European Geriatric Medicine最新文献

Purpose: The purpose of the study was to investigate the effects of satisfaction with meaningful activities and their performance on the memory function among community-dwelling older adults 3 years later.

Methods: A longitudinal analysis was conducted on 288 community-dwelling older adults aged 65 years and more who had completed the survey in 2019 and 2022 as participants in the Tarumizu Study. Meaningful activities were assessed in 2019 using the Aid for Decision-Making in Occupation Choice for activities. Satisfaction with and performance of meaningful activities were assessed, and the bottom 25% were classified into two groups: low satisfaction and low performance. Memory function was assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool in 2019 and 2022. Changes in memory function over 3 years were analyzed by satisfaction and performance of meaningful activities.

Results: Two-way analysis of variance with group (satisfaction with and performance of meaningful activities) and time (2019 and 2022) as factors showed no statistically significant group-time interaction for memory in the satisfaction with meaningful activities group (F = 1.4, p = 0.24). Meanwhile, a statistically significant group-time interaction was observed for memory in the meaningful activity performance group, indicating that high performance of meaningful activities may play a protective role against memory decline (F = 7.4, p = 0.007).

Conclusion: Higher performance of meaningful activities may protect against age-related changes in memory. A careful assessment of meaningful activities, and engagement that enhances performance may be useful in designing health support against memory decline.

Purpose: We compared the performance of SARC-F, SARC-CalF, calf circumference (CC), and body mass index (BMI)-adjusted CC for sarcopenia case-finding in community-dwelling older adults.

Methods: Data of Finnish participants (women/men n = 192/36, mean age (SD) of 76.9 (4.8) years) recruited in the SPRINTT trial (NCT02582138) were used. Sarcopenia was determined as a combination of low muscle function (chair-stand-test) and low appendicular lean mass (ALM) detected by whole-body dual-energy X-ray absorptiometry. Associations of case-finding tools with sarcopenia were analysed using ROC curves and logistic regression.

Results: The rates of probable and confirmed sarcopenia were 95% and 18% in women and 94% and 36% in men, respectively. Performance of CC for sarcopenia (women AUC 0.85 [95% CI 0.78-0.92]/ men 0.85 [95% CI 0.71-1.0]) was superior to that of other tools; (AUC in women/men for SARC-F was 0.57/0.50, for SARC-CalF 0.76/0.79, and for BMI-adjusted CC 0.68/0.66). The best performance was found for a CC cut-off point of ≤ 34 cm in women with sensitivity/specificity 82.4/75.3% and ≤ 36 cm in men with sensitivity/specificity 76.9/87.0%. For each cm decrease in CC, adjusted for age and BMI, there was a 30% increase in the odds of sarcopenia in women (OR 1.30, 95% CI 1.09─1.56). Although there was a similar pattern in men, the results did not reach statistical significance (OR 1.34, 95% CI 0.84- 2.14).

Conclusions: CC was superior to other tools for sarcopenia case-finding. The best performance was found for a CC cut-off point of ≤ 34 cm in women and ≤ 36 cm in men.

Introduction: Generative Artificial Intelligence (AI) is a technological innovation with wide applicability in daily life, which could help elderly people. However, it raises potential conflicts, such as biases, omissions and errors.

Methods: Descriptive study through the negative stereotypes towards aging questionnaire (CENVE) conducted on chatbots ChatGPT, Gemini, Perplexity, YOUChat, and Copilot was conducted.

Results: Of the chatbots studied, three were above 50% in responses with negative stereotypes, Copilot with high ageism level results, followed by Perplexity. In the health section, Copilot was the chatbot with the most negative connotations regarding old age (13 out of 20 points). In the personality section, Copilot scored 14 out of 20, followed by YOUChat.

Conclusion: The Copilot chatbot responded to the statements more ageistically than the other platforms. These results highlight the importance of addressing any potential biases in AI to ensure that the responses provided are fair and respectful for all potential users.

Purpose: Current measures of frailty often rely on subjective assessments or complex scoring systems. This study aims to investigate the utility of a novel anthropometric measure, the Weight-Adjusted Waist Index (WWI), as a simple and objective predictive marker for frailty in older adults.

Methods: This cross-sectional study included 847 patients aged 65 years and older. Comprehensive geriatric assessments and anthropometric measurements were conducted. Frailty was diagnosed using the Clinical Frailty Scale (CFS). The association between WWI and frailty was analyzed using multivariate logistic regression analysis.

Results: The mean age of the participants was 74.9 ± 6 years, with 56.3% (n = 477) being women and 14.8% (n = 125) classified as frail. The frail group had a significantly higher WWI than the non-frail group (p < 0.001). In multivariate logistic regression analysis, WWI remained significantly associated with frailty, even after adjusting for other potential confounding factors (OR = 2.51, 95% CI 1.77-3.57, p < 0.001). The predictive ability of WWI for frailty was measured by the area under the receiver operating characteristic (ROC) curve, which was 0.705 (95% CI 0.67-0.73; p < 0.001). The optimal WWI threshold for predicting frailty was identified as > 12.

Conclusion: The Weight-Adjusted Waist Index shows significant potential as a simple and objective predictive marker for frailty in older adults.

Purpose: One third of Dutch nursing home residents relocated at least once during length of stay. Roughly 75 percent were individual relocations and the other 25 percent concerned group relocations. The average yearly number of individual relocations was about 3 times as high in the first 4 months after admission compared with later periods.

Methods: We performed an historical cohort study of pseudonymized registration data from a Dutch electronic health record. We selected data from nursing home residents aged 65 years and older who stayed on a ward for physical impairment or dementia and passed away between 2015 and 2019. Our study sample consisted of 26,060 long-stay nursing home residents from 67 nursing homes in the Netherlands. We examined the number of relocations, trends over time, individual versus group relocations and relocation destinations.

Results: We found that approximately one-third of long-stay nursing home residents relocated at least once with an average of 36 relocations per 100 residents per year. Roughly, 75 percent of relocations were individual relocations and 25 percent concerned group relocations. In the first 4 months after admission, the average number of individual relocations per 100 resident per year was about 3 times as often compared to later periods after admission. Most individual relocations were within the same type of care.

Conclusion: A considerable proportion of Dutch long-stay nursing home residents experienced one or more relocations. Relocations for individual reasons occurred mostly in the first months after admission. Further investigation is warranted to explore which factors lead to relocations.

Purpose: Sarcopenia is a potentially reversible syndrome that increases the risk of cardiogenic cachexia and adverse outcomes in older patients with heart failure (HF). Despite its clinical significance, sarcopenia remains underdiagnosed due to the complexities of comprehensive assessment in patients with acute HF. This study aimed to evaluate whether the SARC-F questionnaire, its inviduals components, and the handgrip strength test (HGS) can predict short-term prognostic risk in very old patients recently discharged after acute HF.

Methods: We consecutively enrolled patients aged 75 years or older hospitalized with acute HF in the Geriatrics Unit of a tertiary care hospital. All patients underwent physical examination, complete blood tests, point-of-care ultrasound, and a comprehensive geriatric assessment, including physical performance through SARC-F and HGS. The thirty-day post-discharge mortality rate was assessed by phone interview.

Results: Out of 184 patients hospitalized with acute HF who were enrolled in the study (mean [SD], 86.8 [5.9] years, 60.3% female), 47 died within 30 days after discharge. By multivariate logistic analysis, HGS (β = - 0.73 ± 0.03, p = 0.008) and SARC-F [adjusted OR = 1.18 (CI 95% 1.03-1.33), p = 0.003] resulted independently associated with mortality. Furthermore, two SARC-F sub-items, namely, limitation in rising from a chair and history of falls [aOR: 3.26 (CI95% 1.27-8.34), p = 0.008; aOR: 3.30 (CI 95% 1.28-8.49), p = 0.01; respectively] emerged as determinants of 30-days mortality.

Conclusion: SARC-F and HGS test independently predict 30-day post-discharge mortality in oldest-old patients hospitalized for acute HF.

Purpose: Sarcopenia is a geriatric syndrome characterized by progressive loss of muscle mass and function. Meteorin-like (Metrnl) is a secretory protein that has protective effects on skeletal muscle injury. However, the association of Metrnl level with sarcopenia remains unclear.

Methods: A total of 772 community-dwelling older adults (median age = 76 years), comprising 409 males and 363 females, from both urban and rural areas were enrolled. Serum Metrnl was measured by enzyme-linked immunosorbent assay. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were measured for the assessment of sarcopenia.

Results: We found that serum Metrnl levels were lower in patients with sarcopenia [median (IQR) = 180.1 (151.3-220.3) pg/mL] than older adults without sarcopenia [211.9 (163.2-270.0) pg/mL, P < 0.001]. Receiver-operating characteristic curve analysis showed that the optimal cut-off value of serum Metrnl level that predicted sarcopenia was 197.2 pg/mL with a sensitivity of 59.2% and a specificity of 63.8% (AUC = 0.63, 95% CI = 0.59-0.67, P < 0.001). Multivariate logistic regression analyses showed that lower serum Metrnl level (< 197.2 pg/mL) was significantly associated with increased risk of sarcopenia (adjusted OR = 2.358, 2.36, 95% CI = 1.528-3.685, P < 0.001). Moreover, serum Metrnl concentration was positively correlated with the components of sarcopenia including ASMI (r = 0.135, P < 0.001), grip strength (r = 0.102, P = 0.005), and gait speed (r = 0.106, P = 0.003).

Conclusions: Taken together, our findings demonstrate that low serum Metrnl level is correlated with increased risk of sarcopenia in the older adults.

Purpose: Postoperative delirium (POD) is a common and serious neuropsychiatric syndrome that leads to higher morbidity and mortality. We investigated the association between serum C-reactive protein (CRP) and the occurrence of POD in older hip fracture patients, and whether CRP predicted POD better than a clinical model.

Methods: Patients aged ≥ 75 years admitted for surgical repair of an acute hip fracture were recruited. We compared serum CRP levels between patients with and without POD.

Results: Sixty patients were included, of whom 21 (35%) developed POD. Serum CRP levels were significantly higher in patients who developed delirium (p = 0.011). In a multiple regression model including clinical variables and CRP, cognitive impairment (p = 0.003) and infection (p = 0.001) were the best predictors of POD.

Conclusions: Although higher levels of serum CRP were significantly associated with POD in older hip fracture patients, pre-existing cognitive impairment and infections were the most important risk factors for POD.