BMC Geriatrics最新文献

{"title":"The impact of patient-facility language discordance on potentially inappropriate prescribing of antipsychotics in long-term care home in Ontario, Canada: a retrospective population health cohort study.","authors":"Michael Reaume, Cayden Peixoto, Michael Pugliese, Peter Tanuseputro, Ricardo Batista, Claire E Kendall, Josette-Renée Landry, Denis Prud'homme, Marie-Hélène Chomienne, Barbara Farrell, Lise M Bjerre","doi":"10.1186/s12877-024-05446-8","DOIUrl":"10.1186/s12877-024-05446-8","url":null,"abstract":"<p><strong>Background: </strong>Appropriate use of medication is a key indicator of the quality of care provided in long-term care (LTC). The objective of this study was to determine whether resident-facility language concordance/discordance is associated with the odds of potentially inappropriate prescribing of antipsychotics (PIP-AP) in LTC.</p><p><strong>Methods: </strong>We conducted a population-based, retrospective cohort study of LTC residents in Ontario, Canada from 2010 to 2019. We obtained resident language from standardized resident assessments, and derived facility language by determining the proportion of residents belonging to each linguistic group within individual LTC homes. Using linked administrative databases, we identified all instances of PIP-AP during a 1-year follow-up period. PIP-AP was defined using the STOPP-START criteria, which have previously been shown to predict adverse clinical events such as emergency department (ED) visits and hospitalizations. The association between linguistic factors and PIP-AP was assessed using adjusted multivariable logistic regression analysis.</p><p><strong>Results: </strong>We identified 198,729 LTC residents consisting of 162,814 Anglophones (81.9%), 6,230 Francophones (3.1%), and 29,685 Allophones (14.9%). The odds of PIP-AP of were higher for both Francophones (aOR 1.15, 95% CI 1.08-1.23) and Allophones (aOR 1.11, 95% CI 1.08-1.15) when compared to Anglophones. When compared to English LTC homes, French LTC homes had greater odds of PIP-AP (aOR 1.12, 95% CI 1.05-1.20), while Allophone homes had lower odds of PIP-AP (aOR 0.82, 95% CI 0.77-0.86). Residents living in language-discordant LTC homes had higher odds of PIP-AP when compared to LTC residents living in language-concordant LTC homes (aOR 1.07, 95% CI 1.04-1.10).</p><p><strong>Conclusion: </strong>This study identified linguistic factors related to the odds of PIP-AP in LTC, suggesting that the linguistic environment may have an impact on the quality of care provided to residents.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"889"},"PeriodicalIF":3.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520977","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":"The relationship between oropharyngeal dysphagia and dehydration in older adults.","authors":"Müberra Tanrıverdi, Cihan Heybeli, Ömer Faruk Çalım, Merve Durna, Orhan Özturan, Pinar Soysal","doi":"10.1186/s12877-024-05492-2","DOIUrl":"10.1186/s12877-024-05492-2","url":null,"abstract":"<p><strong>Background: </strong>Relationship between dysphagia and dehydration has not been studied widely. The aim of this study is to determine the frequency of dysphagia and dehydration in geriatric outpatient clinic, to evaluate the relationship between these two conditions.</p><p><strong>Methods: </strong>The cross-sectional study included 1345 patients. Plasma osmolarity (Posm) was calculated using the following formula: [1.86 x (Na + K) + 1.15 x glucose + urea + 14]. Overt dehydration was defined as a calculated Posm of > 300 mmol/L. Eating Assessment Tool (EAT-10) score of ≥ 3 was accepted as dysphagia. Associations between dehydration and dysphagia was evaluated.</p><p><strong>Results: </strong>Mean age was 78 ± 8 years, and 71% were females. Dysphagia was observed in 27% of patients. Dysphagia was associated with a higher number of drug exposure, dependency on basic activities of daily living and geriatric depression (p < 0.05). Overt dehydration was found in 29% of patients with dysphagia, and 21% of patients with no dysphagia (p = 0.002); and dysphagia was significantly associated with overt dehydration mmol/L (OR 1.49, 95% CI 1.13-1.96, p = 0.005) after adjustments for age and sex. In another model, EAT-10 score was found as one of the independent predictors of overt dehydration (OR1.03, 95% CI 1.00-1.06, p = 0.38), along with diabetes mellitus (OR 2.32, 95% CI 1.72-3.15, p < 0.001), chronic kidney disease (OR 3.05, 95% CI 2.24-4.15, p < 0.001), and MNA score (OR 0.97, 95% CI 0.94-1.00, p = 0.031).</p><p><strong>Conclusion: </strong>EAT-10 scale was independently associated with overt dehydration among older adults, as MNA score was. Correction of both dysphagia and malnutrition might improve overt dehydration to a better extent than correction either of these factors alone. Future studies are needed to test cause and effect relationships.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"885"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494779","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":"Impact of telephone coaching supporting a physical maintenance exercise programme for older adults at risk of falls: a randomised controlled trial.","authors":"Guy Rince, Christelle Volteau, June Fortin, Catherine Coat Couturier, Thomas Rulleau","doi":"10.1186/s12877-024-05488-y","DOIUrl":"10.1186/s12877-024-05488-y","url":null,"abstract":"<p><strong>Background: </strong>Encouraging compliance with recommended levels of exercise for older adults is a public health challenge. A minimal-resource solution is telephone coaching.</p><p><strong>Objectives: </strong>Primary aim: to compare timed up and go (TUG) performance 6 months after beginning a home exercise program between a group of older individuals who received additional telephone coaching, and a control group performing the home exercise program alone. Secondary aims: to compare functional and fall-related outcomes between groups at 6 and 12 months.</p><p><strong>Methods: </strong>Multicentre, assessor-blinded, randomised, controlled, open label, prospective study. Inclusion criteria included age ≥ 65 years, ≥ 1 fall in the past year, and discharged home from hospital rehabilitation or outpatient physiotherapy. All participants received a home exercise booklet and were asked to perform a set of exercises as often as possible (daily). The coaching group additionally received a monthly telephone call (total 5 calls) from their previous physiotherapist. Primary outcome was TUG performance at 6 months. Outcomes were measured at inclusion, and at 6 and 12 months. The primary outcome was analysed using a linear mixed model adjusted for the baseline value.</p><p><strong>Results: </strong>In total, 99 individuals were included (coaching group n = 50, control group, n = 49; mean [SD] age 83.1 [5.8] years and 77% women). TUG performance did not differ between groups at 6 months (adjusted difference 1.37, SE 1.32, 95% CI 1.26 to 4.01, p = 0.30). Secondary outcomes did not differ between groups at 6 or 12 months except compliance to the exercise program was higher in the coaching than the control group at 6 months (adjusted difference 1.0, SE 0.5, 95% CI 0.02 to 2.0, p = 0.05).</p><p><strong>Conclusions: </strong>The lack of difference between the groups in the time taken to complete the TUG at 6 months suggests that the monthly telephone coaching sessions did not improve the effectiveness of a home exercise programme in elderly people who had suffered at least one fall. The trial was registered on ClinicalTrials.gov (NCT02828826; 11th of july 2016, last modification 16th of September 2024).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"879"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494842","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 pilot randomized controlled trial of a virtual peer-support exercise intervention for female older adults with cancer.","authors":"Jenna Smith-Turchyn, Susanne Sinclair, Erin K O'Loughlin, Anthea Innes, Madison F Vani, Marla Beauchamp, Stuart M Phillips, Julie Richardson, Lehana Thabane, Catherine M Sabiston","doi":"10.1186/s12877-024-05495-z","DOIUrl":"10.1186/s12877-024-05495-z","url":null,"abstract":"<p><strong>Background: </strong>Regular exercise can mitigate side effects of cancer treatment. However, only a small proportion of adults with cancer meet exercise guidelines, and older adults (> 65 years) are underrepresented in cancer rehabilitation research. Peer support facilitates health-promoting behaviours in general populations, but interventions merging exercise and peer support for older adults with cancer are not examined. The purpose of this study was to determine the feasibility and preliminary effectiveness of a virtual partner-based peer support exercise intervention for older adult female cancer survivors.</p><p><strong>Methods: </strong>Older adult female cancer survivors with internet access and currently participating in < 150 min of moderate-vigorous physical activity per week were included in this study. Participants were matched with a partner and given a peer support guide, exercise guidelines, and a Fitbit Inspire©. In addition, intervention group dyads (AgeMatchPLUS) had weekly 1-h virtual sessions with a qualified exercise professional for 10 weeks. Dyads randomized to the control group (AgeMatch) independently supported their partner around exercise for 10 weeks. The primary outcome was feasibility, measured using retention and adherence rates. Secondary outcomes included exercise volume, social support, quality of life, physical function, and physical activity enjoyment. Descriptive statistics were used to report feasibility and an ANCOVA was used to explore between group differences on secondary outcomes at post-intervention (10 weeks post baseline) and post-tapering timepoints (14 weeks post baseline).</p><p><strong>Results: </strong>Eighteen participants (9 dyads; mean age 72 years (SD: 5.7 years)) were included in the pilot trial. Retention and adherence rates to the AgeMatchPLUS intervention were 100% and 95% respectively. All but one participant was satisfied with the quality of their peer match. Preliminary effects were seen between group, favouring AgeMatchPLUS for exercise-related social support post-intervention (effect size (d) = 0.27, 95% CI = 0,0.54) and physical activity enjoyment at post-tapering (d = 0.25, 95% CI = 0,0.52) and favouring the AgeMatch group for 30 s sit-to-stand repetitions at post-tapering (d = 0.31, 95% CI = 0.004, 0.57). No other effects were found.</p><p><strong>Conclusions: </strong>A virtual partner-based exercise intervention for older adults with cancer is feasible and shows preliminary effect benefits. Findings inform future trials aimed at increasing exercise in older adults with cancer.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (ID: NCT05549479, date: 22/09/22).</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"887"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494848","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":"Determinants of depressive symptoms among persons 80 years and older: longitudinal national evidence from the health, aging, and retirement study in Thailand, 2015-2022.","authors":"Supa Pengpid, Karl Peltzer, André Hajek, Dararatt Anantanasuwong, Wasin Kaewchankha","doi":"10.1186/s12877-024-05479-z","DOIUrl":"10.1186/s12877-024-05479-z","url":null,"abstract":"<p><strong>Background: </strong>Few studies have longitudinally assessed the determinants of depressive symptoms among persons 80 years and older. The aim of this study was to estimate the determinants of depressive symptoms among persons 80 years and older based on 4-wave national longitudinal data from Thailand.</p><p><strong>Methods: </strong>Data from the Health, Aging, and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons 80 years and older (analytic sample: n = 2763 observations). For the pooled sample, average age was 85.0 years (range 80-117 years). Established measurements were used to assess depressive symptoms. Linear fixed effects regression was applied to assess the time-variant determinants and outcomes.</p><p><strong>Results: </strong>Regressions found that higher functional disability and an increase in the number of chronic conditions worsened depressive symptoms. More favourable self-rated physical health, and higher exercise frequency improved depressive symptoms. In addition, among women higher subjective economic status decreased depressive symptoms.</p><p><strong>Conclusions: </strong>This longitudinal study enhances our understanding of the determinants of depressive symptoms among persons 80 years and older. Strategies to delay or decrease functional disability, chronic conditions, increase physical activity, and improve subjective economic status may help in reducing depressive symptoms.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"880"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494852","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":"Independent and joint effects of self-reported physical activity and sedentary behaviors on mortality in community-dwelling older persons: a prospective cohort study.","authors":"Cheng-Chieh Lin, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Yu-Chien Lin, Shing-Yu Yang, Tsai-Chung Li","doi":"10.1186/s12877-024-05493-1","DOIUrl":"10.1186/s12877-024-05493-1","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the joint and independent effects of self-reported physical activity and sedentary behavior on mortality in older persons.</p><p><strong>Methods: </strong>A prospective community-based cohort study was conducted to examine physical activity (PA) level and sitting time (ST) in relation to mortality among 1,786 older persons aged 65 years and above. PA was assessed by a checklist of 26 self-reported items about PA and hours per week, and the metabolic equivalent hours/week was derived, and ST was measured by a self-reported item asking the average number of hours spent sitting per day. The participants were divided into four combination groups of PA and ST based on WHO guideline and values found in literature: high PA/short ST group, high PA/long ST group, low PA/long ST group, and low PA/short ST group. Data on death ascertainment were obtained through linkage with the national death datasets and expanded cardiovascular disease (CVD) included cardiovascular disease, diabetes, and chronic kidney disease.</p><p><strong>Results: </strong>After follow-up for a median 11.1 years, 599 mortality cases were recorded, giving a crude all-cause mortality of 32.5/1,000 person-years, CVD mortality of 8.6/1,000 person-years, expanded CVD mortality of 11.9/1,000 person-years, and nonexpanded CVD mortality of 20.8/1,000 person-years. For all-cause, and expanded CVD, the hazards ratios (HRs) for the low PA/long ST group remained significant compared with that for the high PA/short ST group after all covariates were considered [HRs for all-cause mortality: 1.4 [95% confidence interval (CI) 1.1, 1.8]; and expanded CVD mortality: 1.7 (95% CI 1.1, 2.4).</p><p><strong>Conclusions: </strong>The independent effect of PA and the joint effects of PA and ST are associated with all-cause and expanded CVD death risks. Expanded CVD mortality may be minimized by engaging in PA and reducing sedentary behaviors.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"886"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494843","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":"Risk factors for in-hospital mortality in older patients with acute respiratory distress syndrome due to COVID-19: a retrospective cohort study.","authors":"David Rene Rodriguez Lima, Jimmy Hadid Anzueta Duarte, Cristhian Rubio Ramos, Laura Otálora González, Darío Isaías Pinilla Rojas, Leonardo Andrés Gómez Cortés, Edith Elianna Rodríguez Aparicio, Andrés Felipe Yepes Velasco, German Devia Jaramillo","doi":"10.1186/s12877-024-05411-5","DOIUrl":"10.1186/s12877-024-05411-5","url":null,"abstract":"<p><strong>Background: </strong>Advancing age is associated with an increase in mortality among patients with acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). This study aimed to determine risk factors for in-hospital mortality in patients over 60 years old with COVID-19-related ARDS (C-ARDS).</p><p><strong>Methods: </strong>This was an observational, analytical, retrospective study conducted on a cohort that included all patients aged 60 years or older diagnosed with COVID-ARDSwho were admitted to a high-complexity hospital in Bogotá, Colombia, between March 2020 and July 2021.</p><p><strong>Results: </strong>A total of 1563 patients were included in the analysis, with a median age of 73 years (interquartile range [IQR]: 67-80) and 811 deaths (51.8%). Independent risk factors for in-hospital mortality were identified as follows: patients aged 71-80 [OR 1.87 (95% CI 1.33-2.64)], age > 80 [OR 8.74 (95% CI 5.34-14.31)], lactate dehydrogenase (LDH) [OR 1.009 (95% CI 1.003-1.0015)], severe C-ARDS [OR 2.16 (95% CI 1.50-3.11)], use of invasive mechanical ventilation (IMV) [OR 12.94 (95% CI 9.52-17.60)], and use of steroids [OR 1.49 (95% CI 1.09-2.03)]. In patients over 80 years of age (n = 388), the primary risk factor associated with in-hospital mortality was the use of IMV (n = 76) [OR 6.26 (95% CI 2.67-14.69)], resulting in an in-hospital mortality rate of 89.4% (n = 68) when this therapy was implemented.</p><p><strong>Conclusions: </strong>The primary risk factors for in-hospital mortality in patients older than 60 years were age, the use of IMV, the severity of C-ARDS, use of steroids and elevated LDH values. Among patients older than 80 years, the main risk factor for in-hospital mortality was the use of IMV. In cases of C-ARDS in older patients, the decision to initiate IMV should always be individualized; therefore, the use of alternative oxygen delivery systems as the first-line approach can be considered.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"878"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494861","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":"Drug-gene interactions in older patients with coronary artery disease.","authors":"Shizhao Zhang, Chao Lv, Lisha Dong, Yangxun Wu, Tong Yin","doi":"10.1186/s12877-024-05471-7","DOIUrl":"10.1186/s12877-024-05471-7","url":null,"abstract":"<p><strong>Background: </strong>Older patients with coronary artery disease (CAD) are particularly vulnerable to the efficacy and adverse drug reactions, and may therefore particularly benefit from personalized medication. Drug-gene interactions (DGIs) occur when an individual's genotype affects the pharmacokinetics and/or pharmacodynamics of a victim drug.</p><p><strong>Objectives: </strong>This study aimed to investigate the impact of cardiovascular-related DGIs on the clinical efficacy and safety outcomes in older patients with CAD.</p><p><strong>Methods: </strong>Hospitalized older patients (≥ 65 years old) with CAD were consecutively recruited from August 2018 to May 2022. Eligible patients were genotyped for the actionable pharmacogenetic variants of CYP2C9, CYP2C19, CYP2D6, CYP3A5, and SLCO1B1, which had clinical annotations or implementation guidelines for cardiovascular drugs. Allele frequencies and DGIs were determined in the cohort for the 5 actionable PGx genes and the prescribed cardiovascular drugs. All patients were followed up for at least 1 year. The influence of DGIs on the cardiovascular drug-related efficacy outcomes (all-cause mortality and/or major cardiovascular events, MACEs) and drug response phenotypes of \"drug-stop\" and \"dose-decrease\" were evaluated.</p><p><strong>Results: </strong>A total of 1,017 eligible older patients with CAD were included, among whom 63.2% were male, with an average age of 80.8 years old, and 87.6% were administrated with polypharmacy (≥ 5 medications). After genotyping, we found that 96.0% of the older patients with CAD patients had at least one allele of the 5 pharmacogenes associated with a therapeutic change, indicating a need for a therapeutic change in a mean of 1.32 drugs of the 19 cardiovascular-related drugs. We also identified that 79.5% of the patients had at least one DGI (range 0-6). The median follow-up interval was 39 months. Independent of age, negative association could be found between the number of DGIs and all-cause mortality (adjusted HR: 0.84, 95% CI: 0.73-0.96, P = 0.008), and MACEs (adjusted HR: 0.84, 95% CI: 0.72-0.98, P = 0.023), but positive association could be found between the number of DGIs and drug response phenotypes (adjusted OR: 1.24, 95% CI: 1.05-1.45, P = 0.011) in the elderly patients with CAD.</p><p><strong>Conclusions: </strong>The association between cardiovascular DGIs and the clinical outcomes emphasized the necessity for the integration of genetic and clinical data to enhance the optimization of cardiovascular polypharmacy in older patients with CAD. The causal relationship between DGIs and the clinical outcomes should be established in the large scale prospectively designed cohort study.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"881"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494837","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":"Impact of age on clinical characteristics and 1-year outcomes of non-disabling ischemic cerebrovascular events: A multicenter prospective cohort study.","authors":"Zhongzhong Liu, Songdi Wu, Xuemei Lin, Qingli Lu, Weiyan Guo, Na Zhang, Tong Liu, Linna Peng, Lingxia Zeng","doi":"10.1186/s12877-024-05491-3","DOIUrl":"10.1186/s12877-024-05491-3","url":null,"abstract":"<p><strong>Background: </strong>The exploration of age-related clinical features and adverse outcomes of non-disabling ischemic cerebrovascular disease (NICE) has been largely unaddressed in current research. This study aimed to analyze the differences in clinical characteristics and prognostic outcomes of NICE across various age groups, utilizing data from the Xi'an Stroke Registry Study in China.</p><p><strong>Methods: </strong>The age distribution of NICE was categorized into four groups: age ≤ 54 years, age 55-64 years, age 65-74 years, and age ≥ 75 years. Multivariate Cox logistic regression analysis was employed to evaluate the 1-year risk of outcome events in each age group of patients with NICE. A subgroup analysis was conducted to explore interaction factors influencing age-dependent outcomes in patients with NICE.</p><p><strong>Results: </strong>This study included 1,121 patients with NICE aged between 23 and 96 years, with an average age of 63.7 ± 12.2 years. Patients aged ≥ 75 years had a higher proportion of women, lower education levels, and a greater likelihood of having urban employee medical insurance. Those aged < 55 years had a higher prevalence of smoking, while individuals aged > 65 years showed a higher prevalence of comorbidities. Furthermore, there was a significant decrease in body mass index among patients aged ≥ 75 years. Laboratory tests indicated well-controlled blood lipids, liver function, and inflammation across all age groups, but renal function was notably reduced in patients with NICE aged ≥ 75 years. Adjusting for potential confounding factors revealed a significant increase in the one-year risk of all-cause mortality and poor prognosis among patients aged ≥ 75 years compared to those aged < 55 years, with no significant gender difference observed. Subgroup analysis indicated that patients with NICE who consumed alcohol were more prone to experience all-cause mortality with advancing age.</p><p><strong>Conclusions: </strong>Age significantly influences the clinical characteristics and prognostic outcomes of NICE patients. Clinicians should consider age-specific characteristics when diagnosing, treating, and developing prevention strategies. Tailored prevention and treatment strategies for different age groups can enhance prognosis and reduce adverse outcomes in NICE patients.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"884"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494840","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":"Prevalence of potentially inappropriate medications according to STOPP-Frail criteria in nursing home residents, the SHELTER study.","authors":"Alireza Malek Makan, Hein van Hout, Graziano Onder, Harriet Finne-Soveri, Daniela Fialova, Rob van Marum","doi":"10.1186/s12877-024-05450-y","DOIUrl":"10.1186/s12877-024-05450-y","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the prevalence of potentially inappropriate medications (PIMs) in nursing home residents across eight countries and investigate differences between residents with and without cognitive impairment, as well as those with and without life expectancy of six months or less.</p><p><strong>Methods and deign: </strong>The study utilized the second edition of the STOPP-Frail criteria to operationalize PIMs in the baseline assessment of nursing home residents participating in the Services and Health for Elderly in Long TERm care (SHELTER) project. The data were collected between 2009 and 2012. The project was conducted in eight countries: Czech Republic, England, Finland, France, Germany, Italy, the Netherlands, and Israel. Cognitive impairment was measured by the cognitive performance scale (CPS). The presence of end-stage disease with a life expectancy of six months or less was recorded. The study included residents aged 60 years or older who underwent a valid medication assessment.</p><p><strong>Results: </strong>Among the 3,832 eligible residents, 87.9% had at least one PIM. Specifically, 24.3%, 23.5%, 18.8%, and 19.3% of residents had one, two, three, and four or more PIMs, respectively. On average, each person was prescribed 2.16 PIMs. Cognitively impaired residents (n = 1999) had an average of 1.96 PIMs (SD 1.49) per person, while residents with a low CPS score (n = 1783) had an average of 2.40 PIMs (SD 1.57) per person, showing a statistically significant difference (P < 0.001). Similarly, NH residents with life expectancy of six months or less had an average of 1.66 PIMs (SD 1.30), whereas those without had an average of 2.17 PIMs (SD 1.55) (p < 0.001). The average number of PIMs varied across countries, ranging from 3.23 in Finland to 2.15 in the UK (P < 0.001). Anti-platelets and aspirin were the most prescribed PIMs, accounting for over 38.0% of prescriptions.</p><p><strong>Conclusions: </strong>This study highlights the high prevalence of PIMs among nursing home residents. However, PIMs were somewhat lower in residents with cognitive impairment and life expectancy of six months or less. Efforts must continue to improve the rationale behind prescribing practices in nursing homes.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"882"},"PeriodicalIF":3.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494859","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}