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Geriatrics, Volume 9, Issue 5 (October 2024) – 28 articles

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18 pages, 665 KiB  
Article
Experiencing Cerebrovascular Diseases like Stroke and Fear of Falling: Longitudinal Results from the Survey of Health, Ageing and Retirement in Europe
by Agon Tahiraj, Hans-Helmut König and André Hajek
Geriatrics 2024, 9(5), 133; https://doi.org/10.3390/geriatrics9050133 - 11 Oct 2024
Abstract
Objective: The aim of this study was to clarify the link between experiencing cerebrovascular diseases (strokes as an explicit example) and fear of falling (FOF) among middle-aged and older adults in Europe. Methods: Longitudinal data were used from wave 5 to wave 7 [...] Read more.
Objective: The aim of this study was to clarify the link between experiencing cerebrovascular diseases (strokes as an explicit example) and fear of falling (FOF) among middle-aged and older adults in Europe. Methods: Longitudinal data were used from wave 5 to wave 7 of the representative Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported tools were used to quantify the key variables. Fear of falling was similarly assessed using a dichotomous yes or no question, “For the past six months at least, have you been bothered by any of the health conditions on this card”, with fear of falling being one of the options. It was adjusted for various sociodemographic and health-related factors. In particular, to account for unobserved heterogeneity, conditional fixed effect regressions (FE) were used. Accordingly, change in an individual’s FOF status over the included waves was analysed and correlated with the reported change of all the included time-varying independent variables within the same individual, including experiencing stroke or other cerebrovascular diseases. The final analytical sample equalled n = 22.071 observations. Results: Conditional logistic FE regressions showed that the onset of a stroke or other forms of cerebrovascular disease was not associated with an increased likelihood of experiencing fear of falling (OR = 1.25, p = 0.095). However, stratified by sex, such an association was present in men (OR = 1.79, p = 0.006), though not in women (OR = 0.94, p = 0.732). Conclusions: The onset of a stroke or other cerebrovascular diseases was associated with an increased likelihood of experiencing FOF in men but not women. Efforts are required to assist older men in avoiding FOF after the onset of stroke or other cerebrovascular pathologies. Full article
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20 pages, 57108 KiB  
Article
Pilot Study on Gaze Characteristics of Older Drivers While Watching Driving Movies
by Kaori Kawabata, Yuya Nakajima, Kazuki Fujita, Mamiko Sato, Koji Hayashi and Yasutaka Kobayashi
Geriatrics 2024, 9(5), 132; https://doi.org/10.3390/geriatrics9050132 - 10 Oct 2024
Abstract
Objective: This study aims to clarify the gazing characteristics of older drivers while driving cars using a gaze analysis device. Methods: The participants included 16 older and 12 middle-aged drivers who drove cars daily. After conducting cognitive and attentional function tests, eye [...] Read more.
Objective: This study aims to clarify the gazing characteristics of older drivers while driving cars using a gaze analysis device. Methods: The participants included 16 older and 12 middle-aged drivers who drove cars daily. After conducting cognitive and attentional function tests, eye gaze while watching driving videos was measured using an eye tracker. Ten driving videos were prepared. In addition, a total of 34 hazard areas were analyzed. Results: The results of the gaze measurement parameters were statistically compared between the two groups. In the older group, the gaze analysis results indicated that while viewing driving videos, the search for areas close to the car was expanded. In addition, in several hazard areas, we observed a decrease in the number of drivers gazing at the driver, shortened total gazing time, delay in the timing of gazing, and decrease in the number of visits. Conclusions: Older drivers’ eye movement is increased; however, it is characterized by gazing at unimportant areas, indicating an inefficient scanning pattern. Although these results do not indicate an obvious decline in driving ability among older drivers, the decline in hazard perception may become apparent in some situations. The data contain underpowered results and require revalidation in larger studies. Full article
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10 pages, 225 KiB  
Article
The Association of Walking Ability with Oral Function and Masticatory Behaviors in Community-Dwelling Older People: A Cross-Sectional Study
by Takako Ujihashi, Kazuhiro Hori, Hiromi Izuno, Masayo Fukuda, Misao Sawada, Shogo Yoshimura, Shoko Hori, Fumuko Uehara, Hinako Takano and Takahiro Ono
Geriatrics 2024, 9(5), 131; https://doi.org/10.3390/geriatrics9050131 - 9 Oct 2024
Abstract
Background/Objectives: An association between oral function and physical fitness, including walking capacity, has been reported. However, the association between masticatory behaviors and walking ability—both of which represent patterns of movement in daily life—has not been clarified. This study aimed to investigate the [...] Read more.
Background/Objectives: An association between oral function and physical fitness, including walking capacity, has been reported. However, the association between masticatory behaviors and walking ability—both of which represent patterns of movement in daily life—has not been clarified. This study aimed to investigate the association between masticatory behaviors, oral function, and walking capacity in older people. Methods: One hundred community-dwelling older people (31 men, 69 women, mean age 75.7 ± 6.3 years) were selected to participate in this study. Age, sex, masticatory behaviors, oral functions (tongue pressure, tongue–lips motor function, occlusal force, and masticatory performance), and walking capacity were assessed. Masticatory behaviors were assessed during the consumption of one rice ball (100 g) using a wearable chewing counter, and the number of chews, chewing rate, the number of chews per bite, and meal time were recorded. Walking capacity was assessed using the timed up and go test (TUG). Spearman’s rank correlation coefficients were calculated to assess the strength and direction of the association. Results: Moderate negative correlations were observed between TUG time and tongue pressure and between TUG time and tongue–lips motor function (/ta/ and /ka/) (rs = −0.33, −0.21, −0.28, respectively). In addition, moderate negative correlations between TUG time and chewing rate (rs = −0.22) and between TUG time and meal time (rs = 0.33) were observed, suggesting that lower walking capacity was associated with slower chewing rate and longer meal times. Conclusions: In community-dwelling older people, declines in mastication speed and dexterity and tongue strength are associated with lower walking capacity. Full article
14 pages, 244 KiB  
Article
Demographics, Clinical Characteristics, and Well-Being of Veterans with TBI and Dementia and Their Caregivers
by Linda O. Nichols, Jennifer Martindale-Adams, Ronald T. Seel, Jeffrey K. Zuber and Paul B. Perrin
Geriatrics 2024, 9(5), 130; https://doi.org/10.3390/geriatrics9050130 - 8 Oct 2024
Abstract
Background: This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans’ demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers’ demographic, clinical, and care-related characteristics and well-being. Methods: Veterans’ caregivers [...] Read more.
Background: This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans’ demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers’ demographic, clinical, and care-related characteristics and well-being. Methods: Veterans’ caregivers (N = 110) completed a telephone-based survey. Results: Veterans averaged eight comorbid health conditions, with over 60% having chronic pain, hypertension, post-traumatic stress disorder, or depression. Caregivers reported helping with an average of three activities of daily living, with the highest percentages of Veterans needing assistance with grooming, dressing, and bathing. Almost all Veterans needed assistance with shopping, cooking, medication management, housework, laundry, driving, and finances. Veterans averaged two safety risks, the most common being access to dangerous objects, access to a gun, and not being able to respond to emergency situations. Although Veterans averaged 14 behavioral concerns, caregivers reported that their family needs relating to TBI were generally met or partly met, and they voiced confidence in their ability to respond to behaviors and control their upsetting thoughts. Caregivers’ mean burden score was severe, while mean depression and anxiety scores were mild. Caregivers reported an average of 10.5 h per day providing care and 20.1 h per day on duty. Conclusions: The findings demonstrate the increased presence of impairments, safety risks, and behavioral issues in Veterans with comorbid TBI and dementia, as well as increased impacts on families’ burdens and care provision requirements. Clinicians should be alert for and educate TBI patients and caregivers on the warning signs of post-TBI dementia and its associated functional, behavioral, and safety risk profile, as well as challenges related to caregiver well-being. Healthcare policymakers must consider the increased caregiver demands associated with comorbid TBI and dementia, as well as the need for expanded long-term support and services. Full article
11 pages, 720 KiB  
Article
Cost-Effectiveness of GaitSmart and an Artificial Intelligence Solution for Rehabilitation of Patients Undergoing Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) in Older Population in the United Kingdom
by Fernando Zanghelini, Aisling Ponzo, Georgios Xydopoulos, Richard Fordham and Saval Khanal
Geriatrics 2024, 9(5), 129; https://doi.org/10.3390/geriatrics9050129 - 5 Oct 2024
Abstract
Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether [...] Read more.
Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC). Methods: Decision-analytic modelling was conducted to estimate the cost-effectiveness over a seventeen-week time horizon from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain the input parameters, and a sensitivity analysis was performed to address uncertainties. Results: Over a seventeen-week time horizon, GS incurred cost savings of GBP 450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results. Conclusions: GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement in gait in people undergoing THA or TKA, compared to the SoC. Full article
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14 pages, 1365 KiB  
Article
Influence of Walking, Manual Techniques, and Elastic Resistance Exercise on Shoulder Posture in Healthy Elderly Individuals
by Klára Novotová and Dagmar Pavlů
Geriatrics 2024, 9(5), 128; https://doi.org/10.3390/geriatrics9050128 - 4 Oct 2024
Abstract
In this study, we investigated the effect of regular walking and its combination with manual techniques/resistance exercise. The position of the shoulder girdle was assessed using the acromion-wall distance (AD). The intervention took place twice a week for 4 weeks. A total of [...] Read more.
In this study, we investigated the effect of regular walking and its combination with manual techniques/resistance exercise. The position of the shoulder girdle was assessed using the acromion-wall distance (AD). The intervention took place twice a week for 4 weeks. A total of 88 seniors over the age of 60 successfully completed the study. The results showed a statistically significant improvement of AD in the left shoulder within the group that underwent walking combined with resistance exercise. The remaining groups did not show any statistically significant change in AD. Background: The world population is rapidly aging; therefore, it is necessary to respond to this challenge in time. One of the typical involutional signs of old age is a hunched posture combined with a forward position of the shoulder girdle. This posture negatively impacts various bodily functions, postural stability, and strain on the musculoskeletal system. Objectives: We aimed to evaluate the effect of walking and walking combined with manual therapy/resistance exercise on scapular positioning in healthy elderly individuals. Methods: Participants of experimental groups underwent a 4-week training session that involved walking and manual techniques/resistance training applied 2x/week. Participants of the control group maintained their usual daily habits. Results: Our results showed statistically significant improvement in scapular positioning of the left shoulder in participants who underwent regular walking combined with resistance exercise training. Conclusions: These results suggest that regular walking combined with resistance training, when properly dosed, may beneficially influence scapular positioning in healthy elderly individuals. Full article
(This article belongs to the Section Healthy Aging)
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10 pages, 269 KiB  
Article
Running Plus Strength Training Positively Affects Muscle Strength and Quality in Both Younger (Below 50 Years Old) and Older (Above 50 Years Old) Women
by Lavínia Vivan, Vinícius Ribeiro dos Anjos Souza, Aldo Seffrin, Claudio Andre Barbosa de Lira, Rodrigo Luiz Vancini, Katja Weiss, Beat Knechtle and Marilia Santos Andrade
Geriatrics 2024, 9(5), 127; https://doi.org/10.3390/geriatrics9050127 - 4 Oct 2024
Abstract
Background/Objectives: Sarcopenia is a muscular disease characterized by loss of muscular strength and function, affecting mainly women, and associated with increased mortality risk. The aim of this study was to compare active women with inactive women of different age groups regarding muscle mass, [...] Read more.
Background/Objectives: Sarcopenia is a muscular disease characterized by loss of muscular strength and function, affecting mainly women, and associated with increased mortality risk. The aim of this study was to compare active women with inactive women of different age groups regarding muscle mass, strength, and muscle quality. Methods: This study included 147 women (85 runners and 62 inactive), divided into <50 and ≥50 years old. Participants were evaluated for knee flexor and extensor peak torque (PT), body composition, and training habits. Results: For knee extensor muscles, there was an age group effect (F(2.146) = 40.5; p < 0.001) on absolute PT (Nm); an age group effect (F(2.146) = 44.1; p < 0.001) and a physical activity group effect (F(2.146) = 113.0; p < 0.001) on PT adjusted by body mass (Nm/kg); and an age group effect (F(2.146) = 36.9; p < 0.001) and a physical activity group effect (F(2.146) = 6.1; p = 0.014) on PT adjusted by lean mass (Nm/kgLM). There was no interaction effect. Conclusion: In both age groups, active women had greater strength and higher muscle quality than inactive women, but the difference in strength, muscle mass, and muscle quality between younger and older women were the same among runners and inactive women. Full article
(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)
11 pages, 494 KiB  
Article
Missed Insights for Earlier Management of Parkinson’s Disease and the Value of Dopamine Transporter (DAT) Scans
by Mohib Hafeez, Elizabeth Eoff, Jeanne Wei and Gohar Azhar
Geriatrics 2024, 9(5), 126; https://doi.org/10.3390/geriatrics9050126 - 1 Oct 2024
Abstract
Background/Objectives: This retrospective study focused on the role of Dopamine Transporter (DAT) scans in diagnosing Parkinson’s Disease (PD) in older adults with cognitive impairment (CI). Methods: We retrospectively analyzed brain imaging of 6483 individuals aged 60 and above with CI. Among these, 297 [...] Read more.
Background/Objectives: This retrospective study focused on the role of Dopamine Transporter (DAT) scans in diagnosing Parkinson’s Disease (PD) in older adults with cognitive impairment (CI). Methods: We retrospectively analyzed brain imaging of 6483 individuals aged 60 and above with CI. Among these, 297 underwent a DAT scan, with 189 testing positive and 89 starting dopamine therapy. In contrast, 173 patients exhibited PD-associated structural changes on CT or MRI without receiving DAT scans or treatment. Results: Of these patients, 50 (29%) experienced falls. This points towards a potential missed diagnosis of PD, which can respond to therapy in the early stages. Conclusions: Our results suggest that providers may overlook subtle signs of parkinsonism in patients with CI, resulting in symptoms worsening and treatment delay. Since CI is often first brought to the attention of PCPs, our findings call for an increased effort to inform PCPs of the role of DAT scans in aiding the diagnosis of dopamine deficiency states. By understanding PD-related structural changes seen on brain imaging and using a DAT scan to confirm dopamine deficiency, treatment for PD or related states might be started earlier or a timely referral made to a specialist, reducing patient disability and improving their quality of life. Full article
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19 pages, 314 KiB  
Article
Influence of Obesity and Sociodemographic Features on the Physical Fitness of Breast Cancer Survivors
by Malgorzata Biskup, Pawel Macek, Marek Zak, Halina Krol, Malgorzata Terek-Derszniak and Stanislaw Gozdz
Geriatrics 2024, 9(5), 125; https://doi.org/10.3390/geriatrics9050125 - 1 Oct 2024
Abstract
Introduction: Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast [...] Read more.
Introduction: Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed. Materials and Methods: This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed. Results: More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category. Conclusions: In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance. Full article
(This article belongs to the Section Geriatric Oncology)
3 pages, 156 KiB  
Editorial
Time for a Re-Think? The Rationale for Multi-Component Intervention to Prevent Malnutrition in At-Risk Community-Dwelling Older Adults
by Johnny Naylor, Alexandra M. Johnstone and Phyo K. Myint
Geriatrics 2024, 9(5), 124; https://doi.org/10.3390/geriatrics9050124 - 23 Sep 2024
Abstract
Dietary strategies for early intervention in older adults are highly desirable, as they encourage individuals to retain a good functional status despite morbidity [...] Full article
(This article belongs to the Section Geriatric Nutrition)
12 pages, 647 KiB  
Article
Physical Function Trajectory among High-Functioning Long-Term Care Facility Residents: Utilizing Japanese National Data
by Kasumi Ikuta, Maiko Noguchi-Watanabe, Miya Aishima, Tatsuhiko Anzai, Kunihiko Takahashi and Sakiko Fukui
Geriatrics 2024, 9(5), 123; https://doi.org/10.3390/geriatrics9050123 - 19 Sep 2024
Abstract
Physical function trajectory (PFT) is associated with mortality and hospitalization risks. We aimed to identify and compare the PFTs of newly admitted high-functioning older adults during their first six months at long-term care (LTC) facilities. In this multicenter retrospective cohort study, we included [...] Read more.
Physical function trajectory (PFT) is associated with mortality and hospitalization risks. We aimed to identify and compare the PFTs of newly admitted high-functioning older adults during their first six months at long-term care (LTC) facilities. In this multicenter retrospective cohort study, we included newly admitted high-functioning older adults (Barthel index > 60) from 47 Japanese LTC facilities. The primary outcome was physical function changes after admission. Data were collected from the Long-Term Care Information System for Evidence (LIFE), which monitored LTC facility residents’ function between 1 January 2021 and 31 January 2022. A group-based trajectory model and binomial logistic regression analyses were applied to identify and compare residents’ PFTs. Among the 718 residents included, the average age was 85.69 years and 64.5% were female. PFTs were classified as maintenance (66.0%), improvement (9.5%), slight decline (16.6%), and large decline (7.9%). The improvement group had significantly fewer residents who expressed a lack of interest in daily activities (odds ratio (OR) 0.45; 95% confidence interval (CI) 0.21–0.97) compared to the maintenance group. The large decline group had significantly more residents with a low BMI at admission (OR 2.42; 95% CI 1.29–4.55) and residents who did not use dentures (OR 0.49; 95% CI 0.26–0.95), compared to the maintenance group. Considering future PFTs may aid the development of care plans and the provision of appropriate interventions. Moreover, utilizing existing data has the potential to maintain residents’ physical independence and enhance the quality of care without burdening residents themselves or staff. Full article
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16 pages, 403 KiB  
Article
The Association of Cognitive Impairment and Depression with Malnutrition among Vulnerable, Community-Dwelling Older Adults: A Large Cross-Sectional Study
by George Karam, Nada Abbas, Lea El Korh, Alexander Abi Saad, Lara Nasreddine and Krystel Ouaijan
Geriatrics 2024, 9(5), 122; https://doi.org/10.3390/geriatrics9050122 - 19 Sep 2024
Abstract
(1) Background: Mental health issues in older adults, particularly cognitive impairment and depression, can affect nutritional status. This study investigates the prevalence of malnutrition among community-dwelling older adults at risk of social exclusion and dependency in Lebanon and its association with cognitive impairment [...] Read more.
(1) Background: Mental health issues in older adults, particularly cognitive impairment and depression, can affect nutritional status. This study investigates the prevalence of malnutrition among community-dwelling older adults at risk of social exclusion and dependency in Lebanon and its association with cognitive impairment and depression. (2) Methods: This cross-sectional study used secondary data from the TEC-MED project, involving 1410 older adults aged 60 and above in Beirut. Nutritional status was assessed with the Mini Nutritional Assessment _Short Form (MNA_SF), cognitive impairment with the AD8 Dementia Screening Interview, and depression with the Geriatric Depression Scale (GDS-15). (3) Results: 87.2% of participants were at risk of malnutrition, and 2.5% were malnourished. Cognitive impairment was present in 82.2% of the sample and 45% experienced moderate to severe depression. Malnourished individuals had significantly higher rates of cognitive impairment (96.7% vs. 57.8%) and depression (85.7% vs. 23.2%). Significant associations were found between the risk of malnutrition, decreased food intake, cognitive impairment, and depression; however, no significant association was found with BMI. Logistic regression analysis indicated that older age, cognitive impairment, and depression were significant predictors of malnutrition, while having a caregiver was protective. (4) Conclusions: The high prevalence of risk of malnutrition among vulnerable older adults with cognitive impairment and depression underscores the need for policies integrating nutritional screening into routine health check-ups for older adults. Full article
(This article belongs to the Special Issue Nutrition Care and Support in Geriatrics)
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18 pages, 928 KiB  
Article
Facilitating Domestic and Civic-Style Activity in the Later Life of Army Veterans: The Influencing Culture of the Royal Hospital Chelsea
by Helen Cullen, Alison K. Osborne, Matthew D. Kiernan and Gemma Wilson-Menzfeld
Geriatrics 2024, 9(5), 121; https://doi.org/10.3390/geriatrics9050121 - 15 Sep 2024
Abstract
The Royal Hospital Chelsea has been home to veterans of the British Army since 1692. Opportunities to remain physically active throughout the life course of its residents include participation in numerous hobbies within the quasi-military environment, and in the civic engagement representational role [...] Read more.
The Royal Hospital Chelsea has been home to veterans of the British Army since 1692. Opportunities to remain physically active throughout the life course of its residents include participation in numerous hobbies within the quasi-military environment, and in the civic engagement representational role of the Chelsea Pensioner. This study examines the influence the Royal Hospital Chelsea culture has on resident opportunities to remain active. A non-traditional mixed-methods convergent design was used across three participant groups. Staff and established residents engaged in semi-structured qualitative interviews, with established residents and a cohort of new residents completing Quality of Life questionnaires. The findings indicate established Chelsea Pensioners experienced a sense of pride and purpose, elevated social status, and increased life satisfaction as a result of engaging in multiple activities. New Chelsea Pensioners demonstrated a trend towards increased quality of life after six months’ residence at the Royal Hospital Chelsea. Further research is required to explore the transferability of similar interventions into other residential establishments. Full article
(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)
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4 pages, 177 KiB  
Editorial
Reconsidering “Aging Well” According to Multiple Definitions: A Multidimensional Approach to Clinical Psychology of Aging
by Luca Gaviano, Roberto Pili, Andrea Domenico Petretto, Roberta Berti, Gian Pietro Carrogu, Martina Pinna and Donatella R. Petretto
Geriatrics 2024, 9(5), 120; https://doi.org/10.3390/geriatrics9050120 - 15 Sep 2024
Abstract
Aging is a phase of life that, though inevitable, includes an extraordinary variety of experiences, challenges, and opportunities [...] Full article
15 pages, 304 KiB  
Review
Frailty and Loneliness in Older Adults: A Narrative Review
by Andreea-Cristina Gheorghe, Elena Bălășescu, Ionela Hulea, Gabriela Turcu, Mihai Iustin Amariei, Alin-Victor Covaciu, Cătălina-Andreea Apostol, Melisa Asan, Andrei-Cosmin Badea, Ana-Cristina Angelușiu, Maria-Mirabela Mihailescu-Marin, Daniela Adriana Ion and Roxana Ioana Nedelcu
Geriatrics 2024, 9(5), 119; https://doi.org/10.3390/geriatrics9050119 - 13 Sep 2024
Abstract
(1) Background: In a society with an advancing aging rate, medical systems are coming under pressure due to an increasing flow of older patients with multiple somatic diseases, exacerbated by their psychological and sociological backgrounds. We aimed to investigate the relationship between frailty [...] Read more.
(1) Background: In a society with an advancing aging rate, medical systems are coming under pressure due to an increasing flow of older patients with multiple somatic diseases, exacerbated by their psychological and sociological backgrounds. We aimed to investigate the relationship between frailty and loneliness in older adults and to provide a holistic perspective on these concepts. Our research question was “Is there a link between the loneliness and frailty in older people?” (2) Methods: To assess the link between loneliness and frailty, we conducted a search accessing Index Medicus and PubMed; the timeframe of our research was from 2013 until 2023. Data regarding the study population, as well as loneliness and frailty assessments and approaches, were extracted. (3) Results: A positive relationship between loneliness and the appearance and progression of frailty in older adults is argued for. (4) Conclusions: Frailty and loneliness in older adults are often interconnected and can have a significant impact on their overall well-being. Early identification of frailty by assessing risk factors (including loneliness and/or social isolation) should become a standard of care for older patients. Appropriate combined interventions that effectively address both frailty and loneliness (physical exercises, psychological support, and social engagement) can promote healthier aging, prevent health deterioration, maintain independence, and reduce healthcare costs. Full article
(This article belongs to the Collection Frailty in Older Adults)
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11 pages, 768 KiB  
Article
Modified R-GLIM Score Is a Good Prognostic Tool to Predict a Long-Term Prognosis in Poor Conditioned Elderly Patients with Aspiration Pneumonia, a Pilot Study
by Yoshinori Wakita, Nobuhiro Asai, Wataru Ohashi, Naoharu Mori, Masato Maekawa and Hiroshige Mikamo
Geriatrics 2024, 9(5), 118; https://doi.org/10.3390/geriatrics9050118 - 12 Sep 2024
Abstract
Background. While prognostic guidelines for pneumonia have widely allowed clinicians to treat patients, poor prognostic factors for 1- or 2-year survival times have never been mentioned to our knowledge. Patients and methods. We conducted this retrospective study to evaluate whether malnutrition according to [...] Read more.
Background. While prognostic guidelines for pneumonia have widely allowed clinicians to treat patients, poor prognostic factors for 1- or 2-year survival times have never been mentioned to our knowledge. Patients and methods. We conducted this retrospective study to evaluate whether malnutrition according to the GLIM criteria is a poor prognostic factor for 1- or 2-year survival among patients with aspiration pneumonia. All patients with community-onset aspiration pneumonia who were admitted to Aichi Medical University and had intervention from our nutrition support team (NST) in 2019 and 2020 were enrolled in this study. Results. A total of 56 patients were enrolled in the study. The mean age was 86 ± 6.5 and 25 (45%) were male. Thirty-one patients died during this observational period. Comparing the survival and death group, higher respiratory rate (RR) and malnutrition were seen more frequently in the death group than in the survival group. Then, the patients were divided into the following three groups: those with an RR ≥ 22 and malnutrition, those with malnutrition, and a control group [patients who were not malnourished and had a low RR (<22)]. Comparing the three groups, patients with an RR ≥ 22 and malnutrition had significantly shorter overall survival times (OSs) than those in the other groups (p = 0.009 by Log-Rank test) for 1-year prognosis. The result of 2-year prognosis displayed a statistical significance that was the same as that for 1-year prognosis (p = 0.004 by Log-Rank test). The Cox hazard regression model showed that a higher RR was an independent poor prognostic factor for 1- and 2-year survival among aspiration pneumonia patients. Conclusions. This pilot study showed that combined scores of higher RR and malnutrition according to the GLIM criteria (modified R-GLIM score) was an independent poor prognostic factor for 1 or 2-year survival among super-elderly patients (aged over 80 years) with aspiration pneumonia. Full article
(This article belongs to the Section Geriatric Pulmonology)
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8 pages, 218 KiB  
Opinion
Embracing Connection: A Review of First-Ever Clinical Guidelines on Social Isolation and Loneliness in Older Adults
by Peter M. Hoang and David Conn
Geriatrics 2024, 9(5), 117; https://doi.org/10.3390/geriatrics9050117 - 11 Sep 2024
Abstract
Social isolation and loneliness are major public health concerns and are associated with morbidity and mortality. As this is an increasing issue in older adults, guidance for healthcare providers is a priority. The Canadian Coalition for Senior’s Mental Health (CCSMH) has developed the [...] Read more.
Social isolation and loneliness are major public health concerns and are associated with morbidity and mortality. As this is an increasing issue in older adults, guidance for healthcare providers is a priority. The Canadian Coalition for Senior’s Mental Health (CCSMH) has developed the first Canadian social isolation and loneliness guidelines to help providers recognize, assess, and manage social isolation and loneliness among older adults. We review and summarize these guidelines to support healthcare and social service providers to apply best practices and evidence-based care for older adults experiencing social isolation and loneliness. Full article
12 pages, 462 KiB  
Article
Challenges in Conducting Exercise Recovery Studies in Older Adults and Considerations for Future Research: Findings from a Nutritional Intervention Study
by Eleanor Jayne Hayes, Christopher Hurst, Antoneta Granic, Avan A. Sayer and Emma Stevenson
Geriatrics 2024, 9(5), 116; https://doi.org/10.3390/geriatrics9050116 - 10 Sep 2024
Abstract
Maximising the potential benefit of resistance exercise (RE) programs by ensuring optimal recovery is an important aim of exercise prescription. Despite this, research surrounding recovery from RE in older adults is limited and inconsistent. The following randomised controlled trial was designed to investigate [...] Read more.
Maximising the potential benefit of resistance exercise (RE) programs by ensuring optimal recovery is an important aim of exercise prescription. Despite this, research surrounding recovery from RE in older adults is limited and inconsistent. The following randomised controlled trial was designed to investigate the efficacy of milk consumption for improving recovery from RE in older adults. However, the study encountered various challenges that may be applicable to similar studies. These include recruitment issues, a lack of measurable perturbations in muscle function following RE, and potential learning effects amongst participants. Various considerations for exercise research have arisen from the data which could inform the design of future studies in this area. These include (i) recruitment—consider ways in which the study design could be altered to aid recruitment or allow a longer recruitment period; (ii) learning effects and familiarisation—consider potential learning effects of outcome measures and adjust familiarisation accordingly; (iii) identify, validate and optimise protocols for outcome measures that are applicable for the specific population; (iv) adjust the exercise protocol according to the specific aims of the study (e.g., are you replicating a usual exercise bout or is the intent to cause large amounts of muscle damage?). Full article
(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)
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14 pages, 397 KiB  
Article
Factors Associated with Increased Burden of Caregivers of People with Dementia with Lewy Bodies
by Shunji Toya, Mamoru Hashimoto, Yuta Manabe, Hajime Yamakage and Manabu Ikeda
Geriatrics 2024, 9(5), 115; https://doi.org/10.3390/geriatrics9050115 - 9 Sep 2024
Abstract
The burden of caregivers of people with dementia with Lewy bodies (DLB) is high; however, factors related to their caregiving burden are not fully clarified. We herein investigated factors associated with increasing caregiver burden for caregivers of people with DLB. To explore factors [...] Read more.
The burden of caregivers of people with dementia with Lewy bodies (DLB) is high; however, factors related to their caregiving burden are not fully clarified. We herein investigated factors associated with increasing caregiver burden for caregivers of people with DLB. To explore factors associated with caregiver burden, a linear regression analysis was conducted using the J-ZBI_8 total score as the dependent variable and a total of 36 factors as independent variables. This analysis included 252 pairs of people with DLB and their caregivers. Caregivers’ mean J-ZBI_8 was 8.4, indicating that caregiver burden was generally high. First, we identified 20 factors associated with caregiver burden in univariable analysis. Finally, multivariable analysis found three significant factors: irritability (β = 0.208, p < 0.001), use of “short stay” or “small-scale, multifunctional home care” (β = 0.208, p < 0.001), and nighttime behavior (β = 0.138, p = 0.020) were significantly associated with J-ZBI_8 total scores. Irritability and nighttime behavior were found to be contributing factors to caregiver burden. High caregiver burden among caregivers of people with DLB may result in the use of social services providing overnight stays, but to what extent such services reduce caregiver burden is unknown. Full article
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13 pages, 1281 KiB  
Article
Freedom from Recurrence across Age in Non-Melanoma Skin Cancer Treated with Image-Guided Superficial Radiation Therapy
by Aaron S. Farberg, Randy V. Heysek, Robert Haber, Rania Agha, Kevin M. Crawford, Ji Xinge and Jeffrey Blake Stricker
Geriatrics 2024, 9(5), 114; https://doi.org/10.3390/geriatrics9050114 - 5 Sep 2024
Abstract
Non-melanoma skin cancers (NMSCs) are a significant cause of morbidity and mortality; their incidence is increasing most in older patients. NMSCs have traditionally been treated with surgical excision, curettage, Mohs micrographic surgery (MMS), and superficial radiotherapy (SRT). Image-guided SRT (IGSRT) is a treatment [...] Read more.
Non-melanoma skin cancers (NMSCs) are a significant cause of morbidity and mortality; their incidence is increasing most in older patients. NMSCs have traditionally been treated with surgical excision, curettage, Mohs micrographic surgery (MMS), and superficial radiotherapy (SRT). Image-guided SRT (IGSRT) is a treatment option for poor surgical candidates or patients with low- or high-risk, early-stage NMSC who prefer to avoid surgery. This large retrospective cohort study compared 2-, 4-, and 6-year freedom from recurrence in biopsy-proven NMSC lesions treated with IGSRT (n = 20,069 lesions) between patients aged < 65 years (n = 3158 lesions) and ≥65 years (n = 16,911 lesions). Overall freedom from recurrence rates were 99.68% at 2 years, 99.57% at 4 years, and 99.57% at 6 years. Rates did not differ significantly by age (p = 0.8) nor by sex among the two age groups (p > 0.9). There was a significant difference in recurrence among older patients when analyzed by stage (p = 0.032), but no difference by stage in younger patients (p = 0.7). For early-stage NMSCs, IGSRT is a clinically equivalent alternative to MMS and statistically significant in superiority to non-image-guided SRT. This study demonstrates that there is no significant effect of age on 2-, 4-, or 6-year freedom from recurrence in patients with IGSRT-treated NMSC. Full article
(This article belongs to the Section Geriatric Oncology)
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20 pages, 304 KiB  
Article
“Physical Activity Is Not the Answer to Everything, but It Is to a Lot”: Stakeholders’ Perceived Determinants of Implementing Physical Activity Interventions for Older Adults
by Janet M. Boekhout, Rieteke Hut, Jannique G. Z. van Uffelen, Gesa Czwikla and Denise A. Peels
Geriatrics 2024, 9(5), 113; https://doi.org/10.3390/geriatrics9050113 - 4 Sep 2024
Viewed by 164
Abstract
Although many physical activity (PA) interventions for older adults have proven effective in controlled research settings, optimal implementation in real life remains challenging. This study identifies determinants perceived by stakeholders when implementing community-based PA interventions for older adults. We interviewed 31 stakeholders guided [...] Read more.
Although many physical activity (PA) interventions for older adults have proven effective in controlled research settings, optimal implementation in real life remains challenging. This study identifies determinants perceived by stakeholders when implementing community-based PA interventions for older adults. We interviewed 31 stakeholders guided by the Consolidated Framework for Implementation Research (CFIR). Results showed that stakeholders are very specific about the role they can play in implementation, making collaboration between stakeholders crucial. Barriers and motivators were identified in the CFIR intervention characteristics domain (relative advantage, complexity and costs, evidence quality and strength, and adaptability and trialability), in the outer setting domain (cosmopolitism, patient needs, and external policy and incentives), in the inner setting domain (implementation climate, relative priority, compatibility and organizational incentives and rewards) and in the individual characteristics domain (knowledge and beliefs, and other personal attributes). An overarching theme was the stakeholders’ emphasis on aiming for broad health goals in interventions, as they perceive PA as a means to reach these goals rather than an end in itself. Another overarching theme requiring attention in future implementation efforts is the need to tailor implementation efforts to the specific needs of older adults as the end users of the intervention. Full article
(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)
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21 pages, 2015 KiB  
Article
Implementation of the Expert Nursing Standard: Caregivers’ Oral Health Knowledge
by Ina Nitschke, Felix Schulz, Elmar Ludwig and Julia Jockusch
Geriatrics 2024, 9(5), 112; https://doi.org/10.3390/geriatrics9050112 - 3 Sep 2024
Viewed by 277
Abstract
The promotion of oral health in nursing care is essential for preventing oral diseases and maintaining health in elderly vulnerable populations. There is a need for standardized guidelines and education. The aim of this study was to collect data on the attitudes and [...] Read more.
The promotion of oral health in nursing care is essential for preventing oral diseases and maintaining health in elderly vulnerable populations. There is a need for standardized guidelines and education. The aim of this study was to collect data on the attitudes and hopes of caregivers regarding the implementation of the German Expert Nursing Standard “Promotion of Oral Health in Nursing” (GENS-POHN) and to evaluate their oral healthcare knowledge before implementation. A cross-sectional study was conducted in five different care settings in Germany. A self-administered questionnaire was used to collect data on the attitudes and hopes of nursing assistants regarding the GENS-POHN. Oral healthcare knowledge was evaluated before implementation. Most participants had a positive attitude towards the GENS-POHN and hoped that its implementation would lead to greater safety and competence in daily oral healthcare tasks. Few participants currently use screening or assessment instruments for oral care. There is a need for further education and training, as well as the development and implementation of standardized guidelines and tools for screening and assessment, in oral care. The GENS-POHN as an expert standard could be made accessible to an international audience by translating it into other respective national languages, thereby enhancing its usability for a wider range of users. Full article
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10 pages, 786 KiB  
Article
New Psychometric Evidence of the Life Satisfaction Scale in Older Adults: An Exploratory Graph Analysis Approach
by Julio Dominguez-Vergara, Brigitte Aguilar-Salcedo, Rita Orihuela-Anaya and José Villanueva-Alvarado
Geriatrics 2024, 9(5), 111; https://doi.org/10.3390/geriatrics9050111 - 2 Sep 2024
Viewed by 238
Abstract
The objective of the present study was to analyze the psychometric properties of a life satisfaction scale in older Peruvian adults using an exploratory graph analysis (EGA) approach. A total of 407 older adults aged between 60 and 95 years (M = 69.5; [...] Read more.
The objective of the present study was to analyze the psychometric properties of a life satisfaction scale in older Peruvian adults using an exploratory graph analysis (EGA) approach. A total of 407 older adults aged between 60 and 95 years (M = 69.5; SD = 6.7) from three comprehensive elderly care centers (CIAMs) in Lima, Peru, were recruited. A non-probabilistic convenience sampling was used. The Satisfaction with Life Scale (SWLS) was analyzed using EGA with the Gaussian GLASSO model to assess its dimensionality and structural consistency. The relationship with other variables was analyzed using scales such as the GAD-7 and PHQ-9. The network structure of the SWLS indicates a single dimension. Additionally, network loadings (nodes) were examined, showing high values (>0.35) for most items except item 1, which had a moderate loading (>0.25). Structural reliability showed that a single dimension was identified 100% of the time. The post hoc CFA considering the unidimensional network structure obtained through EGA showed satisfactory fit (χ2/df = 3.48, CFI = 0.96, TLI = 0.92, SRMR = 0.02, RMSEA = 0.07 [90% CI 0.05, 0.08]). Finally, internal consistency reliability was acceptable (ω = 0.92). The SWLS measure is robust and consistent. These findings are a valuable reference for advancing research on aging in Peru, as they provide a practical, valid, and reliable measure. Full article
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10 pages, 256 KiB  
Review
Impact of Gut Microbiota on Aging and Frailty: A Narrative Review of the Literature
by Selene Escudero-Bautista, Arianna Omaña-Covarrubias, Ana Teresa Nez-Castro, Lydia López-Pontigo, Maribel Pimentel-Pérez and Alonso Chávez-Mejía
Geriatrics 2024, 9(5), 110; https://doi.org/10.3390/geriatrics9050110 - 31 Aug 2024
Viewed by 463
Abstract
Aging is a natural, complex, and individual process that focuses on the progressive decay of the body and a decrease in cell function that begins in approximately the sixth decade of life and ends with death. Current scientific evidence shows that the aging [...] Read more.
Aging is a natural, complex, and individual process that focuses on the progressive decay of the body and a decrease in cell function that begins in approximately the sixth decade of life and ends with death. Current scientific evidence shows that the aging process is mostly related to genetic load and varies because of the environment. Therefore, aging can be adjusted through the intervention of factors that control homeostasis in genetic, biochemical, and immunological processes, including those involving the gut microbiota. Indeed, the diversity of the gut microbiota decreases during aging, based on the presence of modifications in the hormonal, immunological, and operational processes of the gastrointestinal tract. These modifications lead to a state of dysbiosis. However, altering bacterial communities remains complicated due to the great diversity of factors that influence their modification. Alterations caused by the aging process are known to foster dysbiosis and correspond to conditions that determine the degree of frailty in senior citizens. Consequently, the microbial structure can be used as a biomarker for geriatric care in the promotion of healthy aging. Full article
(This article belongs to the Special Issue Nutrition Care and Support in Geriatrics)
9 pages, 712 KiB  
Article
Group Reminiscence Therapy for Dementia to Improve Well-Being and Reduce Behavioral Symptoms
by Nobuhiko Yanagida, Takumi Yamaguchi and Yuko Matsunari
Geriatrics 2024, 9(5), 109; https://doi.org/10.3390/geriatrics9050109 - 28 Aug 2024
Viewed by 325
Abstract
The global increase in dementia cases highlights the urgent need for effective treatment and care strategies. The aim of this study was to evaluate the effects of group reminiscence therapy on cognitive function, subjective well-being, and behavioral and psychological symptoms of dementia (BPSD) [...] Read more.
The global increase in dementia cases highlights the urgent need for effective treatment and care strategies. The aim of this study was to evaluate the effects of group reminiscence therapy on cognitive function, subjective well-being, and behavioral and psychological symptoms of dementia (BPSD) in older adults with moderate to severe dementia. A pre–post comparative design was used, with 49 participants receiving eight group reminiscence therapy sessions over 4 weeks. Baseline, one-week, and one-month postintervention assessments were conducted using the Hasegawa Dementia Scale-Revised (HDS-R), the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH), and the Philadelphia Geriatric Center Morale Scale (PGC Morale Scale). The results showed no significant improvement in HDS-R scores, but significant improvements in PGC Morale Scale (p = 0.0417) and NPI-NH scores (p = 0.00226), indicating improved well-being and reduced BPSD. These findings suggest that group reminiscence therapy is effective in improving BPSD. Future research should focus on extending the duration of the intervention, including different populations, and combining group reminiscence therapy with other therapeutic approaches to fully determine its long-term benefits and mechanisms. Research on its cost-effectiveness and cultural applicability could further validate and improve the use of group reminiscence therapy in diverse care settings. Full article
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15 pages, 1608 KiB  
Article
Age-Related Differences in the Functional Demand Placed on the Lumbar Spine during Walking in Healthy Older versus Younger Men
by Alexander Dallaway, Michael Duncan, Corbin Griffen, Derek Renshaw, Jason Tallis and John Hattersley
Geriatrics 2024, 9(5), 108; https://doi.org/10.3390/geriatrics9050108 - 23 Aug 2024
Viewed by 423
Abstract
Age-related declines in the musculoskeletal system may place additional demands on the lumbar spine during everyday activities such as walking. This study aimed to investigate age-related differences in the functional demand (FD) of walking on the lumbar spine in older and younger adults. [...] Read more.
Age-related declines in the musculoskeletal system may place additional demands on the lumbar spine during everyday activities such as walking. This study aimed to investigate age-related differences in the functional demand (FD) of walking on the lumbar spine in older and younger adults. A motion analysis system with integrated force plates was used to acquire kinematic and kinetic data on 12 older (67.3 ± 6.0 years) and 12 younger (24.7 ± 3.1 years) healthy men during walking at a self-selected speed along a 10 m walkway. Isokinetic dynamometry was used to acquire the maximal joint moment capacity of the lumbar spine. The FD of the lumbar spine was calculated as the muscle moment during key phases of the gait cycle (GC) relative to the maximum moment capacity of the lumbar spine. The difference in FD between age groups was not significant (p = 0.07) and there were no significant differences between the young group (YG) and older group (OG) for any individual phase in the GC. Despite the lack of statistical significance, the results indicate that a practical difference may exist, as walking was approximately 20% more functionally demanding on the lumbar spine in the OG compared to the YG. Therefore, older adults may employ modified gait strategies to reduce mechanical load whilst walking to fall within the limits of their maximal force-producing capacity in the lumbar spine, which may have implications for injury risk. Full article
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36 pages, 839 KiB  
Systematic Review
Definitions of Ageing According to the Perspective of the Psychology of Ageing: A Scoping Review
by Luca Gaviano, Roberto Pili, Andrea Domenico Petretto, Roberta Berti, Gian Pietro Carrogu, Martina Pinna and Donatella Rita Petretto
Geriatrics 2024, 9(5), 107; https://doi.org/10.3390/geriatrics9050107 - 23 Aug 2024
Cited by 1 | Viewed by 446
Abstract
In the last decades, the scientific interest in ageing has increased due to the progressive ageing of the global population and due to the importance of guaranteeing the elder people and the next generations a good quality of life and biopsychological well-being. However, [...] Read more.
In the last decades, the scientific interest in ageing has increased due to the progressive ageing of the global population and due to the importance of guaranteeing the elder people and the next generations a good quality of life and biopsychological well-being. However, nowadays, there is not a common and accepted definition of ageing. This situation may refer to the complexity and relevance of the ageing topic and it means that the concept of ageing needs to be understood in a deeper way as a multidimensional and complex process that includes different elements distinctive. The main goal of this review is to explore the definitions and conceptual models of ageing according to a psychological point of view, through a biopsychosocial approach, that integrates biological, psychological, and social aspects with the main goal of a better understanding of the complexity of the process itself. Methods: We conducted a review of the literature through PubMed, Scopus, Web of Science and Google Scholar databases, and we followed the PRISMA-ScR guidelines, analysing papers written in English between 2002 and 2023. Results: The review showed different conceptual models of ageing, including Rowe and Kahn’s successful ageing model, the World Health Organization’s models, and others like the “Selection, Optimization and Compensation” Model. Also, the determinants and predictors of ageing have been analysed highlighting the individual variability and the multidimensional nature of ageing. The geographic diversity of the included studies allowed for the analysis of cultural, socioeconomic, and environmental differences in the conceptualisation of ageing. Conclusions: The results emphasise the importance of targeted interventions and programs aimed at promoting well-being during ageing, considering the complexity and multidimensionality of the ageing process. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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11 pages, 203 KiB  
Article
Dementia Care Nursing for Apathetic Older Patients: A Qualitative Study
by Mana Doi, Asumi Tanaka, Nanae Nemoto, Tenna Watanabe and Yuka Kanoya
Geriatrics 2024, 9(5), 106; https://doi.org/10.3390/geriatrics9050106 - 23 Aug 2024
Viewed by 325
Abstract
The number of patients hospitalized with dementia is increasing, but one symptom, apathy, tends to be overlooked and unaddressed. Thus, this study determines how nurses certified in dementia nursing engage with older patients with dementia who exhibit apathy during hospitalization. A qualitative study [...] Read more.
The number of patients hospitalized with dementia is increasing, but one symptom, apathy, tends to be overlooked and unaddressed. Thus, this study determines how nurses certified in dementia nursing engage with older patients with dementia who exhibit apathy during hospitalization. A qualitative study using semi-structured interviews with 10 dementia care nurses in Japan was conducted. Through conventional content analysis, 10 categories were generated. They included (1) initiating patient engagement when their physiological or daily-life problems become more pronounced, (2) assessing and identifying the causes of decreased motivation from multiple perspectives, (3) assessing patients from multiple perspectives to determine the best way to start supporting them, (4) providing reassurance through basic dementia care, (5) incorporating pleasant stimuli into the hospital environment, (6) providing care based on patients’ circumstances and abilities by collaborating with multiple professionals. Nurses initiate involvement with patients when their daily life problems become more pronounced. They conduct comprehensive assessments from multiple perspectives and collaborate with other professionals to ensure patient care and safety. They also extend their support to patients’ families and maintain long-term involvement. Apathetic older patients benefit from basic nursing care practices and a patient-centered approach, which do not require specialization or additional costs and resources. Full article
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