| 1. |
- Corsonello, Andrea, et al.
(författare)
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Design and methodology of the screening for CKD among older patients across Europe (SCOPE) study : a multicenter cohort observational study
- 2018
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Ingår i: BMC Nephrology. - : BMC. - 1471-2369. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align laboratory and biomarker results with medical and functional data obtained from this cohort. The study was registered at ClinicalTrials.gov, identifier NCT02691546, February 25th 2016. Methods/design: An observational, multinational, multicenter, prospective cohort study in community dwelling persons aged 75 years and over, visiting the outpatient clinics of participating institutions. The study will enroll 2450 participants and is carried out in Austria, Germany, Israel, Italy, the Netherlands, Poland and Spain. Participants will undergo clinical and laboratory evaluations at baseline and after 12 and 24 months-follow-up. Clinical evaluation also includes a comprehensive geriatric assessment (CGA). Local laboratory will be used for 'basic' parameters (including serum creatinine and albumin-to-creatinine ratio), whereas biomarker assessment will be conducted centrally. An intermediate telephone follow-up will be carried out at 6 and 18 months. Discussion: Combining the use of CGA and the investigation of novel and existing independent biomarkers within the SCOPE study will help to provide evidence in the development of European guidelines and recommendations in the screening and management of CKD in older people.
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| 2. |
- Corsonello, Andrea, et al.
(författare)
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Estimated glomerular filtration rate and functional status among older people : A systematic review
- 2018
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Ingår i: European journal of internal medicine. - : Elsevier. - 0953-6205 .- 1879-0828. ; 56, s. 39-48
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Forskningsöversikt (refereegranskat)abstract
- Background: The association between chronic kidney disease (CKD) and functional status may change as a function of the equation used to estimate glomerular filtration rate (eGFR). We reviewed the predictive value of different eGFR equations in regard to frailty and disability outcomes. Methods: We searched Pubmed from inception to March 2018 for studies investigating the association between eGFR and self-reported and/or objective measures of frailty or disability. Cross-sectional and longitudinal studies were separately analysed. Results: We included 16 studies, one of which reporting both cross-sectional and longitudinal data. Three out of 7 cross-sectional studies compared different eGFR equations in regard to their association with functional status: two studies showed that cystatin C-based, but not creatinine-based eGFR may be associated with hand-grip strength or frailty; another study showed that two different creatinine-based eGFR equations may be similarly associated with disability. Four out of 10 longitudinal studies provided comparative data: two studies reported similar association with disability for different creatinine-based eGFR equations; one study showed that creatinine-based eGFR was not associated with frailty, but a not significant trend for association was observed with cystatin C-based eGFR; one study showed that cystatin C-based but not creatinine-based eGFR may predict incident mobility disability, while both methods may predict gait speed decline. High heterogeneity was observed in regard to confounders included in reviewed studies. None of them included the most recently published equations. Conclusion: Available data do not support the superiority of one of the eGFR equations in terms of measuring or predicting functional decline.
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| 3. |
- Ekdahl, Anne Wissendorff, et al.
(författare)
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Primary and Community Care
- 2018
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Ingår i: Learning geriatric medicine : A study guide for medical students - A study guide for medical students. - Cham : Springer International Publishing. - 2509-6079 .- 2509-6060. - 9783319619972 - 9783319619965 ; , s. 305-311
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Bokkapitel (refereegranskat)abstract
- Care of older persons in community and primary care differs substantially between European countries, but most countries pursue the concept of “ageing in place”, meaning that most older people do not live in institutions. More and more older people are living alone. Relatives still play an important role in the care of older people, but it differs substantially within Europe, and will probably remain the case even in the future. Care of older people with complex needs requires corresponding complex teams to be able to provide adequate and good quality of care, which means that there must be geriatric skills to diagnose, treat, and comprehensively follow up people with common geriatric diseases, including dementia, within primary and community care. Specially designed structures within primary and community care should work proactively to take care of older people as many do not and cannot seek care appropriately. One of the reasons for this is cognitive decline.
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| 4. |
- Windhaber, Thomas, et al.
(författare)
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Educational strategies to train health care professionals across the education continuum on the process of frailty prevention and frailty management : a systematic review
- 2018
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 30:12, s. 1409-1415
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Forskningsöversikt (refereegranskat)abstract
- Background In addition to the normal process of ageing, frailty, defined as a geriatric syndrome, is becoming more prevalent. Around 10% of people over 65years and 25-50% of those aged over 85years are frail. Frail elderly are more vulnerable to external stressors and have an increased risk of adverse health outcomes. To tackle these challenges, European Union (EU) member states need to develop a health work force capable of the right skills mix. A goal-centred education and training of professionals is crucial for effective and efficient health care delivery for Europe's greying population.Aims The aim of this study was to systematically collect, review and critically appraise studies carried out to investigate the efficacy and effectiveness of comprehensive educational programmes for health professionals related to frailty prevention and/or frailty management.Methods A systematic review was carried out searching the databases PubMed, CINAHL, Cochrane CENTRAL, Medline, Up to date and Embase. Additionally, a manual search of the reference lists and searches via Google Scholar and greylit.org was done.Results No relevant publications addressing the evidence and sustainability of educational/training programmes for frailty prevention and/or frailty management were identified.Discussion The result of an empty review is surprising because several educational programmes in different countries are currently run.Conclusions A significant knowledge gap exists in the scientific literature regarding education and training of health care workers regarding prevention and management of frailty. Further research is needed to identify effective educational strategies for health professionals to prevent and manage frailty.
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