BMC Geriatrics最新文献

Background: Population aging and the increase in memory-related diseases have motivated the search for accessible cognitive screening instruments. To develop a digital memory and learning test (DMLT) based on Rey's Auditory Verbal Learning Test (RAVLT) principles to assess cognition in the elderly and identify early cognitive decline.

Methods: The research was divided into two phases: developing the digital test and the experimental phase of comparison with a reference test. The test was designed to assess episodic declarative memory through auditory-verbal learning. The experimental procedure involved 18 elderly participants and aimed to compare the performance on the digital test with the traditional RAVLT, followed by an evaluation of participant satisfaction.

Results: Performance on the digital test and the RAVLT was comparable, with no significant statistical differences, indicating convergent validity between the instruments. Electroencephalographic activity analyses revealed correlations between wave patterns and test performance, suggesting that the digital test may provide additional insights into the neurophysiological processes underlying cognitive performance. Satisfaction assessment revealed high participant acceptance.

Conclusion: The DMLT is a promising tool for cognitive assessment in the elderly, offering an accessible alternative. The high acceptance among elderly participants suggests that the test has potential for clinical and research use, although further studies are needed to validate its effectiveness in broader clinical settings.

Background: Cognitive impairment is a common health problem among older adults. Previous studies have proven the association between sleep quality and cognitive impairment, but the specific underlying mechanisms need to be further explored. This study aimed to examine the relationship between sleep quality and cognitive impairment and the mediating effect of frailty in this relationship among the rural older adults.

Methods: Data from a cross-sectional study conducted in rural areas of Shandong Province from September to December in 2023. A total of 695 rural older adults were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Frailty was defined using the FRAIL scale. We assessed cognitive impairment using the Dementia Screening Interview (AD8). Logistic regression analyse was used to assess the relationship between sleep quality and cognitive impairment. And the Karlson-Holm-Breen (KHB) method was performed to test the mediating role of frailty in this relationship.

Results: After adjusting for all covariates, sleep quality was significantly associated with cognitive impairment (OR = 1.047, 95% CI: 1.005-1.090). Frailty mediated the relationship between sleep quality and cognitive impairment, with a mediation effect value of 0.010 (95% CI: 0.001-0.020), accounting for 17.86% of the total effect.

Conclusions: We found there was an association between sleep quality and cognitive impairment, and frailty mediated the above relationship. Comprehensive intervention measures should be taken to reduce the incidence of frailty in the older adults and to improve their sleep quality, thereby preventing and delaying the occurrence and development of cognitive impairment.

Background: A scarcity of data exists concerning atrial fibrillation (AF) during the perioperative stage of non-cardiothoracic surgery, particularly orthopedic surgery. In addition, given the frequency and significant impact of AF in the perioperative period, therefore our aim was to identify prognosis and predictors of elderly hip fracture patients with perioperative AF.

Methods: An examination of hip fracture patients at the Third Hospital of Hebei Medical University, who had been hospitalized from January 2018 to October 2020 in succession, was conducted retrospectively. To determine independent risk factors for paroxysmal AF in elderly hip fracture patients, univariate and multivariate logistic regression analysis were employed. The Kaplan-Meier survival curve demonstrated the correlation between all-cause mortality in the non-AF, paroxysmal AF, and permanent AF groups. An assessment of the correlation between baseline factors, complications, and all-cause mortality was conducted through univariable and multivariable Cox proportional hazards analysis.

Results: Enrolling 1,376 elderly patients with hip fractures, we found 1,189 in the non-AF group, 103 in the paroxysmal AF group, and 84 in the permanent AF group. Kaplan-Meier survival curves revealed a significantly lower overall survival rate in elderly hip fracture patients with AF, especially permanent AF. Based on COX regression analysis, we found that the main risk factors for all-cause death in elderly hip fracture patients with AF were concomitant pulmonary infection(HR 2.006,95%CI 1.019-3.949, P = 0.044), hyponatremia(HR 2.417,95%CI 1.177-4.961, P = 0.016), permanent AF(HR 2.806, 95%CI 1.036-4.198, P = 0.039). Independent risk factors for perioperative paroxysmal AF in elderly hip fracture patients were hypertension(OR 2.248, 95% CI 1.415-3.571, P = 0.001), COPD(OR 4.694, 95% CI 2.207-9.980, P < 0.001) and ACCI(OR 1.436, 95%CI 1.072-1.924, P = 0.015).

Conclusions: The mortality risk is high in elderly patients with hip fractures combined with AF. The independent risk factors for their death include permanent AF, pulmonary infection and hyponatremia. The independent risk factors for perioperative paroxysmal AF in elderly patients with hip fractures are ACCI, hypertension and COPD. we should identify risk factors and optimize the treatment plan at an early stage.

Background: The prevalence of age-related eye disorders is increasing with the aging of the global population. Community-based visual health education for the elderly has become a crucial intervention. With the advancement of technology, the application of extended reality (XR), such as virtual reality (VR) and augmented reality (AR), in health education has become more popular. This study aims to assess the effectiveness of educating the elderly about common age-related eye disorders through a novel AR-based health education workshop.

Methods: An AR-based education workshop was designed for the elderly to understand the major visual symptoms of several eye diseases and experience the challenges faced by visually impaired people. The effectiveness of the workshop was assessed by conducting pre- and post-activity surveys to measure the knowledge acquisition of the participants from this workshop.

Results: The intervention was found to significantly improve knowledge of age-related eye diseases among the elderly, while the participants' age and education level could influence the effectiveness of their knowledge gained from the workshop.

Conclusions: Our study revealed the potential of the use of AR technology in facilitating health education on eye diseases in the elderly. The specific backgrounds and characteristics of target participants and the combination of AR with other pedagogical approaches warrant further investigation to maximize the impact of AR-based workshops in health education in broader healthcare contexts.

Background: Comprehensive Geriatric Assessment is the gold standard of clinical care for older patients but its application in the primary care setting is limited, possibly due to its time-consuming process. Hence, a brief geriatric assessment could be a feasible alternative. We conducted a scoping review to identify which brief geriatric assessment tools have been evaluated or implemented in primary and community care settings and to identify the domains assessed including their reported outcomes.

Methods: CENTRAL, PubMed and Embase were searched using specific text words and MeSH for articles published from inception that studied evaluation or implementation of brief geriatric assessments in primary care or community setting.

Results: Twenty-five articles were included in the review, of which 11 described brief geriatric assessments implemented in community, nine in primary care and five in mixed settings. Physical health, functional, mobility/balance and psychological/mental emerged as four domains that are most assessed in brief geriatric assessments. Self-reported questionnaire is the key approach, but uncertainty remains on the validity of subjective cognitive assessments. Brief geriatric assessments have been administered by non-healthcare professionals. The duration taken to complete ranged from five to 20 min. Studies did not report significant change in the clinical outcomes of older adults except for better identification of those with higher needs.

Conclusion: The studies reported that brief geriatric assessments could identify older adults with unmet needs or geriatric syndromes, but they did not report improved health outcomes when combined with clinical intervention pathways. Clarity of brief geriatric assessments' questions is important to ensure the feasibility of using self-administered questionnaire by older adults. Future studies should determine which groups of older adults benefit the most from the brief assessments when these are paired with additional evaluations and interventions.

Background: To our knowledge capture-recapture techniques have not been used to estimate dementia prevalence using routinely collected data in England, nor have they been used to estimate changes in undiagnosed dementia over time. In this study we aimed to use routinely collected electronic health records to estimate the number of undiagnosed dementia cases there are in England and how this has changed over time. We also aimed to assess whether proportion of undiagnosed cases differed by age group, ethnicity, socioeconomic deprivation and sex.

Methods: We used routinely collected primary care data linked to hospital episode statistics from 1997 to 2018. We tabulated capture of dementia in each of the two datasets and used the Lincoln-Petersen estimator to estimate numbers of missing dementia diagnoses per year along with the estimated total number of cases and the proportion of cases identified. We calculated age and sex-adjusted prevalence of dementia for each year and used proportion of cases identified to estimate the underlying population prevalence of dementia per year. We conducted beta regression to estimate how sex, age band, deprivation and ethnic group affects the proportion of dementia cases identified, adjusting for year.

Results: Proportion of cases out of the estimated total that were identified, rose from 42.4% in 1997 to 84.4% in 2018. Estimated population prevalence of dementia rose from 1997 to a high of 4.4% in 2018 in those aged ≥ 65. Proportion of dementia cases identified did not vary by sex but a lower proportion of those from the South Asian ethnic group were diagnosed compared to the White population (coeff -0.115, 95% CI -0.218 to -0.011). Compared to those aged 65-74, those aged 75-84 and 85 + had higher proportions of dementia diagnosed (75-84 Coeff 0.259, 95% CI 0.153-0.366; 85 + Coeff 0.185, 95% CI 0.079-0.291). Those living in the two most deprived areas had a higher proportion of dementia diagnosed compared to the least deprived area (IMD quintile 4 vs 1 coeff 0.093, 95% CI 0.014 to 0.173, IMD quintile 5 vs 1 coeff 0.162, 95% CI 0.083 to 0.242).

Conclusions: Proportion of dementia cases identified has increased over time and results indicate that underlying prevalence of dementia may be lower than previously estimated but this needs replication. Greater focus needs to be given to those with dementia onset at younger ages and those from South Asian backgrounds as dementia is relatively under-diagnosed in these groups.

Introduction: Calf muscular vein thrombosis (CMVT) is a type of distal deep vein thrombosis, which is common in geriatric hip fracture patients. However, studies focusing on whether the orthopedic operation has an impact on the prognosis of geriatric hip fracture patients with CMVT are very limited. Therefore, the aim of this study was to explore whether geriatric hip fractures with CMVT affect the mortality of patients within one year postoperatively. The difficulty of the operation, postoperative complications, the status of thrombosis, and function scores were also compared.

Materials and methods: Geriatric hip fracture patients who underwent surgery between January 2019 and January 2021 were included. Patients were divided into groups with and without CMVT by preoperative color Doppler ultrasound examination. Propensity score-matching (PSM) was performed in a ratio of 1:1 between the patient with and without CMVT groups. Baseline characteristics, laboratory results, perioperative indicators and prognosis of patients were collected retrospectively. Intraoperative and postoperative comparisons were conducted between patients with and without CMVT.

Results: Two hundred and sixty geriatric hip fracture patients were included. Eighty-nine patients in each group were matched after PSM. There was no significant difference in mortality between the two groups at one-month, three-month, six-month, and one-year postoperatively. However, patients with CMVT had longer hospital stays, a higher incidence of postoperative complications, and a higher incidence of thrombosis progression than patients without CMVT in the follow-up.

Conclusion: No significant difference in mortality within one year postoperatively was observed in Chinese geriatric hip fracture patients with or without CMVT formation. Strategies such as close monitoring the status of thrombosis, individualized care, and strengthening rehabilitation are recommended to reduce the risk of complications and optimize patient outcomes in this patient population.

Trial registration: Chinese Clinical Trial Registry (ChiCTR2300069411). Registered March 15, 2023, https://www.chictr.org.cn/showproj.html?proj=192079 .

Background: Everyday life in residential long-term care is widely portrayed as boring. However, empirical evidence on this topic remains limited, particularly for the vulnerable group of people living with dementia. A better understanding of everyday life and the associated experiences of boredom could facilitate the development of practical strategies to reduce boredom in this target group. The aim of this study is therefore to analyse everyday activities, daily routines and the frequency and types of boredom in people living with dementia in residential long-term care.

Data and methods: In five long-term care facilities, participants were observed for two days in 20-minute time slots (from 7 am to 7 pm) using the Maastricht Electronic Daily Live Observation Tool. Semi-structured interviews were conducted with people living with dementia about their daily routines and experiences of boredom. Qualitative content analysis based on Mayring was applied, using the five boredom types from Goetz et al. as deductive categories. Observational data was analysed descriptively and merged with qualitative data on daily routines. In all, 46 people living with dementia (average age: 84.65 ± 7.15 years, 89.13% female, average DSS: 6.50 ± 3.15) were observed at 2760 time points. Of these, 17 participants took part in the interviews.

Results: The residents spend 47.5% of their day doing nothing and follow a routine that is strongly determined by communal meals. 62.5% of participants are bored, with 18.5% describing boredom as a constant/prevalent condition in their everyday lives. All five types of boredom are reflected in the interviews, with apathetic boredom being the most common.

Conclusions: Although people living with dementia follow almost the same daily routine in residential long-term care, they experience everyday life very differently, ranging from no boredom, to feelings of pleasant relaxation when bored to strongly negative feelings such as hopelessness and frustration. These findings suggest that interventions to prevent or reduce boredom need to be personalised in order to effectively combat the highly individual nature of boredom. Person-centred dementia care provides a valuable intervention strategy to meet this requirement.

Clinical trial number: Not applicable.