Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Chronic pruritus (CP) is a prevalent condition in older adults, with a significant impact on the quality of life (QoL), yet data on CP in German geriatric inpatients are scarce.

Objective: The study provides descriptive data on the prevalence and severity of CP and its impact on QoL and psychological well-being in cognitively capable geriatric inpatients. Furthermore, the study appraises the feasibility and adherence of a 2-month lipid-enriched emollient treatment, as recommended in current guidelines, with a view to informing and optimizing care for this vulnerable group.

Material and methods: The present pilot study constitutes a prospective, single-center, observational study. Participants were recruited from a geriatric hospital ward in Germany. Over 2 months the cream was to be applied twice daily. Severity, QoL and psychological well-being were assessed before and after the intervention using three validated questionnaires, the Hospital Anxiety and Depression Scale (HADS), the Dermatology Life Quality Index (DLQI) and the Working Group Pruritus Research (Arbeitsgemeinschaft Pruritusforschung, AGP) questionnaire. The data on the geriatric assessment scores, medication and previous illnesses were taken from the medical records.

Results: Among 214 hospitalized patients, 8.4% had CP. After 2 months, all median scores improved: the HADS anxiety and depression from 6 to 3.5 or 4.5, the numeric rating scale (NRS) of the worst pruritus from 7 to 5.5 and the DLQI from 3 to 1.

Conclusion: Despite suboptimal scores in the geriatric assessment, the intervention led to an overall improvement in pruritus severity, QoL and psychological well-being.

Background: Old age and service centers (ASZ) in Munich offer preventive and care services for older people. As initiating contact with existing support services is a barrier, the street work project "Senior citizens visited by experts in the community" (SAVE) was introduced. Since 2019 SAVE experts have been providing advice to older people who are in public spaces and appear to be in need of support. The aim of our study was to examine the implementation of SAVE to identify recommendations for action.

Method: The SAVE evaluation is based on a mixed methods multistage design with a participatory approach. Firstly, secondary data (SAVE statistics, project documents) were analyzed. In addition, participant observations (n = 4), a focus group (n = 6) and interviews with SAVE experts (n = 4) and ASZ managers (n = 5) were conducted. To integrate the data the respective results were compared, triangulated and jointly interpreted.

Results: According to the statistics (period: January 2020-June 2023) the project reached 1546 people (57% women, 2847 contacts). Common problems identified included physical and mental illnesses, financial difficulties and loneliness. The derived recommendations for action address the following topics: SAVE requirements profile, basic equipment, implementation, orientation phase, public awareness and collegial cooperation.

Conclusion: The SAVE project offers an innovative way of reaching older people in their community by providing information, building relationships, giving on-site counselling and providing additional support. The project can be seen as an important measure to prevent distress among older people.

Background: High-quality contributions to international aging research and the advancement of geriatrics in Germany require physicians who are both clinically and scientifically active.

Objective: Investigation of the research activity, research interests and research conditions of physicians working in geriatrics in Germany, in order to identify the scientific potential, structural barriers and areas in need of support.

Material and methods: In a nationwide online cross-sectional survey, data were collected on the professional situation, and research activity, as well as research interests and obstacles.

Results: Among 273 participants one third were scientifically active, one third not interested and one third fundamentally interested but currently inactive. The largest proportion of scientifically active participants (47%) worked at university hospitals with a chair in geriatrics, where the highest research satisfaction was reported. The most frequently cited barrier was the limited compatibility of clinical work and research (49%). At nonuniversity hospitals without a chair in geriatrics many participants were interested in research but inactive and workplace-related obstacles predominated (55%). Men more often held a doctoral degree or habilitation and were more often active in research. Women accounted for two thirds of interested but inactive participants in research and expressed particular interest in polypharmacy (59%) and nutritional medicine (40%).

Discussion: Targeted measures are needed to strengthen geriatric research in Germany, particularly to support women and physicians at nonuniversity institutions. Key strategies include mentoring, protected research time and expansion of chairs in geriatrics. Despite structural barriers, interest in research remains high.

Levodopa in combination with a decarboxylase inhibitor has an elimination half-life (t_1/2) in older people of 1.8 h. The pharmacokinetics are complex and depend on galenics, body weight, sex, gastrointestinal motility and accompanying diseases. Levodopa plasma concentrations after oral dosing vary intraindividually and interindividually. The decarboxylase inhibitors benserazide and carbidopa possess different t_1/2. In advanced Parkinson's disease, intrajejunal levodopa or subcutaneous foslevodopa combined with a decarboxylase inhibitor infusion can maintain constant levodopa plasma levels during daytime. To rapidly reach steady state, an adequate morning bolus is required. Absorption and elimination of entacapone and opicapone are similar to levodopa. Entacapone as a reversible catechol O‑methyltransferase (COMT) inhibitor must be administered concomitant to levodopa. Opicapone as irreversible COMT inhibitor is administered once daily at night. Rasagiline and selegiline are irreversible inhibitors of monoamine oxidase B. Therefore, in spite of their short t_1/2 they are dosed once daily. Absorption of rasagiline is independent of meals. Clinically established dopamine agonists activate D1/D5 dopamine motor receptors less strongly than the dopaminergic receptors of D2/D3/D4group. This is a probable reason for their numerous adverse effects particularly in older people with Parkinson's disease.

Background: Health limitations affect long-term care (LTC) needs differently. For instance, people with cognitive limitations require more organizational support, whereas those with functional limitations require more personal care. While the impact of singular health limitations on LTC has been widely studied, little attention has been given to the prevalences of co-occurring health limitations that drive LTC needs.

Objectives: Our exploratory study seeks to address the gap in understanding the prevalence of multiple, intertwining health limitations that contribute to the need for LTC.

Materials and methods: We used data from the German Medical Service (MD). The MD assesses LTC needs and assigns care grades, which serve as the basis for LTC insurance benefits. The available data contains all assessments in 2019 of adults living in Bavaria (the largest state in Germany), focusing on those with first-time LTC needs (N = 101,227). Using latent class analysis, we identified combinations of limitations across six health dimensions (e.g., mobility, cognition).

Results: Among first-time LTC recipients, 5 distinct classes of care needs were identified. Two classes reflect single limitations: mobility limitations, and the need for assistance with medical therapy. Three classes point to various combinations of limitations. While classes differed in size, they also varied significantly by age, gender, and care grade.

Conclusion: The co-occurrence of health limitations is not an exception but a central feature of LTC needs even at the initial stages of dependency, emphasizing the importance of tailored care strategies. These insights can help local authorities and care providers offer targeted LTC services more strategically.