Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: Violence against older people in the domestic environment is a widespread phenomenon with potentially far-reaching consequences for those affected. There are indications that older people in need of care are particularly affected by violence.

Methods: Nationwide cross-sectional online survey of family caregivers (n = 1021) on stress and incidents of abuse in support and care during the coronavirus pandemic.

Results: Of the family caregivers 39.3% reported having committed some form of abuse against the person in need of care in the last 6 months, with an increase in abuse during the coronavirus pandemic. Risk factors for the occurrence of abuse against people in need of care included abuse originating from the person in need of care, a higher level of care or living with the person surveyed.

Conclusion: The results of the study indicate that there is considerable potential for preventing abuse by supporting and relieving the burden on family caregivers. In emergency situations such as the coronavirus pandemic, a focus should be placed on maintaining access to appropriate counselling and relief services for family caregivers.

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.

Background: Falls and related injuries in older ages are becoming a major public health problem.

Objective: This study aims to investigate the factors influencing the risk of falls and self-reported fall-related injuries among older adults in Turkey.

Material and methods: In this large population-based cross-sectional study, data from 2721 persons aged over 65 years were collected using simple random sampling. Anthropometric indices, demographic characteristics, medical history and fall status were collected.

Results: The rate of falling (35.3% vs. 20.1%) and fear of falls (53.6% vs. 29.3%) were higher in women than men. Female gender, fear of falling, chronic disease and a lower education level were found to increase the risk of both falling and fall-related injuries. Age, obesity and appendicular muscle mass did not significantly affect the risk of falling or injuries (p > 0.05).

Conclusion: Sex, education level, fear of falling and the presence of chronic diseases are associated with the risk of falling and fall injuries in the older Turkish population. Health professionals should assess older people for these risk factors and provide specific advice and care to prevent falls.

Background: Treadmill perturbation-based balance training (PBT) is considered a promising approach to fall prevention in older adults. It aims to improve reactive balance control in response to unexpected disturbances-one of the most common causes of falls in everyday life.

Objective: To introduce treadmill-based perturbation training as an innovative therapeutic method in geriatric rehabilitation and to provide practical insights into its implementation.

Methods: The article combines a narrative literature analysis on the use of PBT with a report on experiences from inpatient and outpatient geriatric rehabilitation at the Agaplesion Bethesda Klinik Ulm. The training takes place on treadmills with targeted, multidirectional perturbations under therapeutic supervision.

Results: Randomized studies and meta-analyses show that even small amounts of PBT can lead to a significant reduction in the fall rate (up to -46%) and the number of people who fall (up to -29%). In clinical practice, rehabilitation patients report an increased sense of security and greater confidence in their own mobility. Integrated into interdisciplinary rehabilitation processes, a standardized protocol with 40 perturbations per unit has been established. Implementation requires a step-by-step approach, careful indication, and team coordination.

Conclusion: Treadmill PBT can be easily integrated into geriatric rehabilitation concepts. Experience shows that training under controlled conditions addresses everyday fall mechanisms and strengthens the sense of safety of rehabilitation patients.

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.

Background: Rehabilitation measures in short-term care (KuP), e.g., in the form of mobile geriatric rehabilitation (MoGeRe), are rarely carried out. One of the reasons for this is that the need for rehabilitation is not identified in advance.

Research question and objective: The MosaiK (mobile geriatric rehabilitation in short-term care) project aimed to identify the rehabilitation needs of people registered for a KuP at an early stage, initiate a MoGeRe and improve the quality of the two health service areas.

Material and methods: A checklist was used to identify the need for rehabilitation by the KuP admission management. If the results were positive, referring physicians were asked to apply for a MoGeRe for the future KuP guest. If the MoGeRe was approved, case conferences were held in which KuP personnel participated. Video visits between the MoGeRe and the patients and an arm and leg trainer for self-training during the therapy-free period supplemented the program. The processes were evaluated qualitatively in the form of focus groups as well as descriptively and quantitatively.

Results: In 40 cases a review of the need for rehabilitation was suggested by the KuP admission management based on the results of the checklist. The MoGeRe was approved in 27 out of 28 applications. The joint case conference was held at least once for 70.0% of MosaiK patients and a video visit was carried out for 75.0%; the arm and leg trainer was used in 64% of cases.

Conclusion: The implementation of the newly implemented processes was largely successful and required relatively little additional effort compared to (remunerated) routine care. The approach should therefore also be transferable to other forms of MoGeRe.

In view of the rapidly growing number of older and very old people, geriatric rehabilitation is becoming increasingly more important. The aim is not primarily to cure illnesses but more to maintain or restore functional abilities in order to ensure participation, autonomy and quality of life. The article conveys the concepts of geriatric rehabilitation, including the approach based on the International Classification of Functioning, Disability and Health (ICF), participatory goal definition and basic geriatric rehabilitation management. Access routes and access prerequisites in accordance with the German Social Security Statutes V (SGB V) are presented and the differences between the four forms of care, inpatient, outpatient, mobile and early rehabilitation, are clarified. Particular attention is paid to individualized goal planning and the selection of suitable rehabilitation strategies (restitution, compensation, adaptation). Finally, challenges and future prospects are discussed.

Background: Falls are a significant health problem for seniors, often indicating increasing mobility impairment and risk of injury. Although necessary for the identification of seniors at risk, only few validated German questionnaires on falls risk exist.

Objective: To validate the German Fall Risk Check (FRC) in independently living, community-dwelling older people against objective measurement of standing and walking balance as assessed by the Short Physical Performance Battery (SPPB).

Material and methods: In a larger randomized controlled trial, evaluating home emergency call systems, we recruited 190 seniors in Hamburg, Germany, to fill in the FRC and pass a comprehensive geriatric assessment. The performance of FRC as a diagnostic test is described by typical measures, such as sensitivity (SN), specificity (SP), predictive values, positive/negative likelihood ratios (LR+/LR-), and area under the curve (AUC) in receiver operator characteristic (ROC) curve analysis, each with corresponding 95% confidence intervals (CI).

Results: In total, 190 seniors with an average age 80.5 years (± 5.5 years), 75.3% women could be analyzed. The sample showed advanced comorbidity and concerns about falling in about one third, and mobility and cognitive impairment in about one half. We calculated: SN 0.679 (95% CI 0.571-0.771); SP 0.743 (95% CI 0.654-0.816); LR+ 2.643 (95% CI 1.858-3.761); and LR- 0.432 (95% CI 0.309-0.604). The unadjusted AUC was 0.711 (95% CI 0.635-0.787), adjusted for sex and age 0.753 (95% CI 0.683-0.824).

Conclusion: The FRC appears to be a valid questionnaire, identifying impaired balance in community-dwelling seniors.