BMC Geriatrics最新文献

Background: In community settings, relatives often provide care to their older family members, which is sometimes perceived as a high burden, overwhelming and stressful, contributing to an increased risk of elder abuse. In most countries, relatives have no legal obligation to provide care when family members are admitted to nursing homes; nevertheless, studies have shown that relatives continue to provide emotional, instrumental, and personal care after admission, often related to the understaffing and high workload of nursing staff. Despite the growing interest in elder abuse in nursing homes, most studies have concentrated on the abuse perpetrated by nursing staff or co-residents, but few studies have explored the abuse that relatives may perpetrate.

Methods: This study was a cross-sectional survey of 3,693 nursing staff members recruited from 100 nursing homes in Norway, to examine the extent of relative-to-resident abuse in Norwegian nursing homes, as observed by nursing staff.

Results: The findings indicate that 45.6% of the nursing staff had observed one or more episodes of relative-to-resident abuse during the past year. Among the subtypes of abuse, 44.8% of the nursing staff had observed psychological abuse, 8.4% had observed physical abuse, 2.7% had observed financial/material abuse, and 0.7% had observed sexual abuse at least once during the past year.

Conclusions: This is the first large study exploring the extent of relative-to-resident abuse in nursing homes, which is a phenomenon that is significantly less addressed than abuse committed by staff and co-residents. The findings in our study illustrate that abuse committed by relatives needs more awareness and attention to improve the well-being of nursing home residents. Further research is recommended to enhance our understanding of such abuse and should include other approaches measuring the proportion of relative-to-resident abuse, as relying solely on staff observations is insufficient for determining the prevalence in this case. Future studies should also examine the cumulative impact of victimization in nursing homes and should include an analysis of how cases of abuse are reported and handled.

Background: Health literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people's HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.

Methodology: Relevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and "Quality Assessment Criteria for Survey Research Reports".

Results: A total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.

Conclusion: Based on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

Background and aim: Given the rapid technological advancements and increased usage of digital tools, understanding older people's attitudes toward technology is vital. Assessing their views can help identify barriers and facilitators to adoption. This understanding is essential for developing effective educational strategies and user-friendly technologies that enhance seniors' quality of life. Therefore, the present study aimed to psychometrically evaluate the scale for measuring attitudes-both willingness and anxiety-toward technology (TechPH) in Iranian older adults.

Methods: This methodological study was conducted on 420 older individuals (aged 60 and above) in Tehran in 2024 to perform a psychometric test of the attitudes toward technology scale (TechPH). Validation was carried out using translation validity methods, including translation-back translation with bilingual experts (n = 2), face validity with a sample of the older population (n = 10), content validity with a panel of 11 experts, and construct validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) (n = 420). Instrument reliability was determined through test-retest and internal consistency (Cronbach's alpha) methods with a sample of older individuals (n = 30). Data analysis was performed using SPSS version 16 and EQS 6.4 software.

Results: A comparison of Persian and English translations revealed acceptable translation validity and cultural adaptability for the scale. Each item's Content Validity Index (CVI) and Content Validity Ratio (CVR) were determined, with a total average CVI of 0.95. The results of EFA indicated that the sample size was adequate, as shown by the KMO value of 0.754. Additionally, Bartlett's sphericity test demonstrated a significant correlation between the items (χ² = 221.819, df = 15, P < 0.0001). EFA revealed that two extracted factors explained 41.002% and 18.111% of the total variance. Furthermore, CFA yielded suitable estimates based on the general fit indices of the model (RMSEA = 0.061, IFI = 0.979, GFI = 0.983, CFI = 0.978, CMIN/DF = 1.769, MFI = 0.989, AGFI = 0.942). In evaluating test-retest stability and internal consistency, the values of the Intra-class Correlation Coefficient (ICC) and Cronbach's α were 0.85 and 0.77, respectively, indicating appropriate reliability for the scale.

Conclusion: P.TechPH, the first Persian version of the scale for measuring technophilia and technophobia among Iranian older people, has favorable psychometric properties. It can serve as a standard tool for assessing older people's attitudes toward technology in various studies.

Background: The prevalence of abnormal electrocardiography (ECG) increases with aging, and these abnormalities may have an impact on anesthesia management. Although a normal ECG does not guarantee a healthy heart, an abnormal ECG can quickly identify a patient who is at high risk of cardiac complications.

Objective: The aim of this study was to determine the prevalence and associated factors of preoperative abnormal electrocardiography among older surgical patients at selected teaching hospitals in southern Ethiopia, from February 15 to June 15, 2022.

Methodology: A multicenter cross-sectional study was conducted at three randomly selected teaching hospitals in southern Ethiopia on 246 elderly surgical patients recruited consecutively. Data were entered into Epidata version 4.6, then exported and analyzed in STATA version 16. A binary logistic regression model was used to examine factors associated with abnormal ECG, and variables with a P-value < 0.2 were entered into the multivariate analysis to identify independent factors. Both crude and adjusted odds ratios were reported, and a P-value < 0.05 was considered statistically significant. The data were presented using frequencies, tables, charts, and figures.

Result: In the current study, 120 (48.78%) of older surgical patients had abnormal preoperative ECGs. In terms of severity, 55.3% were classified as minor, while 44.16% were major ECG abnormalities. The most common ECG abnormalities were left axis deviation (LAD), left ventricular hypertrophy (LVH), and ST segment changes. The presence of comorbidity (AOR = 3.44, P = 0.001), age ≥ 70 years (AOR = 2.5, P = 0.011), history of angina (AOR = 5.9, P = 0.011), history of smoking (AOR = 5.07, P = 0.024) and urban residency (AOR = 1.89, P = 0.039) were the strongest risk factors for an abnormal ECG.

Conclusion and recommendation: Our study shows that older patients are more likely to have an abnormal ECG before surgery, regardless of symptoms or risk factors. Therefore, it is suggested that all older patients undergo preoperative ECG screening. Further prospective cohort studies are needed to investigate the impact and outcome of patients with preoperative abnormal ECG.

Background: Pressure sores significantly affect elderly patients, with the sacrum being especially vulnerable, often due to its proximity to the anus and potential for fecal contamination. Despite preventive measures such as frequent repositioning and specialized cushions, some sores still necessitate surgical intervention. Postoperative care focuses on monitoring, hygiene, and pressure alleviation. This study assessed the efficacy of Closed-Incision Negative Pressure Wound Therapy (CI-NPWT) for postoperative wound management in patients with sacral pressure sores treated with local flaps.

Methods: A retrospective analysis was performed on sacral sore patients who underwent reconstructive surgery from March 2019 through April 2023. Surgical procedures involved debridement and wound coverage using gluteal artery perforator-based fasciocutaneous flaps, followed by postoperative monitoring. Patients were grouped into conventional monitoring or NPWT management, with the latter utilizing the INFOV.A.C. The therapy unit was calibrated to 125 mmHg. Data on patient demographics, flap metrics, fluid drainage amounts, and six-month postoperative outcomes were collected, and then analyzed with SPSS Statistics.

Results: In this study of 52 patients with sacral pressure sores, the NPWT group (n = 25) showed significantly fewer flap complications and a lower drainage volume on the seventh postoperative day (mean 17.2 cc) compared to the conventional dressing group (mean 27.8 cc, P < 0.05). No postoperative complications were observed in the NPWT group, whereas the conventional group (n = 27) experienced one infection and three cases of dehiscence. Both groups achieved a 100% flap survival rate.

Conclusion: Closed-incision negative pressure wound therapy (CI-NPWT) shows promise in reducing wound dehiscence and infection rates in elderly patients undergoing sacral pressure sore reconstruction with local flaps. However, further research with larger, randomized studies is needed to confirm its effectiveness as an alternative to conventional postoperative care.

Trial registration: The study was retrospectively registered by the Institutional Review Board of Seoul Metropolitan Government-Seoul National University Boramae Medical Center (No. 20-2023-25, Date: Mar. 24 2023).

Background: This study aims to investigate the relationships between the Chinese Healthy Eating Index (CHEI), psychological balance, depressive symptoms, and cognitive function in the rural older population. Additionally, it examines the impact of CHEI on cognitive function and the potential chain mediating roles of psychological balance and depressive symptoms.

Methods: The study utilized data from 2,552 rural older adults aged 65 and above, drawn from the Chinese Longitudinal Healthy Longevity Study (CLHLS). The CHEI was self-reported, with scores ranging from 0 to 50, representing adherence to healthy eating habits. Psychological balance was assessed using status and personality-emotion characteristics recorded in the database, with scores ranging from 6 to 30. Cognitive function was measured using the Mini-Mental State Examination (MMSE), with scores ranging from 0 to 30; higher scores indicated better cognitive function. Depressive symptoms were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with scores ranging from 0 to 30, where higher scores reflected more severe depressive symptoms.

Results: The median CHEI score was 40.0 (IQR: 34.0-45.0), reflecting moderate adherence to healthy dietary practices. The median Psychological Balance score was 19.0 (IQR: 17.0-21.0), and the median Depressive Symptoms score was 13.0 (IQR: 10.0-15.0), indicating mild depressive symptoms among participants. Additionally, the median Cognitive Function score was 28.0 (IQR: 27.0-29.0), suggesting relatively stable cognitive abilities within the sample. Correlational analysis revealed the following: (1) Depressive symptoms were negatively correlated with both cognitive function (r_s = -0.100, p < 0.001) and CHEI (r_s = -0.206, p < 0.001), as well as with psychological balance (r_s = -0.142, p < 0.001). (2) CHEI was positively correlated with both cognitive function (r_s = 0.144, p < 0.001) and psychological balance (r_s = 0.131, p < 0.001). (3) Cognitive function was also positively correlated with psychological balance (r_s = 0.096, p < 0.001). Mediation analysis demonstrated that both psychological balance and depressive symptoms partially mediated the relationship between CHEI and cognitive function, forming a chain-mediating effect.

Conclusion: The Chinese Healthy Eating Index was found to have a direct positive impact on cognitive function in rural older adults. Furthermore, it exerted an indirect effect through the independent and chain-mediating roles of psychological balance and depressive symptoms. These findings suggest that dietary adherence can influence cognitive health not only directly but also by improving psychological well-being and reducing depressive symptoms.

Background: In questionnaire surveys, questions about self-reported number of teeth (SRNT) are often used as a measure oral health. This study investigated the validity of SRNT in older Japanese people.

Methods: In total, 4984 75- and 80-year-old patients who underwent dental examinations were enrolled. A self-administered questionnaire that asked about the number of teeth was used in the analysis. The percentage agreement and kappa value were calculated for the agreement between SRNT and observed numbers of teeth. To identify factors that affect the reliability of SRNT, a logistic regression analysis was performed using correctness of SRNT as the dependent variable.

Results: Among the 3950 participants who responded as to whether they had ≥ 20 teeth, the degree of agreement was 92.9% (kappa value 0.856, p < 0.001) in an objective evaluation. Of the 2621 participants who reported their numbers of teeth, the SRNT and observed number of teeth matched in 57.5% (kappa value 0.559; p < 0.001). Observed number of teeth and annual dental checkup had a significant effect on the accuracy of SRNT. Multivariate logistic regression analysis, with the agreement between SRNT and the observed number of teeth (i.e. whether the number of teeth exceeded 20) as the dependent variable, showed that the observed number of teeth, use of interdental cleaning tools, and annual dental checkup were significantly associated with the agreement between SRNT and the actual number of teeth. In multivariate analysis with tooth number agreement (± 1 tooth) as the dependent variable, the observed number of teeth and use of interdental cleaning tools were significantly associated with the agreement between SRNT and the observed number of teeth.

Conclusion: Although SRNT did not perfectly match the observed numbers of teeth, the results of this study imply that the SRNT of older people is reliable and useful in epidemiological studies.

Background: As the global aging population expands, understanding older adults' preferences for place of death becomes pivotal in ensuring person-centered end-of-life care.

Objective: This study aimed to investigate the influence of sociodemographic, health, and lifestyle-related factors on end-of-life care preferences of older adults in South Tyrol, Italy.

Methods: Employing a cross-sectional design, a population-based survey was conducted with a stratified probabilistic sample of adults aged ≥ 75 years in South Tyrol (Autonomous Province of Bolzano/Bozen, Italy). From a randomly selected sample of 3,600 older adults, participants were invited to respond to a questionnaire that included items on older adults' preferences for place of death and socio-demographic and health- and lifestyle-related factors, including frailty (e.g., PRISMA-7). Descriptive and multinomial logistic regression analyses were performed.

Results: The majority (55.3%) of the 1,695 older adults (participation rate: 47%) expressed a preference for dying at home and 12.7% indicated a desire for specialized end-of-life care in a healthcare facility. However, 27.9% refrained from disclosing their end-of-life care preferences. The factors influencing these preferences concerning the place of death included age, native language, educational level, living situation, and community. Compared to the preference of dying at own home or home of family or friends, older adults aged ≥ 85 years (OR = 0.57, P = 0.002) and living in an urban area (OR = 0.40, P < 0.001) were less likely to prefer dying at a hospital, palliative care unit, or hospice. Older adults living alone (OR = 1.90, P < 0.001), Italian-speaking (OR = 1.46, P = 0.03), and those with an educational level above high school (OR = 1.69, P = 0.002) were more likely to prefer dying at a hospital, palliative care unit, or hospice.

Conclusions: End-of-life care preferences among older adults in South Tyrol were associated with socio-demographic, yet not health- and lifestyle-related factors. Recognizing and integrating these preferences is essential for developing, implementing, and evaluating interventions to promote advance care planning and provide effective, patient-centered end-of-life care.

Background: Aging is an irreversible progressive decline in physical function. Graves' disease (GD) is a common cause of hyperthyroidism and is characterized by elevated levels of the thyroid hormone (TH). High TH levels are associated with aging and a shortened lifespan. The causal relationship between GD and aging has yet to be investigated.

Methods: We used genome-wide association study (GWAS) datasets and Mendelian randomization (MR) analysis to explore the causal link between GD and aging. To assess the statistical power of instrumental variables (IVs), F-statistics and R² were used. MR analysis was conducted using inverse-variance weighting (IVW), MR-Egger, weighted median, and weighted mode. The odds ratio (OR) and 95% CI were calculated to estimate the relative risk of GD to the outcomes. The Cochran Q test, I², MR-PRESSO test, and MR-Egger regression intercept were calculated using statistical and leave-one-out analyses to test the heterogeneity, horizontal pleiotropy, and stability of the IVs on the outcomes.

Results: F-statistics of the five IVs were greater than 10, and the R² values ranged from 0.033 to 0.156 (R² > 0.01). According to the results of the IVW analysis, GD had no causal effect on facial aging (p = 0.189), age-related macular degeneration (p = 0.346), and Alzheimer's disease (p = 0.479). There was a causal effect of GD on the remaining outcomes: telomere length (TL) (OR = 0.982; 95%CI:0.969-0.994; p = 0.004), senile cataract (OR = 1.031; 95%CI:1.002-1.060; p = 0.033), age-related hearing impairment (OR = 1.009; 95%CI:1.004-1.014; p = 0.001), chronic obstructive pulmonary disease (COPD) (OR = 1.055; 95%CI:1.008-1.103; p = 0.020), and sarcopenia (OR = 1.027; 95%CI:1.009-1.046; p = 0.004).

Conclusions: GD accelerates the occurrence of age-related phenotypes including TL, senile cataracts, age-related hearing impairment, COPD, and sarcopenia. In contrast, there are no causal linkages between GD and facial aging, age-related macular degeneration, or Alzheimer's disease. Further experimental studies could be conducted to elucidate the mechanisms by which GD facilitates aging, which could help slow down the progress of aging.

Objectives: Observe the effect of integrated care for older people on intrinsic capacity in elderly patients.

Methods: Sixty elderly patients from department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between June 2021 and December 2021 were selected and divided into control group and intervention group with 30 patients in each group using random sampling method. Two groups implement routine care, and the intervention group implement integrated care by a "hospital-community-family" multidisciplinary team. After 12 weeks of intervention, the differences in frailty, cognition, depression scores, comprehension social support scores, and World Quality of Life Scale scores were compared between the two groups.

Results: Before intervention, there was no significant difference in the grip strength, step speed, frailty scores, cognition, depression scores, social support and quality of survival between the control group and the intervention group. After intervention, grip strength and depression scores improved both in the control group and the intervention group, but there was no difference between the two groups. Cognitive scores, comprehension social support and quality of survival scores improved only in the intervention group, while only the cognitive ability showed significant differences between the intervention group and the control group after 12 weeks of intervention (P<0.05).

Conclusions: Integrated care for older people intervention can help to improve the intrinsic capacity of the patients, especially cognitive abilities.