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Geriatrics, Volume 5, Issue 2 (June 2020) – 19 articles

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6 pages, 1242 KiB  
Communication
The Clinical Frailty Scale: Do Staff Agree?
by Rebekah L. Young and David G. Smithard
Geriatrics 2020, 5(2), 40; https://doi.org/10.3390/geriatrics5020040 - 25 Jun 2020
Cited by 14 | Viewed by 7296
Abstract
The term frailty is being increasingly used by clinicians, however there is no strict consensus on the best screening method. The expectation in England is that all older patients should have the Clinical Frailty Scale (CFS) completed on admission. This will frequently rely [...] Read more.
The term frailty is being increasingly used by clinicians, however there is no strict consensus on the best screening method. The expectation in England is that all older patients should have the Clinical Frailty Scale (CFS) completed on admission. This will frequently rely on junior medical staff and nurses, raising the question as to whether there is consistency. We asked 124 members of a multidisciplinary team (consultants, junior doctors, nurses, and allied health professionals; physiotherapists, occupational therapists, dietitians, speech and language therapists) to complete the CFS for seven case scenarios. The majority of the participants, 91/124 (72%), were trainee medical staff, 16 were senior medical staff, 12 were allied health professions, and 6 were nurses. There was broad agreement both between the professions and within the professions, with median CFS scores varying by a maximum of only one point, except in case scenario G, where there was a two-point difference between the most junior trainees (FY1) and the nursing staff. No difference (using the Mann–Whitney U test) was found between the different staff groups, with the median scores and range of scores being similar. This study has confirmed there is agreement between different staff members when calculating the CFS with no specific preceding training. Full article
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13 pages, 249 KiB  
Article
Pain and Its Impact on Functional Health: 7-Year Longitudinal Findings among Middle-Aged and Older Adults in Indonesia
by Vasoontara Sbirakos Yiengprugsawan, John Piggott, Firman Witoelar, Fiona M Blyth and Robert G Cumming
Geriatrics 2020, 5(2), 39; https://doi.org/10.3390/geriatrics5020039 - 22 Jun 2020
Cited by 4 | Viewed by 3805
Abstract
Pain is a growing public health issue worldwide, but there is limited population-based evidence in low- and middle-income country settings. Using nationwide Indonesian Family Life Survey (IFLS) data in 2007 and 2014, this research sets out to investigate the associations between changes in [...] Read more.
Pain is a growing public health issue worldwide, but there is limited population-based evidence in low- and middle-income country settings. Using nationwide Indonesian Family Life Survey (IFLS) data in 2007 and 2014, this research sets out to investigate the associations between changes in pain status between two time points and its impact on functional health outcomes among middle-aged and older adults in Indonesia. Analyses focused on 7936 adults aged 50 years and older in 2014 who responded to both waves. Functional health was assessed using a composite score of functional limitations (range 20–100), representing difficulty in performing activities of daily living, and grip strength (kilograms). Multivariate linear regression models were used to analyse associations between pain measured in 2007 and 2014 and functional health in 2014. Severe pain in the latest wave of IFLS was associated with older age, female, lower education, having chronic conditions or depressive symptoms. Notably, those who reported ‘low–medium’ pain in 2007 and ‘severe’ pain in 2014 belonged to the most vulnerable group with worst functional health outcomes (4.96 points higher limitation scores and 1.17 kg weaker average grip strength). Findings have implications for public health policy in monitoring and management of pain including related co-morbidities as an increasingly critical component of population ageing. Full article
(This article belongs to the Special Issue Feature Papers in Geriatrics)
21 pages, 587 KiB  
Review
Effect of Self-Management Support for Elderly People Post-Stroke: A Systematic Review
by Sedsel Kristine Stage Pedersen, Susanne Lillelund Sørensen, Henriette Holm Stabel, Iris Brunner and Hanne Pallesen
Geriatrics 2020, 5(2), 38; https://doi.org/10.3390/geriatrics5020038 - 18 Jun 2020
Cited by 8 | Viewed by 4948
Abstract
A systematic review was undertaken to determine the efficacy of self-management interventions for people with stroke over the age of 65 in relation to psychosocial outcomes. PubMed, Embase, and PsycInfo were searched for randomized controlled clinical trials. Studies were eligible if the included [...] Read more.
A systematic review was undertaken to determine the efficacy of self-management interventions for people with stroke over the age of 65 in relation to psychosocial outcomes. PubMed, Embase, and PsycInfo were searched for randomized controlled clinical trials. Studies were eligible if the included people with stroke had a mean age ≥65 years in both the intervention and control group. Data on psychosocial measurements were extracted and an assessment of methodological quality was undertaken. Due to heterogeneity across the studies, the results were synthesized narratively. Eleven studies were identified. They included different self-management interventions in terms of theoretical rationales, delivery, and content. Seven psychosocial outcomes were identified: i) self-management, ii) self-efficacy, iii) quality of life, iv) depression, v) activities of daily living, vi) active lifestyle, and vii) other measures. Self-management interventions for people with stroke over the age of 65 may be beneficial for self-management, self-efficacy, quality of life, activity of daily living, and other psychosocial outcomes. However, low study quality and heterogeneity of interventions, as well as variation in time of follow-up and outcome measures, limit the possibility of making robust conclusions. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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16 pages, 851 KiB  
Article
Potentially Inappropriate Prescribing and Potential Prescribing Omissions in 82,935 Older Hospitalised Adults: Association with Hospital Readmission and Mortality within Six Months
by Roger E. Thomas, Leonard T. Nguyen, Dave Jackson and Christopher Naugler
Geriatrics 2020, 5(2), 37; https://doi.org/10.3390/geriatrics5020037 - 12 Jun 2020
Cited by 19 | Viewed by 3570
Abstract
Polypharmacy with “potentially inappropriate medications” (PIMs) and “potential prescribing omissions” (PPOs) are frequent among those 65 and older. We assessed PIMs and PPOs in a retrospective study of 82,935 patients ≥ 65 during their first admission in the period March 2013 through February [...] Read more.
Polypharmacy with “potentially inappropriate medications” (PIMs) and “potential prescribing omissions” (PPOs) are frequent among those 65 and older. We assessed PIMs and PPOs in a retrospective study of 82,935 patients ≥ 65 during their first admission in the period March 2013 through February 2018 to the four acute-care Calgary hospitals. We used the American Geriatric Society (AGS) and STOPP/START criteria to assess PIMs and PPOs. We computed odds ratios (ORs) for key outcomes of concern to patients, their families, and physicians, namely readmission and/or mortality within six months of discharge, and controlled for age, sex, numbers of medications, PIMs, and PPOs. For readmission, the adjusted OR for number of medications was 1.09 (1.09–1.09), for AGS PIMs 1.14 (1.13–1.14), for STOPP PIMs 1.15 (1.14–1.15), for START PPOs 1.04 (1.02–1.06), and for START PPOs correctly prescribed 1.16 (1.14–1.17). For mortality within 6 months of discharge, the adjusted OR for the number of medications was 1.02 (1.01–1.02), for STOPP PIMs 1.07 (1.06–1.08), for AGS PIMs 1.11 (1.10–1.12), for START PPOs 1.31 (1.27–1.34), and for START PPOs correctly prescribed 0.97 (0.94–0.99). Algorithm rule mining identified an 8.772 higher likelihood of mortality with the combination of STOPP medications of duplicate drugs from the same class, neuroleptics, and strong opioids compared to a random relationship, and a 2.358 higher likelihood of readmission for this same set of medications. Detailed discussions between patients, physicians, and pharmacists are needed to improve these outcomes. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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14 pages, 982 KiB  
Review
The Role of Eye Tracking Technology in Assessing Older Driver Safety
by David B. Carr and Prateek Grover
Geriatrics 2020, 5(2), 36; https://doi.org/10.3390/geriatrics5020036 - 7 Jun 2020
Cited by 21 | Viewed by 6206
Abstract
A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is [...] Read more.
A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is in the area of driving safety. Methods: We reviewed the literature to identify the changes in ET parameters with older adults and neurodegenerative disease. Results: This narrative review provides a brief overview of oculomotor system anatomy and physiology, defines common eye movements and tracking variables that are typically studied, explains the most common methods of eye tracking measurements during driving in simulation and in naturalistic settings, and examines the association of impairment in ET parameters with advanced age and neurodegenerative disease. Conclusion: ET technology is becoming less expensive, more portable, easier to use, and readily applicable in a variety of clinical settings. Older adults and especially those with neurodegenerative disease may have impairments in visual search parameters, placing them at risk for motor vehicle crashes. Advanced driver assessment systems are becoming more ubiquitous in newer cars and may significantly reduce crashes related to impaired visual search, distraction, and/or fatigue. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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19 pages, 1043 KiB  
Article
Feasibility and Validity of a Low-Cost Racing Simulator in Driving Assessment after Stroke
by Jonathan Tiu, Annie C. Harmon, James D. Stowe, Amen Zwa, Marc Kinnear, Latch Dimitrov, Tina Nolte and David B. Carr
Geriatrics 2020, 5(2), 35; https://doi.org/10.3390/geriatrics5020035 - 29 May 2020
Cited by 7 | Viewed by 4585
Abstract
There is a myriad of methodologies to assess driving performance after a stroke. These include psychometric tests, driving simulation, questionnaires, and/or road tests. Research-based driving simulators have emerged as a safe, convenient way to assess driving performance after a stroke. Such traditional research [...] Read more.
There is a myriad of methodologies to assess driving performance after a stroke. These include psychometric tests, driving simulation, questionnaires, and/or road tests. Research-based driving simulators have emerged as a safe, convenient way to assess driving performance after a stroke. Such traditional research simulators are useful in recreating street traffic scenarios, but are often expensive, with limited physics models and graphics rendering. In contrast, racing simulators developed for motorsport professionals and enthusiasts offer high levels of realism, run on consumer-grade hardware, and can provide rich telemetric data. However, most offer limited simulation of traffic scenarios. This pilot study compares the feasibility of research simulation and racing simulation in a sample with minor stroke. We determine that the racing simulator is tolerated well in subjects with a minor stroke. There were correlations between research and racing simulator outcomes with psychometric tests associated with driving performance, such as the Trails Making Test Part A, Snellgrove Maze Task, and the Motricity Index. We found correlations between measures of driving speed on a complex research simulator scenario and racing simulator lap time and maximum tires off track. Finally, we present two models, using outcomes from either the research or racing simulator, predicting road test failure as linked to a previously published fitness-to-drive calculator that uses psychometric screening. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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10 pages, 572 KiB  
Article
Effectiveness of the “Mente Sana [Healthy Mind]” Cognitive Training Program for Older Illiterate Adults with Mild Cognitive Impairment
by Yaneth del Rosario Palo Villegas, Andrea Elena Pomareda Vera, María Elena Rojas Zegarra and M. Dolores Calero
Geriatrics 2020, 5(2), 34; https://doi.org/10.3390/geriatrics5020034 - 23 May 2020
Cited by 5 | Viewed by 3993
Abstract
Aging can lead to functional and cognitive alterations, sometimes limiting older adults in their social development, especially illiterate groups of older adults who receive poor attention from healthcare systems. In this context, the present investigation proposes the cognitive training program “MENTE SANA [HEALTHY [...] Read more.
Aging can lead to functional and cognitive alterations, sometimes limiting older adults in their social development, especially illiterate groups of older adults who receive poor attention from healthcare systems. In this context, the present investigation proposes the cognitive training program “MENTE SANA [HEALTHY MIND]” to improve the cognitive functions of illiterate older adults in Arequipa (Peru). It is a type of quasi-experimental research with a pre-test/post-test design with a homogenous control group. The sample was made up of adults 60 years old and above and of female gender. The Montreal Cognitive Assessment (MoCA) test was used to detect the level of cognitive decline in illiterate older adults. The 50-sessions program was applied to all the older adults with mild cognitive impairment that were selected for the study, on a daily basis. It was found that the tested group improved their cognitive functions compared to the control group. These results help to propose adapted cognitive training programs for illiterate people. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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10 pages, 437 KiB  
Article
Inverse Correlation Between Grip Strength and Serum Phosphorus: A Retrospective Observational Study in Japanese Elderly with Poorly Controlled Type 2 Diabetes
by Sho Tanaka, Masahiro Takubo, Genta Kohno, Masaru Kushimoto, Jin Ikeda, Katsuhiko Ogawa, Yutaka Suzuki, Masanori Abe, Hisamitsu Ishihara and Midori Fujishiro
Geriatrics 2020, 5(2), 33; https://doi.org/10.3390/geriatrics5020033 - 19 May 2020
Cited by 4 | Viewed by 3129
Abstract
The aim of this study was to investigate factors associated with sarcopenia among elderly patients with poorly controlled diabetes mellitus (DM). We retrospectively analyzed 41 patients with type 2 DM, aged ≥65 years who required diabetes education hospitalization. Patients were classified into two [...] Read more.
The aim of this study was to investigate factors associated with sarcopenia among elderly patients with poorly controlled diabetes mellitus (DM). We retrospectively analyzed 41 patients with type 2 DM, aged ≥65 years who required diabetes education hospitalization. Patients were classified into two groups according to the presence or absence of a weakened hand grip, and clinical characteristics were compared. Patients with a weakened hand grip (n = 21) scored worse on a mini-mental state examination (24.3 vs. 26.5, p = 0.04), showed a higher prevalence of diabetic peripheral neuropathy (76% vs. 40%, p = 0.03), and had a higher serum phosphorus concentration (3.8 vs. 3.3 mg/dL, p < 0.01) compared to those without a weakened hand grip (n = 20). The serum phosphorus concentration was inversely correlated to hand grip strength (r = −0.501, p < 0.001) among the total of 41 patients. This inverse association was also confirmed after adjusting the effects of estimated glomerular filtration rate, age, and glycated hemoglobin. Thus, cognitive impairment, diabetic peripheral neuropathy, and high serum phosphorus concentrations are associated with hand grip weakness in elderly patients with type 2 DM. Full article
(This article belongs to the Section Geriatric Endocrinology and Metabolic Disorder)
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14 pages, 216 KiB  
Article
Long-Term Outcomes in Stroke Patients with Cognitive Impairment: A Population-Based Study
by Majed Obaid, Clare Flach, Iain Marshall, Charles D. A. Wolfe and Abdel Douiri
Geriatrics 2020, 5(2), 32; https://doi.org/10.3390/geriatrics5020032 - 18 May 2020
Cited by 29 | Viewed by 4547
Abstract
This study assesses five year outcomes of patients with cognitive deficits within the first three months after stroke. Population-based data from the South London Stroke Register between 1995 and 2018 were studied. Cognitive function was assessed using the Abbreviated-Mental-Test or Mini-Mental-State-Examination. Multivariable Poisson [...] Read more.
This study assesses five year outcomes of patients with cognitive deficits within the first three months after stroke. Population-based data from the South London Stroke Register between 1995 and 2018 were studied. Cognitive function was assessed using the Abbreviated-Mental-Test or Mini-Mental-State-Examination. Multivariable Poisson regression models with robust standard errors were constructed, to evaluate relative risks (RRs) and associations between post-stroke deterioration in cognitive function during the first three months on dependency, mortality, depression and institutionalisation. A total of 6504 patients with first-ever strokes were registered with a mean age of 73 (SD: 13.2). During the first three months post-stoke, approximately one-third of these stroke survivors either cognitively improved (37%), deteriorated (30%) or remained unchanged (33%). Post-stroke cognitive impairment was associated with increases, in five years, of the risks of mortality, dependency, depression and being institutionalised by RRs 30% (95% confidence interval: 1.1–1.5), 90% (1.3–2.6), 60% (1.1–2.4) and 50% (1.1–2.3), respectively. Deterioration in cognitive function by 10% or more between seven days and three months was associated with an approximate two-fold increased risk in mortality, dependency, and being institutionalised after one year, compared to stable cognitive function; RRs 80% (1.1–3.0), 70% (1.2–2.4) and two-fold (1.3–3.2), respectively. Monitoring further change to maintain cognitive abilities should be a focus to improve outcomes. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
4 pages, 167 KiB  
Case Report
COVID-19 and Gastrointestinal Symptoms—A Case Report
by Alistair J. Mackett and Victoria L. Keevil
Geriatrics 2020, 5(2), 31; https://doi.org/10.3390/geriatrics5020031 - 15 May 2020
Cited by 6 | Viewed by 4703
Abstract
COVID-19, a new illness secondary to a novel Coronavirus emerged in December 2019 in China. Our early understanding of the clinical features of COVID-19 has been based on case series emerging from the first outbreak in Wuhan. These features included fever, a dry [...] Read more.
COVID-19, a new illness secondary to a novel Coronavirus emerged in December 2019 in China. Our early understanding of the clinical features of COVID-19 has been based on case series emerging from the first outbreak in Wuhan. These features included fever, a dry cough, myalgia and dyspnea. Gastrointestinal symptoms were rarely reported as a key feature. We present a case report of a 74-year-old male who presented with symptoms of gastroenteritis and subsequently tested positive for COVID-19. This article aims to highlight an uncommon presentation of COVID-19 and that a high index of suspicion is required for COVID-19 in older people given their greater likelihood of presenting atypically. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in the Elderly)
2 pages, 149 KiB  
Editorial
Decision-Making in COVID-19 and Frailty
by Susan Moug, Ben Carter, Phyo Kyaw Myint, Jonathan Hewitt, Kathryn McCarthy and Lyndsay Pearce
Geriatrics 2020, 5(2), 30; https://doi.org/10.3390/geriatrics5020030 - 6 May 2020
Cited by 23 | Viewed by 6034
Abstract
We write in response to the COVID-19 pandemic and the important recognition of co-existing frailty [COVID-19 rapid guideline: critical care in adults; NICE NG159] [...] Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in the Elderly)
12 pages, 1601 KiB  
Article
A Novel Exercise for Enhancing Visuospatial Ability in Older Adults with Frailty: Development, Feasibility, and Effectiveness
by Miyuki Nemoto, Hiroyuki Sasai, Noriko Yabushita, Keito Tsuchiya, Kazushi Hotta, Yoshihiko Fujita, Taeho Kim, Takehiko Tsujimoto, Tetsuaki Arai and Kiyoji Tanaka
Geriatrics 2020, 5(2), 29; https://doi.org/10.3390/geriatrics5020029 - 3 May 2020
Cited by 6 | Viewed by 5564
Abstract
We aimed to develop a novel exercise to improve visuospatial ability and evaluate its feasibility and effectiveness in older adults with frailty. A non-randomized preliminary trial was conducted between June 2014 and March 2015. We recruited 35 adults with frailty (24 women), aged [...] Read more.
We aimed to develop a novel exercise to improve visuospatial ability and evaluate its feasibility and effectiveness in older adults with frailty. A non-randomized preliminary trial was conducted between June 2014 and March 2015. We recruited 35 adults with frailty (24 women), aged 66–92 years. Participants were assigned to either locomotive- or visuospatial-exercise groups. All participants exercised under the supervision of physiotherapists for 90 min/week for 12 weeks. The visuospatial exercise participants used cubes with six colored patterns and were instructed to “reproduce the same colored pattern as shown in the photo”, using the cubes. In the locomotive exercise group, lower extremity functional training was provided. Rates of retention and attendance measured feasibility. Most participants completed the intervention (77.3%, locomotive; 84.6%, visuospatial) and had good attendance (83.8%, locomotive; 90.7%, visuospatial). Mini-mental state examination (MMSE), clock drawing test (CDT), and seven physical performance tests were conducted before and after interventions. The improvement in the MMSE score, qualitative analysis of CDT, grip strength, and sit and reach assessments were significantly greater in the visuospatial exercise group than in the locomotive exercise group. The cube exercise might be a feasible exercise program to potentially improve visuospatial ability and global cognition in older adults with frailty. Full article
(This article belongs to the Collection Frailty in Older Adults)
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6 pages, 1024 KiB  
Article
Measurement of Oral Moisture on Oral Dryness Patients
by Fumi Mizuhashi, Kaoru Koide, Shuji Toya and Tomoko Nashida
Geriatrics 2020, 5(2), 28; https://doi.org/10.3390/geriatrics5020028 - 30 Apr 2020
Cited by 3 | Viewed by 3740
Abstract
Many elderly patients have oral dryness; thus, it is necessary to evaluate the oral moisture in a clinical setting. The aim of this study was to clarify the importance of controlling the measuring pressure of the oral moisture-checking device. The influence of the [...] Read more.
Many elderly patients have oral dryness; thus, it is necessary to evaluate the oral moisture in a clinical setting. The aim of this study was to clarify the importance of controlling the measuring pressure of the oral moisture-checking device. The influence of the measuring pressure of the oral moisture-checking device was examined using agar under 10 measuring pressure conditions (Kruskal–Wallis test). Fifty-five oral dryness patients were examined the lingual moisture using the device with and without a tongue depressor. The tongue depressor was placed underneath the tongue to support it during the measurement. The mean value and the coefficient of variation of five measurements was evaluated (paired t-test or Wilcoxon signed-ranks test). The agar moisture values changed according to the measuring pressure (p < 0.05). The lingual moisture value with the tongue depressor was higher than that without the tongue depressor (p < 0.05). The coefficient of variation with the tongue depressor was smaller than that without the tongue depressor (p < 0.01). The results of this study indicated that the measuring pressure of oral moisture-checking device influenced the measurement value, and it is necessary to support the tongue for the measurement of lingual mucosal moisture in a uniform manner. Full article
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10 pages, 578 KiB  
Review
A Systematic Review Examining Associations between Cardiovascular Conditions and Driving Outcomes among Older Drivers
by Ganesh M. Babulal, Ramana Kolady, Sarah H. Stout and Catherine M. Roe
Geriatrics 2020, 5(2), 27; https://doi.org/10.3390/geriatrics5020027 - 28 Apr 2020
Cited by 4 | Viewed by 4664
Abstract
There is a vast literature on stroke as a cardiovascular disease and driving outcomes, however little is known about other cardiovascular conditions and driving. The purpose of this review is to examine the literature for studies assessing the effect of non-stroke, vascular conditions [...] Read more.
There is a vast literature on stroke as a cardiovascular disease and driving outcomes, however little is known about other cardiovascular conditions and driving. The purpose of this review is to examine the literature for studies assessing the effect of non-stroke, vascular conditions on daily driving, reported crash risk and driving decline in older adult drivers as captured by naturalistic methodologies. A systematic review of Embase, Ovid and Scopus Plus examined articles on driving and vascular conditions among older adults. A search yielded 443 articles and, following two screenings, no articles remained that focused on non-stroke, vascular conditions and naturalistic driving. As a result, this review examined non-stroke, vascular conditions in nine driving studies of older adults that used road testing, driving simulators and self-report measures. These studies fell into three categories—heart failure, vascular dementia and white matter hyperintensities/leukoaraiosis. The combined findings of the studies suggest that heart failure, vascular dementia and white matter hyperintensities (WMH) negatively impact driving performance and contribute to driving cessation among older adults. Future research should examine cardiovascular risk factors like hypertension, hypercholesterolemia, myocardial infraction or atherosclerosis using naturalistic driving measurement, as well as traditional measures, in order to more fully characterize how these conditions impact older adult driving. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
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17 pages, 3249 KiB  
Article
Trajectory of Psychosocial Measures Amongst Informal Caregivers: Case-Controlled Study of 1375 Informal Caregivers from the English Longitudinal Study of Ageing
by Toby Smith, Amanda Saunders and Jay Heard
Geriatrics 2020, 5(2), 26; https://doi.org/10.3390/geriatrics5020026 - 27 Apr 2020
Cited by 6 | Viewed by 3402
Abstract
Informal caregivers provide vital support for older adults living in the community with chronic illnesses. The purpose of this study was to assess the psychosocial status of informal caregivers of community-dwelling adults over an eight-year period. Informal caregivers of adult care-recipients were identified [...] Read more.
Informal caregivers provide vital support for older adults living in the community with chronic illnesses. The purpose of this study was to assess the psychosocial status of informal caregivers of community-dwelling adults over an eight-year period. Informal caregivers of adult care-recipients were identified from Wave 1 of the English Longitudinal Study of Ageing (ELSA) cohort. Multivariate regression analysis models were constructed to assess the association between participant’s psychosocial characteristics and informal caregiving. Multilevel modelling explored the psychosocial changes between caregivers and non-caregivers over eight years. 1375 informal caregivers and 2750 age-matched non-caregivers were analyzed. Self-reported loneliness (Odd Ratio (OR): 0.26; 95% confidence intervals (CI): 0.01–0.51) and relationship status (OR: 0.36; 95% CI: 0.16–0.46) were independently associated with caregiving. Caregivers were more socially isolated with less holidaying abroad (OR: 0.51; 95% CI: 0.35–0.66), attendance to church (OR: 0.30; 95% CI: 0.11–0.49), or charity groups (OR: 0.35; 95% CI: 0.14–0.55). On multilevel analysis, over time (eight-years), caregivers reported greater loneliness (p < 0.01), change in relationship status (p = 0.01) and reduced control, autonomy, and pleasure (p ≤ 0.01) compared to non-caregivers. Given the deleterious effects caregiving can place on health and wellbeing, further interventions are required to improve these psychosocial factors. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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4 pages, 205 KiB  
Editorial
Ageing and COVID-19: What Is the Role for Elderly People?
by Donatella Rita Petretto and Roberto Pili
Geriatrics 2020, 5(2), 25; https://doi.org/10.3390/geriatrics5020025 - 26 Apr 2020
Cited by 108 | Viewed by 17384
Abstract
Italy is one of the oldest countries in Europe and in the world and now it is also one of the first countries that are fighting against COVID-19. In our country, the increasing life expectancy (80.5 for males and 84.9 for females, with [...] Read more.
Italy is one of the oldest countries in Europe and in the world and now it is also one of the first countries that are fighting against COVID-19. In our country, the increasing life expectancy (80.5 for males and 84.9 for females, with a total life expectancy of 82.9) has led to very positive consequences for health and the well-being of elderly people: a very high number of older adults lives and acts independently in their daily life, even if they have one or more than one chronic disease. In the time of COVID-19′s outbreak in Italy, the focus of the media was on elderly people for two main reasons. First, many older people demonstrated a very high civic sense and they were helping society to fight against the pandemic. Second, also in Italy, like in China, the older adults are at higher risk in being infected with COVID-19 and if they get ill, they have a higher risk of death. The balance previously achieved between age-related disorders and a good quality of life and good health is now under high pressure. It is very important to protect elderly people from infection, but also it is important to respect them and to support them in this complex situation. There is a great risk of “ageism”. In agreement with Lloyd-Sherlock and colleagues (2020), in this editorial we propose some hints of analysis, starting from the ongoing experience in Italy. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in the Elderly)
2 pages, 154 KiB  
Editorial
COVID-19: A Geriatric Emergency
by Virginia Boccardi, Carmelinda Ruggiero and Patrizia Mecocci
Geriatrics 2020, 5(2), 24; https://doi.org/10.3390/geriatrics5020024 - 26 Apr 2020
Cited by 28 | Viewed by 6913
Abstract
The older Italian population is posing a challenge in the number of deaths for coronavirus disease 2019 (COVID-19). According to previous data from China, pre-existing health conditions dramatically increase the risk of dying from COVID-19. The presence of multiple diseases in older patients [...] Read more.
The older Italian population is posing a challenge in the number of deaths for coronavirus disease 2019 (COVID-19). According to previous data from China, pre-existing health conditions dramatically increase the risk of dying from COVID-19. The presence of multiple diseases in older patients may be considered as a mark of frailty, which increases the person’s vulnerability to stress and impairs the multisystemic compensatory effort to restore homeostasis. The clinical complexity associated with the management of frailty may increase the risk of complications during infection as well as the lack of the early recognition of atypical symptoms. There is an urgent need to share expertise and clinical management skills with geriatricians as well as the need for early diagnosis to start treatment at the earliest convenience in the community, with the aim to avoid the collapse of intensive care units. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infections in the Elderly)
13 pages, 232 KiB  
Article
The Relationship between in-Vehicle Technologies and Self-Regulation among Older Drivers
by Austin M. Svancara, Leon Villavicencio, Tara Kelley-Baker, William J. Horrey, Lisa J. Molnar, David W. Eby, Thelma J. Mielenz, Linda Hill, Carolyn DiGuiseppi, David Strogatz and Guohua Li
Geriatrics 2020, 5(2), 23; https://doi.org/10.3390/geriatrics5020023 - 16 Apr 2020
Cited by 1 | Viewed by 3840
Abstract
The study sought to understand the relationship between in-vehicle technologies (IVTs) and self-regulatory behaviors among older drivers. In a large multi-site study of 2990 older drivers, self-reported data on the presence of IVTs and avoidance of various driving behaviors (talking on a mobile [...] Read more.
The study sought to understand the relationship between in-vehicle technologies (IVTs) and self-regulatory behaviors among older drivers. In a large multi-site study of 2990 older drivers, self-reported data on the presence of IVTs and avoidance of various driving behaviors (talking on a mobile phone while driving, driving at night, driving in bad weather, and making left turns when there is no left turn arrow) were recorded. Self-reports were used to identify whether avoidance was due to self-regulation. Hierarchical logistic regressions were used to determine whether the presence of a particular IVT predicted the likelihood of a given self-regulatory behavior after controlling for other factors. Results suggest that the presence of Integrated Bluetooth/Voice Control systems are related to a reduced likelihood of avoiding talking on a mobile phone while driving due to self-regulation (OR = 0.37, 95% CI = 0.29–0.47). The presence of a Navigation Assistance system was related to a reduced likelihood of avoiding talking on a mobile phone while driving (OR= 0.65, 95% CI = 0.50–0.84) and avoiding driving at night due to self-regulation (OR = 0.80, 95% CI = 0.64–1.00). Present findings suggest in-vehicle technologies may differently influence the self-regulatory behaviors of older drivers. Full article
(This article belongs to the Special Issue Aging and Driving: 2019)
15 pages, 3507 KiB  
Review
Surgical Treatment of Femoral Neck Fractures: A Brief Review
by Ellen Lutnick, Jeansol Kang and David M. Freccero
Geriatrics 2020, 5(2), 22; https://doi.org/10.3390/geriatrics5020022 - 1 Apr 2020
Cited by 28 | Viewed by 15785
Abstract
Hip fracture is a cause for concern in the geriatric population. It is one of the leading causes of traumatic injury in this demographic and correlates to a higher risk of all-cause morbidity and mortality. The Garden classification of femoral neck fractures (FNF) [...] Read more.
Hip fracture is a cause for concern in the geriatric population. It is one of the leading causes of traumatic injury in this demographic and correlates to a higher risk of all-cause morbidity and mortality. The Garden classification of femoral neck fractures (FNF) dictates treatment via internal fixation or hip replacement, including hemiarthroplasty or total hip arthroplasty. This review summarizes existing literature that has explored the difference in outcomes between internal fixation, hemiarthroplasty, and total hip arthroplasty for nondisplaced and displaced FNF in the geriatric population, and more specifically highlights the risks and benefits of a cemented vs. uncemented approach to hemiarthroplasty. Full article
(This article belongs to the Special Issue Orthopaedic Surgery and Rehabilitation in the Aging Population)
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