Ting Lia, Chang Yua, Feng Lv, Zhen Feng, Yan Hou, Li Ren, Ping Li
Objective This study investigated whether cognitive training (CT) ameliorates postoperative delirium (POD) in older patients undergoing total hip and knee arthroplasty. Methods This clinical trial was conducted from 18 February to 10 July 2023 and included individuals aged 60–79 who underwent elective total hip and knee arthroplasties with surgery durations ≤3 hours under general anaesthesia. Patients with preoperative cognitive dysfunction and dementia were excluded. The incidence of POD was compared between the CT and routine care (RC) groups as the primary outcome. Secondary outcomes included adverse events, postoperative pain within 48 hours, and POD characteristics. Results In this study, 122 individuals were divided into two groups. The overall incidence of POD was 8.2% (10 out of 122), with no significant difference between the two groups (9.8% for CT group vs. 6.6% for RC group; P = .509). Secondary outcomes also showed no significant difference between the two groups. The training time was less, and the compliance rate was poor in the CT group (4.0%). Nonetheless, the results revealed a significant difference in POD rates among CT subgroups, and a robust correlation was identified between CT sessions lasting less than the median duration of 12 minutes and the incidence of POD (P = .043). Conclusion The incidence of POD in older patients undergoing total hip or knee arthroplasty may not be mitigated by CT. As POD was exclusively observed in patients with fewer CT sessions, it suggests that the compliance-recommended CT sessions may contribute to the POD.
{"title":"The effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial","authors":"Ting Lia, Chang Yua, Feng Lv, Zhen Feng, Yan Hou, Li Ren, Ping Li","doi":"10.1093/ageing/afaf020","DOIUrl":"https://doi.org/10.1093/ageing/afaf020","url":null,"abstract":"Objective This study investigated whether cognitive training (CT) ameliorates postoperative delirium (POD) in older patients undergoing total hip and knee arthroplasty. Methods This clinical trial was conducted from 18 February to 10 July 2023 and included individuals aged 60–79 who underwent elective total hip and knee arthroplasties with surgery durations ≤3 hours under general anaesthesia. Patients with preoperative cognitive dysfunction and dementia were excluded. The incidence of POD was compared between the CT and routine care (RC) groups as the primary outcome. Secondary outcomes included adverse events, postoperative pain within 48 hours, and POD characteristics. Results In this study, 122 individuals were divided into two groups. The overall incidence of POD was 8.2% (10 out of 122), with no significant difference between the two groups (9.8% for CT group vs. 6.6% for RC group; P = .509). Secondary outcomes also showed no significant difference between the two groups. The training time was less, and the compliance rate was poor in the CT group (4.0%). Nonetheless, the results revealed a significant difference in POD rates among CT subgroups, and a robust correlation was identified between CT sessions lasting less than the median duration of 12 minutes and the incidence of POD (P = .043). Conclusion The incidence of POD in older patients undergoing total hip or knee arthroplasty may not be mitigated by CT. As POD was exclusively observed in patients with fewer CT sessions, it suggests that the compliance-recommended CT sessions may contribute to the POD.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"116 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pekka Karhunen, Sari Tuomisto, Sirkka Goebeler, Mika Martiskainen, Eloise Kok
Background Atrophic gastritis—the end stage of chronic gastritis—is an asymptomatic disease due to Helicobacter pylori infection causing decreased vitamin B12 and folate absorption, which may lead to severe haematological and neuropsychological disorders including Alzheimer’s disease. The diagnosis requires endoscopy and biopsies from symptomatic patients, explaining why its true prevalence in the population is not well-known. Objective We aimed to evaluate the prevalence of various stages of chronic gastritis in an autopsy series most closely representing the general population. Subjects and Methods Gastric mucosa samples were collected prospectively from out-of-hospital deaths included in the Tampere Sudden Death Study (n = 70, mean age 63, age range 22–91 years). Antrum and corpus samples were stained with a H. pylori antibody and staged histopathologically. Results Chronic gastritis with or without atrophic changes was detected in 40% of the cases. The proportion of healthy mucosa decreased age-dependently from 71.4% among individuals aged <50 years to 43.5% among the oldest individuals (>70 years), and that of chronic non-atrophic gastritis from 21.4% to 8.7%. In contrast, the prevalence of atrophic gastritis was 27.1% and increased in the age groups from 7.1% to 47.8% (P = .019) among the oldest individuals, showing a strong association (P < .0001) with H. pylori immunopositivity. Conclusions Atrophic gastritis is a common feature of the ageing stomach, which is observed in every second individual aged 70+ years, showing a strong association with H. pylori immunopositivity. Atrophic gastritis may be a more common risk factor in old age for diseases associated with low serum B12 and folate levels than has been previously known.
{"title":"Common occurrence of atrophic gastritis in an ageing non-hospitalised population: an autopsy study","authors":"Pekka Karhunen, Sari Tuomisto, Sirkka Goebeler, Mika Martiskainen, Eloise Kok","doi":"10.1093/ageing/afaf047","DOIUrl":"https://doi.org/10.1093/ageing/afaf047","url":null,"abstract":"Background Atrophic gastritis—the end stage of chronic gastritis—is an asymptomatic disease due to Helicobacter pylori infection causing decreased vitamin B12 and folate absorption, which may lead to severe haematological and neuropsychological disorders including Alzheimer’s disease. The diagnosis requires endoscopy and biopsies from symptomatic patients, explaining why its true prevalence in the population is not well-known. Objective We aimed to evaluate the prevalence of various stages of chronic gastritis in an autopsy series most closely representing the general population. Subjects and Methods Gastric mucosa samples were collected prospectively from out-of-hospital deaths included in the Tampere Sudden Death Study (n = 70, mean age 63, age range 22–91 years). Antrum and corpus samples were stained with a H. pylori antibody and staged histopathologically. Results Chronic gastritis with or without atrophic changes was detected in 40% of the cases. The proportion of healthy mucosa decreased age-dependently from 71.4% among individuals aged &lt;50 years to 43.5% among the oldest individuals (&gt;70 years), and that of chronic non-atrophic gastritis from 21.4% to 8.7%. In contrast, the prevalence of atrophic gastritis was 27.1% and increased in the age groups from 7.1% to 47.8% (P = .019) among the oldest individuals, showing a strong association (P &lt; .0001) with H. pylori immunopositivity. Conclusions Atrophic gastritis is a common feature of the ageing stomach, which is observed in every second individual aged 70+ years, showing a strong association with H. pylori immunopositivity. Atrophic gastritis may be a more common risk factor in old age for diseases associated with low serum B12 and folate levels than has been previously known.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"32 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie J Miller, Frank Zhang, Steven Taylor, Richard Woodman, Andrew P Shoubridge, Lito E Papanicolas, Geraint B Rogers
Background Biological ageing, healthcare interactions, and pharmaceutical and environmental exposures in later life alter the characteristics of the oropharyngeal (OP) microbiome. These changes, including an increased susceptibility to colonisation by pathobiont species, have been linked with diverse health outcomes. Objectives To investigate the relationship between OP microbiome characteristics and all-cause mortality in long-term aged care residents. Methods OP swabs were collected from 190 residents of five aged care facilities in South Australia. Microbiota composition was assessed by shotgun metagenomics and related to health outcomes during a 12-month follow-up period. OP carriage of Staphylococcus aureus and methicillin resistance was confirmed by qPCR. Results OP carriage of S. aureus was identified in 13 (6.8%) residents. Detection of S. aureus was significantly associated with an increased risk of mortality (adjusted HR [95% CI]: 9.7 [3.8–24.9], P < .0001), compared with non-carriers, independent of methicillin resistance. Staphylococcus aureus carriage demonstrated a stronger association with mortality risk than the total number of comorbidities at the univariate level (S. aureus HR [95% CI]: 7.2 [3.4–15.5], P < .0001 vs. comorbidity count HR [95% CI]: 1.1 [1.0–1.3], P = .03), and remained significant after multivariable adjustment. Staphylococcus aureus detection was significantly associated with total number of comorbidities (adjusted OR [95% CI]: 1.4 [1.0–2.0], P = .04). Conclusion OP S. aureus carriage predicts all-cause mortality in long-term aged care. We speculate that S. aureus carriage represents a marker of general health, including prior healthcare exposures. OP S. aureus carriage could contribute to estimations of general health in older individuals and thereby inform care strategies.
{"title":"Oropharyngeal Staphylococcus aureus is linked to higher mortality in long-term aged care residents","authors":"Sophie J Miller, Frank Zhang, Steven Taylor, Richard Woodman, Andrew P Shoubridge, Lito E Papanicolas, Geraint B Rogers","doi":"10.1093/ageing/afaf042","DOIUrl":"https://doi.org/10.1093/ageing/afaf042","url":null,"abstract":"Background Biological ageing, healthcare interactions, and pharmaceutical and environmental exposures in later life alter the characteristics of the oropharyngeal (OP) microbiome. These changes, including an increased susceptibility to colonisation by pathobiont species, have been linked with diverse health outcomes. Objectives To investigate the relationship between OP microbiome characteristics and all-cause mortality in long-term aged care residents. Methods OP swabs were collected from 190 residents of five aged care facilities in South Australia. Microbiota composition was assessed by shotgun metagenomics and related to health outcomes during a 12-month follow-up period. OP carriage of Staphylococcus aureus and methicillin resistance was confirmed by qPCR. Results OP carriage of S. aureus was identified in 13 (6.8%) residents. Detection of S. aureus was significantly associated with an increased risk of mortality (adjusted HR [95% CI]: 9.7 [3.8–24.9], P &lt; .0001), compared with non-carriers, independent of methicillin resistance. Staphylococcus aureus carriage demonstrated a stronger association with mortality risk than the total number of comorbidities at the univariate level (S. aureus HR [95% CI]: 7.2 [3.4–15.5], P &lt; .0001 vs. comorbidity count HR [95% CI]: 1.1 [1.0–1.3], P = .03), and remained significant after multivariable adjustment. Staphylococcus aureus detection was significantly associated with total number of comorbidities (adjusted OR [95% CI]: 1.4 [1.0–2.0], P = .04). Conclusion OP S. aureus carriage predicts all-cause mortality in long-term aged care. We speculate that S. aureus carriage represents a marker of general health, including prior healthcare exposures. OP S. aureus carriage could contribute to estimations of general health in older individuals and thereby inform care strategies.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Madden, Ciara Rice, Amanda Lavan, Desmond O’ Donnell, Conal Cunningham, Roman Romero-Ortuno, Susie O'Callaghan, Rose-Anne Kenny, Robert Briggs
Background While ambulatory blood pressure monitoring (ABPM) biomarkers can predict cardiovascular and cerebrovascular outcomes, little work to date has examined their link with falls. The objective of this study was to examine associations between ABPM biomarkers and further falls in a cohort of older people with recent falls. Methods A consecutive series (n = 118) of patients≥70 years undergoing falls assessment including 24-hour ABPM were recruited and followed to their next clinical appointment, where incident falls were recorded (minimum follow-up 1 month). ABPM biomarkers included standard deviation for overall systolic blood pressure (sBP), minimum sBP value, sBP values <100 mmHg, sBP dipping (normal dipping>10%, non-dipper 0–10%, reverse dipper <0%) and sBP morning surge (average 2-hour post-awakening sBP minus the lowest night-time sBP). Logistic regression models assessed the relationship between ABPM biomarkers and further falls. Results One quarter of participants reported a further fall at mean 7 months’ follow-up. Hypotensive episodes were independently associated with further falls, odds ratio 4.52 (95% CI 1.56, 13.11); P = .006). Minimum sBP values were also independently associated with further falls, with a 3% reduction in falls for every 1 mmHg increase in sBP (adjusted odds ratio 0.97 (95% CI 0.94, 0.99); P = .027)). For every increase in morning surge by 1 mmHg, there was a 6% increase in falls (adjusted odds ratio 1.06 (95% CI 1.02, 1.10); P = .005). There was no association between dipping status and further falls. Discussion ABPM biomarkers may represent important modifiable risk factors for future falls, and ABPM should be integrated into a comprehensive falls assessment in older patients.
{"title":"Can ambulatory blood pressure biomarkers predict future falls amongst older people?","authors":"Rachel Madden, Ciara Rice, Amanda Lavan, Desmond O’ Donnell, Conal Cunningham, Roman Romero-Ortuno, Susie O'Callaghan, Rose-Anne Kenny, Robert Briggs","doi":"10.1093/ageing/afaf049","DOIUrl":"https://doi.org/10.1093/ageing/afaf049","url":null,"abstract":"Background While ambulatory blood pressure monitoring (ABPM) biomarkers can predict cardiovascular and cerebrovascular outcomes, little work to date has examined their link with falls. The objective of this study was to examine associations between ABPM biomarkers and further falls in a cohort of older people with recent falls. Methods A consecutive series (n = 118) of patients≥70 years undergoing falls assessment including 24-hour ABPM were recruited and followed to their next clinical appointment, where incident falls were recorded (minimum follow-up 1 month). ABPM biomarkers included standard deviation for overall systolic blood pressure (sBP), minimum sBP value, sBP values &lt;100 mmHg, sBP dipping (normal dipping&gt;10%, non-dipper 0–10%, reverse dipper &lt;0%) and sBP morning surge (average 2-hour post-awakening sBP minus the lowest night-time sBP). Logistic regression models assessed the relationship between ABPM biomarkers and further falls. Results One quarter of participants reported a further fall at mean 7 months’ follow-up. Hypotensive episodes were independently associated with further falls, odds ratio 4.52 (95% CI 1.56, 13.11); P = .006). Minimum sBP values were also independently associated with further falls, with a 3% reduction in falls for every 1 mmHg increase in sBP (adjusted odds ratio 0.97 (95% CI 0.94, 0.99); P = .027)). For every increase in morning surge by 1 mmHg, there was a 6% increase in falls (adjusted odds ratio 1.06 (95% CI 1.02, 1.10); P = .005). There was no association between dipping status and further falls. Discussion ABPM biomarkers may represent important modifiable risk factors for future falls, and ABPM should be integrated into a comprehensive falls assessment in older patients.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Jolliffe, Taya A Collyer, Ka Hei Sun, Lisa Done, Siobhan Barber, Michele L Callisaya, David A Snowdon
Background Geriatric Evaluation and Management (GEM) services provide subacute care for older adults with complex conditions. Meaningful activities are important for preventing functional decline in hospitalised older adults; however, no studies have evaluated GEM inpatients’ participation in such activities. Objective To determine the proportion of time GEM inpatients spend performing meaningful activities during the day and investigate whether ward environments and day of the week are associated with activity levels. Method This observational study used behavioural mapping to audit inpatients across three GEM wards. Observations were made at 10-minute intervals over 12 consecutive hours on weekdays and 10.5 hours on weekend days. Activities were categorised as physical, cognitive or social. Logistic mixed models were used to analyse factors associated with engagement in meaningful activities. Results In total, 60 030 minutes were observed among 70 inpatients. Overall, GEM inpatients spent 16%, 6% and 18% of observed time in physically, cognitively and socially meaningful activities, respectively. Weekend days were associated with higher odds of cognitive engagement (OR 4.79, 95% CI 1.71–13.41, P = .003) but lower odds of social engagement (OR 0.57, 95% CI 0.38–0.85, P = .006). Time spent outside patients’ rooms was positively associated with all types of meaningful activities. The odds of physically meaningful activity were not found to vary between weekends and weekdays. Conclusions GEM inpatients demonstrate lower engagement in meaningful activities compared to rehabilitation contexts. The positive association between activity levels and time spent outside patients’ rooms emphasises the importance of accessible communal areas. Interventions to promote active participation are needed in inpatient GEM settings.
{"title":"Geriatric evaluation and management inpatients spend little time participating in physically, cognitively or socially meaningful activity: a time–motion analysis","authors":"Laura Jolliffe, Taya A Collyer, Ka Hei Sun, Lisa Done, Siobhan Barber, Michele L Callisaya, David A Snowdon","doi":"10.1093/ageing/afaf043","DOIUrl":"https://doi.org/10.1093/ageing/afaf043","url":null,"abstract":"Background Geriatric Evaluation and Management (GEM) services provide subacute care for older adults with complex conditions. Meaningful activities are important for preventing functional decline in hospitalised older adults; however, no studies have evaluated GEM inpatients’ participation in such activities. Objective To determine the proportion of time GEM inpatients spend performing meaningful activities during the day and investigate whether ward environments and day of the week are associated with activity levels. Method This observational study used behavioural mapping to audit inpatients across three GEM wards. Observations were made at 10-minute intervals over 12 consecutive hours on weekdays and 10.5 hours on weekend days. Activities were categorised as physical, cognitive or social. Logistic mixed models were used to analyse factors associated with engagement in meaningful activities. Results In total, 60 030 minutes were observed among 70 inpatients. Overall, GEM inpatients spent 16%, 6% and 18% of observed time in physically, cognitively and socially meaningful activities, respectively. Weekend days were associated with higher odds of cognitive engagement (OR 4.79, 95% CI 1.71–13.41, P = .003) but lower odds of social engagement (OR 0.57, 95% CI 0.38–0.85, P = .006). Time spent outside patients’ rooms was positively associated with all types of meaningful activities. The odds of physically meaningful activity were not found to vary between weekends and weekdays. Conclusions GEM inpatients demonstrate lower engagement in meaningful activities compared to rehabilitation contexts. The positive association between activity levels and time spent outside patients’ rooms emphasises the importance of accessible communal areas. Interventions to promote active participation are needed in inpatient GEM settings.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Denise Wilfling, Anja Kühn, Frederike Lüth, Almuth Berg, Thomas Klatt, Gabriele Meyer, Jonas Dörner, Margareta Halek, Sascha Köpke, Martin Nikolaus Dichter, Ralph Möhler
Background People living with dementia often suffer from sleep disturbances. The MoNoPol-Sleep (multimodal, nonpharmacological intervention for sleep disturbances in people with dementia living in nursing homes) study aimed to develop and evaluate a multimodal, nonpharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes. Objectives To investigate implementation fidelity, adoption, barriers and facilitators of the multimodal, nonpharmacological intervention. Design Mixed-methods process evaluation alongside an exploratory cluster-randomised controlled trial. Setting Twenty-two nursing homes in three regions in Germany. Subjects Nursing staff, nursing home managers, sleep nurses and other target groups of the intervention from the participating nursing homes. Methods Questionnaires, qualitative interviews and documentation of the intervention’s implementation. Results The intervention was predominately implemented as planned, but implementation fidelity varied between the clusters. The most frequently planned and implemented sleep-promoting interventions were daytime activities. There is some evidence that person-centredness slightly increased in the intervention group. The commitment of nursing home managers, the motivation of nurses and good cooperation with the main contact persons of the research team were identified as facilitating context factors. Identified barriers were financial and time resources and low motivation of the nurses. The results of the cRCT have been published elsewhere. Conclusions For a successful implementation, involvement of nurses from day and night shifts and other stakeholders is crucial. Based on the results of this process evaluation conducted alongside an exploratory trial, the intervention can be adapted and further developed to evaluate its effectiveness in a future full trial. Clinical Trial Registration ISRCTN No ISRCTN36015309.
{"title":"Process evaluation of an intervention to reduce sleep problems in people living with dementia in nursing homes: a mixed-methods study","authors":"Denise Wilfling, Anja Kühn, Frederike Lüth, Almuth Berg, Thomas Klatt, Gabriele Meyer, Jonas Dörner, Margareta Halek, Sascha Köpke, Martin Nikolaus Dichter, Ralph Möhler","doi":"10.1093/ageing/afaf051","DOIUrl":"https://doi.org/10.1093/ageing/afaf051","url":null,"abstract":"Background People living with dementia often suffer from sleep disturbances. The MoNoPol-Sleep (multimodal, nonpharmacological intervention for sleep disturbances in people with dementia living in nursing homes) study aimed to develop and evaluate a multimodal, nonpharmacological intervention to prevent and reduce sleep disturbances in people with dementia living in nursing homes. Objectives To investigate implementation fidelity, adoption, barriers and facilitators of the multimodal, nonpharmacological intervention. Design Mixed-methods process evaluation alongside an exploratory cluster-randomised controlled trial. Setting Twenty-two nursing homes in three regions in Germany. Subjects Nursing staff, nursing home managers, sleep nurses and other target groups of the intervention from the participating nursing homes. Methods Questionnaires, qualitative interviews and documentation of the intervention’s implementation. Results The intervention was predominately implemented as planned, but implementation fidelity varied between the clusters. The most frequently planned and implemented sleep-promoting interventions were daytime activities. There is some evidence that person-centredness slightly increased in the intervention group. The commitment of nursing home managers, the motivation of nurses and good cooperation with the main contact persons of the research team were identified as facilitating context factors. Identified barriers were financial and time resources and low motivation of the nurses. The results of the cRCT have been published elsewhere. Conclusions For a successful implementation, involvement of nurses from day and night shifts and other stakeholders is crucial. Based on the results of this process evaluation conducted alongside an exploratory trial, the intervention can be adapted and further developed to evaluate its effectiveness in a future full trial. Clinical Trial Registration ISRCTN No ISRCTN36015309.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Emerging evidence suggests coronavirus disease 2019 (COVID-19) infection may increase the risk of developing dementia, although studies have reported conflicting findings. This meta-analysis aimed to synthesise the literature on the association between COVID-19 and the risk of new-onset dementia. Methods PubMed, Embase and Web of Science were searched for cohort studies or case–control studies that investigated new-onset dementia development among adult COVID-19 survivors compared to individuals without COVID-19 infection from inception to 9 November 2023. Studies that exclusively involved populations younger than 18 years, with known dementia or lacked adequate data about the risk of dementia were excluded. Two authors independently conducted the screening of eligible studies, data extraction and risk of bias assessment. The primary outcome was new-onset dementia following COVID-19 infection. Data were pooled using random-effects models, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Results A total of 15 retrospective cohort studies encompassing 26 408 378 participants were included. Pooled analysis indicated COVID-19 was associated with an increased risk of new-onset dementia (HR = 1.49, 95% CI: 1.33–1.68). This risk remained elevated when compared with non-COVID cohorts (HR = 1.65, 95% CI: 1.39–1.95), and respiratory tract infection cohorts (HR = 1.29, 95% CI: 1.12–1.49), but not influenza or sepsis cohorts. Increased dementia risk was observed in both males and females, as well as in individuals older than 65 years (HR = 1.68, 95% CI: 1.48–1.90), with the risk remaining elevated for up to 24 months. Conclusion This meta-analysis demonstrates a significant association between COVID-19 infection and increased risk of developing new-onset dementia, which underscores the need for cognitive monitoring and early intervention for COVID-19 survivors to address potential long-term neurological impacts.
{"title":"Risk of new-onset dementia following COVID-19 infection: a systematic review and meta-analysis","authors":"Qianru Zhang, Ragasudha Botta, Ying Xu, James Cheng-Chung Wei, Tao-Hsin Tung","doi":"10.1093/ageing/afaf046","DOIUrl":"https://doi.org/10.1093/ageing/afaf046","url":null,"abstract":"Background Emerging evidence suggests coronavirus disease 2019 (COVID-19) infection may increase the risk of developing dementia, although studies have reported conflicting findings. This meta-analysis aimed to synthesise the literature on the association between COVID-19 and the risk of new-onset dementia. Methods PubMed, Embase and Web of Science were searched for cohort studies or case–control studies that investigated new-onset dementia development among adult COVID-19 survivors compared to individuals without COVID-19 infection from inception to 9 November 2023. Studies that exclusively involved populations younger than 18 years, with known dementia or lacked adequate data about the risk of dementia were excluded. Two authors independently conducted the screening of eligible studies, data extraction and risk of bias assessment. The primary outcome was new-onset dementia following COVID-19 infection. Data were pooled using random-effects models, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. Results A total of 15 retrospective cohort studies encompassing 26 408 378 participants were included. Pooled analysis indicated COVID-19 was associated with an increased risk of new-onset dementia (HR = 1.49, 95% CI: 1.33–1.68). This risk remained elevated when compared with non-COVID cohorts (HR = 1.65, 95% CI: 1.39–1.95), and respiratory tract infection cohorts (HR = 1.29, 95% CI: 1.12–1.49), but not influenza or sepsis cohorts. Increased dementia risk was observed in both males and females, as well as in individuals older than 65 years (HR = 1.68, 95% CI: 1.48–1.90), with the risk remaining elevated for up to 24 months. Conclusion This meta-analysis demonstrates a significant association between COVID-19 infection and increased risk of developing new-onset dementia, which underscores the need for cognitive monitoring and early intervention for COVID-19 survivors to address potential long-term neurological impacts.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"91 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina Manietta, Mike Rommerskirch-Manietta, Daniel Purwins, Christiane Knecht, Martina Roes
Background Dementia-friendly hospitals are increasingly discussed in healthcare, politics, research and society as a way to improve hospital stays for people with dementia. However, the perspective of people with dementia is often underrepresented, and current definitions and concepts are primarily based on the expertise of healthcare professionals. Objectives To identify characteristics of a dementia-friendly hospital from the perspective of people with dementia. Methods A qualitative design embedded in a case study was used. We conducted 15 semi-structured interviews with people with dementia during their hospital stay. The interviews were analysed using reflexive thematic analysis with an inductive approach. In our study, we adopted a participatory approach and actively involved people with dementia and other stakeholders in the development of the interview guide and in the data analysis. Results The participants expect more than what’s necessary from a dementia-friendly hospital, as presented by eight characteristics identified: (i) The most important thing is how we treat each other; (ii) Someone cares about ME; (iii) No hully gully! I want professional care; (iv) Focusing on my goals; (v) LOOK! I’ve still got capabilities; (vi) Skipping Groundhog Day; (vii) A bit of both: mingle and single, and (viii) Recognising what relatives mean to me. Conclusion Our results highlight the importance of involving people with dementia in the development of dementia-friendly hospitals as only they have the lived experience and a different perspective from that of healthcare professionals.
{"title":"‘Firstly, I’m not treated like a fool.’—the perspective of people with dementia on a dementia-friendly hospital","authors":"Christina Manietta, Mike Rommerskirch-Manietta, Daniel Purwins, Christiane Knecht, Martina Roes","doi":"10.1093/ageing/afaf048","DOIUrl":"https://doi.org/10.1093/ageing/afaf048","url":null,"abstract":"Background Dementia-friendly hospitals are increasingly discussed in healthcare, politics, research and society as a way to improve hospital stays for people with dementia. However, the perspective of people with dementia is often underrepresented, and current definitions and concepts are primarily based on the expertise of healthcare professionals. Objectives To identify characteristics of a dementia-friendly hospital from the perspective of people with dementia. Methods A qualitative design embedded in a case study was used. We conducted 15 semi-structured interviews with people with dementia during their hospital stay. The interviews were analysed using reflexive thematic analysis with an inductive approach. In our study, we adopted a participatory approach and actively involved people with dementia and other stakeholders in the development of the interview guide and in the data analysis. Results The participants expect more than what’s necessary from a dementia-friendly hospital, as presented by eight characteristics identified: (i) The most important thing is how we treat each other; (ii) Someone cares about ME; (iii) No hully gully! I want professional care; (iv) Focusing on my goals; (v) LOOK! I’ve still got capabilities; (vi) Skipping Groundhog Day; (vii) A bit of both: mingle and single, and (viii) Recognising what relatives mean to me. Conclusion Our results highlight the importance of involving people with dementia in the development of dementia-friendly hospitals as only they have the lived experience and a different perspective from that of healthcare professionals.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"29 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Filiz Demirdağ, Esma Nur Kolbaşı, Kubra Yildiz Guler
Background The increase in fat tissue and the decrease in muscle mass with advancing age have prompted researchers to explore the coexistence of sarcopenia and obesity, i.e. sarcopenic obesity (SO). SO may lead to malnutrition due to poor diet quality, while malnutrition may contribute to SO by causing further muscle loss and metabolic imbalances. Objectives The aims were to investigate: (i) the prevalence of SO in community-dwelling older adults, (ii) the diagnostic ability of two different malnutrition methods, and (iii) the association between SO and malnutrition. Methods Community-dwelling older adults (≥65 years) were invited to participate. SO assessment was conducted based on the ESPEN/EASO consensus criteria. Malnutrition was evaluated based on both the Global Leadership Initiative on Malnutrition (GLIM) criteria and the Mini-Nutritional Assessment (MNA). Results Five hundred and ninety older adults (69.3% women, mean age: 74.31 ± 6.55 years) were included in the study. The overall prevalence of SO was 5.9% (n = 35). The prevalence of malnutrition was 23.9% according to the GLIM criteria, while it was 3.1% according to MNA. The agreement between the two measurements was ĸ = 0.32. There was no association between SO and malnutrition based on either GLIM (P: .06, OR: 1.971, 95% CI: 0.966–4.024) or MNA (P: .948, OR: 1.934, 95% CI: 0.119–7.306). Conclusions Even though the agreement for diagnosing malnutrition between GLIM criteria and MNA was fair, the number of participants diagnosed with malnutrition by GLIM criteria was almost eight times higher than MNA. No association was established between SO and malnutrition defined by GLIM or MNA. Clinical trial number NCT05122104.
{"title":"The association between sarcopenic obesity and malnutrition in community-dwelling older adults","authors":"Filiz Demirdağ, Esma Nur Kolbaşı, Kubra Yildiz Guler","doi":"10.1093/ageing/afaf040","DOIUrl":"https://doi.org/10.1093/ageing/afaf040","url":null,"abstract":"Background The increase in fat tissue and the decrease in muscle mass with advancing age have prompted researchers to explore the coexistence of sarcopenia and obesity, i.e. sarcopenic obesity (SO). SO may lead to malnutrition due to poor diet quality, while malnutrition may contribute to SO by causing further muscle loss and metabolic imbalances. Objectives The aims were to investigate: (i) the prevalence of SO in community-dwelling older adults, (ii) the diagnostic ability of two different malnutrition methods, and (iii) the association between SO and malnutrition. Methods Community-dwelling older adults (≥65 years) were invited to participate. SO assessment was conducted based on the ESPEN/EASO consensus criteria. Malnutrition was evaluated based on both the Global Leadership Initiative on Malnutrition (GLIM) criteria and the Mini-Nutritional Assessment (MNA). Results Five hundred and ninety older adults (69.3% women, mean age: 74.31 ± 6.55 years) were included in the study. The overall prevalence of SO was 5.9% (n = 35). The prevalence of malnutrition was 23.9% according to the GLIM criteria, while it was 3.1% according to MNA. The agreement between the two measurements was ĸ = 0.32. There was no association between SO and malnutrition based on either GLIM (P: .06, OR: 1.971, 95% CI: 0.966–4.024) or MNA (P: .948, OR: 1.934, 95% CI: 0.119–7.306). Conclusions Even though the agreement for diagnosing malnutrition between GLIM criteria and MNA was fair, the number of participants diagnosed with malnutrition by GLIM criteria was almost eight times higher than MNA. No association was established between SO and malnutrition defined by GLIM or MNA. Clinical trial number NCT05122104.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"43 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johanna Pöyhönen, Jenni Lehtisalo, Hanna-Maria Roitto, Esko Levälahti, Timo Strandberg, Miia Kivipelto, Jenni Kulmala, Riitta Antikainen, Hilkka Soininen, Jaakko Tuomilehto, Tiina Laatikainen, Tiia Ngandu
Background Frailty often precedes and co-occurs with dementia. A multidomain lifestyle intervention has shown favourable effects on cognition. We aimed to investigate if frailty status modifies this intervention effect. Methods The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) recruited 1259 participants aged 60–77 years who were at risk of dementia. They were randomised to receive a multidomain intervention (diet, exercise, cognitive training and vascular risk monitoring) or regular health advice for two years. The outcome was a change in cognition (neuropsychological test battery composite score). Frailty and prefrailty were defined according to the Fried phenotype. Mixed models were used to investigate if frailty status at baseline modified the intervention effect on cognition. Results Frailty status (prefrail/frail n = 520, robust n = 625) at baseline did not modify the effect of intervention on global cognition during the 2-year follow-up (P-value for frailty × intervention × time interaction > .05). Concerning cognitive subdomains, similar results were found. Among prefrail/frail persons, within-group analyses suggested a beneficial intervention effect on executive function and processing speed and also on global cognition when frail participants (n = 15) were excluded from the analyses. Being prefrail/frail was related to less improvement in global cognition, memory and executive function domains compared with being robust when intervention was not taken into consideration. Conclusions A multidomain intervention is likely to be beneficial to cognition regardless of frailty status. Prefrail participants seemed particularly responsive to preventive intervention. Thus, an optimal time for a multidomain lifestyle intervention may be at the prefrailty stage.
{"title":"Impact of frailty status on the effect of a multidomain lifestyle intervention on cognition","authors":"Johanna Pöyhönen, Jenni Lehtisalo, Hanna-Maria Roitto, Esko Levälahti, Timo Strandberg, Miia Kivipelto, Jenni Kulmala, Riitta Antikainen, Hilkka Soininen, Jaakko Tuomilehto, Tiina Laatikainen, Tiia Ngandu","doi":"10.1093/ageing/afaf041","DOIUrl":"https://doi.org/10.1093/ageing/afaf041","url":null,"abstract":"Background Frailty often precedes and co-occurs with dementia. A multidomain lifestyle intervention has shown favourable effects on cognition. We aimed to investigate if frailty status modifies this intervention effect. Methods The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) recruited 1259 participants aged 60–77 years who were at risk of dementia. They were randomised to receive a multidomain intervention (diet, exercise, cognitive training and vascular risk monitoring) or regular health advice for two years. The outcome was a change in cognition (neuropsychological test battery composite score). Frailty and prefrailty were defined according to the Fried phenotype. Mixed models were used to investigate if frailty status at baseline modified the intervention effect on cognition. Results Frailty status (prefrail/frail n = 520, robust n = 625) at baseline did not modify the effect of intervention on global cognition during the 2-year follow-up (P-value for frailty × intervention × time interaction &gt; .05). Concerning cognitive subdomains, similar results were found. Among prefrail/frail persons, within-group analyses suggested a beneficial intervention effect on executive function and processing speed and also on global cognition when frail participants (n = 15) were excluded from the analyses. Being prefrail/frail was related to less improvement in global cognition, memory and executive function domains compared with being robust when intervention was not taken into consideration. Conclusions A multidomain intervention is likely to be beneficial to cognition regardless of frailty status. Prefrail participants seemed particularly responsive to preventive intervention. Thus, an optimal time for a multidomain lifestyle intervention may be at the prefrailty stage.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"12 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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