Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: The consensus definition of sarcopenia enables a clear diagnostic algorithm. The syndrome can now also be coded in Germany (International Classification of Diseases 10, ICD-10 GM 62.50). Compared to the estimated prevalence it is still significantly underdiagnosed. Current treatment options include resistance training and a protein-rich diet, while pharmacological options are still missing.

Objective: The Munich Sarcopenia Registry (MUSAR) aims to raise awareness of the syndrome and affected individuals. Additionally, it seeks to gain insights into risk factors, causes and treatment approaches. This publication conducts an initial analysis of 90 patient datasets with varying degrees of sarcopenia and examines the cohort for key geriatric parameters.

Material and methods: Since 2018 patients from the geriatric clinic of the Ludwig Maximilians University Munich have been able to contribute their data to the registry. Sociodemographic, anthropometric, functional, and laboratory data are collected in a web-based registry.

Results: Compared to patients without sarcopenia, patients with sarcopenia are significantly older, have more comorbidities and show poorer functional performance as well as reduced quality of life.

Discussion: The results highlight the urgent need for further research and the development of new forms of treatment to improve the quality of life and independence of these patients. Challenges such as difficult recruitment complicate this endeavor. The MUSAR aims to minimize these issues and provides a valuable basis for generating extensive data through the systematic collection of patient data during hospital stays.

Background: Family caregivers (FC) rarely utilize formal and informal help, which affects their burden and quality of life. Factors that result in rejection are often psychosocial (shame, guilt, heteronomy and social expectations). Previous studies on psychosocial reasons neglected the spiritual dimension. This study aims to identify the psychosociospiritual reasons for the (non)utílization of help from the perspective of FCs.

Methods: This qualitative study conducted semi-structured interviews with 24 FCs between August 2022 and July 2023 and analyzed according to Mayring.

Results: The FCs request formal and informal help to find a balance between their needs and those of the persons in need of care and to develop and maintain interpersonal boundaries. Help is rejected due to negative experiences with help offers as well as personal, familiar, and social role expectations. As long as nursing care is seen as the only meaning in life, help from outside can be perceived as a threat.

Conclusion: When utilizing help, it is not only about the quality of the offered help but also about its compatibility with one's own values and aims. Psychosociospiritual counselling should be provided before counselling for benefits.

The optimal treatment of fragility fractures is carried out as part of an orthogeriatric comanagement. The orthogeriatric ward round is particularly important from a geriatric perspective. This article presents important aspects and contents of the geriatric ward round and is intended to provide recommendations for geriatricians working in geriatric trauma centers on trauma surgery wards.

Background: Changes in lifestyle could reduce dementia cases by 45%. Successful international prevention initiatives show the importance of involving primary target groups early in the process of program development.

Objective: The aim of this study was to explore (1) the knowledge about dementia/brain health, (2) offers of activities related to dementia prevention in the community and (3) the feasibility of introducing the experience of art as a brain health-promoting method in a sample of community-dwelling older persons.

Material and methods: Senior volunteers from the community were invited to a workshop and a follow-up telephone interview. During the workshop, participants received expert input on dementia/brain health followed by several group discussion rounds using a "World Café" approach. After 6 weeks, participants were invited to a structured telephone interview.

Results: A total of 26 persons participated in the workshop, 20 of whom (mean age: 70.60 years) took part in the telephone interview. The workshop data revealed 4 main needs: (1) more information on dementia/brain health (2) a broader offer of activities for physical/mental stimulation in the community (3) the definition of a "brain health strategy", and (4) development of specific services to experience art. The telephone interviews revealed a high motivation to start with dementia prevention but appropriate services are missing in the communities.

Conclusion: Our findings provide first insights into attitudes towards dementia prevention/brain health in an Austrian sample of senior citizens. People need information about the potential of dementia prevention and specific services need to be developed in the communities.

Background: The Barthel Index is the most commonly used instrument for assessing basic self-care ability; however, it only records impairments first at the stage of needing personal support.

Objective: Based on the long version of the Hamburg Classification Manual (HEMB-L), the Barthel plus (Bplus) was developed in consultation with specialist nursing personnel as an operationalization that also depicts compensated impairments via point-neutral subscaling. The article presents the instrument and its quality characteristics.

Material and methods: For patients in acute geriatric care the Bplus was employed twice at an interval of more than 1 week and audio recordings were made. The Bplus was assessed by telephone 1, 12, 24 and 36 months after discharge. The effect size (Cohen's d) was calculated for the sensitivity to change during the inpatient course. The interrater reliability and agreement with the HEMB‑L were determined taking the evaluation of the audio files by blinded examiners into account.

Results: Between 29 April 2019 and 25 June 2021 a total of 124 patients were included in the study. The Barthel Index scores obtained using the Bplus and HEMB‑L did not show a significant difference. The interrater reliability, internal consistency and change sensitivity of the Bplus were high, each at > 0.9. For activities performed independently but with impairment, there was an increased risk of care dependency occurring over the course of the study.

Conclusion: While maintaining the same sum score as the HEMB‑L, the Bplus can highlight abilities prone to a high risk for loss of independence and thus facilitate the prevention of progressive care dependency.

Background: With the growing use of artificial intelligence (AI) in various areas of life, AI technologies are increasingly being developed for the nursing and care of older people and are intended to contribute to greater safety for older people in need of care and to relieve the burden on caregivers; however, research into the attitudes and practices of older people in need of care towards AI is only just beginning.

Objective: The aim of the article is to ask which learning processes emerge as older nursing home residents interact with AI technologies and how these can be supported with concepts from geragogy.

Material and methods: The data consist of 10 guideline-assisted interviews with older nursing home residents aged 83-96 years and records of participant observations (75 h). Data collection took place in summer 2022 and fall 2023 in two nursing homes that use AI-based fall sensors and social robots. The material was analyzed using situation analysis.

Results: Nursing home residents showed an active interest in engaging with AI technologies, for example, by trying to relate experiences with AI technologies with experiences from their life course (biography-oriented learning practices) and engaging with AI technologies in everyday life (everyday-oriented learning practices). Residents are therefore interested actors in processes of technology implementation but rarely perceive themselves as competent in the context of AI.

Conclusion: The article shows the learning practices and potentials of residents and discusses possibilities of a geragogical approach for a differentiated understanding of AI technologies in nursing.

Against the background of demographic ageing in cities, it becomes increasingly more important to study the living conditions of old persons. Using municipal statistical data from the Inner City Monitoring System and geodata, the study examined the number of facilities for the provision of services of general interest in the areas of health and the needs of daily living in urban districts of major German cities. The focus is on districts with a high proportion of people aged 65 years and over in order to assess if there is sufficient provision of infrastructure for older people. In addition, survey data are combined with municipal statistical data in order to examine self-assessments of the distances to such facilities. The results show small-scale disparities as there are significant differences between old and young districts (few people aged 65 years and older). There are fewer pharmacies and post offices in older districts. The accessibility of the infrastructure within walking distance is rated worse in old districts than in young districts. This can be particularly problematic for very old and less mobile people whose radius of mobility is limited to the residential area. It can be concluded that small-scale municipal monitoring is crucial to detect gaps in the infrastructure. In further studies, the actual use of infrastructures and the diversity in the group of older people are taken into account.

Increasing loss of health in old age leads to particular challenges in this phase of life. In response to this, there are support services predominantly aimed at dealing with the resulting changes in living conditions; however, these mostly do not address the subjective view of individuals. With a biographically guided view of health literacy in old age, the article focuses on educational processes in the lives of older people regarding their health experience and actions and questions the environmental influences. The empirical data of the article are based on 12 qualitative interviews conducted with people aged 73-92 years. The analyses show that the two heuristics of biography and environment can be used to reconstruct relevant educational processes over the life span that shape health experience and action in old age. A definition of biographical health literacy derived from this and a model of health literacy in old age are presented. The article concludes with specific recommendations for action in the practice.