in the pedicle screw group at 6 months postoperatively (P = 0.05). The estimated blood loss and operation time were significantly lower in the cortical bone trajectory group than in the pedicle screw group (P = 0.017 and P < 0.001, respectively). Postoperative morbidity was also lower in the cortical bone trajectory group (P = 0.049).</p><p><strong>Conclusions: </strong>Despite these limitations, our study findings indicate that cortical bone trajectory is not inferior to posterior lumbar interbody fusion with pedicle screw fixation if there is a need for fusion in older patients aged ≥ 80 years.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"37"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain computer interfaces for cognitive enhancement in older people - challenges and applications: a systematic review.","authors":"Ping-Chen Tsai, Asangaedem Akpan, Kea-Tiong Tang, Heba Lakany","doi":"10.1186/s12877-025-05676-4","DOIUrl":"https://doi.org/10.1186/s12877-025-05676-4","url":null,"abstract":"<p><strong>Background: </strong>Brain-computer interface (BCI) offers promising solutions to cognitive enhancement in older people. Despite the clear progress received, there is limited evidence of BCI implementation for rehabilitation. This systematic review addresses BCI applications and challenges in the standard practice of EEG-based neurofeedback (NF) training in healthy older people or older people with mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>Articles were searched via MEDLINE, PubMed, SCOPUS, SpringerLink, and Web of Science. 16 studies between 1st January 2010 to 1st November 2024 are included after screening using PRISMA. The risk of bias, system design, and neurofeedback protocols are reviewed.</p><p><strong>Results: </strong>The successful BCI applications in NF trials in older people were biased by the randomisation process and outcome measurement. Although the studies demonstrate promising results in effectiveness of research-grade BCI for cognitive enhancement in older people, it is premature to make definitive claims about widespread BCI usability and applicability.</p><p><strong>Significance: </strong>This review highlights the common issues in the field of EEG-based BCI for older people. Future BCI research could focus on trial design and BCI performance gaps between the old and the young to develop a robust BCI system that compensates for age-related declines in cognitive and motor functions.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"36"},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous high-soy protein soymilk intake affects ordinary walking speed in the Japanese pre-frail and frail elderly: a randomized controlled trial.","authors":"Nene Sato, Yuji Terashima, Makoto Sugawara, Ryoichi Unno, Hiroaki Asao, Mitsuhiro Iwasaki, Tomoyuki Watanabe, Tomoko Uno, Mitsuo Maruyama","doi":"10.1186/s12877-024-05539-4","DOIUrl":"https://doi.org/10.1186/s12877-024-05539-4","url":null,"abstract":"<p><strong>Background: </strong>To investigate whether continuous intervention using soymilk containing high soy protein improves physical frailty, a randomized controlled trial was conducted among the Japanese pre-frail and frail elderly.</p><p><strong>Methods: </strong>Japanese pre-frail and frail elderly participants (n = 73) were randomly assigned to the high-soy protein and control groups, who then ingested soymilk containing 14.5 g/200 ml and 3.2 g/200 ml of soy protein, respectively. Before and after the 12-week intervention, walking speed, skeletal muscle mass, grip strength, and the revised Japanese CHS questionnaire regarding fatigue and physical activity were examined to evaluate the impact of each soymilk on physical frailty and compare the variation between the two groups. Physical activity (monitored using a pedometer), dietary intake (determined by questionnaire), and estimated protein intake (determined by casual urine testing) were also recorded before and after the intervention.</p><p><strong>Results: </strong>For the final analysis of the entire cohort (n = 70), there were no significant differences in the endpoints between the two groups. In the subgroup analysis, among participants with a walking speed of at least 1 m/s (n = 35, P = 0.012) and at least 5,000 steps/day before intervention (n = 27, P = 0.0083), the variation in walking speed after the 12-week intervention was significantly higher in the high-soy protein group than in the control group. Estimated protein intake was also significantly higher in the high-soy protein group than in the control group after the intervention. Regarding physical activity and dietary intake, no significant differences were observed between the groups before or after the intervention.</p><p><strong>Conclusion: </strong>The continuous 12-week intervention of high soy protein increased the walking speed among the Japanese pre-frail and frail elderly participants who had an ordinarily high walking speed and high step counts.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry, UMIN000044999. Registered July 29, 2021; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000051409 .</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"35"},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between edaravone use and activities of daily living in older patients with atherothrombotic stroke: an observational study using Japanese real-world data.","authors":"Yukari Ogawa, Hiroko Akiyama, Takeshi Horii, Kiyoshi Mihara","doi":"10.1186/s12877-024-05666-y","DOIUrl":"https://doi.org/10.1186/s12877-024-05666-y","url":null,"abstract":"<p><strong>Background: </strong>Edaravone is marketed in nine countries, although only Japan has approved edaravone for improvement of neurological symptom, disability of activities of daily living (ADL), and functional disability associated with acute stroke. This study aimed to elucidate the association of edaravone use with ADL using real-world data of older patients with atherothrombotic stroke.</p><p><strong>Methods: </strong>This retrospective observational research using the Medical Data Vision database in Japan included patients aged 65 years and older who had acute ischemic stroke of the atherothrombotic subtype. Primary outcome was ADL improvement defined as change in Barthel Index from admission to discharge of greater than zero points. The major secondary outcome was good functional outcome (Barthel Index ≥ 90 or modified Rankin Scale 0-2 at discharge). Multivariate logistic regression analyses were conducted to calculate odds ratios with 95% confidence intervals for the outcomes. We further compared the change in Barthel Index from admission to discharge and in-hospital death rate between the edaravone- and non-edaravone- treated patients.</p><p><strong>Results: </strong>A total of 5,576 patients were included in this study, and were divided into edaravone group (n = 3,825) and non-edaravone group (n = 1,751). The median age of this cohort was 79 years, and median Barthel Index at admission was 30 points. Edaravone use was associated with improved ADL with an adjusted odds ratio of 1.18 (95% confidence interval: 1.01‒1.37). However, no significant association was observed between edaravone use and good functional outcome. The edaravone group had significantly greater change in Barthel Index from admission to discharge than the non-edaravone group, with a difference of 5 points. The in-hospital death rate was comparable between the two groups.</p><p><strong>Conclusions: </strong>Edaravone use may contribute to improve ADL at discharge in patients aged 65 years and older with atherothrombotic stroke.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"31"},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}