Geriatrics & Gerontology International最新文献

Aim: This study aimed to investigate the associations between bed-rest time and food intake and between bed-rest time and constipation in older nursing home residents.

Methods: We conducted a cross-sectional study using data from the Long-term Care Information System for Evidence (LIFE) database. We used data collected from older nursing home residents registered in the LIFE database between April 2022 and March 2023. We compared outcome data between the short-bed-rest group (≥9 h out of bed per day) and the long-bed-rest group (<9 h out of bed per day). The outcomes were the percentage of food intake provided in the last 3 days, the percentage of energy sufficiency (the percentage of energy intake to energy requirements), and the incidence of constipation.

Results: The short-bed-rest group consisted of 265 people (53.9%). The short-bed-rest group showed a significantly higher percentage of food intake (93.1 ± 12.3 vs. 85.2 ± 21.6), a higher percentage of energy sufficiency (104.8 ± 19.4 vs. 92.2 ± 26.2), and a lower incidence of constipation (6.0% vs. 18.5%) than the long bed-rest group. Multivariable analyses revealed that shorter bed-rest time was independently and significantly associated with the percentage of food intake (standardized coefficient: 0.28, P < 0.001), the percentage of energy sufficiency (standardized coefficient 0.30, p < 0.001), and incidence of constipation (odds ratio: 0.12, P < 0.001).

Conclusion: Bed-rest time is associated with food intake and constipation in older nursing home residents. Geriatr Gerontol Int 2025; ••: ••-••.

Aim: Treatment withholding or withdrawal (TWW) is frequent in the emergency department (ED). Most studies on this topic only study patients who die in the ED. The main aim of this study was to determine 30-day mortality after a TWW decision in the ED, for patients discharged alive from ED.

Methods: This was a retrospective monocentric study conducted from January 1, 2020, to March 31, 2022, in a university hospital in France. Classes of TWW levels were low, medium and high, corresponding to do-not-resuscitate order, treatment withholding and treatment withdrawal, respectively. The secondary aim was to determine if there were predictive factors of survival among patients with medium-level TWW.

Results: Overall, 280 patients were included and 219 (78%) were analyzed, with mean age of 82 (±12) years. Respectively, 12 (5%), 145 (66%) and 62 (28%) had a low, medium, or high level of TWW. A total of 78 (36% [95% CI, 29%-42%]) patients were alive on day 30 following their ED admission: 7 (11%) with a high level, 63 (43%) with a medium level and 8 (67%) with a low level. No difference was found after adjustment between surviving and nonsurviving patients having a medium TWW level.

Conclusions: Among patients having a TWW decision in the ED, 36% of patients were alive at 30 days. The decision to limit some therapeutics for patients does not mean an imminent death, and those patients need adequate care. The care pathway for these patients must be organized accordingly. Geriatr Gerontol Int 2025; ••: ••-••.

Tirzepatide could control postprandial hyperglycemia even in cases with diminished β-cell function. This finding gives new insight into the treatment of older patients with diabetes. However, tilzepatide does not replace basal insulin in cases with diminished β-cell function and requires careful observation for sarcopenia.

Introduction: The high prevalence of malnutrition, sarcopenia and cachexia among older adults presents a significant health care challenge, underscoring the need for effective screening tools. Given the frequent overlap of these conditions, a tool capable of simultaneously screening for all three conditions is imperative.

Methods: The development process included an extensive review of existing assessment instruments and data on risk factors, clinical presentations, and consequences of the three conditions. The tool underwent rigorous testing to evaluate its reliability and validity in a sample of 300 older adults. It was compared against standard diagnostic criteria and assessed alongside other screening tools, including the Mini Nutritional Assessment-Short Form, the Short Nutritional Assessment Questionnaire and the Simple Questionnaire to Rapidly Diagnose Sarcopenia.

Results: Eighteen percent (n = 54) of participants were diagnosed with an overlap of the three conditions, 10% (n = 30) of cases presented with sarcopenia alone and 3% (n = 10) were diagnosed with malnutrition only. The new tool demonstrated Cronbach's alpha of 0.818 and high construct validity. The newly developed tool and Mini Nutritional Assessment-Short Form had the highest diagnostic accuracy for predicting the malnutrition and sarcopenia. The Short Nutritional Assessment Questionnaire had the highest diagnostic accuracy for predicting cachexia, whereas the Simple Questionnaire to Rapidly Diagnose Sarcopenia exhibited the lowest diagnostic accuracy across all conditions. The retention criteria for items were deemed valid for the 19 items included in the finalized version of the new tool.

Conclusions: Screening for malnutrition, sarcopenia and cachexia in older adults using a single tool was feasible. The new tool was easy to use and did not require anthropometric measurements or physical performance tasks. Geriatr Gerontol Int 2025; ••: ••-••.