BMC Geriatrics最新文献

{"title":"Exploring the pathways between depression, anxiety, stress, and quality of life on life satisfaction: a path analysis approach.","authors":"Uday Narayan Yadav, Saruna Ghimire, Ranju Mehta, Isha Karmacharya, Sabuj Kanti Mistry, Arm Mehrab Ali, Om Prakash Yadav, Man Kumar Tamang, Suresh Mehata, Roshan Pokharel, Mark Fort Harris","doi":"10.1186/s12877-024-05618-6","DOIUrl":"10.1186/s12877-024-05618-6","url":null,"abstract":"<p><strong>Background: </strong>Life satisfaction, one promising health asset, is associated with reduced risk of several chronic diseases and mortality. Mental health conditions and quality of life (QoL) are important aspects of well-being in late life and are significantly associated with life satisfaction. Despite the complex interrelationships between mental health, QoL and life satisfaction, the current literature has evaluated the simple association between them and failed to consider the complex pathways among these variables, especially among the older population. Hence, this study explores the pathways between mental health conditions (depression, anxiety, and stress), QoL and life satisfaction among older adults in eastern Nepal.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in eastern Nepal via face-to-face interviews with 847 older adults selected by multi-stage cluster sampling. The 5-item Satisfaction with Life Scale and 13-item Older People's QoL scale assessed life satisfaction and QoL, respectively. The 21-item Depression, Anxiety and Stress scale measured mental health conditions. The relationship between QoL, depression, anxiety, and stress with life satisfaction was first evaluated using linear regression, subsequently by path analysis.</p><p><strong>Results: </strong>The mean (± SD) life satisfaction and QoL score were 19.7 (± 5.3) and 42.9 (± 7.1), respectively. More than one-fifth of the participants had moderate to severe depression (30%), anxiety (34%), and stress (20%). In adjusted regression analysis, QoL was positively associated (β: 0.44; 95% CI: 0.40 to 0.48) with life satisfaction, whereas depression, anxiety, and stress were inversely associated. In the path analysis, the relationship between depression and stress with life satisfaction was mediated by QoL. Depression was indirectly related to life satisfaction (mediated by QoL, β = -0.25), whereas stress was both directly (β = -0.11) and indirectly (mediated by QoL, β = -0.08) related to life satisfaction.</p><p><strong>Conclusions: </strong>Given the high mental health burden among the older Nepali population and its potential impact on life satisfaction and QoL, routine screening for mental health should be encouraged in clinical practice. Additionally, community-based interventions and mental health promotion programs should be launched at regional and local levels.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1025"},"PeriodicalIF":3.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871310","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 correlation study between blood glucose fluctuation and chronic pain in the older people with type 2 diabetes mellitus.","authors":"Qinyi Huang, Mengjie Cui, Yangliu Yin, Cancan Hui, Yuwei Cheng, Shuqian Wang, Xiujuan Hu, Xiaorong Yin, Xiaoxiang Zhang, Xinyu Sun, Tiantian Tang, Lang Lang, Yan Sun","doi":"10.1186/s12877-024-05616-8","DOIUrl":"10.1186/s12877-024-05616-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the correlation between blood glucose fluctuation parameters and other clinical data with chronic pain in older patients ( ≧ 60 years) with type 2 diabetes mellitus (T2DM), as well as evaluating the predictive value of risk of these parameters for chronic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Clinical data were collected from 60 older patients with T2DM undergoing chronic pain who were hospitalized in the Department of Geriatric Endocrinology at the First Affiliated Hospital of Anhui Medical University. Pain scores using the numeric rating scale (NRS) were administered to all study participants by a dedicated person. Based on their pain scores, patients were categorized into two groups: mild pain group (NRS ≤ 5, n = 28) and severe pain group (NRS &gt; 5, n = 32). Blood glucose levels were continuously monitored using the Continuous Glucose Monitoring System (CGMS). Spearman correlation analysis was performed to investigate the correlation between pain scores and blood glucose fluctuation parameters, as well as other clinical data of concern. Comparing general clinical information and relevant data recorded by CGMS between the two groups. Binary logistic regression was used to identify factors influencing the severity of chronic pain in old patients with T2DM combined with chronic pain. Additionally, the predictive value of Mean Amplitude of Glycemic Excursions (MAGE), Coefficient of Variation (CV), and Time in Range (TIR) for chronic pain severity was assessed using Receiver Operating Characteristic (ROC) curve analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Spearman correlation analysis revealed positive correlations between pain scores and the following variables: gender, age, duration of diabetes, duration of pain, MAGE, CV, mean blood glucose (MBG), standard deviation (SD), Mean of Daily Differences (MODD), and the highest glucose level. Conversely, pain scores were negatively correlated with red blood cell (RBC) count, hemoglobin (Hb), estimated glomerular filtration rate (eGFR). There were statistically significant differences in gender, age, disease duration, pain duration, Hb, eGFR, MAGE, CV, TIR, MBG, SD, MODD, and highest blood glucose values between the two groups. The gender, age, duration of diabetes, duration of pain, Hb, eGFR, MAGE, TIR, CV, MBG, SD, and MODD were identified as the risk factors for the severity of chronic pain in older T2DM patients by using binary logistic regression analysis. ROC curve analysis showed that the area under the curve for MAGE was 0.741 (sensitivity: 53.1%, specificity: 89.3%), for CV it was 0.668 (sensitivity: 40.6%, specificity: 89.3%), and for TIR it was 0.763 (sensitivity: 67.9%, specificity: 84%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The chronic pain is strongly correlated with blood glucose fluctuation parameters in older patients with T2DM. This work shows that those indicators of blood glucose fluctuations can be used for predicting chronic pain level in ol","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1028"},"PeriodicalIF":3.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871251","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":"Anticholinergic burden and frailty in older inpatients: insights from analysis of admission and discharge medicines using four anticholinergic scales.","authors":"Mohammed Adem Mohammed, Amy Hai Yan Chan, Nasir Wabe, Ayesha Ali, Louis Harris, Sianne West, Rhea Colaabavala, Justine Aw, Jeff Harrison","doi":"10.1186/s12877-024-05394-3","DOIUrl":"10.1186/s12877-024-05394-3","url":null,"abstract":"<p><strong>Background: </strong>Exposure to high anticholinergic burden is associated with adverse outcomes in older adults. Older adults with frailty have greater vulnerability to adverse anticholinergic effects. There is limited data on anticholinergic burden in hospitalised older adults with frailty particularly, in New Zealand. This study aimed to (i) examine exposure to anticholinergic medicines in older inpatients using multiple scales, and (ii) describe the association of patient factors such as frailty with anticholinergic exposure.</p><p><strong>Methods: </strong>We reviewed admission and discharge medicines of 222 older patients (≥ 65 years) in a New Zealand hospital. Sociodemographic, diagnostic and medication data were collected from electronic health records. Anticholinergic burden was quantified using the Anticholinergic Burden Classification (ABC), Anticholinergic Cognitive Burden Scale (ACB), Anticholinergic Risk Scale (ARS), and Drug Burden Index (DBI). Frailty was assessed using frailty index (FI) and the Hospital Frailty Risk score (HFRS); higher scores indicate higher frailty. Multivariable logistic regression analysis was used to determine patient factors associated with anticholinergic burden.</p><p><strong>Results: </strong>Depending on the scale used, the mean anticholinergic burden ranged from 0.65 to 1.83 on admission and 0.59 to 1.40 at discharge, with 32-74% of the patients on admission and 25-65% at discharge prescribed at least one anticholinergic medicine. About 1 in 3 patients had high anticholinergic burden on admission and discharge. On admission, being frail (adjusted odds ratio [AOR] 5.16, 95% confidence interval [95% CI] 1.57, 16.97), having history of readmission (AOR 4.96, CI 1.58, 15.59), and higher number of medicines [AOR range 1.18 CI 1.10, 1.26 (ARS scale) to 1.25 CI 1.15, 1.36 (DBI scale)] were associated with higher odds of anticholinergic exposure. At discharge, pre-frail (DBI scale: AOR = 6.58, CI 1.71-25.32) and frail patients (ACB scale: AOR = 5.73, CI 1.66, 19.70) and those with higher number of medicines [AOR range 1.18 CI 1.09, 1.29 (ARS scale) to 1.33 CI 1.20, 1.49 (DBI scale)] had higher odds of anticholinergic exposure.</p><p><strong>Conclusion: </strong>A reduction in the anticholinergic burden from admission to discharge was observed in the study population yet, one-third of the study cohort were discharged with high anticholinergic medicines. Enhancing hospital prescribers' and pharmacists' awareness about anticholinergic burden and targeted interventions such as in-hospital deprescribing are needed to reduce high anticholinergic exposure in acute setting.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1022"},"PeriodicalIF":3.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871283","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 number of functional teeth and physical function among community-dwelling older adults: Korean Frailty and Aging Cohort Study.","authors":"Nahyun Lim, Daehyun Lee, Seung-Yun Shin, Chang Won Won, Miji Kim","doi":"10.1186/s12877-024-05585-y","DOIUrl":"10.1186/s12877-024-05585-y","url":null,"abstract":"<p><strong>Background: </strong>Functional teeth are important for maintaining appropriate masticatory function and nutritional intake, affecting physical function in older adults. This study aimed to evaluate the association between number of functional teeth and physical function in community-dwelling older Korean adults.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among a total of 2,527 participants (mean age, 76.5 ± 3.9; 53.4% women) who were enrolled in the Korean Frailty and Aging Cohort Study (2016-2017). Participants were categorized based on the number of functional teeth into two groups: < 20 and ≥ 20 functional teeth. Functional teeth were defined as the remaining natural teeth with visible crowns, with or without restorations, prosthetic pontics, or dental implants on panoramic radiography. Physical function was assessed using handgrip strength, gait speed, five-times sit-to-stand test (5TSTS) duration, and the Short Physical Performance Battery (SPPB) score. Multivariate linear and logistic regression models were used to evaluate the association between number of functional teeth and physical function.</p><p><strong>Results: </strong>Of all the participants, 869 (34.3%) had < 20 functional teeth. After full adjustment for sociodemographic factors, lifestyle, health condition, and oral health, an increase in one functional tooth was associated with a corresponding increase in gait speed (men: B = 0.002, p = 0.032; women: B = 0.002, p = 0.013) and SPPB (men: B = 0.019, p < 0.001; women: B = 0.018, p < 0.001) in both men and women. The time taken for the 5TSTS was shorter for an increase in one more functional tooth (men, B=-0.033, p = 0.006; women, B=-0.036, p = 0.021) in both men and women. An increase in one functional tooth was associated with a corresponding increase in handgrip strength only in men (men, B = 0.049, p = 0.009; women, B=-0.003, p = 0.814). The associations between < 20 functional teeth and low handgrip strength [odds ratio (OR) = 1.46, 95% confidence interval (CI): 1.03-2.06], long 5TSTS duration (OR = 1.47, 95% CI: 1.07-2.02), and low SPPB scores (OR = 1.64, 95% CI: 1.07-2.53) were significant in fully adjusted model compared with ≥ 20 functional teeth only in men.</p><p><strong>Conclusions: </strong>Fewer functional teeth were associated with low physical function in older adults. Our results emphasize the importance of maintaining adequate functional teeth to preserve physical function in community-dwelling older adults.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1024"},"PeriodicalIF":3.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871286","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":"Features of effective hospital fall prevention trials: an intervention component analysis.","authors":"Charlotte McLennan, Catherine Sherrington, Jenni Suen, Veethika Nayak, Vasi Naganathan, Katy Sutcliffe, Dylan Kneale, Abby Haynes, Suzanne Dyer","doi":"10.1186/s12877-024-05587-w","DOIUrl":"10.1186/s12877-024-05587-w","url":null,"abstract":"<p><strong>Background: </strong>Falls in hospitals continue to burden patients, staff, and health systems. Prevention approaches are varied, as well as their success at preventing falls. Intervention component analysis (ICA) is useful in indicating important features associated with successful interventions in sets of trial with high heterogeneity.</p><p><strong>Methods: </strong>We conducted an ICA of systematically identified randomised controlled trials of interventions for preventing falls in older people in hospitals. Trial characteristics were extracted; inductive thematic analysis of published papers from included trials to seek triallists perspectives on drivers of success or failure of trials was conducted (ICA stage one) followed by a stratified thematic synthesis by trial outcomes, where trials were classified as positive or negative based on their falls rate or falls risk ratios (ICA stage two) and mapped to the presence of the theorised drivers of success or failure of the trials.</p><p><strong>Results: </strong>45 trials met the inclusion criteria. Inductive thematic analysis of 50 papers revealed three key drivers (themes), each with subthemes, of effective inpatient hospital fall prevention trials. Theme 1, integration with the local setting, was present in 79% of the positive trials and 67% of the negative trials (79% vs 62% engaging ward staff and 33% vs 43% engaging hospital management). Theme 2, responsive interventions, was present in 83% of the positive trials and 71% of the negative trials (29% vs 38% targeting patient risk assessments and 83% vs 57% tailoring to patient needs and abilities). Theme 3, patient and family involvement, featured in 83% of the positive trials and 52% of the negative trials (50% vs 19% through fall prevention awareness and 58% vs 48% through an active role in fall prevention).</p><p><strong>Conclusion: </strong>Tailored fall prevention approaches and involving patient and family in fall prevention through increasing awareness, in addition to integration with the local intervention setting, appear to play a role in impacting the effectiveness of fall prevention interventions. These theories should be considered in the design of future fall prevention programs and trials and require further evaluation in high quality trials.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"24 1","pages":"1023"},"PeriodicalIF":3.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871314","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657633/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656952/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657982/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658105/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658053/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}