Australasian Journal on Ageing最新文献

Objectives: To synthesise evidence on food waste in Aged Residential Care (ARC) facilities, identify organisational, cultural and structural drivers, and develop a conceptual model to inform practice and research.

Methods: Following PRISMA guidelines, five databases (1990-2025) were searched. Nineteen peer-reviewed studies met inclusion criteria. Narrative synthesis and inductive coding were used to identify barriers, facilitators and organisational responses, which were integrated into a conceptual model of the ARC food waste ecosystem.

Results: Food waste responses were largely fragmented and rarely embedded in strategy or policy. Barriers and facilitators commonly overlapped, including communication, training and infrastructure. Resident involvement was limited, and few studies evaluated intervention effectiveness or used theoretical framing.

Conclusions: Food waste in ARC is an ecosystem issue shaped by interdependent organisational, staff, resident and policy factors. The model highlights leverage points for integrated, sustainable change linking waste reduction, staff capacity and resident wellbeing.

Objective: Although frailty appears higher in rural and socioeconomically disadvantaged areas, existing evidence often lacks adjustment for possible population confounders. This study examined the independent associations between geographic remoteness and area-level socioeconomic status with frailty.

Methods: We constructed a 33-item frailty index using data from 5740 participants of the Island Study Linking Ageing and Neurodegenerative Disease (ISLAND), a web-based longitudinal cohort of adults aged 50 years and over in Tasmania, Australia. After linking participant postcodes to Modified Monash Model remoteness and Index of Relative Socioeconomic Advantage and Disadvantage, we examined frailty distribution and its associations with geographic and sociodemographic factors using descriptive statistics, spatial mapping and multivariable linear regression models.

Results: The analytical sample mean age was 69.3 years (SD = 8.0) and most were women (72%). Frailty index scores followed a gamma distribution (mean score = 0.16, SD = 0.09), increased with age and were highest in central and western areas of Tasmania. After adjustment for age, gender, education, retirement and migrant status, frailty index scores were significantly higher in rural towns (β = 0.011 [95% confidence interval, CI = 0.005, 0.016]) and remote communities (β = 0.023 [95% CI = 0.009, 0.038]) than regional centres. Similarly, after full adjustment, compared with areas of the highest socioeconomic advantage, frailty was significantly higher in areas of middle (β = 0.013 [95% CI = 0.007, 0.018]) or low (β = 0.024 [95% CI = 0.018, 0.030]) socioeconomic advantage.

Conclusions: The distribution of frailty across Tasmania varied by geographic remoteness and socioeconomic disadvantage. Integrating frailty assessment into regional health planning may support targeted interventions for vulnerable subpopulations, particularly in rural and disadvantaged communities.

Introduction: High-risk medications are medications associated with significant patient harm or death if misused or used in error. This study aimed to develop a national consensus high-risk medication list for use in Australian residential aged care.

Methods: A 3-round modified Delphi study involving Australian healthcare professionals was conducted. In Round 1, participants indicated their level of agreement, on a 9-point Likert scale, whether 60 medications/medication classes were considered high-risk and should be included in a high-risk medication list for Australian residential aged care. Round 2 included medications/medication classes that did not reach consensus and new medications identified by participants. Consensus was defined as 70% or more of participants responding at 7 or higher on the Likert scale. In Round 3, participants were asked to prioritise medications/medication classes that reached consensus in Round 1 or 2.

Results: In total, 42 participants completed Round 1, and 35 (83%) completed all three rounds. Participants included pharmacists (n = 21), prescribers (n = 15), nurses (n = 5) and a paramedic (n = 1), with representation from all Australian states and mainland territories. Overall, 26 medications reached consensus (21 in Round 1, five in Round 2) and were categorised into 15 medications/medication classes for prioritisation in Round 3. The final prioritisation list was opioids, insulin, benzodiazepines, anticoagulants, z-drugs, antipsychotics, lithium, sulfonylureas with high risk of hypoglycaemia, chemotherapeutic agents, methotrexate, digoxin, narrow therapeutic range antiepileptics, tricyclic antidepressants, immunosuppressants for transplant and sedating antihistamines.

Discussion: This is the first, national consensus list of high-risk medications developed specifically for Australian residential aged care. It can be used to implement targeted strategies to minimise medication-related harm.

Objectives: This study evaluated the quality and quantity of Goals of Patient Care (GoPC) documentation amongst older adults admitted under General Surgery at a tertiary hospital, comparing standards before and after integration of proactive geriatric medicine input via the Older Adult Surgical Inpatient Service (OASIS).

Methods: A retrospective audit was performed of older adults discharged from General Surgery over a 6-month period. Quantity was defined as total number and percentage of patients with documented GoPC. Quality was defined as time from admission to completion and rate of documentation of patient preferences. Service impact was explored via the specialty team authorising the GoPC form and the ceiling of care identified.

Results: In total, 526 patient care episodes were included pre-OASIS and 532 post-OASIS. Of these, 50 patients (10%) had completed GoPC forms pre-OASIS, increasing to 139 patients (26%) post-OASIS (p < 0.001). Completion within 48 h of admission improved from 22 patients (44%) pre-OASIS to 97 patients (70%) post-OASIS. Inclusion of patient preferences increased from 39 (78%) to 102 (73%; p = 0.65). The Older Adult Surgical Inpatient Service completed 88 (63%) of GoPC forms in the relevant cohort, though completion by the surgical team remained unchanged (29 pre-OASIS vs. 30 post-OASIS). There was an almost twofold increase in the number of patients with GoPC 'not for CPR' (47 vs. 102).

Conclusions: Goals of Patient Care document completion for older adults admitted to General Surgery are below that recommended by local hospital policy. With the initiation of OASIS, there was a significant improvement in the quantity and quality of GoPC documentation.

Objective: The rapid growth in the use of online platforms for obtaining health-related information, together with the increasing incidence of Alzheimer's disease (AD), has made the evaluation of online information quality essential. The purpose of this research was to assess the quality and reliability of the more likely to be viewed YouTube videos related to exercise in individuals living with AD.

Methods: This descriptive study evaluated the quality and reliability of YouTube videos related to AD and exercise. Fifty-six English language videos were selected from the top search results based on keywords. Video sources, view rate metrics and content characteristics were recorded. The quality and reliability of the videos were independently evaluated by three physiotherapists using the Global Quality Scale (GQS) and DISCERN tool.

Results: High-quality videos had higher DISCERN scores and greater view rate (p = 0.02), whereas low-quality videos showed minimal interaction (p < 0.001). Dislike rates were similar across all groups. In addition, Pearson correlation analysis indicated a very strong positive relationship (r = 0.97, p < 0.001) between views and likes, indicating that more viewed videos tend to receive more likes.

Conclusions: Video quality may have an influence on both the reliability of the information and viewer interaction, as reflected by view and like metrics. A considerable number of YouTube videos on exercise for individuals living with AD were shown to be of low or moderate quality. The findings highlight the need for improved oversight, collaboration between healthcare professionals and content creators, and the promotion of evidence-based digital health information to protect vulnerable populations.

Objectives: Although acute appendicitis has a lower incidence among older adults compared with those in younger age groups, there is emerging evidence to suggest that older adults bear greater morbidity and mortality. The purpose of this study was to gauge the differences in acute appendicitis-related mortality among older individuals across different stratifications.

Methods: Death certificate data from 1999 to 2020 were accessed from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 people were obtained for each stratification and used to calculate annual percentage changes (APCs).

Results: There was an overall decrease in acute appendicitis-related AAMR from 1999 to 2020, with an APC of -3.28 (95% confidence intervals [95% CI]: -3.85 to -2.70). The highest overall AAMRs (crude mortality rates in case of age) observed for each stratification were the following: men: 1.11 deaths per 100,000 (95% CI: 1.07-1.14), non-Hispanic Black people: 0.92 deaths per 100,000 non-Hispanic Black people (95% CI: 0.86-0.99), older adults aged 85 years and older: 2.15 deaths per 100,000 people (95% CI: 2.06-2.23), the Midwest and the West: 0.93 deaths per 100,000 people living in the Midwest and the West (95% CI: 0.89-0.98), Vermont: 1.36 deaths per 100,000 people living in Vermont (95% CI: 0.90-1.96) and non-metropolitan areas: 1.05 deaths per 100,000 people living in Non-metropolitan areas (95% CI: 1.00-1.10) with respect to sex, race, age, census region, individual states and urban-rural classification, respectively.

Conclusions: Acute appendicitis AAMRs for older adults had an overall decline between 1999 and 2020. Despite the overall decline in mortality rates, more research is needed to understand racial and economic disparities affecting clinical outcomes related to acute appendicitis.

Cognitive interventions, including cognitive stimulation therapy, cognitive rehabilitation and cognitive training, are increasingly recommended as key components of non-pharmacological post-diagnostic support for people with dementia. Cognitive interventions may help delay cognitive decline, enhance goal-directed functional abilities and improve quality of life. Despite inclusion in clinical guidelines and recommendations, guidance on the delivery of these interventions within Australian community settings remains limited and is underutilised. This article addresses a critical translation gap in cognitive interventions for people with dementia, synthesises the evidence through an Australian practice and policy lens, examines current uptake in community settings and identifies barriers, enablers and delivery models to inform implementation strategies. Community settings are defined as memory clinics, primary care, hospital outpatient services, allied health providers, community aged care and non-government providers. Current evidence indicates cognitive interventions have varying benefits across different outcomes, including cognitive function, social engagement, everyday functioning, quality of life and goal attainment. International practices related to implementation are explored, along with future directions for expanding access through technology, flexible delivery models, group-based approaches and integrating these interventions into existing care structures. Addressing the gap between recommendations and current practices requires building community awareness, improving access to professional education and training, and careful resource allocation. Cognitive interventions should be part of comprehensive rehabilitation and can be personalised to individual needs and goals. Expanding access and improving the availability of a range of cognitive interventions in community settings is crucial to ensure people with dementia receive best practice post-diagnostic support.