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Swimming upstream in a sea of ageism 在年龄歧视的海洋中逆流而上。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-29 DOI: 10.1111/ajag.13370
Amanda Barusch
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引用次数: 0
Systemic ageism in Australia 澳大利亚的系统性老龄歧视。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-29 DOI: 10.1111/ajag.13369
Jane Sims
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引用次数: 0
The Australian Frailty Network: Development of a consumer-focussed national response to frailty 澳大利亚虚弱网络:制定以消费者为中心的国家虚弱应对措施。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-29 DOI: 10.1111/ajag.13365
Natasha Reid, Adrienne Young, Loretta Baldassar, Anja Christoffersen, Tracy Comans, Simon Conroy, Christopher Etherton-Beer, Jason Ferris, Maria Fiatarone Singh, Sarah Fox, Emily H. Gordon, Manonita Ghosh, Chandana Guha, Sarah Hilmer, Lisa Kouladjian O’Donnell, Benignus Logan, Kristiana Ludlow, Michelle Miller, Mark Morgan, Alison Mudge, John Muscedere, Donna Reidlinger, Kenneth Rockwood, Rosemary Saunders, David Ward, Paul Yates, Ruth E. Hubbard

Frailty is an important concept in the care of older adults. Over the past two decades, significant advances have been made in measuring frailty. While it is now well-recognised that frailty status is an important determinant of outcomes from medical illnesses or surgical interventions, frailty measurement is not currently routinely integrated into clinical practice. In the community setting, it is uncommon for general practitioners to deliver frailty-optimised care. In hospitals, there is substantial variability in how people living with frailty are managed. This variability is notable between and even within disciplines. Furthermore, gains from understanding frailty mechanisms and risk factors are not yet applied/implemented at scale to delay the progression of frailty in community-dwellers. The Australian Frailty Network (AFN) is a national collaborative group of researchers, clinicians, non-government organisations, consumers and policymakers, in which the engagement and active involvement of consumers has been embedded from the outset. The AFN aims to generate new knowledge to improve health outcomes, to ensure evidence-based management is translated into clinical practice and to build capacity in multidisciplinary and translational frailty research. Here, we describe the development of the AFN, highlighting important milestones: (i) securing funding for the network and flagship elements; (ii) an inaugural summit to establish the strategic vision, values and scope with end-users; (iii) sabbatical visits to learn from international examples; and (iv) developing the governance structure and an actionable plan encompassing consumer engagement, research, education and policy and practice to maximise impact.

虚弱是老年人护理中的一个重要概念。在过去的二十年里,虚弱测量取得了重大进展。虽然现在人们已经充分认识到,虚弱状态是内科疾病或外科手术治疗结果的重要决定因素,但虚弱测量目前并未被常规纳入临床实践。在社区环境中,全科医生很少提供针对虚弱状态的优化护理。在医院,对体弱患者的管理方式也存在很大差异。这种差异在学科之间甚至学科内部都非常明显。此外,通过了解虚弱机制和风险因素所取得的成果尚未大规模应用/实施,以延缓社区居民的虚弱进展。澳大利亚虚弱网络(AFN)是一个由研究人员、临床医生、非政府组织、消费者和政策制定者组成的全国性合作团体,从一开始就有消费者的参与和积极参与。AFN 的目标是创造新知识以改善健康状况,确保将循证管理转化为临床实践,并建设多学科和转化虚弱研究的能力。在此,我们将介绍 AFN 的发展历程,并重点介绍其重要的里程碑:(i) 为网络和旗舰要素争取资金;(ii) 举行首次峰会,与最终用户一起确立战略愿景、价值观和范围;(iii) 开展休假访问,学习国际范例;(iv) 制定管理结构和可操作的计划,包括消费者参与、研究、教育、政策和实践,以最大限度地扩大影响。
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引用次数: 0
Gender disparity regarding the impact of retirement on marital satisfaction: Evidence from a longitudinal study of older Korean adults 退休对婚姻满意度影响的性别差异:来自韩国老年人纵向研究的证据。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-29 DOI: 10.1111/ajag.13373
In Cheol Hwang, Hong Yup Ahn, Yujin Park

Objective

To investigate the impact of retirement on marital satisfaction by gender on Koreans aged >45 years in a large, nationally representative cohort.

Methods

Retirement status and marital satisfaction data of 5867 individuals were analysed. Marital dissatisfaction was defined as a satisfaction score reduction of more than 10 points versus the previous wave. Lagged generalised estimating equation (GEE) models adjusted for demographics (age, sex, education level and household income), health-related habits (smoking and drinking status) and comorbidities (obesity, hypertension, type 2 diabetes, and depression and frailty) were used to confirm the relationship between retirement and marital dissatisfaction.

Results

The final GEE model adjusted for covariates revealed sex-specific differences in marital satisfaction after retirement. Whereas male retirees reported higher satisfaction than non-retired men, female retiree responses revealed lower satisfaction than non-retired women. Furthermore, these trends were consistent regardless of the time elapsed after retirement.

Conclusions

Marital satisfaction should be screened in women during the transition to retirement.

目的在一个具有全国代表性的大型队列中,按性别调查 45 岁以上韩国人退休对婚姻满意度的影响:分析了 5867 人的退休状况和婚姻满意度数据。婚姻不满意度的定义是满意度得分与上一次相比下降超过 10 分。采用滞后广义估计方程(GEE)模型,对人口统计学(年龄、性别、教育水平和家庭收入)、健康相关习惯(吸烟和饮酒状况)和合并症(肥胖、高血压、2 型糖尿病、抑郁和虚弱)进行调整,以确认退休与婚姻不满意度之间的关系:根据协变量调整的最终 GEE 模型显示,退休后的婚姻满意度存在性别差异。男性退休人员的满意度高于非退休男性,而女性退休人员的满意度则低于非退休女性。此外,无论退休时间长短,这些趋势都是一致的:结论:在向退休过渡期间,应对女性的婚姻满意度进行筛查。
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引用次数: 0
The representation of Australians living with dementia in voluntary assisted dying research: A scoping review 澳大利亚痴呆症患者在自愿协助死亡研究中的代表性:范围界定审查
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-09 DOI: 10.1111/ajag.13371
Adrienne Matthys, Belinda Cash, Bernadette Moorhead

Objectives

To critically examine which stakeholders are participating in voluntary assisted dying (VAD) research, to identify the representation of Australians living with dementia.

Methods

A scoping review of peer-reviewed literature to examine which stakeholders are represented in Australian VAD research was conducted. This review was informed by the Arksey and O'Malley Framework for Scoping Reviews, and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR). Searches were conducted systematically across key academic databases to gather Australian research articles written in English that were published between 2017 and August 2023.

Results

After screening, 21 publications formed the dataset. Of the 21 publications, none of them represented Australians living with dementia. The voice of one person living with a terminal illness was included in a study of care partners, and four studies explored the views of community members. The most dominant voices in the dataset were health-care practitioners, who were represented in 16 studies.

Conclusions

Australian VAD research is a contested space where all stakeholders with a relevant contribution to policy and practice must be represented in contemporary Australian research. As living experience experts with a wealth of experiential knowledge to contribute, the voices of people living with dementia need to be represented in future Australian VAD research through inclusive research design, to ensure a greater balance in stakeholder representation across the VAD literature.

方法 对同行评议的文献进行了一次范围界定综述,以考察哪些利益相关者参与了澳大利亚的自愿协助死亡(VAD)研究。此次综述参考了Arksey和O'Malley的《范围界定综述框架》以及《范围界定综述首选报告项目》(PRISMA-ScR)。我们在主要学术数据库中进行了系统搜索,以收集 2017 年至 2023 年 8 月间发表的澳大利亚英文研究文章。在这 21 篇出版物中,没有一篇是以澳大利亚痴呆症患者为代表的。在一项关于护理伙伴的研究中,包含了一位身患绝症者的声音,另有四项研究探讨了社区成员的观点。数据集中最主要的声音是医疗保健从业人员的声音,他们在 16 项研究中有所体现。结论澳大利亚的 VAD 研究是一个有争议的领域,所有对政策和实践有相关贡献的利益相关者都必须在当代澳大利亚的研究中有所体现。作为拥有丰富经验知识的生活体验专家,痴呆症患者的声音需要通过包容性的研究设计在未来的澳大利亚老年痴呆症研究中得到体现,以确保老年痴呆症文献中利益相关者代表的更大平衡。
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引用次数: 0
Perceived acceptability of online volunteer-led exercise classes: Perspectives of rural volunteer exercise leaders and older people 网上志愿者指导的锻炼课程的可接受性:农村志愿运动领导者和老年人的观点。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-02 DOI: 10.1111/ajag.13359
Natalie McDermott, Md Saifur Rahman, Rachel Winterton, Nazmul Ahasan, Carly Barnes, Adelle Kennedy

Objective

This study assessed perceived acceptability of online rural volunteer-led exercise classes among volunteer leaders and older people during the COVID-19 pandemic and interrogate differences in acceptability between older people who were currently participating in regular exercise and those who were not.

Method

A case study was conducted of an existing volunteer-led exercise program using a cross-sectional preintervention survey (38 volunteer exercise leaders and 172 program participants).

Results

Thirty per cent (n = 11) of the volunteer leaders reported an interest in running the online classes. Motivations included providing opportunities for participants and keeping themselves and participants fit. Thirty-four per cent (n = 42) of the older participants reported an intent to join the online classes, which was primarily attributed to the desire to keep active and to socialise. However, over 60% of the respondents across both categories did not want to engage in online exercise classes. This was primarily attributed to a preference for face-to-face classes and lack of confidence in conducting or using online activities or services. Older participants who did not regularly exercise were statistically more likely to report perceived challenges attending an online class, and to identify the use of internet-based technologies as a barrier to attendance.

Conclusion

Digital literacy was a challenge for the older respondents, particularly for those who were not currently engaged in regular exercise. Organisations implementing online exercise programs should recognise that this form of delivery will pose challenges to cohorts of rural older people who are not undertaking regular physical activity and address the individual and environmental barriers to digital uptake.

研究目的本研究评估了在 COVID-19 大流行期间,志愿者领导者和老年人对农村志愿者领导的在线锻炼课程的可接受性,并询问了目前定期参加锻炼的老年人和未参加锻炼的老年人在可接受性方面的差异:方法:通过干预前的横断面调查(38 名志愿运动领导者和 172 名计划参与者),对现有的志愿者领导的运动计划进行了案例研究:结果:30%(n = 11)的志愿者领导表示有兴趣开设在线课程。他们的动机包括为参与者提供机会,以及让自己和参与者保持健康。34%(n = 42)的老年参与者表示有意参加在线课程,这主要是因为他们希望保持活跃和社交。然而,超过 60% 的两类受访者都不想参加在线锻炼课程。这主要是因为他们更喜欢面对面的课程,以及对开展或使用在线活动或服务缺乏信心。据统计,不经常锻炼的老年参与者更有可能认为参加在线课程有困难,并认为使用互联网技术是参加在线课程的障碍:数字素养是老年受访者面临的一项挑战,尤其是对于那些目前没有定期锻炼的人来说。实施在线锻炼计划的机构应认识到,这种授课形式将对那些没有定期参加体育锻炼的农村老年人群构成挑战,并应解决个人和环境对数字化学习的障碍。
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引用次数: 0
Response to: Potentially inappropriate medications and potential prescribing omissions in hospitalized older adults in New Zealand: A retrospective study 回应:新西兰住院老年人的潜在不当用药和潜在处方遗漏:回顾性研究。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-29 DOI: 10.1111/ajag.13368
Sania Khan
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引用次数: 0
Response to Letter to the editor 回应致编辑的信。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-29 DOI: 10.1111/ajag.13367
Victoria Woodcroft-Brown, Jack Bell, Chrysanth Ranjeev Pulle, Rebecca Mitchell, Jacqueline Close, Catherine McDougall, Sarah Hurring, Mitchell Sarkies
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引用次数: 0
Postoperative delirium increases follow-up mortality following hip arthroplasty in older patients with femoral neck fracture 术后谵妄会增加股骨颈骨折老年患者髋关节置换术后的随访死亡率。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-26 DOI: 10.1111/ajag.13366
Penghuan Wu, Ying Yang, Aidong Yuan, Yu Wang, Yingze Zhang

Objective

This study aimed to identify independent perioperative risk factors and follow-up mortality associated with postoperative delirium in older patients undergoing hip arthroplasty at a large teaching hospital in South China. We aimed to establish a specialised model to predict the risk of postoperative delirium.

Methods

This retrospective observational study was conducted in the orthopaedics department of the hospital between January 2018 and December 2022. Participants were stratified into two groups: those with and those without postoperative delirium. The study included demographics, clinical characteristics, surgery-related and laboratory specifics, as well as details on delirium.

Results

In this study of 241 participants, the median age was 80 years (IQR, 74.5–85), with postoperative delirium observed in 43 individuals (18%). Multivariate logistic regression analysis identified age (OR, 1.07; 95% CI, 1.01–1.14; p = .03), arrhythmia (OR, 7.97; 95% CI, 2.25–28.29; p = .001), dementia (OR, 7.08; 95% CI, 1.73–28.95; p = .006) and a lower level of red blood cells (RBC) (OR, .33; 95% CI, .17–.64; p < .001) as independent factors associated with postoperative delirium after hip arthroplasty. Patients experiencing both preoperative and postoperative delirium had significantly higher follow-up mortality compared to those with postoperative delirium only and those without delirium (80% vs. 38% vs. 24%, p = .02).

Conclusions

The specialised model was established to effectively predict delirium following hip arthroplasty in patients with femoral neck fracture. Postoperative delirium strongly associates with follow-up mortality. Proactive management is crucial for minimising delirium occurrence after hip arthroplasty and improving patient outcomes.

研究目的本研究旨在确定在华南一家大型教学医院接受髋关节置换术的老年患者中,与术后谵妄相关的独立围手术期风险因素和随访死亡率。我们旨在建立一个专门的模型来预测术后谵妄的风险:这项回顾性观察研究于 2018 年 1 月至 2022 年 12 月期间在该医院骨科进行。参与者被分为两组:术后谵妄患者和无术后谵妄患者。研究内容包括人口统计学、临床特征、手术相关和实验室具体情况以及谵妄的详细情况:在这项有 241 人参与的研究中,中位年龄为 80 岁(IQR,74.5-85),有 43 人(18%)出现术后谵妄。多变量逻辑回归分析确定了年龄(OR,1.07;95% CI,1.01-1.14;P = .03)、心律失常(OR,7.97;95% CI,2.25-28.29;P = .001)、痴呆(OR,7.08;95% CI,1.73-28.95;P = .006)和较低的红细胞(RBC)水平(OR,0.33;95% CI,0.17-0.64;P 结论:专用模型的建立可有效预测股骨颈骨折患者髋关节置换术后的谵妄。术后谵妄与随访死亡率密切相关。积极的管理对于减少髋关节置换术后谵妄的发生和改善患者预后至关重要。
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引用次数: 0
Hearing loss, social isolation and depression in participants aged 50 years or over in Tasmania, Australia 澳大利亚塔斯马尼亚州 50 岁或以上参与者的听力损失、社会隔离和抑郁症。
IF 1.4 4区 医学 Q4 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-26 DOI: 10.1111/ajag.13363
Mohammed Shoaib Hamrah, Larissa Bartlett, Lynette Ruth Goldberg, Aidan Bindoff, James Clement Vickers

Objective

Acquired hearing loss (HL) in adult life is one of the most prevalent health conditions and is associated with several chronic diseases. Hearing loss can lead to reduced social activity and individuals' perceptions of supportiveness within social networks. This study explored the effects of corrected vs. uncorrected hearing loss on social support, social isolation, anxiety and depression.

Methods

We undertook a cross-sectional study. An online survey was completed by 7442 Australian residents aged 50 years or older as part of the Island Study Linking Ageing and Neurodegenerative Disease (ISLAND). Respondents were grouped into those with no reported acquired HL, those with corrected HL (managed with hearing aids and other listening devices) and those with uncorrected HL.

Results

Hearing loss was reported by 1274 participants (17%). Compared to male participants, there was a higher proportion of female participants in the No-HL group (25% male, 75% female). Compared to participants with corrected or no-HL, those with HL (n = 548, 7%) reported significantly smaller (p = .007) and less supportive social networks (p = .001), higher self-reported anxiety (p < .001) and depression (p < .001) symptoms. Depression scores were significantly higher in those with HL-corrected than No-HL (SMD = .10, p = .04).

Conclusions

Uncorrected HL was associated with poor mental health and social isolation, compounding the risk of dementia. Correcting for HL appeared to mitigate these outcomes, except for depression. Longitudinal studies are needed to track the effects of HL correction over time. Hearing status needs to be assessed when people present with mental health concerns, so health professionals can make appropriate referrals and provide relevant advice and support.

目的:成年后获得性听力损失(HL)是最普遍的健康问题之一,与多种慢性疾病相关。听力损失会导致社交活动减少,并降低个人对社交网络中支持度的感知。本研究探讨了经矫正与未经矫正的听力损失对社会支持、社会隔离、焦虑和抑郁的影响:我们进行了一项横断面研究。作为 "岛屿老龄化与神经退行性疾病关联研究"(ISLAND)的一部分,7442 名年龄在 50 岁或以上的澳大利亚居民完成了一项在线调查。受访者被分为未报告获得性听力损失者、已矫正听力损失者(使用助听器和其他听力设备)和未矫正听力损失者:有 1274 名参与者(17%)报告了听力损失。与男性参与者相比,无听力损失组中女性参与者的比例更高(男性占 25%,女性占 75%)。与有听力损失或无听力损失的参与者相比,有听力损失的参与者(n = 548,7%)的社交网络明显较小(p = .007),支持性较弱(p = .001),自我报告的焦虑程度较高(p = .001):未校正的 HL 与心理健康状况不佳和社会隔离有关,增加了痴呆症的风险。对 HL 进行校正似乎可以减轻这些结果,但抑郁除外。需要进行纵向研究,以跟踪随时间变化的听力矫正效果。当人们出现精神健康问题时,需要对听力状况进行评估,以便卫生专业人员能够做出适当的转诊并提供相关建议和支持。
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引用次数: 0
期刊
Australasian Journal on Ageing
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