| 1. |
- Akner, Gunnar, 1953-, et al.
(författare)
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Personalized Geriatric Medicine
- 2014
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Ingår i: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 5, s. 145-146
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Amrouch, Cheima, et al.
(författare)
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Applicability of STOPP/START prescribing criteria in integrated Swedish administrative health registries and a Swedish population-based cohort
- 2024
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Ingår i: European Geriatric Medicine. - 1878-7649 .- 1878-7657.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The STOPP/START criteria are frequently applied in observational studies to assess potentially inappropriate prescribing in older adults. This study aimed to assess the applicability of the three available STOPP/START versions in two distinct data sources.Methods To evaluate the applicability of the three versions of STOPP/START criteria, we used two observational data sources: (i) Integrated Swedish administrative health registries (ISHR) encompassing routinely collected health data and (ii) the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K), based on health professional-led clinical assessments. The Anatomical Therapeutic Classification code (ATC) was used to categorise medications. Diseases were categorised using the international classification of diseases version 10 (ICD10).Results The first STOPP/START version demonstrated an applicability rate of 80% in ISHR and 84% in SNAC-K. The second version demonstrated an applicability of 64% in ISHR and 74% in SNAC-K. The third version showed an applicability of 66% in ISHR and 77% in SNAC-K. Challenges in applicability included broad definitions, vague terminology, and the lack of information on disease severity, symptomatic traits, and stability of certain conditions.Conclusion The applicability of the STOPP/START criteria in observational studies seems to have decreased in more recent versions of the tool. Population-based studies with comprehensive clinical assessments may offer higher applicability compared to studies based on administrative data. Future versions of the STOPP/START criteria should prioritise clear and unambiguous definitions to improve their applicability in research and promote result generalisability and comparability.
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| 3. |
- Bahat, Gulistan, et al.
(författare)
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Paving the way for applying GLIM criteria in clinical practice and research : how to define mild to moderate and severe reduced muscle mass
- 2022
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Ingår i: European Geriatric Medicine. - : Springer Nature. - 1878-7649 .- 1878-7657. ; 13:3, s. 611-614
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Tidskriftsartikel (refereegranskat)abstract
- Key summary pointsAim To report grade 1 and grade 2 reduced muscle mass cut-offs for skeletal muscle mass (SMM) adjusted by body mass index (BMI) to increase the applicability of the GLIM criteria. Findings Grade 1 vs. grade 2 low muscle mass (LMM) thresholds were 1.189 and 0.954 kg/BMI vs. 1.049 and 0.823 kg/BMI in males and females, respectively. Message While validation studies are needed to evaluate their predictive ability, our approach presented here seems applicable and the cut-off values acceptable for use until population-specific values in different populations or global generic cut-offs are identified. Purpose Among approaches to adjust skeletal muscle mass (SMM) for body size, adjustment for body mass index (BMI) correlated better with functional measures. To enhance applicability of GLIM criteria, we report grade 1 and grade 2 reduced muscle mass cut-offs for SMM adjusted by BMI. Methods 301 young, healthy adults involving students, patient relatives and staff working in the university hospital were included. SMM was estimated by bio-impedance analysis (BIA). SMM index (BMI) [SMMI(BMI)] was calculated as SMM/BMI. Grade 1 low muscle mass (LMM) was defined as "mean young SMMI(BMI)-one standard deviation" and grade 2 LMM as "mean young SMMI(BMI)-two standard deviations". Results Mean age was 26.5 +/- 4.6 (62.1% male). Grade 1 vs grade 2 LMM thresholds were 1.189 and 0.954 kg/BMI vs 1.049 and 0.823 kg/BMI in males and females, respectively. Conclusion This is the first report identifying stage 1 and stage 2 LMM thresholds for SMMI adjusted by BMI. Studies are needed to evaluate their predictive validity.
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| 4. |
- Balducci, Marco, et al.
(författare)
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SARS-CoV-2 vaccination and risk of infectious diseases in hospitalized older patients
- 2024
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Ingår i: European Geriatric Medicine. - 1878-7649 .- 1878-7657. ; 15:2, s. 509-517
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Vaccinations, for example flu vaccine, may be a cause of cross-reactive immunostimulation that prevents a larger spectrum of infections. However, whether SARS-CoV-2 vaccinations may also determine this effect is unclear. This study aims, first, to assess the incidence of infections at hospital admission and during the hospitalization in older inpatients vaccinated and unvaccinated against SARS-CoV-2; second, to compare length of hospital stay and in-hospital mortality between vaccinated and unvaccinated individuals.Methods This retrospective study included 754 older inpatients admitted to the Geriatrics and Orthogeriatrics Units of the University Hospital of Ferrara (Italy) between March 2021 and November 2021. Sociodemographic and health-related data, and the diagnosis of infections at hospital admission and during hospitalization were collected from medical records.Results The sample’s mean age was 87.2 years, 59.2% were females, and 75.5% were vaccinated against SARS-CoV-2. Vaccinated individuals had 36% lower odds of intra-hospital infections (OR = 0.64, 95%CI 0.44–0.94) and 39% lower in-hospital death (HR = 0.61, 95%CI 0.39–0.95), also after adjusting for potential confounders, while no significant results emerged about infections at hospital admission. Considering the hospitalization’s endpoints, SARS-CoV-2 vaccination was associated with a lower probability of being transferred to long-term care or other hospital departments than returning home (OR = 0.63, 95%CI 0.40–0.99).Conclusions In older inpatients, SARS-CoV-2 vaccination seems to be associated with a lower likelihood of intra-hospital infectious diseases not caused by SARS-CoV-2 and all-cause in-hospital mortality. The vaccination coverage in the older population could limit not only the onset and severity of COVID-19 but also the occurrence of other infectious diseases.
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| 5. |
- Blain, H., et al.
(författare)
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A comprehensive fracture prevention strategy in older adults : the European union geriatric medicine society (EUGMS) statement
- 2016
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Ingår i: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 7:6, s. 519-525
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Tidskriftsartikel (refereegranskat)abstract
- Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.
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| 6. |
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| 7. |
- Bruyere, O., et al.
(författare)
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Assessment of muscle mass, muscle strength and physical performance in clinical practice : An international survey
- 2016
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Ingår i: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 7:3, s. 243-246
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Several tools are available for the assessment of muscle mass, muscle strength and physical performance in clinical research. However, few data are available on the usage of these tools in clinical practice.Methods: This study aimed to assess their usage by means of a large online international survey. Since sarcopenia is a specific condition where the assessment of muscle mass, muscle strength and physical performance is important, the survey also assessed the tools used for the diagnosis of this geriatric syndrome.Results: The survey was completed by 255 clinicians from 55 countries across 5 continents. Among these clinicians with geriatrics, rheumatology and endocrinology as major fields of interest, 53.3% assess muscle mass in daily practice, 54.5% muscle strength and 71.4% physical performance. However, the tools used are very different and no single tool is used by all clinicians. The tools and the cut-off values used by clinicians to diagnose sarcopenia are also heterogeneous.Conclusion: Because some tools used for the assessment of muscle mass, muscle strength or physical performance in daily practice are less validated than others, a greater awareness from the clinicians of the importance of using appropriate tools is needed.
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| 8. |
- Cabrera, Esther, et al.
(författare)
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Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes : A systematic review
- 2015
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Ingår i: European Geriatric Medicine. - Oxford : Elsevier BV. - 1878-7649 .- 1878-7657. ; 6:2, s. 134-150
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Tidskriftsartikel (refereegranskat)abstract
- Background: Two-thirds of nursing home residents suffer from dementia and there is a need for effective and efficient interventions with meaningful outcomes for these individuals. This study aims to identify current best practices in non-pharmacological interventions in nursing homes.Methods: A systematic literature review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guideline. Studies and Randomized Controlled Trials (RCT) evaluating non-pharmacological interventions focused on improving the Quality of Care (QoC) and/or Quality of Life (QoL) of people with dementia (PwD) living in nursing homes were included. For individual study evaluation, the Cochrane Collaboration risk of bias assessment tool was used.Results: A total of 31 articles were included and five main categories emerged: psychosocial and educational, physical activity, sensorial therapies, staff-focused interventions and complex interventions. Psychosocial interventions were the most exhaustively studied and evaluated interventions. Few studies related to physical therapy were identified and they did not provide enough evidence of their effectiveness. Therapeutic touch was revealed to have positive effects on residents with dementia.Conclusion: Psychosocial interventions have been shown to have the potential to improve the QoL and QoC of people with dementia in nursing homes. Before implementation of the intervention, it is recommended that activities are adjusted according to residents' characteristics and external factors controlled to achieve effectiveness and to structure a well-designed intervention. However, there is not enough evidence to support the effectiveness of non-pharmacological interventions in general. Further well-designed research is needed on non-pharmacological interventions in nursing facilities. (C) 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
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| 9. |
- Cawthon, Peggy M., et al.
(författare)
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Defining terms commonly used in sarcopenia research : a glossary proposed by the Global Leadership in Sarcopenia (GLIS) Steering Committee
- 2022
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Ingår i: European Geriatric Medicine. - : Springer. - 1878-7649 .- 1878-7657. ; 13:6, s. 1239-1244
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Tidskriftsartikel (refereegranskat)abstract
- MethodsThe aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings. The Global Leadership Initiative in Sarcopenia (GLIS) aims to bring together leading investigators in sarcopenia research to develop a single definition that can be utilized worldwide; work on a global definition of sarcopenia is ongoing. The first step of GLIS is to develop the common terminology, or a glossary, that will facilitate agreement on a global definition of sarcopenia as well as interpretation of clinical and research findings.ResultsSeveral terms that are commonly used in sarcopenia research are defined, including self-reported measures of function and ability; objective physical performance tests; and measures related to muscle function and size.ConclusionAs new methods and technologies are developed, these definitions may be expanded or refined over time. Our goal is to promote this common language to describe sarcopenia and its components in clinical and research settings in order to increase clinical awareness and research interest in this important condition. We hope that the use of common terminology in sarcopenia research will increase understanding of the concept and improve communication around this important age-related condition.Key summary pointsAimThe aim of this paper is to define terms commonly related to sarcopenia to enable standardization of these terms in research and clinical settings.FindingsThis paper provides definitions for commonly used terminology in sarcopenia in both clinical and research settings. As new methods and technologies are developed, this terminology may be expanded or refined over time.MessageWe hope that the use of common terminology in sarcopenia research will increase understanding of the concept and improve communication around this important age-related condition.
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| 10. |
- Dahlqvist, Jenny, et al.
(författare)
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Does comprehensive geriatric assessment (CGA) in an outpatient care setting affect the causes of death and the quality of palliative care? A subanalysis of the age-FIT study
- 2019
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Ingår i: European Geriatric Medicine. - : Springer Science and Business Media LLC. - 1878-7649 .- 1878-7657. ; 10:3, s. 455-462
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purposes of this study were to retrospectively study whether comprehensive geriatric assessment (CGA) given to community-dwelling old patients with high health care usage has effects regarding: (1) the cause of death and (2) the quality of the provided palliative care when compared to patients without CGA-based care. Method: This study includes secondary data from a randomised controlled trial (RCT) with 382 participants that took place in the periods 2011–2013. The present study examines all electronical medical records (EMR) from the deceased patients in the original study regarding cause of death [intervention group (IG) N = 51/control group (CG) N = 66] and quality of palliative care (IG N = 33/CG N = 41). Descriptive and comparative statistics were produced and the significance level was set at p < 0.05. Results: The causes of death in both groups were dominated by cardiovascular and cerebrovascular diseases with no statistical difference between the groups. Patients in the intervention group had a higher degree of support from specialised palliative care teams than had the control group (p = 0.01). Conclusion: The present study in an outpatient context cannot prove any effects of CGA on causes of death. The study shows that CGA in outpatient care means a higher rate of specialised palliative care, but the study cannot show any effects on the palliative quality parameters measured. Further studies with statistical power are needed.
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| 11. |
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| 12. |
- Dong, Huan-Ji, et al.
(författare)
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Effects of proactive healthcare on pain, physical and activities of daily living functioning in vulnerable older adults with chronic pain: a pragmatic clinical trial with one- and two-year follow-up
- 2024
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Ingår i: European Geriatric Medicine. - : SPRINGER. - 1878-7649 .- 1878-7657.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate the changes in pain, physical and activities of daily living (ADL) functioning in vulnerable older adults with chronic pain after proactive primary care intervention. Methods This study was embedded in a prospective, pragmatic, matched-control multicenter trial at 19 primary care practices in Sweden, with proactive medical and social care (Intervention Group, IG, n = 134) in comparison with usual care (Control Group, CG, n = 121). Patients with chronic pain, defined as pain experienced longer than 3 months, were included in this subgroup analysis. Data on pain aspects, physical and ADL functioning were collected in the questionnaires at baseline, one- and two-year follow-up (FU-1 and FU-2). Data on prescribed pain medications was collected by local health authorities. Results Mean age was 83.0 +/- 4.7 years with almost equal representation of both genders. From baseline until FU-2, there were no significant within-group or between-group changes in pain intensity. Small adjustments of pain medication prescriptions were made in both groups. Compared to FU-1, the functional changes were more measurable at FU-2 as fewer participants had impaired physical functioning in IG (48.4%) in comparison to CG (62.6%, p = 0.027, Effect Size phi = 0.14). Higher scores of ADL-staircase (more dependent) were found in both groups (p < 0.01, Effect Size r = 0.24 in CG and r = 0.16 in IG). Conclusion Vulnerable older adults with chronic pain seemed to remain physical and ADL functioning after proactive primary care intervention, but they may need tailored strategies of pain management to improve therapeutic effects.
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| 13. |
- Ekdahl, Anne
(författare)
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The organisation of hospitals and the remuneration systems are not adapted to frail old patients giving them bad quality of care and the staff feelings of guilt and frustration
- 2014
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Ingår i: European Geriatric Medicine. - : Elsevier Masson. - 1878-7649 .- 1878-7657. ; 5:1, s. 35-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the coming half-century, the population of old people will increase, especially in the oldest age groups. Therefore, the prevalence of multiple chronic conditions, and consequently, the need of health care including care in hospital, is rising. Materials and methods: This article includes results from three mainly qualitative articles (interviews with frail old people, physicians, and an observational study in acute medical wards) and a cross-sectional survey of newly discharged elderly patients. Results: Health care does not take a holistic approach to patients with more complex diseases, such as frail old people. The remuneration system rewards high production of care in terms of numbers of investigations and operations, turnover of hospital beds, and easy accessibility to care. Frail old people do not feel welcome in hospital, with their complex diseases and a need of more time to recover. The staff providing care feels frustrated, and often guilty when taking care of old people. Discussion and conclusion: To improve quality of care of frail elderly, a model is suggested with the following main components: more hospital wards which can address the patients whole situation medically, functionally, and psychologically, i.e comprehensive geriatric assessment (CGA). Better identification of frail elderly people is necessary, together with a change in remuneration system, with a focus on the patients functional status and quality of life. More training in geriatrics is required for staff to feel confident when treating frail old people.
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| 14. |
- Ekdahl, A. W., et al.
(författare)
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Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting : a systematic review and meta-analysis
- 2015
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Ingår i: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 6:6, s. 523-540
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Forskningsöversikt (refereegranskat)abstract
- Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care.Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings.Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015.Study eligibility: Randomized controlled trials.Participants: Older adults aged ≥ 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups.Intervention: CGA.Control: Usual care.Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality.Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences.Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group.Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.
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| 15. |
- Elyn, Antoine, et al.
(författare)
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End of life care practice and symptom management outcomes of nursing home residents with dementia : secondary analyses of IQUARE trial
- 2019
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Ingår i: European Geriatric Medicine. - : Springer Science and Business Media LLC. - 1878-7649 .- 1878-7657. ; 10:6, s. 947-955
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Tidskriftsartikel (refereegranskat)abstract
- Purpose End-of-life care is a central issue in nursing homes. Poor care outcomes have been reported, especially among residents with dementia. Our aim was two-fold: to assess whether the diagnosis of dementia was associated with specific patterns of care and symptom management for residents with dementia during the last 6 months of life, and to compare these patterns of care between residents with dementia who died within 6 months and those who survived longer. Methods Secondary prospective analyses of the IQUARE trial (trial registration number NCT01703689). 175 nursing homes in South West France. Residents with and without dementia at baseline (May-June 2011), stratified according to their vital status at 6-month follow-up. Results Of 6275 residents enrolled in IQUARE study (including 2688 with dementia), 494 (7.9%) died within 6 months. Compared to residents without dementia (n = 254), those with dementia (n = 240) were less likely to be self-sufficient (OR = 0.08, 95% CI 0.01-0.64). They were more likely to have physical restraints (OR = 1.65, 95% CI 1.08-2.51) and less likely to be prescribed benzodiazepines (OR = 0.58, 95% CI 0.38-0.88). Among residents with dementia, those who died during the first 6 months of follow-up were more likely to be identified with a formal end-of-life status (OR = 5.71, 95% CI 3.48-9.37) although such identification remains low with only 15% of them. They were more likely to experience pain (OR = 1.43, 95% CI 1.04-1.97) and to be physically restrained (OR = 1.46, 95% CI 1.08-1.98). However, pain relief and psychological distress management were not improved. Conclusions Poor quality indicators such as physical restraints are associated with end-of-life care for residents with dementia. Among symptom management outcomes, pain medication remains low even if pain complaint increased at life end.
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| 16. |
- Freiberger, Ellen, et al.
(författare)
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Short physical performance battery is not associated with falls and injurious falls in older persons : longitudinal data of the SCOPE project
- 2024
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Ingår i: European Geriatric Medicine. - 1878-7649 .- 1878-7657.
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Falls and fall-related injuries in older persons are a major public health problem. Our objective was to study the predictive value of the Short Physical Performance Battery (SPPB) in the cohort of the SCOPE project on falls, injurious falls, and possible difference of prediction between indoors and outdoors falls.METHODS: For this sub-study of the SCOPE project participants reporting no falls at baseline, and survey data on falls at the 12-month and 24-month follow-up were included. Participant´s characteristics were assessed during the baseline interview and medical examinations. Falls as well as injurious falls and fall circumstances were obtained self-reported. SPPB and its association with fallers vs. no fallers at 12 and at 24 months were studied with logistic regression models.RESULTS: The 1198 participants had a median age of 79 years (77-82), and a median SPPB of 10 (8-11), with a 52.5% of female. A total of 227 and 277 falls (12- and 24- month visits, respectively) were reported. In the crude model, the SPPB sum scores (p < 0.001) as well as most single item scores were significant different between fallers and non-fallers over time. However, the association was attenuated in models adjusted for age, sex, marital status, number of medications, quality of life, handgrip strength, and muscle mass [e.g., 12 months; OR 0.94 (0.87-1.02)]. While SPPB fails to differentiate between injurious and non-injurious falls (p = 0.48), a lower SPPB score was associated with falls at home (p < 0.01) after 24 months.CONCLUSION: SBPP was not able to significantly predict the risk of falling as well as experiencing an injurious fall.TRIAL REGISTRATION: This study was registered prospectively on 25th February 2016 at clinicaltrials.gov (NCT02691546).
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| 17. |
- Gustafson, Yngve, et al.
(författare)
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Delirium. A Swedish perspective.
- 2010
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Ingår i: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 1:6, s. 374-376
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Tidskriftsartikel (refereegranskat)abstract
- The incidence and duration of delirium is probably the best measurement of the quality of acute hospital care of old people. A patient with delirium is always seen as a diagnostic challenge to the geriatric team since the only effective treatment is to prevent, detect and treat the underlying causes of delirium. Predisposing and precipitating factors has to be dealt with simultaneously and the best conditions for the recovery of the brain have to be created. New threats to the brain have to be prevented and harmful medication should be avoided. Long-term follow-up of the patient with delirium is necessary since delirium can be the first symptom of a preclinical dementia.
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| 18. |
- Gustafson, Yngve, et al.
(författare)
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Depression in old age in Austria, Ireland, Portugal and Sweden
- 2013
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Ingår i: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 4:3, s. 202-208
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Tidskriftsartikel (refereegranskat)abstract
- Depression is the third leading cause of disease burden worldwide and the most frequent psychiatric disorder in the older adult population. Depression in old age is disabling, both psychosocially and physically, decreases quality of life and increases mortality. This paper explores the epidemiology, screening, diagnosis and management of depression in old age in four European countries in an attempt to gain a better understanding of the issues contributing to the variability in clinical practice. The prevalence of depression in community dwelling older individuals is high, but studies in the oldest population and in specific settings (like nursing homes) are few. Depression may go undiagnosed, and wide screening programs for early identification of this disease are uncommon. Depression screening is consistently included in comprehensive geriatric assessment, and most geriatricians appear to be confident in its diagnosis and management. Old age psychiatry is still largely underdeveloped, except for Ireland. Primary care physicians start treatment of depression in most countries, referring only complex cases for specialised care. SSRIs seem to be the first line treatment, but choice of antidepressants is widely variable in different countries. Availability of non-pharmacological therapies is still low, and only highly skilled centres use a multifaceted approach to depression care. Attitudes towards depression and mental illness are still mostly negative, which may hinder identification and management of this highly prevalent geriatric problem.
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| 19. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Risk factors for hospital readmission among Swedish older adults
- 2018
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Ingår i: European Geriatric Medicine. - : Springer. - 1878-7649 .- 1878-7657. ; 9:5, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Hospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.MethodsA prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/ Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.ResultsOf the 772 participants, [mean age 69.7 (±11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the frst week; mean days from hospital discharge to readmission was 7.9 (±6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p=0.039) and being a male (OR 1.84, p=0.006) increased the risk of readmission.ConclusionsMost older persons that are readmitted return to hospital within the frst week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.
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| 20. |
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| 21. |
- Lapi, Francesco, et al.
(författare)
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How to support general practitioners to better detect sarcopenia among older adults : a nested case-control analysis
- 2024
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Ingår i: European Geriatric Medicine. - 1878-7649 .- 1878-7657.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study explores correlations of sarcopenia and its proxies, such as history of falls, asthenia, and ambulation issues, with frailty levels among older adults in primary care.Methods In a cohort of 546,590 patients aged 60 years or older, “definite” sarcopenia cases were operationally defined through the use of non-specific diagnostic codes coupled with inspection of free-texts. Proxies of sarcopenia, such as falls history, asthenia, and ambulation issues were considered as well. Frailty was calculated using an Index intended to primary care.Results Overall, 171 definite sarcopenia cases were found, rising to 51,520 cases when including proxies (9.4% prevalence). There was a significant association between severe frailty and increased odds of sarcopenia, consistently observed across different event definitions.Conclusions Sarcopenia was strongly associated with severe frailty in primary care. The history of falls, asthenia, and ambulation issues were reliable proxies to raise the suspect of sarcopenia. Improved strategies for sarcopenia detection, focusing on specific indicators within severely frail individuals, are warranted.
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| 22. |
- Mazya, A. L., et al.
(författare)
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The Ambulatory Geriatric Assessment - a Frailty Intervention Trial (AGe-FIT) - A randomised controlled trial aimed to prevent hospital readmissions and functional deterioration in high risk older adults : A study protocol
- 2013
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Ingår i: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 4:4, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCare of old people with multimorbidity living at home is often fragmented with lack of coordination and information exchange between health care professionals, the elderly and their relatives. This paper describes the protocol of a randomised, controlled study, which aims to compare the efficacy of caring for older people with multimorbidity and three or more hospital admissions in the previous year at a geriatric ambulatory department based on Comprehensive Geriatric Assessment (CGA) versus usual care.Participants and methodsA total of 400 community-dwelling old people with multimorbidity who are living in the city of Norrköping (Sweden) and one of their relatives are recruited for this trial and randomized to an intervention and a control group. Participants in the intervention group receive interdisciplinary care after a CGA at an Ambulatory Geriatric Unit with easy accessibility during working hours in addition to usual care. The control group receives usual care provided by the primary care or hospital.OutcomesThe primary outcome is number of hospitalisation, the secondary outcomes are health-related outcomes including measures of frailty, cognition, symptom burden, feeling of security, quality of life of participants and relatives and as well as costs for health and social care. Participants will be followed for 2 years.DiscussionThis study will contribute to evidence of the effect of two different care models. The study has the potential to change care for older people with multimorbidity.
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| 23. |
- Mezera, Vojtech, et al.
(författare)
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The experiences of early career geriatricians throughout Europe during the COVID-19 pandemic
- 2022
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Ingår i: European Geriatric Medicine. - : Springer Science and Business Media LLC. - 1878-7649 .- 1878-7657. ; 13:3, s. 719-724
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has severely affected older adults and brought about unprecedented challenges to geriatricians. We aimed to evaluate the experiences of early career geriatricians (residents or consultants with up to 10 years of experience) throughout Europe using an online survey. We obtained 721 responses. Most of the respondents were females (77.8%) and residents in geriatric medicine (54.6%). The majority (91.4%) were directly involved in the care of patients with COVID-19. The respondents reported moderate levels of anxiety and feelings of being overloaded with work. The anxiety levels were higher in women than in men. Most of the respondents experienced a feeling of a strong restriction on their private lives and a change in their work routine. The residents also reported a moderate disruption in their training and research activities. In conclusion, early career geriatricians experienced a major impact of COVID-19 on their professional and private lives.
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- Nägga, Katarina, et al.
(författare)
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Evaluation of short cognitive screening tests in 85-year-old men and women
- 2015
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Ingår i: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 6:6, s. 545-550
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study aimed to investigate different aspects of cognition using the Cognitive Assessment Battery (CAB) in community-dwelling older adults aged 85 years. We also investigated the eventual influence of sex on the results and aimed to identify predictors for further cognitive decline after 1 year. Methods: CAB consists of 10 subtests covering the cognitive domains of speed and attention, learning and episodic memory, visuospatial abilities, language, and executive functions. Cognitive tests were performed at baseline (n = 335) and follow-up after 1 year (n = 270). Results: Univariate statistics revealed that men performed better than women on episodic memory (P < 0.05) and on the naming test (P < 0.001). However, floor effects in the paragraph memory test were revealed. There was a high rate of abnormal results on Token Test (67%), PaSMO (50%), Clox (48%), and the cube copying (40%) tests in participants with normal cognition. Logistic regression showed that impaired results on the Stroop III test (odds ratio, 2.38; P < 0.05) was independently associated with an increased risk of cognitive decline. Conclusion: Men performed better than women on the memory and on the naming test. However, due to floor effects in the paragraph memory test in 85 year olds, these results can be disputed. The high rate of abnormal results on the Token Test, PaSMO, Clox, and the cube copying tests in cases with normal cognition indicate that these tests are less suitable for screening in the age group. Impaired result on the Stroop test increased the risk more than two-fold for cognitive decline after 1 year. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
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