Annals of Geriatric Medicine and Research最新文献

Background: The association between physical frailty and performance in different cognitive domains in the absence of cognitive disorders is poorly understood. Hence, we aimed to explore the associations between frailty levels based on the Fried Physical Frailty Phenotype and performance of different cognitive domains. We also aimed to examine the associations between cognitive function and each criterion in the Fried Frailty Scale using the same cognitive domains in a non-dementia population aged 60-96 years.

Methods: This cross-sectional study included 4,329 participants aged 60-96 years, drawn from the "Good Aging in Skåne" population study. Frailty indices included handgrip strength, physical endurance, body mass index (BMI), physical activity, and walking speed. Cognitive function was assessed across eight domains: episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, executive function, and visual perception. We constructed adjusted multiple linear regression models for each cognitive domain, with the frailty levels as the independent variable. Likewise, we constructed linear regression models with each cognitive domain as the dependent variable and frailty criteria as independent variables.

Results: Physical frailty was associated with poor performance in episodic memory, processing speed, semantic memory, verbal fluency, working memory, attention, and executive functions (p<0.001 for all associations). Weaker hand grip strength was independently associated with poorer performance in all cognitive domains (p < 0.015).

Conclusion: Higher levels of frailty were associated with poorer performance in all cognitive domains except visual perception. Describing frailty by considering cognitive functioning may provide a better understanding of frailty.

Background: Physical inactivity is a risk factor for locomotive syndromes and functional limitations in middle-aged and older adults. Therefore, strategies to promote physical activity should be considered. This study investigated whether users of physical activity monitors were more physically active and exhibited a lower risk of locomotive syndrome, compared with non-users.

Methods: We analyzed data from 742 Japanese adults aged 60-79 years. The participants were surveyed for their use of physical activity monitors in their daily lives. We also assessed the prevalence of locomotive syndrome.

Results: We observed significantly higher physical activity levels in users compared with non-users. Moreover, the use of a physical activity monitor was significantly associated with decreased odds of locomotive syndrome (adjusted odds ratio [aOR]=0.48). Significantly lower risk of locomotive syndrome were observed in individuals who had used a monitor for >2 years (aOR=0.42) or had set a personal step goal (aOR=0.32).

Conclusion: Physical activity monitoring may increase engagement in physical activity-associated behavior. Therefore, monitoring could serve as a useful tool to promote physical health in middle-aged and older adults.

Background: There is limited research on social factors related to falls among older adults. This study assessed the association between falls during the past year with social participation, children's support, relationship with children, and social frailty.

Methods: Participants were 17,687 community-dwelling older adults from the 2015 Survey on Health, Well-being, and Aging (SABE) in Colombia. Covariates included sociodemographic characteristics, environmental barriers, psychotropic intake, vision problems, memory loss, multimorbidity, and fear of falling.

Results: In multivariate logistic regression analyses, being socially frail (vs. no-frail) was associated with higher odds of falls (odds ratio [OR]=1.20; 95% confidence interval [CI] 1.10-1.32). Participating in groups (OR=1.07; 95% CI 1.03-1.11), helping others (OR=1.04; 95% CI 1.02-1.06), or volunteering (OR=1.09; 95% CI 1.01-1.17) were also associated with higher odds of falls. These findings were partly explained because most group participants reside in cities where they are more exposed to environmental barriers. In contrast, receiving help, affection, and company from children (OR=0.95; 95% CI 0.93-0.97) was associated with lower fall odds than not receiving it. Moreover, having a good relationship with children was associated with lower odds of falls (OR=0.75; 95% CI, 0.66-0.85) compared to an unsatisfactory relationship.

Conclusion: Support from children and having a good relationship with them were associated with fewer falls; however, social frailty and participation in social groups were associated with more falls.

Background: Recent studies have reported an association between sarcopenia and depression symptoms. To date, no reports have investigated the association between sarcopenia and depression symptoms evaluated using the Geriatric Depression Screening Scale (GDS)-15 in patients with stroke. Therefore, this study aimed to investigate the association between sarcopenia and its components and the improvement of depression symptoms in patients with stroke admitted to a convalescent rehabilitation ward.

Methods: Patients with stroke aged ≥65 years admitted to a convalescent rehabilitation ward were included in the study. Participants were categorized into sarcopenia and non-sarcopenia groups based on the 2019 Asian Working Group for Sarcopenia. Here, depression symptoms were evaluated using the GDS-15, in addition to demographic characteristics. This study's primary outcome was the GDS change from admission to discharge. Multiple regression analysis was performed to investigate the association between GDS change and sarcopenia and its components.

Results: Overall, 118 participants were included, with the mean age of 78.7±8.1 years, and 58 (49%) were classified in the sarcopenia group. Multiple regression analysis showed that sarcopenia (β=-0.283, 95% confidence interval [CI] -1.140 to -0.283, p<0.001) and handgrip strength (β=-0.317, 95% CI -0.162 to -0.014, p=0.021) were independently associated with GDS change.

Conclusion: Sarcopenia and handgrip strength were significantly associated with improved depression symptoms in patients with stroke admitted to a convalescent rehabilitation ward. However, further prospective studies should investigate the association between sarcopenia and depression symptoms in patients with stroke.

Background: In India, the absence of formal training in geriatric dentistry and the lack of recognition of it as a speciality contributes to the deterioration of oral health in the older adults. India lacks specific oral healthcare policies for older adults. Additionally, caregivers' perspective in old age homes regarding oral healthcare services remains underexplored, necessitating further studies in this context.

Methods: A mixed method study was conducted, and the quantitative component focused on assessing the oral health status of institutionalized older adults and caregivers' perceptions using a questionnaire. The qualitative part evaluates caregivers' perceptions of providing oral healthcare services for older adults through in-depth interviews.

Results: Mean DMFT among institutionalized older adults was 15.52±8.23. More than 50% of caregivers perceived that the oral health status of institutionalized older adults was fair. Barriers to oral health services include autonomy, difficulty in traveling, lack of financial support, lack of knowledge and time. Approaches to enhancing oral health services for institutionalized older adults include oral health education for older adults and their caregivers, monthly dental visits to the institution, utilization of portable dental chair services, collaboration with dental colleges/dental clinics, distribution of oral health education materials, and provision of oral hygiene aids.

Conclusion: Findings from our study indicate the need to collaborate with dental institutions to provide oral health services in old age homes, to improve the oral health status of older adults and caregivers' knowledge.

Although neuropsychiatric manifestations are common in survivors of coronavirus disease 2019 (COVID-19), the pathophysiology is not yet elucidated. Here we describe the case of a geriatric inpatient who developed post-COVID depression with psychomotor retardation, anxiety, hopelessness, executive function problems, and suicidal ideations. The language problems and cognitive impairments coemerged with the motor problems. We propose a mechanism associated with problems in energy prediction and regulation in which the coronavirus infection, which causes neuroinflammation and viral activity in the nervous system, interferes with the reward pathway and sensory prediction process. Sigma-1 receptor agonists such as sertraline may regulate energy expenditure and, thus, be beneficial to the process. The treatment improvements in our patient included those in the autonomic nervous system, activity, and circadian rhythm.

Background: This study aimed to reveal differences in the effectiveness of rehabilitation in improving activities of daily living (ADL) in patients with acute stroke across age groups and propose age-appropriate rehabilitation strategies.

Methods: This observational study analyzed nationwide administrative data of inpatients admitted to hospitals with acute stroke between April 1, 2018, and March 31, 2020. The data included the average length of daily rehabilitation sessions, weekly frequency of rehabilitation sessions, and initiation of rehabilitation within 3 days. The primary outcome was the improvement in the Barthel Index (BI) score from admission to discharge. We classified the patients based on age and analyzed improvements in ADL according to rehabilitation characteristics.

Results: An increased daily rehabilitation dose was associated with improved ADL, except in patients aged <65 years (risk ratio [95% confidence interval] in the 65-74, 75-85, and ≥85 years age groups: 1.20 [1.14‒1.27], 1.21 [1.15‒1.27], and 1.43 [1.34‒1.53], respectively; all p<0.001 vs. <65 years: 1.05 [0.98‒1.12]; p=0.18). A rehabilitation frequency of seven sessions per week was associated with improved ADL in the 75-85 years and ≥85 years age groups (1.06 [1.02‒1.10] and 1.08 [1.03‒1.13], respectively; both p<0.001). The effects of initiating rehabilitation within 3 days on ADL post-admission did not differ across age groups.

Conclusion: Increasing the daily dose of rehabilitation was significantly associated with improved ADL in all age groups while increasing the frequency of rehabilitation per week improved ADL in older and very old patients.

Medication is a potential factor influencing frailty. However, the relationship between pharmaceutical treatments and frailty remains unclear. Therefore, we conducted the present systematic review to summarize the association between drug therapy and the risk of incident frailty in older adults. We systematically searched the MEDLINE electronic database for articles indexed between January 1, 2000, and December 31, 2021, for randomized controlled trials (RCTs) and cohort studies reporting frailty changes associated with drug therapy. A total of six RCTs and 13 cohort studies involving 211,948 participants were identified, and their treatments were categorized into six medication classes: analgesics, cardiometabolic medication, chemotherapy, central nervous system (CNS)-active medication, hormonal therapy, and nutritional supplements. While the analysis revealed that only CNS-active medications were associated with an elevated risk of frailty, other medication classes also affected frailty; however, this is not conclusively attributable to a class-wide effect.

Background: Hip fractures are frequent injuries in older patients and are associated with high mortality rates. This study assessed the association between serum lactate level and 30-day mortality in older patients with unilateral hip fractures and examined the prognostic value of this association on the clinical outcomes of these patients.

Methods: This retrospective, single-center study included patients aged ≥65 years admitted to the emergency department due to low-energy trauma and diagnosed with unilateral hip fracture upon admission. The additional inclusion criteria were patients with independent ambulation or walker or cane assistance before the injury, with available data on serum lactate levels on venous blood gas analysis, and who underwent surgery.

Results: Among the 330 included patients, 30.9% experienced postoperative complications and 10.3% died within 30 days. Using a lactate cut-off value of 2 mmol/L to distinguish between living and deceased patients, the sensitivity and specificity were 41% and 88%, respectively. Multivariate logistic regression analysis revealed that high lactate and low albumin levels and male sex were associated with mortality.

Conclusion: Identifying risk factors for mortality in geriatric patients with hip fractures is important. Male sex, low albumin levels, and particularly increased lactate levels were independent predictors of short-term mortality in these patients.