Zeitschrift Fur Gerontologie Und Geriatrie最新文献

As an introduction to this special issue on geroscience, the present work focuses on the complexity of disentangling biomolecular mechanisms of aging from biopsychosocial causes of accelerated aging. Due to this complexity, the biomolecular aging hallmarks of frailty and multimorbidity as predominant aging phenotypes in geriatrics reflect single aspects of the aging process. A possible approach to facilitate the integration of geroscience into healthcare might be to consider aging as the dynamic ratio between damage accumulation at the molecular and cellular level and resilience as strategies that prevent or repair such damage. There is a large body of evidence to show that geroscience has the potential to change healthcare; however, reaching a consensus and translating the best tool to measure aging needs more research on 1) the sensitivity of biomarkers to interventions and 2) the relationship between changes in biomarkers and changes in health trajectories.

As scientists investigated the molecular mechanisms of the biology of aging, they discovered that these are malleable and can enhance healthy longevity by intervening in the drivers of aging, which are leading to disease, dysfunction and death. These exciting observations gave birth to the field of geroscience. As the mechanisms of aging affect almost all mechanisms of life, detailed molecular mechanistic knowledge must be gained or expanded by considering and integrating as many types of data as possible, from genes and transcripts to socioenvironmental factors. Such a large-scale integration of large amounts of data will in turn profit from "deep" bioinformatics analyses that provide insights beyond contextualizing and interpreting the data in the light of knowledge from databases such as the Gene Ontology. The authors suggest that "deep" bioinformatics, employing methods based on artificial intelligence, will be a key ingredient of future analyses.

Background and objective: One possible approach to counter singularization and loneliness of older adults is the development and implementation of socially interactive robots. Little is known about the expectations and experiences of older adults with socially interactive humanoid robots.

Material and methods: In a mixed-methods design study, user expectations before interaction and the experience and evaluation of verbal and non-verbal communication after interaction with a robot were assessed. Semi-structured interviews were conducted after the interaction.

Results: The majority of older adults expected verbal communication. After the interaction the evaluation of the quality of verbal communication differed. Participants did not expect any form of nonverbal communication. Nonverbal communication was highlighted as particularly positive. Gestures, facial expressions, and body movements were described as confidence building.

Conclusion: The robot's ability to communicate nonverbally might positively influence older adults' experience of communication with the robot. In the development of socially interactive robots non-verbal communication should be given more consideration in order to contribute to successful human-robot interaction.

The socioeconomic and technological developments of the past decades have enabled unique progress associated to increased life expectancy and better health for a large part of the world's population; however, multimorbidity, frailty and disability are also on the rise. Geroscience as the new biology of aging is based on the evidence that the main risk factor for noncommunicable chronic diseases (NCD) is the aging process; however, its technology is mostly used for the scientific study of longevity and its interaction with aging medicine and geriatrics is still limited. In this perspective, the need for a tighter exchange between geroscience and geriatrics for longer health span and intrinsic capacity is discussed in the context of existing evidence and knowledge gaps.

Background: Public reporting is supposed to be helpful in differentiating between well and poorly performing nursing homes; however, hospital patients often have difficulties to deal with quality information. Discharge planners (DP) can support them in comparing quality and, by influencing patients' decision, lead to better provision of care in nursing homes.

Objective: This study investigated the choice behavior of DP, their use of quality information and the potential to impact the decision-making of patients.

Material and methods: A total of 70 DP from German hospitals with a geriatric department participated in an online survey. They were asked about information preferences and tools used for nursing home searches. In addition, they assessed quality information items from the new German quality reporting on a Likert scale. To test their comprehension participants were given a case scenario of a typical patient, were shown nursing homes displayed based on a medical comparison portal navigator (AOK-Pflegenavigator) and were asked to select nursing homes in a 3-round experiment.

Results: When looking for a nursing home, DP primarily rely on internal nursing home directories (n = 62; 92.5%). The 3 preferred criteria for decision are: distance to the family (n = 55; 28.80%), bed availability (n = 51; 26.7%) and wishes of patients/relatives (n = 41; 21.47%). The consent score for public reporting was 46.28% and the comprehension ratio was 82.24%.

Discussion: The DP do not advise hospital patients on the performance of nursing homes and rely on the decision-making of patients. This results in a lack of impact on patients' decisions and consequently in a loss of potential for public reporting to lead to better care in nursing homes.

Background and objective: Digital support systems are becoming increasingly more important in long-term inpatient care facilities. Welfare technologies have the potential to make a valuable contribution to maintaining independence in advanced age. At the same time the technologies can support professional caregivers. The aim of the study was to describe the expectations and experiences with a new technology, using the example of a fall sensor system, from the perspective of professional caregivers.

Method: We used a qualitative design with semistructured interviews in two long-term inpatient care facilities. In one facility, three individual interviews took place, while in the other long-term care facility, a group interview with three nursing professionals was conducted. Additionally, one individual interview was conducted with a person in a leadership role in each facility. The time from implementation of the fall sensors to the interviews was between 1 and 3 months. Data were analyzed using qualitative content analysis in MAXQDA.

Results and discussion: The study demonstrated that there was a correspondence between expectations of and retrospective experiences with the new technology among professional nurses. The main facilitating factors of the implementation that were identified were timely information about the risk of falling or a fall that has occurred, maintenance of residents' autonomy and freedom of movement as well as the enhancement of the sense of security among nursing professionals and the associated psychological relief effect. The inhibiting factors of the implementation were compulsory presetting, false alarms and faulty handling of the technology due to missing knowledge.

This case report details the assessment and interdisciplinary collaboration in the management of an 81-year-old patient presenting with acute visual impairment, dizziness, general weakness, gait disturbances and fear of falling. A holistic geriatric evaluation revealed orthostatic dysregulation and an underlying multifactorial gait disorder exacerbated by visual impairment. Ophthalmological findings included left central retinal artery branch occlusion and cataracts. A comprehensive geriatric assessment showed frailty, impaired mobility and decreased functional abilities. Subsequent patient-centered interdisciplinary approaches included treatment for retinal ischemia, orthostatic testing, medication reconciliation, physiotherapy and occupational therapy. This case emphasizes how interdisciplinary collaboration between ophthalmology and geriatrics enables proactive assessment and intervention to reduce the risk of functional decline and loss of autonomy in visually impaired patients, which is of particular relevance considering the increasing prevalence of visual impairment in the ageing population.