Pub Date : 2023-11-08eCollection Date: 2023-01-01DOI: 10.1177/23337214231208824
Anca-Cristina Sterie, Clara Castillo, Ralf J Jox, Christophe J Büla, Eve Rubli Truchard
Background: Documenting decisions about the relevance cardiopulmonary resuscitation (CPR) is a standard practice at hospital admission yet a complex task. Objective: Our aim was to explore how physicians approach and discuss CPR prognosis with older patients recently admitted to a post-acute care unit. Method: We recorded 43 conversations between physicians and patients about the relevancy of CPR that took place at admission at the geriatric rehabilitation service of a Swiss university hospital. Thematic analysis determined (i) who initiated the talk about CPR prognosis, (ii) at what point in the conversation, and (iii) how prognosis was referred to. Results: Prognosis was mentioned in 65% of the conversations. We categorized the content of references to CPR prognosis in five themes: factors determining the prognosis (general health, age, duration of maneuvers); life (association of CPR with life, survival); proximal adverse outcomes (broken ribs, intensive care); long-term adverse outcomes (loss of autonomy, suffering a stroke, pain, generic, uncertainty); and being a burden. Discussion and conclusion: Discussing CPR is important to all patients, including those for whom it is not recommended. Information about CPR prognosis is essential to empower and support patients in expressing their expectations from life-prolonging interventions and attain shared decision-making.
{"title":"\"If I Become a Vegetable, Then no\": A Thematic Analysis of How Patients and Physicians Refer to Prognosis When Discussing Cardiopulmonary Resuscitation.","authors":"Anca-Cristina Sterie, Clara Castillo, Ralf J Jox, Christophe J Büla, Eve Rubli Truchard","doi":"10.1177/23337214231208824","DOIUrl":"10.1177/23337214231208824","url":null,"abstract":"<p><p><b>Background:</b> Documenting decisions about the relevance cardiopulmonary resuscitation (CPR) is a standard practice at hospital admission yet a complex task. <b>Objective</b>: Our aim was to explore how physicians approach and discuss CPR prognosis with older patients recently admitted to a post-acute care unit. <b>Method</b>: We recorded 43 conversations between physicians and patients about the relevancy of CPR that took place at admission at the geriatric rehabilitation service of a Swiss university hospital. Thematic analysis determined (i) who initiated the talk about CPR prognosis, (ii) at what point in the conversation, and (iii) how prognosis was referred to. <b>Results</b>: Prognosis was mentioned in 65% of the conversations. We categorized the content of references to CPR prognosis in five themes: factors determining the prognosis (general health, age, duration of maneuvers); life (association of CPR with life, survival); proximal adverse outcomes (broken ribs, intensive care); long-term adverse outcomes (loss of autonomy, suffering a stroke, pain, generic, uncertainty); and being a burden. <b>Discussion and conclusion</b>: Discussing CPR is important to all patients, including those for whom it is not recommended. Information about CPR prognosis is essential to empower and support patients in expressing their expectations from life-prolonging interventions and attain shared decision-making.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24eCollection Date: 2023-01-01DOI: 10.1177/23337214231208528
Erick Alberto Medina-Jiménez, Christian Oswaldo Acosta-Quiroz, Raquel García-Flores
The objective of this study was to evaluate the reliability and validity of the FES-I scale in community-dwelling older Mexican adults. Participants were 222 older adults, with a mean age of 70 years; 75% were women who completed a sociodemographic data sheet, a Spanish version of the FES-I scale, intended to explore measures of depression, quality of life, and instrumental activities of daily living. Discriminant validity was demonstrated for all items on the FES-I scale and when groups of older adults were compared according to age. Evidence of internal consistency was found in all the items of the FES-I scale (α = .91) and convergent and divergent validity of the FES-I scale with measures of depression and quality of life, except instrumental activities of daily living. The Confirmatory Factor Analysis shows that the FES-I scale partially retains its two-factor measurement properties since five items were removed from the model to fit the data. The FES-I scale is a valid and reliable measure for clinical evaluations of fear of falls in older Mexican adults in the community.
{"title":"Adaptation and Validation of the Falls Efficacy Scale-International (FES-I) in Community-Dwelling Older Mexican Adults.","authors":"Erick Alberto Medina-Jiménez, Christian Oswaldo Acosta-Quiroz, Raquel García-Flores","doi":"10.1177/23337214231208528","DOIUrl":"10.1177/23337214231208528","url":null,"abstract":"The objective of this study was to evaluate the reliability and validity of the FES-I scale in community-dwelling older Mexican adults. Participants were 222 older adults, with a mean age of 70 years; 75% were women who completed a sociodemographic data sheet, a Spanish version of the FES-I scale, intended to explore measures of depression, quality of life, and instrumental activities of daily living. Discriminant validity was demonstrated for all items on the FES-I scale and when groups of older adults were compared according to age. Evidence of internal consistency was found in all the items of the FES-I scale (α = .91) and convergent and divergent validity of the FES-I scale with measures of depression and quality of life, except instrumental activities of daily living. The Confirmatory Factor Analysis shows that the FES-I scale partially retains its two-factor measurement properties since five items were removed from the model to fit the data. The FES-I scale is a valid and reliable measure for clinical evaluations of fear of falls in older Mexican adults in the community.","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/d5/10.1177_23337214231208528.PMC10599116.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54232109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Understanding the factors influencing survival in oldest old population is crucial for providing appropriate care and improving outcomes. This prospective observational study aimed to investigate the determinants of survival in acutely ill oldest old patients during acute hospitalization and 1-month follow-up. Various geriatric domains and biochemical markers were assessed. Among the 70 included patients with a median age of 87 (Inter quartile range: 85-90), the presence of diabetes, delirium, tachypnea, and high sirtuin-5 levels were associated with reduced in-hospital survival. Non-survivors had raised levels of Sirtuin 1 and Sirtuin 5, with an increase of 43% and 70%, respectively. At 1 month, delirium and diabetes were still associated with reduced survival. These findings suggest that type-2 diabetes, delirium, tachypnea, and high sirtuin-5 levels could serve as predictors of reduced survival in acutely ill, hospitalized oldest old patients.
{"title":"Predictors of Survival Among the Oldest Old Following Acute Hospital Admission: Insights From Clinical and Biochemical Factors.","authors":"Bhawana Painkra, Masroor Anwar, Abhinay Kumar Singh, Vishwajeet Singh, Abhijith Rajaram Rao, Akshata Rao, Meenal Thakral, Avinash Chakrawarty, Prasun Chatterjee, Aparajit Ballav Dey","doi":"10.1177/23337214231208077","DOIUrl":"10.1177/23337214231208077","url":null,"abstract":"<p><p>Understanding the factors influencing survival in oldest old population is crucial for providing appropriate care and improving outcomes. This prospective observational study aimed to investigate the determinants of survival in acutely ill oldest old patients during acute hospitalization and 1-month follow-up. Various geriatric domains and biochemical markers were assessed. Among the 70 included patients with a median age of 87 (Inter quartile range: 85-90), the presence of diabetes, delirium, tachypnea, and high sirtuin-5 levels were associated with reduced in-hospital survival. Non-survivors had raised levels of Sirtuin 1 and Sirtuin 5, with an increase of 43% and 70%, respectively. At 1 month, delirium and diabetes were still associated with reduced survival. These findings suggest that type-2 diabetes, delirium, tachypnea, and high sirtuin-5 levels could serve as predictors of reduced survival in acutely ill, hospitalized oldest old patients.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/00/10.1177_23337214231208077.PMC10599112.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54232110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23eCollection Date: 2023-01-01DOI: 10.1177/23337214231205689
Johanna Constantini, Harald R Bliem, Marc Crepaz, Josef Marksteiner
The ever-growing group of people living with dementia (PLWD) and their relatives face great challenges. The Covid 19 pandemic has once again placed a particular challenge on this vulnerable group. What started a decade earlier with telephone-based support groups experienced a real push during the pandemic in the form of video-based self-help services. The aim of this qualitative literature search in MEDLINE, EMBASE, CINAHL, and PsycINFO with keywords related to online, support group, caregiver, and dementia was to collect the reported experiences by the end of 2022. Peer reviewed journal papers were included when published and written in English. After the joint decision of two reviewers, it was decided to only include studies that were published in Medline. The results of the literature search are compared with experiences of the participants in a presentation group that was transformed into an online group at the time of the COVID-19 pandemic via Zoom. In search yielded a total of 129 articles. 113 articles described different types of interventions, 30 of which had a randomized design. The qualitative literature search showed on the one hand a high interest in online support groups but on the other hand that the effectiveness and efficacy in randomized trials is much less clear. In addition, we investigated the assessments and experiences of the participants in a presentation group that was transformed into an online group at the time of the COVID-19 pandemic via Zoom. This study demonstrates that PLWD and carers on virtual group meetings can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. Further research on entry criteria, concerns about online support services in general and necessary support for use is essential to develop the time- and location-independent possibility of video-based online self-help into an important form of support for both PLWD and their caregivers as an additional support option independent of exceptional pandemic situations.
{"title":"A Qualitative Literature Search and Pilot Study of Online Support Groups for Patients With Dementia and Their Carers.","authors":"Johanna Constantini, Harald R Bliem, Marc Crepaz, Josef Marksteiner","doi":"10.1177/23337214231205689","DOIUrl":"10.1177/23337214231205689","url":null,"abstract":"<p><p>The ever-growing group of people living with dementia (PLWD) and their relatives face great challenges. The Covid 19 pandemic has once again placed a particular challenge on this vulnerable group. What started a decade earlier with telephone-based support groups experienced a real push during the pandemic in the form of video-based self-help services. The aim of this qualitative literature search in MEDLINE, EMBASE, CINAHL, and PsycINFO with keywords related to online, support group, caregiver, and dementia was to collect the reported experiences by the end of 2022. Peer reviewed journal papers were included when published and written in English. After the joint decision of two reviewers, it was decided to only include studies that were published in Medline. The results of the literature search are compared with experiences of the participants in a presentation group that was transformed into an online group at the time of the COVID-19 pandemic via Zoom. In search yielded a total of 129 articles. 113 articles described different types of interventions, 30 of which had a randomized design. The qualitative literature search showed on the one hand a high interest in online support groups but on the other hand that the effectiveness and efficacy in randomized trials is much less clear. In addition, we investigated the assessments and experiences of the participants in a presentation group that was transformed into an online group at the time of the COVID-19 pandemic via Zoom. This study demonstrates that PLWD and carers on virtual group meetings can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. Further research on entry criteria, concerns about online support services in general and necessary support for use is essential to develop the time- and location-independent possibility of video-based online self-help into an important form of support for both PLWD and their caregivers as an additional support option independent of exceptional pandemic situations.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/7d/10.1177_23337214231205689.PMC10594960.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50164001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. Method: This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6-8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. Results: In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. Conclusions: The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.
{"title":"Age Group Differences in the Association Between Sleep Status and Frailty Among Community-Dwelling Older Adults: The SONIC Study.","authors":"Toshiki Mizuno, Kayo Godai, Mai Kabayama, Hiroshi Akasaka, Michiko Kido, Masaaki Isaka, Mio Kubo, Yasuyuki Gondo, Madoka Ogawa, Kazunori Ikebe, Yukie Masui, Yasumichi Arai, Tatsuro Ishizaki, Hiromi Rakugi, Kei Kamide","doi":"10.1177/23337214231205432","DOIUrl":"10.1177/23337214231205432","url":null,"abstract":"<p><p><b>Objective:</b> We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. <b>Method:</b> This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6-8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. <b>Results:</b> In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. <b>Conclusions:</b> The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/10/10.1177_23337214231205432.PMC10576426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-06eCollection Date: 2023-01-01DOI: 10.1177/23337214231203472
Tommy Lang, Kenneth Daniel, Michael Inskip, Yorgi Mavros, Maria A Fiatarone Singh
Objective: To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. Methods: The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. Results: Nine dyads were randomized [caregivers: median age 75 (40-81) years, loved ones: 77 (73-88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (-0.10, 2.81); p = .009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (-3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (-1.09, 1.54); p = .622]. Conclusion: The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention and to optimize adoption and sustain adherence over time. Trial registry name: HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program Trial URL: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369 Registration number: ACTRN12617000347369.
{"title":"Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial.","authors":"Tommy Lang, Kenneth Daniel, Michael Inskip, Yorgi Mavros, Maria A Fiatarone Singh","doi":"10.1177/23337214231203472","DOIUrl":"10.1177/23337214231203472","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. <b>Methods</b>: The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. <b>Results</b>: Nine dyads were randomized [caregivers: median age 75 (40-81) years, loved ones: 77 (73-88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (-0.10, 2.81); <i>p</i> = .009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (-3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (-1.09, 1.54); <i>p</i> = .622]. <b>Conclusion</b>: The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention and to optimize adoption and sustain adherence over time. <b>Trial registry name:</b> HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program <b>Trial URL:</b> https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369 <b>Registration number:</b> ACTRN12617000347369.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/4f/10.1177_23337214231203472.PMC10559724.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-05eCollection Date: 2023-01-01DOI: 10.1177/23337214231204729
Vu H Nguyen
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Perspective
{"title":"Making a Move on the Mark of Osteoporosis in Men.","authors":"Vu H Nguyen","doi":"10.1177/23337214231204729","DOIUrl":"10.1177/23337214231204729","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Perspective","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/ba/10.1177_23337214231204729.PMC10559691.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30eCollection Date: 2023-01-01DOI: 10.1177/23337214231201138
Ella T Lifset, Kemeberly Charles, Emilia Farcas, Nadir Weibel, Michael Hogarth, Chen Chen, Janet G Johnson, Mary Draper, Annie L Nguyen, Alison A Moore
The Geriatrics 5Ms: Medications, Mind, Mobility, what Matters most and Multicomplexity is a framework to address the complex needs of older adults. Intelligent Voice Assistants (IVAs) are increasingly popular and have potential to support health-related needs of older adults. We utilized previously collected qualitative data on older adults' views of how an IVA may address their health-related needs and ascertained their fit into the Geriatrics 5Ms framework. The codes describing health challenges and potential IVA solutions fit the framework: (1) Medications: difficulty remembering medications.
Solution: suggest and order nutritious foods, (5) Multicomplexity; managing multimorbidity.
Solution: symptom tracking and communicating with health care professionals. Incorporating the 5Ms framework into IVA design can aid in addressing health care priorities of older adults.
老年医学5Ms:Drugs,Mind,Mobility,what Matters most and Multicomplexity是一个解决老年人复杂需求的框架。智能语音助理(IVA)越来越受欢迎,有可能支持老年人的健康需求。我们利用了之前收集的关于老年人IVA如何满足其健康相关需求的定性数据,并确定了他们是否适合老年医学5Ms框架。描述健康挑战和潜在IVA解决方案的代码符合框架:(1)药物:记忆药物困难。解决方案:提醒。(2) 心理:孤立、焦虑、记忆力减退。解决方法:陪伴,记忆辅助。(3) 机动性:运动障碍。解决方案:激励、锻炼理念。(4) 最重要的是:吃健康的食物。解决方案:建议并点营养丰富的食物,(5)多功能;管理多发病。解决方案:症状跟踪并与医疗保健专业人员沟通。将5Ms框架纳入IVA设计可以帮助解决老年人的医疗保健优先事项。
{"title":"Ascertaining Whether an Intelligent Voice Assistant Can Meet Older Adults' Health-Related Needs in the Context of a Geriatrics 5Ms Framework.","authors":"Ella T Lifset, Kemeberly Charles, Emilia Farcas, Nadir Weibel, Michael Hogarth, Chen Chen, Janet G Johnson, Mary Draper, Annie L Nguyen, Alison A Moore","doi":"10.1177/23337214231201138","DOIUrl":"10.1177/23337214231201138","url":null,"abstract":"<p><p>The Geriatrics 5Ms: Medications, Mind, Mobility, what Matters most and Multicomplexity is a framework to address the complex needs of older adults. Intelligent Voice Assistants (IVAs) are increasingly popular and have potential to support health-related needs of older adults. We utilized previously collected qualitative data on older adults' views of how an IVA may address their health-related needs and ascertained their fit into the Geriatrics 5Ms framework. The codes describing health challenges and potential IVA solutions fit the framework: (1) Medications: difficulty remembering medications.</p><p><strong>Solution: </strong>reminders. (2) Mind: isolation, anxiety, memory loss.</p><p><strong>Solution: </strong>companionship, memory aids. (3) Mobility: barriers to exercise.</p><p><strong>Solution: </strong>incentives, exercise ideas. (4) Matters most: eating healthy foods.</p><p><strong>Solution: </strong>suggest and order nutritious foods, (5) Multicomplexity; managing multimorbidity.</p><p><strong>Solution: </strong>symptom tracking and communicating with health care professionals. Incorporating the 5Ms framework into IVA design can aid in addressing health care priorities of older adults.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41136417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-30eCollection Date: 2023-01-01DOI: 10.1177/23337214231202148
Dominique Bergsma, Claudia Panait, Pascal Leist, Blandine Mooser, Lynn Pantano, Fabian D Liechti, Jenny Gentizon, Christine Baumgartner, Marco Mancinetti, Marie Méan, Joachim M Schmidt Leuenberger, Carole E Aubert
Background: To reduce adverse outcomes of low hospital mobility, we need interventions that are scalable in everyday practice. This study assessed the feasibility and acceptability of the INTOMOB multilevel intervention addressing barriers to hospital mobility without requiring unavailable resources. Methods: The INTOMOB intervention, targeting older patients, healthcare professionals (HCPs) and the hospital environment, was implemented on acute general internal medicine wards of three hospitals (12/2022-03/2023). Feasibility and acceptability of the intervention were assessed and two types of accelerometers compared in a mixed methods study (patient and HCP surveys and interviews). Quantitative data were analyzed descriptively and qualitative data using a deductive approach. Results were integrated through meta-inferences. Results: Of 20 patients (mean age 74.1 years), 90% found the intervention helpful and 82% said the environment intervention (posters) stimulated mobility. The majority of 44 HCPs described the intervention as clear and helpful. There was no major implementation or technical issue. About 60% of patients and HCPs preferred a wrist-worn over an ankle-worn accelerometer. Conclusions: The INTOMOB intervention is feasible and well accepted. Patients' and HCPs' feedback allowed to further improve the intervention that will be tested in a cluster randomized trial and provides useful information for future mobility-fostering interventions.
{"title":"Feasibility and Acceptability of an INtervention TO Increase MOBility in Older Hospitalized Medical Patients (INTOMOB): A Mixed-Methods Pilot Study.","authors":"Dominique Bergsma, Claudia Panait, Pascal Leist, Blandine Mooser, Lynn Pantano, Fabian D Liechti, Jenny Gentizon, Christine Baumgartner, Marco Mancinetti, Marie Méan, Joachim M Schmidt Leuenberger, Carole E Aubert","doi":"10.1177/23337214231202148","DOIUrl":"https://doi.org/10.1177/23337214231202148","url":null,"abstract":"<p><p><b>Background:</b> To reduce adverse outcomes of low hospital mobility, we need interventions that are scalable in everyday practice. This study assessed the feasibility and acceptability of the INTOMOB multilevel intervention addressing barriers to hospital mobility without requiring unavailable resources. <b>Methods:</b> The INTOMOB intervention, targeting older patients, healthcare professionals (HCPs) and the hospital environment, was implemented on acute general internal medicine wards of three hospitals (12/2022-03/2023). Feasibility and acceptability of the intervention were assessed and two types of accelerometers compared in a mixed methods study (patient and HCP surveys and interviews). Quantitative data were analyzed descriptively and qualitative data using a deductive approach. Results were integrated through meta-inferences. <b>Results:</b> Of 20 patients (mean age 74.1 years), 90% found the intervention helpful and 82% said the environment intervention (posters) stimulated mobility. The majority of 44 HCPs described the intervention as clear and helpful. There was no major implementation or technical issue. About 60% of patients and HCPs preferred a wrist-worn over an ankle-worn accelerometer. <b>Conclusions:</b> The INTOMOB intervention is feasible and well accepted. Patients' and HCPs' feedback allowed to further improve the intervention that will be tested in a cluster randomized trial and provides useful information for future mobility-fostering interventions.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/5e/10.1177_23337214231202148.PMC10542323.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-29eCollection Date: 2023-01-01DOI: 10.1177/23337214231202152
Kathlene Camp, Jessica Hartos, Adenike Atanda
Background: Clinical practice guidelines and quality measures provide recommendations for physicians addressing osteoporosis management. This study explored the alignment of osteoporosis clinical practice in a primary care geriatric clinic with recommended guidelines. Methods: This retrospective chart review included 388 patients 65 or older from a primary care geriatric clinic diagnosed with osteopenia or osteoporosis, with or without a fragility fracture. Data included history of falls and use of DXA scans, FRAX® fracture risk assessment tool, osteoporosis medication, and fall risk mitigation plans. Results: For age-related primary fracture prevention, 68% of women and 87% of men had documented DXA scans, and 45% of patients diagnosed with osteoporosis and 42% determined at high risk were prescribed osteoporosis medication. For secondary fracture prevention, 72% of women aged 67 to 85 had DXA scans and 21% were prescribed osteoporosis medication. Only 10% of patients with a history of falls had documented fall risk management plans. Conclusion: Although showing higher rates of primary and secondary prevention outcomes than did research results from general primary care, gaps were identified for high fracture risk patients and fall risk management documentation. Medical record review may not provide sufficient data to capture factors influencing decision-making for fracture prevention.
{"title":"Use of Clinical Practice Guidelines and Quality Metrics to Assess Primary Care Management of Osteoporosis.","authors":"Kathlene Camp, Jessica Hartos, Adenike Atanda","doi":"10.1177/23337214231202152","DOIUrl":"https://doi.org/10.1177/23337214231202152","url":null,"abstract":"<p><p><b>Background:</b> Clinical practice guidelines and quality measures provide recommendations for physicians addressing osteoporosis management. This study explored the alignment of osteoporosis clinical practice in a primary care geriatric clinic with recommended guidelines. <b>Methods</b>: This retrospective chart review included 388 patients 65 or older from a primary care geriatric clinic diagnosed with osteopenia or osteoporosis, with or without a fragility fracture. Data included history of falls and use of DXA scans, FRAX® fracture risk assessment tool, osteoporosis medication, and fall risk mitigation plans. <b>Results</b>: For age-related primary fracture prevention, 68% of women and 87% of men had documented DXA scans, and 45% of patients diagnosed with osteoporosis and 42% determined at high risk were prescribed osteoporosis medication. For secondary fracture prevention, 72% of women aged 67 to 85 had DXA scans and 21% were prescribed osteoporosis medication. Only 10% of patients with a history of falls had documented fall risk management plans. <b>Conclusion</b>: Although showing higher rates of primary and secondary prevention outcomes than did research results from general primary care, gaps were identified for high fracture risk patients and fall risk management documentation. Medical record review may not provide sufficient data to capture factors influencing decision-making for fracture prevention.</p>","PeriodicalId":52146,"journal":{"name":"Gerontology and Geriatric Medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/aa/10.1177_23337214231202152.PMC10541736.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}