Pub Date : 2018-12-30DOI: 10.12809/ajgg-2018-295-oa
Janet Bong May Ing, Howell Menor, Naimah binti Wahab, Nur, Rusyda binti Ishak, M. Bujang, F. E. Sapri
Background. A progressive decrease in muscle mass and consequent muscle strength can lead to disability, morbidity, and mortality. This study aimed to determine the association between handgrip strength and health-related quality of life (HRQOL) in elderly patients with medical conditions. Methods: Those aged ≥60 years who attended the physiotherapy clinics between September and November 2016 were invited to participate. Handgrip strength was measured in kg using a Jamar Handgrip Dynamometer. The SF-36 health survey was used to assess HRQOL; lower scores represent greater disability. Results: A total of 142 female and 87 male elderly patients participated. The most common medical condition was osteoarthritis (25.3%), followed by cardiac problems (20.5%), low back pain (17.4%), others (15.7%), stroke (13.1%), fracture (4.4%), and trigger finger (3.5%). In males and females, the most common medical conditions were cardiac problems (36.8%) and osteoarthritis (31.0%), respectively. Compared with females, males had better handgrip strength (24.46 vs. 15.25 kg, p<0.001) and HRQOL in terms of most SF-36 sub-scores. In males, handgrip strength differed significantly in those with different medical conditions (p=0.026); handgrip strength was highest in those with cardiac problems and lowest in those with osteoarthritis. In females, higher handgrip strength was associated with younger age-group (p=0.003, analysis of covariance). In males, handgrip strength was positively correlated with all domains of SF-36. In females, handgrip strength was positively correlated with domains of physical functioning, role physical, social functioning, and physical component summary. Conclusions: Lower handgrip strength is associated with poor HRQOL, particularly physical functioning, among Malaysian elderly patients with medical conditions. Handgrip strength can be used to determine the physical condition of elderly patients.
{"title":"Handgrip strength and health-related quality of life in elderly patients attending physiotherapy clinics","authors":"Janet Bong May Ing, Howell Menor, Naimah binti Wahab, Nur, Rusyda binti Ishak, M. Bujang, F. E. Sapri","doi":"10.12809/ajgg-2018-295-oa","DOIUrl":"https://doi.org/10.12809/ajgg-2018-295-oa","url":null,"abstract":"Background. A progressive decrease in muscle mass and consequent muscle strength can lead to disability, morbidity, and mortality. This study aimed to determine the association between handgrip strength and health-related quality of life (HRQOL) in elderly patients with medical conditions. Methods: Those aged ≥60 years who attended the physiotherapy clinics between September and November 2016 were invited to participate. Handgrip strength was measured in kg using a Jamar Handgrip Dynamometer. The SF-36 health survey was used to assess HRQOL; lower scores represent greater disability. Results: A total of 142 female and 87 male elderly patients participated. The most common medical condition was osteoarthritis (25.3%), followed by cardiac problems (20.5%), low back pain (17.4%), others (15.7%), stroke (13.1%), fracture (4.4%), and trigger finger (3.5%). In males and females, the most common medical conditions were cardiac problems (36.8%) and osteoarthritis (31.0%), respectively. Compared with females, males had better handgrip strength (24.46 vs. 15.25 kg, p<0.001) and HRQOL in terms of most SF-36 sub-scores. In males, handgrip strength differed significantly in those with different medical conditions (p=0.026); handgrip strength was highest in those with cardiac problems and lowest in those with osteoarthritis. In females, higher handgrip strength was associated with younger age-group (p=0.003, analysis of covariance). In males, handgrip strength was positively correlated with all domains of SF-36. In females, handgrip strength was positively correlated with domains of physical functioning, role physical, social functioning, and physical component summary. Conclusions: Lower handgrip strength is associated with poor HRQOL, particularly physical functioning, among Malaysian elderly patients with medical conditions. Handgrip strength can be used to determine the physical condition of elderly patients.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47971182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geriatric care in nursing homes","authors":"","doi":"10.12809/ajgg-v13n2-ed","DOIUrl":"https://doi.org/10.12809/ajgg-v13n2-ed","url":null,"abstract":"","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42751443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.12809/ajgg-2018-303-oa
J. Luk
Objectives. To evaluate the end-of-life (EOL) programme in a geriatric step-down hospital in enhancing dignified death. Methods. Medical records of patients aged ≥65 years who were admitted to the EOL programme between 24 August 2015 and 31 October 2017 were retrospectively reviewed. The Quality of Dying and Death (QODD) questionnaire was used to assess family member satisfaction of the programme. Results. 235 patients (mean age, 87.9 years) were reviewed. Their principal diagnoses were advanced dementia (n=118, 50.2%), active cancers (n=65, 27.7%), organ failure (n=31, 13.2%), stroke (n=11, 4.7%), and neurodegenerative diseases (n=6, 2.6%). In the last 24 hours before death, 99.2% of patients were pain-free, not agitated, and without excessive secretion. Compared with pre-EOL programme, EOL programme significantly reduced the use of intravenous and ‘big gun’ antibiotics, blood product transfusion, physical restraints, blood tests, haemoglucostix monitoring, and cardiac monitoring (all p<0.001). The number of regular medications dropped from 4.8 to 2.6 per patient (p<0.001). Patients received prompt services from physiotherapists (88.9%), occupational therapists (87.2%), social workers (86.4%), and chaplains (69%). 90.6% of carers stayed with patients beyond visiting hours, and 87.7% were able to say goodbye to their dying relatives. All patients had ‘do not attempt cardiopulmonary resuscitation’ in place and were not resuscitated. 133 (56.6%) QODD questionnaires were returned, and the mean score was 8.5 out of 10. Conclusion. The EOL programme is useful to foster dignified death and comfort care among dying older patients in a geriatric step-down hospital.
{"title":"End-of-life programme for older patients in a geriatric step-down hospital","authors":"J. Luk","doi":"10.12809/ajgg-2018-303-oa","DOIUrl":"https://doi.org/10.12809/ajgg-2018-303-oa","url":null,"abstract":"Objectives. To evaluate the end-of-life (EOL) programme in a geriatric step-down hospital in enhancing dignified death. Methods. Medical records of patients aged ≥65 years who were admitted to the EOL programme between 24 August 2015 and 31 October 2017 were retrospectively reviewed. The Quality of Dying and Death (QODD) questionnaire was used to assess family member satisfaction of the programme. Results. 235 patients (mean age, 87.9 years) were reviewed. Their principal diagnoses were advanced dementia (n=118, 50.2%), active cancers (n=65, 27.7%), organ failure (n=31, 13.2%), stroke (n=11, 4.7%), and neurodegenerative diseases (n=6, 2.6%). In the last 24 hours before death, 99.2% of patients were pain-free, not agitated, and without excessive secretion. Compared with pre-EOL programme, EOL programme significantly reduced the use of intravenous and ‘big gun’ antibiotics, blood product transfusion, physical restraints, blood tests, haemoglucostix monitoring, and cardiac monitoring (all p<0.001). The number of regular medications dropped from 4.8 to 2.6 per patient (p<0.001). Patients received prompt services from physiotherapists (88.9%), occupational therapists (87.2%), social workers (86.4%), and chaplains (69%). 90.6% of carers stayed with patients beyond visiting hours, and 87.7% were able to say goodbye to their dying relatives. All patients had ‘do not attempt cardiopulmonary resuscitation’ in place and were not resuscitated. 133 (56.6%) QODD questionnaires were returned, and the mean score was 8.5 out of 10. Conclusion. The EOL programme is useful to foster dignified death and comfort care among dying older patients in a geriatric step-down hospital.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42230938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-30DOI: 10.12809/ajgg-2017-285-cr
I. Burud, R. Shroff, M. Tata
Gallstone ileus is a mechanical obstruction of the small intestine caused by gallstone impaction. It accounts for 1% to 4% of all cases of mechanical obstruction. Previous acute cholecystitis results in development of a fistula between the gallbladder and the gastrointestinal tract. Diagnosing gallstone ileus is difficult as symptoms and signs are non-specific and most patients are elderly with multiple comorbidities. We report two cases of gallstone ileus in elderly patients. The first case is a 72-yearold man with multiple comorbidities who presented with vomiting, intermittent colicky right-sided abdominal pain, and inability to pass motion. He underwent enterolithotomy alone. The second case is a 73-year-old woman who presented with abdominal pain, distension, fever, and a fistulous communication between the gallbladder and the duodenum. She underwent enterolithotomy, partial cholecystectomy, and closure of the fistula.
{"title":"Gallstone ileus in geriatric patients: a report of two cases","authors":"I. Burud, R. Shroff, M. Tata","doi":"10.12809/ajgg-2017-285-cr","DOIUrl":"https://doi.org/10.12809/ajgg-2017-285-cr","url":null,"abstract":"Gallstone ileus is a mechanical obstruction of the small intestine caused by gallstone impaction. It accounts for 1% to 4% of all cases of mechanical obstruction. Previous acute cholecystitis results in development of a fistula between the gallbladder and the gastrointestinal tract. Diagnosing gallstone ileus is difficult as symptoms and signs are non-specific and most patients are elderly with multiple comorbidities. We report two cases of gallstone ileus in elderly patients. The first case is a 72-yearold man with multiple comorbidities who presented with vomiting, intermittent colicky right-sided abdominal pain, and inability to pass motion. He underwent enterolithotomy alone. The second case is a 73-year-old woman who presented with abdominal pain, distension, fever, and a fistulous communication between the gallbladder and the duodenum. She underwent enterolithotomy, partial cholecystectomy, and closure of the fistula.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43001291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.12809/ajgg-2017-270-ra
Gh Yoon, Ryc Kwan, Jyw Liu, Cky Lai
We reviewed fall prevention guidelines and policies for nursing homes in the USA, Canada, the UK, and Australia, and compared with those in Hong Kong to identify areas for improvement. 1 Department of Asian Studies, School of Social Sciences and Humanities, Northeastern University, Boston, MA, USA 2 School of Nursing, The Hong Kong Polytechnic University, Hong Kong Correspondence to: Claudia KY Lai, Honorary Professor, Centre of Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China. Email: claudia.lai@polyu.edu.hk and compared with those in Hong Kong to identify areas for improvement.
我们回顾了美国、加拿大、英国和澳大利亚养老院的跌倒预防指南和政策，并与香港的指南和政策进行了比较，以确定需要改进的地方。1美国波士顿东北大学社会科学与人文学院亚洲研究系2香港香港理工大学护理学院致：Claudia KY Lai，中国香港特别行政区九龙红磡Yuk Choi路香港理工大学护理学院老年护理中心名誉教授。电子邮件：claudia.lai@polyu.edu.hk并与香港的情况进行比较，以确定需要改进的地方。
{"title":"Fall prevention in nursing homes: comparison of local and international guidelines and policies: a systematic review","authors":"Gh Yoon, Ryc Kwan, Jyw Liu, Cky Lai","doi":"10.12809/ajgg-2017-270-ra","DOIUrl":"https://doi.org/10.12809/ajgg-2017-270-ra","url":null,"abstract":"We reviewed fall prevention guidelines and policies for nursing homes in the USA, Canada, the UK, and Australia, and compared with those in Hong Kong to identify areas for improvement. 1 Department of Asian Studies, School of Social Sciences and Humanities, Northeastern University, Boston, MA, USA 2 School of Nursing, The Hong Kong Polytechnic University, Hong Kong Correspondence to: Claudia KY Lai, Honorary Professor, Centre of Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Kowloon, Hong Kong SAR, China. Email: claudia.lai@polyu.edu.hk and compared with those in Hong Kong to identify areas for improvement.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44147644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.12809/ajgg-2017-257-oa
M. Tsang, KM Yeung, WM Kenny, Wong, PT Lam, KY Lam, CY Lam, Christopher CM Lum
Objectives. The present study aimed to determine advance care planning and end-of-life care preferences of community-dwelling Hong Kong elders with medical problems and their next of kin, and to determine the predictors of their preferences. Methods. Community-dwelling Chinese aged ≥65 years who attended one of the six medical and geriatric out-patient clinics or geriatric day hospitals between July 2012 and August 2013 were included, as were their next of kin. Interview was conducted based on a structured questionnaire. Socio-demographic data, comorbidities, functional status measured by the Katz score, self-perceived health status, and life satisfaction were collected. Preferences for end-of-life care and advance care planning were explored using hypothetical scenarios of an advanced illness. Associations between end-of-life care preferences and other variables were determined. Preferences for end-of-life care were compared between the elders and their next of kin. Results. A total of 153 female and 114 male elders (mean age, 79.2 years) and a total of 128 female and 74 male next of kin were included. Respectively for the elders and next of kin, 87.6% and 88.1% agreed to let ‘nature to guide the elder life’; 83.5% and 97% preferred adequate pain control to keep them ‘free of pain’ despite the side-effect of drowsiness; 65.5% and 43.6% preferred not to use cardiopulmonary resuscitation; 64.8% and 45.1% preferred not to use intubation; 74.9% and 53.9% preferred not to use nasogastric tube feeding; 43.5% and 59.4% preferred ‘repeated courses of antibiotics for infection despite no improvement noted’; 91.6% and 87.9% preferred small oral feeding (rather than the use of nasogastric tube); and 75.5% and 65.6% preferred oral medications (rather than non-invasive positive pressure ventilation). For advance care planning, respectively for the elders and next of kin, 58.4% and 71.4% preferred the doctor to discuss advance care planning with both the patient and family members; 7.9% and 15.1% preferred the doctor to discuss with family members only; 21.7% and 7.0% preferred the doctor to discuss with the patient only; and 11.6% and 6.5% preferred to let the doctor to make decisions. There were significant discordance between elders and next of kin in terms of treatment preference in case of short of breath (p=0.004) and all end-of-life care preferences, except for ‘let nature guide one’s life’. Conclusions. There was significant discordance in end-of-life care preferences between elders and their next of kin. In order to deliver end-oflife care in accordance with elder’s values and beliefs, advance care planning should be discussed with them before they become too ill to do so.
{"title":"Advance care planning and end-oflife care preferences in communitydwelling Hong Kong Chinese elders with medical problems and their next of kin: a cross-sectional study","authors":"M. Tsang, KM Yeung, WM Kenny, Wong, PT Lam, KY Lam, CY Lam, Christopher CM Lum","doi":"10.12809/ajgg-2017-257-oa","DOIUrl":"https://doi.org/10.12809/ajgg-2017-257-oa","url":null,"abstract":"Objectives. The present study aimed to determine advance care planning and end-of-life care preferences of community-dwelling Hong Kong elders with medical problems and their next of kin, and to determine the predictors of their preferences. Methods. Community-dwelling Chinese aged ≥65 years who attended one of the six medical and geriatric out-patient clinics or geriatric day hospitals between July 2012 and August 2013 were included, as were their next of kin. Interview was conducted based on a structured questionnaire. Socio-demographic data, comorbidities, functional status measured by the Katz score, self-perceived health status, and life satisfaction were collected. Preferences for end-of-life care and advance care planning were explored using hypothetical scenarios of an advanced illness. Associations between end-of-life care preferences and other variables were determined. Preferences for end-of-life care were compared between the elders and their next of kin. Results. A total of 153 female and 114 male elders (mean age, 79.2 years) and a total of 128 female and 74 male next of kin were included. Respectively for the elders and next of kin, 87.6% and 88.1% agreed to let ‘nature to guide the elder life’; 83.5% and 97% preferred adequate pain control to keep them ‘free of pain’ despite the side-effect of drowsiness; 65.5% and 43.6% preferred not to use cardiopulmonary resuscitation; 64.8% and 45.1% preferred not to use intubation; 74.9% and 53.9% preferred not to use nasogastric tube feeding; 43.5% and 59.4% preferred ‘repeated courses of antibiotics for infection despite no improvement noted’; 91.6% and 87.9% preferred small oral feeding (rather than the use of nasogastric tube); and 75.5% and 65.6% preferred oral medications (rather than non-invasive positive pressure ventilation). For advance care planning, respectively for the elders and next of kin, 58.4% and 71.4% preferred the doctor to discuss advance care planning with both the patient and family members; 7.9% and 15.1% preferred the doctor to discuss with family members only; 21.7% and 7.0% preferred the doctor to discuss with the patient only; and 11.6% and 6.5% preferred to let the doctor to make decisions. There were significant discordance between elders and next of kin in terms of treatment preference in case of short of breath (p=0.004) and all end-of-life care preferences, except for ‘let nature guide one’s life’. Conclusions. There was significant discordance in end-of-life care preferences between elders and their next of kin. In order to deliver end-oflife care in accordance with elder’s values and beliefs, advance care planning should be discussed with them before they become too ill to do so.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46424961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.12809/ajgg-2017-273-oa
D. Benjamin
Purpose. To compare the Beers Criteria and Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) in identifying potentially inappropriate medication (PIM) and adverse drug reaction (ADR) among Indian geriatric inpatients. Methods. Patients aged ≥60 years who were admitted to the geriatric medicine ward of Bangalore Baptist Hospital between January 2016 and July 2016 were observed throughout the hospital stay. Medical records of patients were reviewed to determine PIM and ADR. The Beers Criteria and STOPP were used to identify PIM. Results. 226 male and 124 female geriatric patients aged 60 to 92 (median, 68) years were included. The median number of medications was 12 (range, 0-26), the median number of comorbidities was 2 (range, 1-6), and the median length of hospital stay was 5 (range, 1-23) days. Respectively for the Beers Criteria and STOPP, 97 (27.7%) and 86 (24.6%) patients were identified to have 136 (38.9%) and 108 (30.9%) PIMs and 11 (3.1%) and 7 (2.0%) ADRs. Beers Criteria was more likely to identify PIM than STOPP (0.2 vs. 0.1 per patient, χ2=43.21, p<0.001). The Beers Criteria was more sensitive (0.59 vs. 0.52) but less specific (0.60 vs. 0.65) than STOPP in identifying PIMs. Conclusion. The Beers Criteria was more sensitive but less specific than STOPP in identifying PIMs. The prevalence of PIMs was high among elderly patients in our geriatric medicine ward. The use of the Beers Criteria or STOPP may help reduce PIM and ADR.
目的。比较Beers标准和老年人潜在不适当处方筛选工具(STOPP)在印度老年住院患者中潜在不适当药物(PIM)和药物不良反应(ADR)的识别效果。方法。对2016年1月至2016年7月在班加罗尔浸信会医院老年医学病房住院的年龄≥60岁的患者进行住院全程观察。回顾患者的医疗记录以确定PIM和ADR。采用Beers标准和STOPP来识别PIM。结果:纳入男性226例，女性124例，年龄60 ~ 92岁(中位68岁)。用药中位数为12(范围0-26)，合并症中位数为2(范围1-6)，住院时间中位数为5(范围1-23)天。根据Beers标准和STOPP, 97例(27.7%)和86例(24.6%)患者分别有136例(38.9%)和108例(30.9%)pim, 11例(3.1%)和7例(2.0%)adr。Beers标准比STOPP更容易识别PIM(每名患者0.2 vs 0.1， χ2=43.21, p<0.001)。在识别pim方面，Beers标准比STOPP更敏感(0.59比0.52)，但特异性较低(0.60比0.65)。结论。在识别pim方面，Beers标准比STOPP更敏感，但特异性较差。我院老年内科病房的老年患者中，pim的患病率较高。使用Beers标准或STOPP可能有助于减少PIM和ADR。
{"title":"Beers Criteria versus Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions in evaluation of drug-prescribing practice in an Indian hospital","authors":"D. Benjamin","doi":"10.12809/ajgg-2017-273-oa","DOIUrl":"https://doi.org/10.12809/ajgg-2017-273-oa","url":null,"abstract":"Purpose. To compare the Beers Criteria and Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) in identifying potentially inappropriate medication (PIM) and adverse drug reaction (ADR) among Indian geriatric inpatients. Methods. Patients aged ≥60 years who were admitted to the geriatric medicine ward of Bangalore Baptist Hospital between January 2016 and July 2016 were observed throughout the hospital stay. Medical records of patients were reviewed to determine PIM and ADR. The Beers Criteria and STOPP were used to identify PIM. Results. 226 male and 124 female geriatric patients aged 60 to 92 (median, 68) years were included. The median number of medications was 12 (range, 0-26), the median number of comorbidities was 2 (range, 1-6), and the median length of hospital stay was 5 (range, 1-23) days. Respectively for the Beers Criteria and STOPP, 97 (27.7%) and 86 (24.6%) patients were identified to have 136 (38.9%) and 108 (30.9%) PIMs and 11 (3.1%) and 7 (2.0%) ADRs. Beers Criteria was more likely to identify PIM than STOPP (0.2 vs. 0.1 per patient, χ2=43.21, p<0.001). The Beers Criteria was more sensitive (0.59 vs. 0.52) but less specific (0.60 vs. 0.65) than STOPP in identifying PIMs. Conclusion. The Beers Criteria was more sensitive but less specific than STOPP in identifying PIMs. The prevalence of PIMs was high among elderly patients in our geriatric medicine ward. The use of the Beers Criteria or STOPP may help reduce PIM and ADR.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47610159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Who and when should we discuss advance care planning?","authors":"","doi":"10.12809/ajgg-v13n1-ed","DOIUrl":"https://doi.org/10.12809/ajgg-v13n1-ed","url":null,"abstract":"","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42758384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.12809/ajgg-2017-284-oa
R. Visvanathan
The health system in Australia is grappling with how best to provide health care to older people in conditions of reduced inpatient beds and an ageing population. Health system managers favour programmes that result in reduced length of hospital stay. We report our hospital’s experience in developing geriatric programmes of excellence that are based on comprehensive geriatric assessment and across the continuum of care, coupled with built environment, teaching, and research. Between 2007 and 2012, the programmes contributed to a 2-day reduction in acute length of stay for patients aged 80 years and older at the hospital. This translated to 8070 bed days or 22 beds saved per year.
{"title":"Implementing geriatric programmes of excellence in Adelaide, Australia","authors":"R. Visvanathan","doi":"10.12809/ajgg-2017-284-oa","DOIUrl":"https://doi.org/10.12809/ajgg-2017-284-oa","url":null,"abstract":"The health system in Australia is grappling with how best to provide health care to older people in conditions of reduced inpatient beds and an ageing population. Health system managers favour programmes that result in reduced length of hospital stay. We report our hospital’s experience in developing geriatric programmes of excellence that are based on comprehensive geriatric assessment and across the continuum of care, coupled with built environment, teaching, and research. Between 2007 and 2012, the programmes contributed to a 2-day reduction in acute length of stay for patients aged 80 years and older at the hospital. This translated to 8070 bed days or 22 beds saved per year.","PeriodicalId":38338,"journal":{"name":"Asian Journal of Gerontology and Geriatrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44829711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.12809/ajgg-2017-278-oa
K. Takada, C. Ura, N. Takei, K. Takeda, Seiji, Morishima, Takanori Ishii, M. Ishikawa, Yoko Miyakawa, Fumiko Miyamae, R. Takahashi
Background. To determine the effect of an oral self-care programme on oral, cognitive, and daily performance functions in rural communitydwelling older people with mild cognitive impairment. Methods. Community-dwelling older people in 10 villages were assigned based on the village they lived and at the request of the local government to either the intervention group or control group. The oral self-care programme was conducted by a dentist and two dental hygienists twice a month for a total of eight sessions. Oral functions included functions of the lips and cheeks, mastication function, swallowing function, oral diadochokinesis, the longest phonation of ‘ah’, and cleanliness of the mouth. Cognitive function was assessed using Mini Mental State Examination. The effect of the programme on cognitive function was evaluated using the Digit Symbol Substitution Test (DSST), part A of the Trail-Making Test, and Five Cognitive Tests. Daily performance was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). Results. 32 women in the intervention group and 32 women in the control group were analysed. Intervention had a significant effect on swallowing function in terms of Repetitive Saliva Swallowing Test score (p<0.001) and the longest phonation of ‘ah’ (p=0.014), cognitive function in terms of the processing speed measured by DSST score (p=0.004), and daily performance in terms of TMIG-IC score (p=0.027) and the instrumental independence sub-score (p=0.015). Surprisingly, mastication power improved significantly in the control group (p=0.036). Conclusion. The oral self-care programme may be an effective means to delay oral, physical, and cognitive decline in rural, communitydwelling older people with mild cognitive impairment.
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