Annals of Geriatric Medicine and Research最新文献

Background: To examine the association between participation frequency in the long-term care prevention program and frailty and locomotive syndrome (LS), stratified by sex.

Methods: A total of 486 older adults residing in City A, Tochigi Prefecture, were included in this study. The participants were categorized into three groups based on the frequency of participation in the long-term care prevention program: low participation, medium participation, and high participation groups. Frailty was assessed using the Questionnaire for Medical Checkup of Old-Old (QMCOO), and LS was assessed using the 5-question Geriatric Locomotive Function Scale (GLFS-5). Frailty and LS were compared separately for men and women in three groups. Additionally, a binomial logistic regression analysis was conducted to examine the association between non-frailty and participation frequency in men.

Results: A total of 141 participants (29.0%) were classified as having frailty, and 160 (32.9%) met the criteria for LS. Intergroup comparisons showed significant differences in frailty prevalence, QMCOO Q1, and Q5, and LS total GLFS-5 score and GLFS-5 Q3, Q4, and Q5 in men. In contrast, intergroup item comparisons showed no significant differences in women. High participation was associated with non-frailty in men across all models in the binomial logistic regression analysis.

Conclusions: For men, a higher frequency of participation in the long-term care prevention program was suggested to be associated not only with frailty but also with components of LS. These findings highlight the importance of promoting social participation among men, maintaining social participation among women, and adopting sex-specific approaches within community settings.

Background: Sarcopenia is a geriatric muscle disease characterized by the loss of muscle mass, strength, and physical function. To better reflect the unique characteristics of sarcopenia in Korean older adults, the Korean Working Group on Sarcopenia (KWGS) developed a diagnostic algorithm, including a new category of "functional sarcopenia." This study aimed to establish evidence-based exercise guidelines tailored to the KWGS framework.

Methods: A multidisciplinary expert committee conducted a systematic review of randomized controlled trials (RCTs) published between 2000 and 2024 to assess exercise interventions according exercise interventions by FITT (frequency, intensity, time, type) principles. Five key questions were developed, focusing on optimizing exercise modalities to improve muscle mass, strength, and physical performance in older adults with or without sarcopenia.

Results: A total of 42 RCTs met the inclusion criteria. Resistance training was most effective for improving muscle mass and strength, while combined resistance and aerobic exercise is most effective for enhancing physical function. The guideline recommends individualized exercise prescriptions based on sarcopenia subtypes and specific functional deficits, supported by evidence grades and levels.

Conclusion: This is the first Korean evidence-based exercise guideline developed within the KWGS algorithm, offering clinical and community practitioners specific, actionable strategies for preventing and managing sarcopenia. It supports tailored interventions using FITT principles aligned with individual goals and sarcopenia classification.

The aim of this work was to identify and characterize the measures employed for assessing postural control in randomized controlled trials (RCTs) of balance interventions in older adults with the reference to the Systems Framework for Postural Control. A scoping review was conducted, and RCTs of balance interventions in older adults published from 2013 to March 2023 were considered for inclusion. Two hundred and seventy-one studies were included with a total of 49 different measures used; the Timed Up and Go test being the most commonly employed. The median number of components of postural control assessed per study was five. The most frequently assessed components were motor systems and static stability, while reactive postural control, cognitive influences and verticality were the least frequently assessed. Postural control in RCTs of balance in older adults was assessed using a wide range of measures, but also from the perspective of a limited number of components.

Background: As the global population ages, including Thailand, health-promoting behaviors (HPBs) have emerged as critical challenges affecting the well-being of community-dwelling older adults. This situation calls for a deeper understanding of the modifiable protective factors involved. The current study aimed to examine the associations between frailty, depression, social support, health literacy (HL), and HPBs among community-dwelling older adults in Thailand.

Methods: A cross-sectional study with a convenience sample of 250 older adults was employed. We collected using validated questionnaires-including Tilburg Frailty Indicator, Thai Geriatric Depression Scale, Social Support Scale, Health Literacy Scale, and Health Promoting Behaviors Scale. We analyzed using descriptive statistics and stepwise multiple linear regression.

Results: This study involved a total of 250 community-dwelling older adults, with a mean age of 70.41 years. The participants had a mean frailty score of 6.78±1.95, indicating that most were classified as frail (score ≥5) based on the Tilburg Frailty Indicator. They also reported no significant depressive symptoms (3.80±2.62), moderate levels of social support (36.70±4.20), poor health literacy (33.15±2.71), and moderate health-promoting behaviors (101.19±7.67). Health literacy, social support, frailty, depression, and comorbidity conditions were significant predictors of health-promoting behaviors, collectively explaining 80.5% of the variance.

Conclusion: These findings emphasize that improved HL, greater social support, reduced frailty, and lower depression scores were associated with healthier behaviors in older adults. Multidisciplinary healthcare teams should consider these factors when designing their intervention strategies to gain a more comprehensive understanding and improve health outcomes.

Community-acquired pneumonia (CAP) in older patients presents unique diagnostic challenges. Unlike typical presentations with fever and cough, older adults may experience atypical symptoms like falls, confusion, or chronic disease deterioration. Immunomodulatory treatments for autoimmune diseases further complicate infection risks. This is the first case of a severe Pseudomonas aeruginosa pneumonia in an 86-year-old rheumatoid arthritis patient on baricitinib and prednisone. Initially admitted after a fall, she showed no respiratory symptoms but had a chest x-ray revealing extensive infiltrative consolidation. Sputum analysis confirmed the pneumonia, which was successfully treated with antibiotics. Following the resolution of the infection, the immunomodulatory therapy could be safely reintroduced. The case underscores the critical need for comprehensive diagnostic evaluation in older adults on immunomodulatory therapy, emphasizing that subtle, non-respiratory symptoms can mask serious infections and require heightened clinical suspicion.

Background: Depression significantly impacts Parkinson's disease (PD) motor function, non-motor symptoms, and quality of life. While physical activity (PA) is associated with improved PD symptoms, the relationship between depression severity, PA levels, and PD symptoms remains underexplored. This study examines the associations between depression severity, PA, and PD motor and non-motor symptoms using a large dataset from the Fox Insight study.

Methods: This cross-sectional study analyzed data from 3,445 individuals with PD completed the Geriatric Depression Scale-Short Form (GDS-S), the Physical Activity Scale for the Elderly (PASE), the Unified Parkinson's Disease Rating Scale Part 2 (UPDRS-2), and the Non-Motor Symptoms Questionnaire (NMSQ). Participants were categorized into four groups based on GDS-S scores: normal (0-4), mild (5-8), moderate (9-11), and severe (≥12). Kruskal-Wallis tests, Pearson correlations, and multiple linear regression analyses were conducted to assess associations between depression severity, PA, and PD symptoms.

Results: Higher depression severity was associated with worse motor (UPDRS-2; χ²=756.72, p<0.001) and non-motor (NMSQ; χ²=1072.13, p<0.001) symptoms and lower PA levels (PASE; χ²=396.24, p<0.001). Regression analysis showed that NMSQ (β=0.449, p<0.001), UPDRS-2 (β=0.212, p<0.001), and PASE (β=-0.171, p<0.001) significantly predicted depression severity.

Conclusion: Depression severity in PD is strongly linked to increased PD symptom. These findings highlight the importance of integrating PA interventions and mental health strategies into PD management to improve overall well-being.

Background: The prevalence of sarcopenia and heart failure (HF) is estimated to be between 8%-34% and 3%-11.8%, respectively. The prevalence of HF in patients with sarcopenia and the prognosis of this association remain unclear.

Methods:  A systematic review was conducted across MEDLINE/PubMed, Embase, CENTRAL, SciELO, and CINAHL databases, with manual searches in Google Scholar and grey literature. Meta-analysis was performed on the gathered results to assess the prevalence of HF in patients with sarcopenia, estimate phenotypes related to left ventricular ejection fraction (LVEF), and evaluate the associated mortality risk.

Results: Out of 7,080 studies, 16 were selected. In patients with sarcopenia, HF prevalence was 32% (95% CI 0.07-0.61, p<0.001, I²=100%). Patients with both conditions showed 45.9% (95% confidence interval [CI], 0.34-0.58; p<0.001, I²=90.69%) with reduced LVEF, 10.3% (95% CI, 0.00-0.29; p<0.001, I²=99%) with mildly reduced LVEF, and 29.1% (95% CI, 0.14-0.45; p<0.001, I²=99%) having preserved LVEF.

Conclusion: HF is highly prevalent in patients with sarcopenia and increases mortality risk.

Background: This study aimed to analyze the coronavirus disease-19 (COVID-19) response in long-term care hospitals (LTCHs) and establish a preparedness and management framework for addressing novel infectious diseases.

Methods: A national survey was conducted in Korea between June 19 and June 30, 2023. Using an anonymous online questionnaire, the survey gathered information on the general characteristics of participating hospitals, preparedness for infectious diseases in LTCHs prior to the COVID-19 pandemic, preparedness for in-house outbreaks during the COVID-19 pandemic, experiences of in-house COVID-19 outbreaks, and a section related to vaccines and treatments.

Results: Of the 1,425 domestic LTCHs, 201 (14.1%) completed the survey. Of the 201, before the COVID-19 pandemic, 24.9% of LTCHs had a disaster preparedness team and 27.9% had conducted training for infectious disease disaster preparedness. During the COVID-19 pandemic, 99.0% of the institutions established response teams for preparedness against COVID-19, and 89.1% of the 201 institutions experienced in-house outbreaks. Most institutions had experienced shortages of materials (78.8%), staff (96.1%), and caregivers (88.3%). The COVID-19 treatments prescribed at the LTCFs were: nirmatrelvir/ritonavir (86.6%), molnupiravir (36.8%), and remdesivir (22.4%). Independent vaccination was administered in 99% of the institutions.

Conclusions: Despite the establishment of response systems, most LTCHs experienced in-house outbreaks during the COVID-19 pandemic. These institutions commonly faced challenges such as staffing shortages and supply constraints. To ensure better preparedness for future outbreaks, infection control systems should be regularly evaluated and maintained through ongoing training, even during non-outbreak periods.

Background: Sarcopenic obesity (SO) is characterized by the coexistence of sarcopenia and obesity, associated with adverse health outcomes. This study aimed to investigate the prevalence of SO as defined by the recently published Japanese Working Group on Sarcopenic Obesity (JWGSO) criteria in post-stroke patients undergoing rehabilitation and its association with activities of daily living (ADL) and length of hospital stay.

Methods: This retrospective cohort study analyzed stroke patients aged 40-75 years undergoing rehabilitation. SO was diagnosed using JWGSO criteria. The primary outcome was the Functional Independence Measure (FIM) motor score at discharge, with length of hospital stay as a secondary outcome. Multiple linear regression analysis was performed to assess associations between SO and outcomes.

Results: The study included 405 patients with a median age of 65 years (interquartile range, 58-71), of whom 60.7% were male. The prevalence of JWGSO-defined SO was 5.4%. Multivariate regression analysis revealed no significant association between JWGSO-defined SO and FIM-motor at discharge (β=0.015, p=0.664) or length of stay (β=0.008, p=0.828). Sarcopenia alone demonstrated significant negative associations with both outcomes.

Conclusion: The prevalence of JWGSO-defined SO in post-stroke rehabilitation patients was 5.4%, with no significant association with ADL or length of hospital stay. Sarcopenia alone showed stronger associations with outcomes, suggesting the importance of addressing muscle mass and strength in stroke rehabilitation.