Archives of Gerontology and Geriatrics Plus最新文献

Objectives

The aim was to determine the knowledge of men about prostate cancer and screening methods, and the influence of these factors on participation in prostate cancer screening.

Participants and methods

Participants in this observational and cross-sectional study were men aged 40 to 79 years. Participation in the study was voluntary. Data were collected in May 2023 via an anonymous online survey.

Results

There is a lack of knowledge about prostate cancer among men in Istria. Most receive information from the media, while a smaller number receive information from physicians. Most have heard that there is a PSA test, but few know that it is a method for early detection. Subjects have different perceptions of digital rectal examination and other screening methods. Some men are afraid of discomfort and pain during the examination, while others do not consider this a problem. Most indicate that they intend to participate in screening in the future and that early detection of prostate cancer is important and a positive attitude towards it influences the decision to participate in the screening program.

Conclusion

The lack of knowledge about prostate cancer among men in Croatia is evident. Although most of the respondents do not consider themselves as a risk group, a positive attitude towards early detection affects the participation in prevention programs. Raising awareness and educating men about prostate cancer and available screening methods are key to increasing the number of participants in prevention programs and reducing the incidence of this disease.

Objectives

This study aimed to explore whether there might exist an interaction between using antidepressants and the influence of depressive symptoms on the recurrence of falls.

Design

Cross-sectional study using secondary data from a randomized clinical trial.

Setting and participants

Community-dwelling older adults (n = 609, aged 73.4 ± 7.4 years) who had experienced at least one fall in the past 12 months.

Methods

Depressive symptoms were measured using the Geriatric Depression Scale, and information about antidepressant usage was collected. Mediation models were built to decompose the effects of depressive symptoms on fall risk into direct effects and indirect effects mediated by antidepressant use.

Results

Depressive symptoms were reported by 29.1 % of the participants, and 27.4 % were using antidepressants. Those with depressive symptoms had 1.86 times the likelihood of being recurrent fallers (OR_TE: 1.861, 95 % CI: 1.197, 2.895), and there was no significant interaction between depressive symptoms and antidepressant use on recurrent falls (P _interaction = 0.989). Antidepressant use might be a significant mediator in the relationship between depressive symptoms and recurrent falls (OR_NIE: 1.140, 95 % CI: 1.007, 1.291), accounting for 21.1 % of the total effect.

Conclusions/implications

Antidepressants probably do not add a significant risk of recurrent falls beyond what is already contributed by the presence of depressive symptoms. A longitudinal study could clarify whether it might be safe to use antidepressants to treat older people with depressive symptoms without increasing the risk of falls the disease leads by itself.

Introduction

Polypharmacy, the concurrent use of multiple medications, poses significant risks to geriatric patients due to increased susceptibility to side effects and interactions. This narrative review addresses the challenges posed by polypharmacy in older adults, emphasizing the importance of reducing adverse effects. The article examines explicit, implicit, and mixed assessment tools used to identify potentially inappropriate medications (PIMs) and minimize adverse effects in geriatric populations.

Conclusion

The article underscores the critical need for accurate assessment and intervention to mitigate the negative consequences of polypharmacy in geriatric patients. The PRISCUS 2.0 List, an extensively updated version of the original PRISCUS list, emerges as a comprehensive tool to aid healthcare professionals in identifying PIMs. Its expanded medication list, incorporation of new evaluation criteria, disease-specific considerations, and enhanced classification system contribute to better identification of inappropriate medications. When we compared with other PIM criteria in previous studies, the EU(7)-PIM list was one of the most comprehensive, and with the PRISCUS 2.0 list update, it was determined that it contains partially more drugs that are inappropriate for the elderly in the Turkish pharmaceutical market. Comparisons between various criteria reveal their varying detection rates and strengths, highlighting the significance of using multiple criteria for a more holistic assessment. Additionally, the advent of online applications offers accessible solutions by consolidating multiple explicit criteria into a single platform, aiding practitioners in making well-informed decisions. The study emphasizes the need for ongoing updates, validation, and suitability assessments for these tools in diverse healthcare settings to ensure their effectiveness.

In pragmatic settings, involving elderly individuals in physical activity programs typically does not require individualized training. Thus, the aim of this study was to assess the impact on functional physical performance and cellular health resulting from a high (10 participants to 1 supervisor) versus low (20 participants to 1 supervisor) supervision ratio in a group-based multicomponent training program for older women. The experimental procedure presented three phases: a) pre-assessment (physical functional performance and cellular health); b) multicomponent training program (2 sessions/week); c) post-assessment. Performance variables were normalized with a t-score and the statistical analysis was based on the individual relative position in the t-score. After the collective multicomponent training intervention, 55 % of participants were above the mean t-score; however, low supervision ratio group (20:1) did not change functional physical performance and cellular health. A high supervision ratio is an important condition to improve individual older women response during a collective multicomponent training program.

Objectives

We investigated the relationship between levels of mastery/conscientiousness and cortisol response in older adults, considering depression status. Based on former research we hypothesized that high and low and not intermediate levels of mastery/conscientiousness would correlate with high cortisol response, particularly in depressed individuals.

Methods

Data from the Netherlands Study of Depression in Older Persons (NESDO) were analyzed. Respondents were categorized into low, intermediate, and high mastery/conscientiousness groups. Regression analyses examined associations between mastery/conscientiousness and evening cortisol (N=412) and cortisol awakening response (N=370), stratified by depression status. Histograms were created to visualize the results.

Results

No significant associations were found between mastery/conscientiousness and cortisol response, irrespective of depression status.

Conclusions

Our findings do not suggest that low or high levels of mastery/conscientiousness increase stress in depressed older adults compared to those with intermediate levels, nor do they differ from non-depressed individuals.

Introduction

The oral cavity is related to nervous system diseases, and oral issues have a bidirectional correlation with cognitive dysfunction. Thus, this study aims to explore the association between oral health problems and cognitive dysfunction in community-dwelling Indian older adults.

Materials and Methods

Utilizing data from LASI, a nationally representative cohort study, this study involved 30,726 participants aged ≥60 years. The oral health problems of study participants were self-reported. Cognitive impairment was assessed using composite score, and a score of less than -1.5 SD was defined as the presence of cognitive impairment.

Results

In univariate analysis, significant associations were observed between oral health problems (loss of some natural teeth, OR: 1.33, 95 % CI: 1.15–1.52, p < 0.001; lost all natural teeth, OR: 2.33, 95 % CI: 1.97–2.76, p < 0.001) and ease of chewing solid food [Fairly well (OR: 1.51, 95 % CI: 1.33–1.71, p < 0.001) and not at all (OR: 2.37, 95 % CI: 2.11–2.67, p < 0.001)] with cognitive impairment. In multivariate analysis, adjusted for various factors, a significant association persisted between loss of all natural teeth (OR: 1.62, 95 % CI: 1.34–1.95, p < 0.001) and the ability to chew solid food. Specifically, individuals reporting chewing solid food “Fairly well” (OR: 1.34, 95 % CI: 1.16–1.52, p < 0.001) and those unable to chew at all (OR: 1.73, 95 % CI: 1.51–1.97, p < 0.001) with cognitive impairment.

Conclusion

The findings of this study underscore a compelling connection between oral health issues and cognitive impairment. Consequently, it is imperative to proactively identify and address oral health problems in older adults.

Introduction

The principal group of people who suffer from fragility hip fractures is the elderly population, gaining relevance given the increase in the average median age of the Chilean and European populations. This fracture risk is associated with a decreased bone density. Physical activity is a protective factor in the risk of falls and a determinant of bone resistance.

Objectives

Determine the impact of physical activity on the probability of suffering a fragility hip fracture in a population ≥ 60 years of age in a public trauma hospital in Chile.

Materials and methods

It was conducted a relational analytical study of cases and controls. A total of 147 patients participated, the case group with osteoporosis hip fracture formed for 72 patients, and the control group without hip fracture 75 patients formed for 75 patients. To quantify physical activity was applied the instrument Global Physical Activity Questionnaire in the control group, and a designed version to assess pre-fracture physical activity in the case group.

Results

There is a significant statistical difference between the incidence of hip fractures and physical activity during leisure time, both for vigorous physical activity (p = 0.002, p < 0.05), moderate physical activity (p < 0.001, p < 0.05), and for moderate physical activity at work (p = 0.016, p < 0.05).

Conclusions

Physical activity during leisure time and moderate physical activity at work showed to be factors associated with a significant decrease in the incidence of fragility hip fractures.

This paper aims to examine the concept of functional decline in older adults from a physiotherapist's perspective. Throughout this paper, the author will shed some light on the conceptualization, identification, and assessment of functional decline among older adults. Also, a reflection on the role of physiotherapists in promoting healthy aging and how prepared they are to meet the changing demographic landscape will be discussed. A narrative literature review methodology was used to search for and analyze relevant articles that have been published in the past three decades. The reviewed materials included peer-reviewed publications that examined the assessment of physical functional decline in older adults. The assessment of functional decline in older adults is commonly done through one assessment measure at a time. Furthermore, assessments for functional decline often happen in emergency rooms when something catastrophic has taken place, such as a fall injury. The findings also suggest that multi-domain assessments are more useful than single-domain assessments in this population. One promising assessment tool for the identification of older adults who are at risk of developing functional decline that is specific to physiotherapy practice was identified and discussed. There is a need for further research to refine the assessment process, and to develop interventions to prevent or mitigate functional decline. Overall, this paper provides valuable insights into current assessment measures of functional decline in older adults relevant to physiotherapy practice and suggests potential areas for future research.

Objectives

We aimed to examine the association between population aging and the prevalence of non-communicable diseases and risk factors in the Brazilian population.

Study design

An ecological study using secondary data from 2010 to 2023 of the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL).

Methods

We estimated the aging rate in 2010 and 2022 as the ratio of people aged 65 or older to those younger than 15 using the 2010 and 2022 Brazilian censuses. We calculated the absolute differences in the prevalence of non-communicable diseases (hypertension, diabetes) and their risk factors (smoking, excessive alcohol consumption, physical inactivity, obesity) and negative health perceptions in 2010 and 2023 for the 26 Brazilian states and the Federal District. Linear regression assessed the relationship between aging rate and health outcomes. We stratified the analyses to explore the differences by sex.

Results

Brazil's aging rate was higher among women than men (average of 0.20 and 0.31, respectively). The increased number of older adults was associated with a higher prevalence of excess weight and diabetes in men. In women, the aging rate was associated with a higher prevalence of smoking, excessive alcohol consumption, obesity, hypertension, and diabetes.

Conclusions

Our findings show a sex-specific association between population aging and the prevalence of health conditions in the Brazilian population. By discerning the sex-specific nuances and untangling the multifactorial influences, this research aspires to contribute valuable insights to the burgeoning field of public health in the face of evolving demographic landscapes.

Purpose

A reduction in life space (LS) is associated with a negative impact on medical and functional status during hospitalization, with potential consequences after discharge. A validated version of an evaluation tool for assessing LS in Japanese individuals in an institutionalized setting is lacking. This study developed and validated a Japanese version of the Life-Space Assessment in Institutionalized Settings (LSA-IS-J).

Material and methods

The LSA-IS-J was developed using a specified process. This study included 30 inpatients admitted to the rehabilitation ward. The Timed Up and Go Test, Berg Balance Scale scores, 10-meter walking time, Functional Independence Measure, and Falls Efficacy Scale-International were used to assess construct validity. For test-retest reliability, the same assessor evaluated the LSA-IS-J within two days. Correlation coefficients were calculated to determine the construct validity.

Results

The mean LSA-IS-J total score mean was 37.7 (standard deviation: 7.4), with skewness of -0.17 and kurtosis of -1.39. No ceiling or floor effects are observed. The test-retest reliability was excellent for the total and subtests, with intraclass correlations ranging from 0.78 to 0.99. The LSA-IS-J showed significant correlations with almost all variables related to motor status and concerns about falling, indicating high construct validity. In contrast, more generic variables were not significantly associated.

Conclusions

The LSA-IS-J demonstrated broad feasibility for assessing LS without ceiling or floor effects among patients undergoing ward-based rehabilitation. The LSA-IS-J also demonstrated excellent test-retest reliability and adequate construct validity for constructs with a high impact on LS.