Geriatrics

13 pages, 1178 KiB

Open AccessArticle

What Combination of Generic Bedside Screening Tools Is Optimal to Capture Patients with Penetration/Aspiration Due to Dysphagia? Comparing Single Bedside Tools Versus Combinations of Tools for Sensitivity and Specificity

by Albert Westergren, David Smithard, Johannes Riis, Christina Emborg, Anne Lund Krarup and Dorte Melgaard

Geriatrics 2025, 10(3), 63; https://doi.org/10.3390/geriatrics10030063 (registering DOI) - 30 Apr 2025

Abstract

Background/Objectives: This study aimed to explore the validity of various generic bedside screening tools, and combinations of these, for capturing dysphagia as compared to aspiration/penetration found through the Flexible Endoscopic Evaluation of Swallowing (FEES). Methods: In this cross-sectional study, participants diagnosed with chronic pulmonary disease (n = 25), Parkinson’s disease (n = 26), multiple sclerosis (n = 24), or stroke (n = 25) participated. Patient-reported outcomes and clinical-rated assessments included: the four-question test (4QT), the Minimal Eating Observation Form—II, the Volume–Viscosity Swallow Test (V-VST), the Penetration–Aspiration Scale, and the FEES. Activities in daily living were assessed with the Barthel Index. The sensitivity, specificity, negative predictive value (NPV), positive predictive value, and accuracy were calculated. Results: The 100 participants’ median age was 72 years, and 42 were women. In total, 78 patients had eating difficulties (MEOF-II). According to the 4QT, 69 patients had dysphagia while 62 had it according to the V-VST. Furthermore, 29 patients had penetration/aspiration according to the FEES. All generic bedside tools performed better when combined with another tool, when compared to the identification of penetration/aspiration according to the FEES. The combination of the MEOF-II and 4QT as well as the combination of the MEOF-II and V-VST proved to have very high sensitivity (96.1–96.3%) and NPVs (92.3% in both instances). Combining the three tools, the MEOF-II, 4QT, and V-VST, did not improve the sensitivity or NPV. Conclusions: A combination of the MEOF-II and 4QT or the MEOF-II and V-VST bedside tools is recommended for identifying patients at risk of penetration/aspiration and in need of further in-depth clinical assessment. Full article

(This article belongs to the Section Dysphagia)

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10 pages, 344 KiB

Open AccessArticle

Validity and Reliability of the Self-Administered Timed Up and Go Test in Assessing Fall Risk in Community-Dwelling Older Adults

by Magda Reis, Maria Teixeira, Carlota Carvão and Anabela Correia Martins

Geriatrics 2025, 10(3), 62; https://doi.org/10.3390/geriatrics10030062 (registering DOI) - 29 Apr 2025

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Abstract

Objectives: This study aimed to evaluate the validity and reliability of the self-administered Timed Up and Go (TUG) test—a gold standard for fall risk screening—by comparing it to the traditional face-to-face assessment conducted by a physiotherapist. Methods: A total of 37 community-dwelling adults—mean age 61.78 ± 6.88, 73% female—who took part in fall risk screening actions in the central region of Portugal were assessed. The protocol included sociodemographic and history of falls questions, the Self-Efficacy for Exercise questionnaire, the Activities and Participation Profile Related to Mobility (PAPM), and three functional tests, namely the 10-Metre Walking Speed (10-MWS), TUG, and 30 Seconds Sit to Stand (30 s STS) tests. Within an interval of 18–24 h after the face-to-face moment, the participants were instructed to self-administer the TUG test at home. The validity and reliability of self-administered TUG test were examined using the limits of agreement, clinically acceptable limit, intra-class correlation coefficients (ICCs), paired t-tests, and Pearson’s coefficient correlation (r). Results: The limits of agreement for self-administered assessment were within the clinically acceptable limits. The average result of the face-to-face TUG test and the self-administered TUG test was 7.47 ± 2.45 and 7.57 ± 3.10 s, respectively. When comparing the two evaluations, they were strongly associated (r = 0.716, p < 0.001), with an excellent ICC of 0.82 (0.65–0.91), for a 95% confidence interval and significance level of 0.05 (p ≤ 0.05). Conclusions: The use of the self-administered TUG test for the screening of risk of fall, using low-cost technology, appears to be valid and reliable in community-dwelling adults aged 50 and above. Enabling older adults to perform the TUG test at home can empower them to take an active role in managing their health and ageing process, while also offering physiotherapists regular feedback for fall prevention. Full article

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12 pages, 547 KiB

Open AccessArticle

Home Caregivers of Elderly People: Perceptions and Quality of Life

by Luís Eduardo Genaro, José Victor Marconato, Aylton Valsecki Júnior, Tânia Adas Saliba and Fernanda Lopez Rosell

Geriatrics 2025, 10(3), 61; https://doi.org/10.3390/geriatrics10030061 (registering DOI) - 29 Apr 2025

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Abstract

Objective: In this study, we aimed to identify the main factors that influence the quality of life of caregivers in the context of home care for the elderly. Methodology: This is a mixed-methods study with a qualitative–quantitative approach, conducted with 138 home caregivers from the city of Itatiba, São Paulo, Brazil. Individual interviews were conducted, and the qualitative data were analyzed using the Collective Subject Discourse technique. Simultaneously, the quantitative approach involved the application of the EQ-5D questionnaire to assess health-related quality of life, and the data were analyzed using descriptive statistics and significance tests. Results: The majority of caregivers were female, accounting for 92.03% of the total, with the predominant age group being over 50 years old (49.28%). The interviews highlighted the regularity of home visits by healthcare professionals, emphasizing the importance of these visits for the continuity of treatment at home. However, some caregivers expressed feelings of loneliness due to social isolation and emotional burden, reporting difficulties in resting at night and experiencing pain. In the quality of life assessment, statistically significant differences were identified in various dimensions of the EQ-5D. Women showed a higher proportion of extreme problems in usual activities (p < 0.001) and pain/discomfort (p = 0.02), while men reported more moderate problems with anxiety/depression (p = 0.03). Conclusions: This study highlights the importance of personalized and accessible care for patients. It underscores the need for emotional support and educational resources for caregivers to mitigate the negative impacts of prolonged caregiving on their physical and emotional health. Full article

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15 pages, 468 KiB

Open AccessArticle

Recognition of Serious Infections in the Elderly Visiting the Emergency Department: The Development of a Diagnostic Prediction Model (ROSIE)

by Thomas Struyf, Lisa Powaga, Marc Sabbe, Nicolas Léonard, Ivan Myatchin, Ben Van Calster, Jos Tournoy, Frank Buntinx, Laurens Liesenborghs, Jan Y. Verbakel and Ann Van den Bruel

Geriatrics 2025, 10(3), 60; https://doi.org/10.3390/geriatrics10030060 - 25 Apr 2025

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Abstract

Background/Objectives: Serious infections in older adults are associated with substantial mortality and morbidity. Diagnosis is challenging because of the non-specific presentation and overlap with pre-existing comorbidities. The objective of this study was to develop a clinical prediction model using clinical features and biomarkers to support emergency care physicians in diagnosing serious infections in acutely ill older adults. Methods: We conducted a prospective cross-sectional diagnostic study, consecutively including acutely ill patients (≥65 year) presenting to the emergency department. Clinical information and blood samples were collected at inclusion by a trained study nurse. A prediction model for any serious infection was developed based on ten candidate predictors that were further reduced to four ad interim using a penalized Firth multivariable logistic regression model. We assessed discrimination and calibration of the model after internal validation using bootstrapping. Results: We included 425 participants at three emergency departments, of whom 215 were diagnosed with a serious infection (51%). In the final model, we retained systolic blood pressure, oxygen saturation, and C-reactive protein as predictors. This model had good discriminatory value with an Area Under the Receiver Operating Characteristic (AUROC) curve of 0.82 (95% CI: 0.78 to 0.86) and a calibration slope of 0.96 (95% CI: 0.76 to 1.16) after internal validation. Addition of procalcitonin did not improve the discrimination of the model. Conclusions: The ROSIE model uses three predictors that can be easily and quickly measured in the emergency department. It provides good discriminatory power after internal validation. Next steps should include external validation and an impact assessment. Full article

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Geriatrics, Volume 10, Issue 3 (June 2025) – 4 articles

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