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Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis 运动计划对社区居住的虚弱和非虚弱老年人体能表现的影响:系统回顾与元分析
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-08 DOI: 10.3390/geriatrics9010008
Cristina Flores-Bello, Elsa Correa-Muñoz, M. Sánchez-Rodríguez, V. Mendoza-Núñez
Background: The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. Aim: To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. Method: A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. Result: We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. Conclusion: Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.
背景:对体能表现的测量是衡量体弱和非体弱老年人身体机能能力的一个指标。目的:综述运动项目对社区中体弱和非体弱老年人体能表现的影响。方法:采用系统综述的方法:根据 PRISMA-2020 标准进行系统性综述。在 PubMed、Scopus、Web of Science、Cochrane Library、SciELO 和 LILACS 中搜索文章,搜索时间截至 2023 年 5 月 4 日。结果变量为体能,通过 SPPB(短期体能测试)进行测量。通过估算平均差(MD)来评估效果。结果:我们发现了 2483 项研究,其中 12 项符合系统综述的资格标准,9 项符合荟萃分析的资格标准。在非虚弱老年人中,运动组对 SPPB 评分的影响明显高于对照组,MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]。同样,在体弱老年人中,运动组对 SPPB 总分的影响也明显高于对照组,MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]。结论我们的研究结果表明,运动项目能有效提高和/或保持有体弱和无体弱的老年人的体能表现,其效果在有体弱的老年人中更为明显,这可能是由于内在能力恢复的余地更大。本系统综述显示,运动训练对有体弱和无体弱的老年人的体能表现有不同的影响。科学证据强化了对包括体弱者在内的所有老年人实施体育锻炼计划的重要性。不过,有必要针对先前根据 SPPB 评分分组的个性化群体,明确规定运动的类型和剂量(持续时间、频率和强度)。
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引用次数: 0
Outcomes of COVID-19-Associated Hospitalizations in Geriatric Patients with Dementia in the United States: A Propensity Score Matched Analysis 美国老年痴呆症患者与 COVID-19 相关的住院治疗结果:倾向得分匹配分析
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-05 DOI: 10.3390/geriatrics9010007
Tomas Escobar Gil, Mohammed A Quazi, Tushita Verma, Amir H. Sohail, Hafiz Abdullah Ikram, A. Nasrullah, Karthik Gangu, Asif Farooq, Abu Baker Sheikh
Previous studies have convincingly demonstrated the negative impact of dementia on overall health outcomes. In the context of the COVID-19 pandemic, there is burgeoning evidence suggesting a possible association between dementia and adverse outcomes, however the relationship has not been conclusively established. We conducted a retrospective cohort study involving 816,960 hospitalized COVID-19 patients aged 65 or older from the 2020 national inpatient sample. The cohort was bifurcated into patients with dementia (n = 180,845) and those without (n = 636,115). Multivariate regression and propensity score matched analyses (PSM) assessed in-hospital mortality and complications. We observed that COVID-19 patients with dementia had a notably higher risk of in-hospital mortality (23.1% vs. 18.6%; aOR = 1.2 [95% CI 1.1–1.2]). This elevated risk persisted even after PSM. Interestingly, dementia patients had a reduced risk of several acute in-hospital complications, including liver failure and sudden cardiac arrest. Nevertheless, they had longer hospital stays and lower total hospital charges. Our findings conclusively demonstrate that dementia patients face a heightened risk of mortality when hospitalized with COVID-19 but are less likely to experience certain complications. This complexity underscores the urgent need for individualized care strategies for this vulnerable group.
以往的研究已令人信服地证明了痴呆症对整体健康结果的负面影响。在 COVID-19 大流行的背景下,有越来越多的证据表明,痴呆症与不良后果之间可能存在关联,但这种关系尚未最终确定。我们开展了一项回顾性队列研究,涉及 2020 年全国住院病人样本中 816960 名 65 岁或以上的 COVID-19 住院病人。该队列分为痴呆症患者(n = 180,845 人)和非痴呆症患者(n = 636,115 人)。多变量回归和倾向得分匹配分析(PSM)评估了院内死亡率和并发症。我们观察到,COVID-19痴呆患者的院内死亡风险明显更高(23.1% vs. 18.6%;aOR = 1.2 [95% CI 1.1-1.2])。即使在 PSM 之后,这种风险升高的情况依然存在。有趣的是,痴呆症患者发生院内急性并发症的风险降低了,包括肝功能衰竭和心脏骤停。不过,他们的住院时间更长,住院总费用更低。我们的研究结果明确表明,痴呆症患者在住院治疗 COVID-19 时面临着更高的死亡风险,但出现某些并发症的可能性较低。这种复杂性凸显了为这一弱势群体制定个性化护理策略的迫切需要。
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引用次数: 0
Influence of Potentially Inappropriate Medication Use on Older Australians’ Admission to Emergency Department Short Stay 潜在用药不当对澳大利亚老年人入住急诊科短期住院的影响
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-04 DOI: 10.3390/geriatrics9010006
Hoa T. M. Tran, C. Roman, Gary Yip, Michael Dooley, M. Salahudeen, B. Mitra
Older people in the emergency department (ED) often pose complex medical challenges, with a significant prevalence of polypharmacy and potentially inappropriate medicines (PIMs) in Australia. A retrospective analysis of 200 consecutive patients aged over 65 years admitted to the emergency short stay unit (ESSU) aimed to identify polypharmacy (five or more regular medications), assess PIM prevalence, and explore the link between pre-admission PIMs and ESSU admissions. STOPP/START version 2 criteria were used for the PIM assessment, with an expert panel categorizing associated risks. Polypharmacy was observed in 161 patients (80.5%), who were older (mean age 82 versus 76 years) and took more regular medications (median 9 versus 3). One hundred and eighty-five (92.5%) patients had at least one PIM, 81 patients (40.5%) had STOPP PIMs, and 177 patients (88.5%) had START omissions. Polypharmacy significantly correlated with STOPP PIM (OR 4.8; 95%CI: 1.90–12.1), and for each additional medication the adjusted odds of having a STOPP PIM increased by 1.20 (95%CI: 1.11–1.28). Nineteen admissions (9.5%) were attributed to one or more PIMs (total 21 PIMs). Of these PIMs, the expert panel rated eight (38%) as high risk, five (24%) as moderate risk, and eight (38%) as low risk for causing hospital admission. The most common PIMs were benzodiazepines, accounting for 14 cases (73.6%). Older ESSU-admitted patients commonly presented with polypharmacy and PIMs, potentially contributing to their admission.
在澳大利亚,急诊科(ED)中的老年人往往面临着复杂的医疗难题,多药和潜在不适当药物(PIMs)的发病率很高。我们对急诊科短期住院病人(ESSU)中连续收治的 200 名 65 岁以上患者进行了回顾性分析,旨在确定多重用药(五种或五种以上常规药物)情况、评估潜在用药不当的发生率,并探讨入院前潜在用药不当与急诊科短期住院病人之间的联系。PIM 评估采用 STOPP/START 第 2 版标准,由专家小组对相关风险进行分类。在161名患者(80.5%)中发现了多重用药现象,这些患者年龄较大(平均年龄为82岁对76岁),服用的常规药物较多(中位数为9种对3种)。185 名患者(92.5%)至少有一次 PIM,81 名患者(40.5%)有 STOPP PIM,177 名患者(88.5%)有 START 漏服。多药治疗与 STOPP PIM 明显相关(OR 4.8;95%CI:1.90-12.1),每增加一种药物,STOPP PIM 的调整几率就增加 1.20(95%CI:1.11-1.28)。有 19 例入院病例(9.5%)归因于一种或多种 PIM(共 21 种 PIM)。在这些 PIMs 中,专家组将其中 8 种(38%)评为高风险,5 种(24%)为中度风险,8 种(38%)为低风险。最常见的 PIMs 是苯二氮卓,占 14 例(73.6%)。ESSU入院的老年患者通常会同时服用多种药物和PIMs,这可能是导致他们入院的原因之一。
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引用次数: 0
Unmet Needs for Support in Activities of Daily Living among Older Persons: The Effects of Family and Household Structures in a Low- and Middle-Income Context 老年人在日常生活活动中未得到满足的支持需求:中低收入背景下家庭和住户结构的影响
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-03 DOI: 10.3390/geriatrics9010005
J. W. Mobolaji
The unmet need for assistance in activities of daily living (ADLs) accentuates older persons’ risk of falls, ill health, hospitalisation, and mortality. In Nigeria, the family arrangements through which older persons derive support are changing due to modernisation, migration, and economic challenges. How the family dynamics explain the unmet needs is poorly understood. This study investigates the influence of family and household structures on older persons’ unmet needs in ADLs in southwestern Nigeria. The study analysed the data of 827 older adults aged ≥65 years selected from Oyo State, southwestern Nigeria, using a multi-stage sampling design. Associations were examined using the Poisson–logit hurdle regression model. From the results, 65% of older persons with difficulties had unmet needs in instrumental ADLs and 59% in basic ADLs. Increased unmet needs were associated with older persons living with non-family members (β = 0.19; p < 0.01; 95% C.I. = 0.05–0.32) and widows (β = 0.27; p < 0.01; 95% C.I. = 0.13–0.42). Conversely, unmet needs decreased with higher family size (β = −0.06; p < 0.001; 95% C.I. = −0.08–−0.03), living in rich households (β = −0.29; p < 0.001; 95% C.I. = −0.42–−0.17), not being the household head (β = −0.27; p < 0.001; 95% C.I. = −0.40–−0.15), close family bonds, and proximity to children/caregivers. The study recommends alternative or complementary home-based support mechanisms for seniors with vulnerable family settings in southwestern Nigeria.
老年人在日常生活活动(ADLs)中对援助的需求得不到满足,这加剧了老年人跌倒、健康状况不佳、住院和死亡的风险。在尼日利亚,由于现代化、移民和经济挑战,老年人获得支持的家庭安排正在发生变化。人们对家庭动态如何解释未满足的需求知之甚少。本研究调查了尼日利亚西南部的家庭和住户结构对老年人日常活动需求未得到满足的影响。研究采用多阶段抽样设计,分析了从尼日利亚西南部奥约州选出的 827 名年龄≥65 岁的老年人的数据。研究采用 Poisson-logit 障碍回归模型对相关性进行了检验。结果显示,65% 有困难的老年人在工具性日常活动方面的需求未得到满足,59% 的老年人在基本日常活动方面的需求未得到满足。与非家庭成员生活在一起的老年人(β = 0.19; p < 0.01; 95% C.I. = 0.05-0.32)和寡妇(β = 0.27; p < 0.01; 95% C.I. = 0.13-0.42)的未满足需求量增加。相反,未满足的需求随着家庭规模扩大(β = -0.06;p < 0.001;95% C.I. = -0.08--0.03)、生活在富裕家庭(β = -0.29;p < 0.001;95% C.I. = -0.42--0.17)、不是户主(β = -0.27;p < 0.001;95% C.I. = -0.40--0.15)、家庭关系密切以及接近子女/照顾者而减少。该研究建议为尼日利亚西南部家庭环境脆弱的老年人提供替代性或补充性家庭支持机制。
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引用次数: 0
Challenging Diagnosis of Invasive Sinus Aspergillosis Mimicking Gradenigo's Syndrome in an Elderly Patient with T-Cell Lymphoma. 一名 T 细胞淋巴瘤老年患者疑似格拉登尼哥综合征的侵袭性窦曲霉病诊断难题。
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-28 DOI: 10.3390/geriatrics9010004
Victoria Ramos de Ascanio, Gloria Liaño-Esteso, David Roldán, Teresa Collazo-Lorduy, Sara Martínez-Flores, José Ángel Hernández-Rivas, Isabel González-Gascón-Y-Marín

(1) Background: Gradenigo's Syndrome (GS) is a rare complication of acute otitis media characterized by the triad of diplopia, otitis, and facial pain. The widespread use of antibiotics has significantly reduced its occurrence. (2) Case summary: We present the case of an elderly patient with T-cell lymphoma who developed neurological deficits resembling GS. The patient was ultimately diagnosed with invasive sinus aspergillosis. The diagnostic process was challenging due to the atypical clinical presentation and the lack of specific imaging findings. A biopsy was the most important test for clarifying the diagnosis. (3) Conclusions: The prognosis for this complication is extremely poor without surgery, and the patient died despite adequate antifungal coverage. Therefore, maintaining high clinical suspicion is paramount to avoid adverse outcomes in similar cases, particularly in the geriatric population, wherein this syndrome's occurrence may not be expected.

(1) 背景:格拉登尼戈综合征(GS)是急性中耳炎的一种罕见并发症,以复视、中耳炎和面部疼痛三联症为特征。抗生素的广泛使用大大降低了其发生率。(2)病例摘要:我们报告了一例患有 T 细胞淋巴瘤的老年患者的病例,该患者出现了类似 GS 的神经功能障碍。患者最终被诊断为侵袭性窦曲霉菌病。由于临床表现不典型且缺乏特异性影像学检查结果,诊断过程极具挑战性。活检是明确诊断的最重要检查。(3)结论:这种并发症如果不进行手术,预后极差,尽管进行了充分的抗真菌治疗,但患者还是死亡了。因此,临床上必须保持高度怀疑,以避免类似病例出现不良后果,尤其是在老年人群中,因为这种综合征的发生可能是意料之外的。
{"title":"Challenging Diagnosis of Invasive Sinus Aspergillosis Mimicking Gradenigo's Syndrome in an Elderly Patient with T-Cell Lymphoma.","authors":"Victoria Ramos de Ascanio, Gloria Liaño-Esteso, David Roldán, Teresa Collazo-Lorduy, Sara Martínez-Flores, José Ángel Hernández-Rivas, Isabel González-Gascón-Y-Marín","doi":"10.3390/geriatrics9010004","DOIUrl":"10.3390/geriatrics9010004","url":null,"abstract":"<p><p>(1) Background: Gradenigo's Syndrome (GS) is a rare complication of acute otitis media characterized by the triad of diplopia, otitis, and facial pain. The widespread use of antibiotics has significantly reduced its occurrence. (2) Case summary: We present the case of an elderly patient with T-cell lymphoma who developed neurological deficits resembling GS. The patient was ultimately diagnosed with invasive sinus aspergillosis. The diagnostic process was challenging due to the atypical clinical presentation and the lack of specific imaging findings. A biopsy was the most important test for clarifying the diagnosis. (3) Conclusions: The prognosis for this complication is extremely poor without surgery, and the patient died despite adequate antifungal coverage. Therefore, maintaining high clinical suspicion is paramount to avoid adverse outcomes in similar cases, particularly in the geriatric population, wherein this syndrome's occurrence may not be expected.</p>","PeriodicalId":12653,"journal":{"name":"Geriatrics","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceptions of Patients, Caregivers, and Healthcare Professionals toward Telemedicine Use for Cognitive and Movement Disorders in the Aegean Islands, Greece: A Pilot Study of the SI4CARE European Project 希腊爱琴海群岛患者、护理人员和医护人员对使用远程医疗治疗认知和运动障碍的看法:欧洲 SI4CARE 项目试点研究
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-26 DOI: 10.3390/geriatrics9010003
Efthalia Angelopoulou, D. Kontaxopoulou, Stella Fragkiadaki, Evangelia Stanitsa, D. Pavlou, J. Papatriantafyllou, C. Koros, Vlado Dimovski, Darja Šemrov, S. Papageorgiou
Background: Patients with neurodegenerative diseases who live in remote areas often have limited access to specialized healthcare, and telemedicine represents a useful solution. The aim of this study was to investigate the perceptions toward the use of a specialized-tertiary telemedicine service of patients with cognitive and movement disorders, caregivers, and local healthcare professionals (HPs) in the Aegean Islands. Methods: Data were derived from the “Specialized Outpatient Clinic of Memory, Dementia and Parkinson’s disease through the National Telemedicine Network”, March 2021–March 2023. The survey included 10 questions (5-point Likert scale). Results: We received 64 questionnaires (25 patients, 18 caregivers, 21 HPs). Most participants positively perceived all aspects of telemedicine, including comfort (mean ± standard deviation: patients 4.5 ± 0.9, caregivers: 4.8 ± 0.5, HPs: 4.6 ± 0.7), access to specialized care (4.7 ± 0.6, 4.7 ± 0.5, 4.9 ± 0.4), number of transportations (4.6 ± 0.8, 4.6 ± 0.9, 4.8 ± 0.5), adequacy of follow-up (4.6 ± 0.7, 4.4 ± 0.8, 4.2 ± 0.7), future telemedicine selection (4.8 ± 0.4, 4.8 ± 0.4, 4.6 ± 0.6), perceived reliable medical assessment (4.7 ± 0.5, 4.6 ± 0.6, 4.3 ± 0.6), information delivery (4.7 ± 0.6, 4.6 ± 0.5, 4.4 ± 0.9), health status improvement (4.6 ± 0.7, 4.6 ± 0.6, 4.0 ± 0.7), cost (4.6 ± 1, 4.6 ± 1, 5.0 ± 0.2), and general satisfaction (4.8 ± 0.4, 4.7 ± 0.5, 4.5 ± 0.6). The commonest recommendations were more frequent visits, medical specialties, and dissemination of information. Conclusions: The positive perception of participants highlights the value of telemedicine for specialized healthcare for neurodegenerative disorders, especially in remote areas.
背景:生活在偏远地区的神经退行性疾病患者获得专业医疗服务的机会往往有限,而远程医疗则是一种有效的解决方案。本研究旨在调查爱琴海群岛的认知和运动障碍患者、护理人员和当地医疗保健专业人员(HPs)对使用专科-三级远程医疗服务的看法。研究方法数据来自 2021 年 3 月至 2023 年 3 月的 "通过国家远程医疗网络提供的记忆、痴呆和帕金森病专科门诊"。调查包括 10 个问题(5 点李克特量表)。结果:我们共收到 64 份调查问卷(25 名患者、18 名护理人员、21 名医疗保健人员)。大多数参与者对远程医疗的各个方面都有积极的看法,包括舒适度(平均值 ± 标准差:患者 4.5 ± 0.9,护理人员 4.8 ± 0.5,HPs 4.8 ± 0.5):4.8±0.5,医护人员:4.6±0.7)、获得专业护理的机会(4.7±0.6,4.7±0.5,4.9±0.4)、交通次数(4.6±0.8,4.6±0.9、4.8 ± 0.5)、随访的充分性(4.6 ± 0.7、4.4 ± 0.8、4.2 ± 0.7)、未来远程医疗的选择(4.8 ± 0.4、4.8 ± 0.4、4.6 ± 0.6)、认为可靠的医疗评估(4.7 ± 0.5,4.6 ± 0.6,4.3 ± 0.6)、信息传递(4.7 ± 0.6,4.6 ± 0.5,4.4 ± 0.9)、健康状况改善(4.6 ± 0.7、4.6 ± 0.6、4.0 ± 0.7)、费用(4.6 ± 1、4.6 ± 1、5.0 ± 0.2)和总体满意度(4.8 ± 0.4、4.7 ± 0.5、4.5 ± 0.6)。最常见的建议是增加就诊次数、增加医疗专科和传播信息。结论参与者的积极看法凸显了远程医疗在神经退行性疾病专业医疗保健方面的价值,尤其是在偏远地区。
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引用次数: 0
Night-Time Hot Spring Bathing Is Associated with a Lower Systolic Blood Pressure among Japanese Older Adults: A Single-Institution Retrospective Cohort Study 日本老年人夜间泡温泉可降低收缩压:单机构回顾性队列研究
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-21 DOI: 10.3390/geriatrics9010002
Satoshi Yamasaki, T. Tokunou, Toyoki Maeda, Takahiko Horiuchi
Hot spring bathing is practiced to help manage hypertension. We retrospectively investigated the effects of hot spring bathing on hypertension with the aim of identifying a novel approach to prevent and manage hypertension. The study cohort comprised 99 patients aged ≥65 years admitted to Kyushu University Beppu Hospital between 1 December 2021 and 30 November 2022 who could walk by themselves and who used hot springs for ≥3 days during their hospital stay. The changes in both systolic and diastolic blood pressure were significantly decreased in the night-time bathing group (n = 21) compared with the noontime (n = 26) and afternoon (n = 52) groups. Night-time hot spring bathing was significantly associated with reduced systolic blood pressure the next morning in older adults. Although prospective randomized controlled trials on night-time hot spring bathing as a hypertension treatment are warranted to investigate whether the practice can prevent hypertension among adults aged ≥65 years, we have initiated a single-center, phase II study on the relationship between sleep quality and quality of life in hypertensive patients after night-time hot spring bathing.
泡温泉有助于控制高血压。我们对温泉浴对高血压的影响进行了回顾性研究,旨在找出一种预防和控制高血压的新方法。研究对象包括九州大学别府医院在 2021 年 12 月 1 日至 2022 年 11 月 30 日期间收治的 99 名年龄≥65 岁、能自行行走且在住院期间泡温泉≥3 天的患者。与中午组(26 人)和下午组(52 人)相比,夜间泡温泉组(21 人)的收缩压和舒张压变化均显著下降。夜间泡温泉与老年人第二天早上收缩压的降低有明显关系。尽管将夜间泡温泉作为高血压治疗方法的前瞻性随机对照试验对于研究这种做法是否能预防年龄≥65 岁的成年人的高血压很有必要,但我们还是启动了一项单中心 II 期研究,研究夜间泡温泉后高血压患者的睡眠质量和生活质量之间的关系。
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引用次数: 0
Mitigating the Harmful Impact of Ageism among Older Individuals: The Buffering Role of Resilience Factors 减轻老龄歧视对老年人的有害影响:复原力因素的缓冲作用
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-20 DOI: 10.3390/geriatrics9010001
L. Brinkhof, S. de Wit, J. M. Murre, Richard Ridderinkhof
Frequent exposure to ageism has significant repercussions on the quality of life and mental well-being/health of older adults. Resilience may play a crucial role in mitigating these effects. The current study aimed to investigate the potential buffering roles of two types of coping variables—behavioral coping and a positive appraisal style—in older adults (N = 2000, aged 55–93). Confirming previous findings, higher levels of perceived negative ageism (PNA) were associated with diminished quality of life and mental well-being, increased depression and loneliness. However, individuals that tend to employ behavioral coping strategies when confronted with challenging/stressful situations showed a weaker relationship between PNA and quality of life, mental well-being, and depression. Embracing a positive appraisal style attenuated the negative impact of PNA on feelings of depression and loneliness. Interestingly, younger older adults appeared to benefit the most from these resilience factors. Despite considerable inter-individual variability, encouraging the utilization of behavioral coping strategies and nurturing a positive appraisal style could serve as effective approaches to mitigate the detrimental effects of PNA.
经常受到老龄歧视会对老年人的生活质量和精神福祉/健康产生重大影响。复原力可能在减轻这些影响方面发挥关键作用。本研究旨在调查两种应对变量--行为应对和积极评价风格--对老年人(2000 人,55-93 岁)的潜在缓冲作用。与之前的研究结果相印证的是,较高程度的消极老龄歧视(PNA)与生活质量和心理健康水平下降、抑郁和孤独感增加有关。然而,在面临挑战/压力时倾向于采用行为应对策略的人,其 PNA 与生活质量、心理健康和抑郁之间的关系较弱。采用积极的评价风格可以减轻 PNA 对抑郁和孤独感的负面影响。有趣的是,年轻的老年人似乎从这些复原因素中获益最多。尽管个体之间存在很大差异,但鼓励使用行为应对策略和培养积极的评价风格可以作为减轻 PNA 负面影响的有效方法。
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引用次数: 0
Translation and Psychometric Properties of the Portuguese Version of the Timed Instrumental Activities of Daily Living (TIADL). 葡萄牙语版日常生活活动计时工具 (TIADL) 的翻译和心理计量特性。
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-18 DOI: 10.3390/geriatrics8060124
Luis Galhardas, Armando Raimundo, José Marmeleira

(1) Background: to examine the psychometric properties of the Portuguese version of the Timed Instrumental Activities of Daily Living (TIADL) in nursing home residents. (2) Methods: Fifty-two participants (85.8 ± 4.2 years) were assessed on two occasions, 10-14 days apart. The same rater administered all assessments. Internal consistency was analysed through Cronbach's α. The reliability was estimated using the intraclass correlation coefficients (ICCs), and the standard error of the mean (SEM) was used to estimate the minimal detectable change (MDC). Construct validity was determined by Spearman's correlation coefficients. (3) Results: For internal consistency, Cronbach's α (0.81) revealed high internal reliability. All of the subtests demonstrated good or excellent reliability and also presented acceptable measurement precision, considering the criterion SEM < SD/2. According to Spearman's rho, correlations with the Portuguese version of the TIADL, the Useful Field of View test, and semantic and phonemic fluency tests were significant, with moderate positive and negative correlations (0.4 < rs < 0.69). (4) Conclusions: The Portuguese version of the TIADL had good to excellent test-retest reliability (ICC > 0.90) and acceptable measurement precision. This test could be a valuable clinical tool for assessing actual performance in instrumental activities of daily living in nursing home residents.

(1) 背景:研究葡萄牙语版日常生活活动计时工具(TIADL)在养老院居民中的心理测量特性。(2) 方法:对 52 名参与者(85.8 ± 4.2 岁)进行了两次评估,每次相隔 10-14 天。所有评估均由同一评分者进行。使用类内相关系数(ICC)估算信度,并使用平均值标准误差(SEM)估算最小可检测变化(MDC)。结构效度通过斯皮尔曼相关系数确定。(3) 结果:在内部一致性方面,Cronbach's α(0.81)显示了较高的内部可靠性。考虑到 SEM < SD/2 的标准,所有分测验都表现出良好或出色的信度,测量精度也可以接受。根据 Spearman's rho,与葡萄牙语版 TIADL、有用视野测试、语义和语音流畅性测试的相关性显著,正负相关适中(0.4 < rs < 0.69)。(4) 结论:葡萄牙语版 TIADL 具有良好至卓越的重测可靠性(ICC > 0.90)和可接受的测量精度。该测试可作为一种有价值的临床工具,用于评估疗养院居民日常生活工具性活动的实际表现。
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引用次数: 0
The Risk of Drug Interactions in Older Primary Care Patients after Hospital Discharge: The Role of Drug Reconciliation. 老年初级保健患者出院后发生药物相互作用的风险:药物协调的作用
IF 2.3 Q3 GERIATRICS & GERONTOLOGY Pub Date : 2023-12-16 DOI: 10.3390/geriatrics8060122
Cristina Vocca, Antonio Siniscalchi, Vincenzo Rania, Cecilia Galati, Gianmarco Marcianò, Caterina Palleria, Luca Catarisano, Ilaria Gareri, Marco Leuzzi, Lucia Muraca, Rita Citraro, Giacinto Nanci, Antonio Scuteri, Rosa Candida Bianco, Iolanda Fera, Antonietta Greco, Giacomo Leuzzi, Giovambattista De Sarro, Bruno D'Agostino, Luca Gallelli

Introduction: Drug-drug interactions (DDIs) represent an important clinical problem, particularly in older patients, due to polytherapy, comorbidity, and physiological changes in pharmacodynamic and pharmacokinetic pathways. In this study, we investigated the association between drugs prescribed after discharge from the hospital or clinic and the risk of DDIs with drugs used daily by each patient.

Methods: We performed an observational, retrospective, multicenter study on the medical records of outpatients referred to general practitioners. DDIs were measured using the drug interaction probability scale. Potential drug interactions were evaluated by clinical pharmacologists (physicians) and neurologists. Collected data were analyzed using the Statistical Package for the Social Sciences.

Results: During the study, we evaluated 1772 medical records. We recorded the development of DDIs in 10.3% of patients; 11.6% of these patients required hospitalization. Logistic regression showed an association among DDIs, sex, and the number of drugs used (p = 0.023).

Conclusions: This observational real-life study shows that the risk of DDIs is common in older patients. Physicians must pay more attention after hospital discharge, evaluating the treatment to reduce the risk of DDIs.

导言:药物间相互作用(DDIs)是一个重要的临床问题,尤其是在老年患者中,原因包括多药治疗、合并症以及药效学和药代动力学途径的生理变化。在这项研究中,我们调查了出院或出诊后处方药物与每位患者日常用药的 DDIs 风险之间的关联:我们对转诊到全科医生处的门诊病人的病历进行了一项观察性、回顾性、多中心研究。使用药物相互作用概率量表测量 DDI。由临床药理学家(内科医生)和神经学家对潜在的药物相互作用进行评估。收集的数据使用社会科学统计软件包进行分析:研究期间,我们评估了 1772 份病历。根据我们的记录,10.3% 的患者出现了 DDIs;其中 11.6% 的患者需要住院治疗。逻辑回归显示,DDIs、性别和用药数量之间存在关联(P = 0.023):这项现实生活中的观察性研究表明,DDIs 风险在老年患者中很常见。医生必须在患者出院后给予更多关注,对治疗进行评估,以降低 DDIs 风险。
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Geriatrics
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