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Volume 6
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Geriatrics, Volume 6, Issue 3 (September 2021) – 32 articles

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14 pages, 2126 KiB  
Article
Stereoscopic Visual Perceptual Learning in Seniors
by Sabine Erbes and Georg Michelson
Geriatrics 2021, 6(3), 94; https://doi.org/10.3390/geriatrics6030094 - 18 Sep 2021
Cited by 4 | Viewed by 3463
Abstract
Background: We showed that seniors can improve their stereoscopic ability (stereoacuity) and corresponding reaction time with repetitive training and, furthermore, that these improvements through training are still present even after a longer period of time without training. Methods: Eleven seniors (average age: 85.90 [...] Read more.
Background: We showed that seniors can improve their stereoscopic ability (stereoacuity) and corresponding reaction time with repetitive training and, furthermore, that these improvements through training are still present even after a longer period of time without training. Methods: Eleven seniors (average age: 85.90 years) trained twice a week for six weeks with dynamic stereoscopic perception training using a vision training apparatus (c-Digital Vision Trainer®). Stereoscopic training was performed in 12 training session (n = 3072) of visual tasks. The task was to identify and select one of four figures (stereoscopic stimuli) that was of a different disparity using a controller. The tests included a dynamic training (showing rotating balls) and a static test (showing plates without movement). Before and after training, the stereoacuity and the corresponding reaction times were identified with the static stereotest in order to determine the individual training success. The changes in respect to reaction time of stereoscopic stimuli with decreasing disparity were calculated. Results: After 6 weeks of training, reaction time improved in the median from 936 arcsec to 511 arcsec. Stereoscopic vision improved from 138 arcsec to 69 arcsec, which is an improvement of two levels of difficulty. After 6 months without training, the improvement, achieved by training, remained stable. Conclusions: In older people, visual training leads to a significant, long-lasting improvement in stereoscopic vision and the corresponding reaction time in seniors. This indicates cortical plasticity even in old age. Full article
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8 pages, 269 KiB  
Review
Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem
by Sintija Lapsa, Arturs Ozolins, Ilze Strumfa and Janis Gardovskis
Geriatrics 2021, 6(3), 93; https://doi.org/10.3390/geriatrics6030093 - 18 Sep 2021
Cited by 18 | Viewed by 4945
Abstract
With increased life expectancy and the growing total population of elderly patients, there has been rise in the number of cases of acute appendicitis in elderly people. Although acute appendicitis is not the most typical pathological condition in the elderly, it is not [...] Read more.
With increased life expectancy and the growing total population of elderly patients, there has been rise in the number of cases of acute appendicitis in elderly people. Although acute appendicitis is not the most typical pathological condition in the elderly, it is not uncommon. Most of these patients require surgical treatment, and as with any acute surgical pathology in advanced age, treatment possibilities are affected by comorbidities, overall health status, and an increased risk of complications. In this literature review we discuss differences in acute appendicitis in the elderly population, with a focus on clinical signs, diagnostics, pathogenesis, treatment, and results. Full article
13 pages, 649 KiB  
Article
Quality of Life in Older Adults: Evidence from Mexico and Ecuador
by Paola Ochoa Pacheco, Rafael Castro Pérez, David Coello-Montecel and Nancy Pamela Castro Zazueta
Geriatrics 2021, 6(3), 92; https://doi.org/10.3390/geriatrics6030092 - 16 Sep 2021
Cited by 2 | Viewed by 3526
Abstract
Older adults are a growing population group in Latin America, hence the importance of deepening studies, proposals, and policies to guarantee their well-being. This article analyzes the perception of quality of life in older adults from Mexico and Ecuador and its association with [...] Read more.
Older adults are a growing population group in Latin America, hence the importance of deepening studies, proposals, and policies to guarantee their well-being. This article analyzes the perception of quality of life in older adults from Mexico and Ecuador and its association with several socioeconomic variables. The study design was cross-sectional. The sample comprised 450 older adults, 238 from Mexico and 212 from Ecuador. The WHOQOL-OLD Quality of Life Questionnaire and a set of sociodemographic variables were used. The results showed a higher perception of quality of life in the Mexican sample regarding most of the dimensions, except for sensory skills and social participation. An association was also found between sensory skills and sports practice, as well as between social participation and education level. The study achieves a binational approach to the reality of older adults in Latin America and confirms that there are differences in each sample that are due to the particularities of each reality. This research contributes to deepening the reality of the elderly, especially in Ecuador, where the quality-of-life studies in all age segments must be strengthened. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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10 pages, 1021 KiB  
Article
The Mini-Cog, Clock Drawing Test, and Three-Item Recall Test: Rapid Cognitive Screening Tools with Comparable Performance in Detecting Mild NCD in Older Patients
by Panita Limpawattana and Manchumad Manjavong
Geriatrics 2021, 6(3), 91; https://doi.org/10.3390/geriatrics6030091 - 16 Sep 2021
Cited by 14 | Viewed by 7144
Abstract
Background: Early mild neurocognitive disorder (mild NCD) detection can allow for appropriate planning and delay disease progression. There have been few studies examining validated mild NCD detection tools. One such tool that may be of use is the Mini-Cog, which consists of the [...] Read more.
Background: Early mild neurocognitive disorder (mild NCD) detection can allow for appropriate planning and delay disease progression. There have been few studies examining validated mild NCD detection tools. One such tool that may be of use is the Mini-Cog, which consists of the clock drawing test (CDT) and three-item recall. Methods: This study aimed to compare the diagnostic properties of the Mini-Cog, the CDT alone, and the three-item recall test alone in mild NCD detection according to DSM-5 criteria. The participants were older patients attending the medicine outpatient clinic. Area under receiver operating characteristic (ROC) curve (AUC) analysis was used to compare the tools’ accuracy. Results: A total of 150 patients were enrolled, 42 of whom were diagnosed as having mild NCD. The AUCs of ROC curves of the three-item recall, CDT, Mini-Cog1, and Mini-Cog2 were 0.71, 0.67, 0.73, and 0.71, respectively (p = 0.36). The sensitivity of the tools was 85.7%, 66.7%, 57.4%, and 69% respectively. The tests performed similarly in participants with ≤6 years of education (p = 0.27) and those with >6 years of education (p = 0.49). Conclusions: All tools exhibited similar acceptable performance in detecting mild NCD and were not affected by education. These convenient tools might be suitable for use in clinical practice. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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13 pages, 861 KiB  
Article
Reasons for and against Nutritional Interventions. An Exploration in the Nursing Home Setting
by Franz J. Grosshauser, Eva Kiesswetter, Gabriel Torbahn, Cornel C. Sieber and Dorothee Volkert
Geriatrics 2021, 6(3), 90; https://doi.org/10.3390/geriatrics6030090 - 16 Sep 2021
Cited by 2 | Viewed by 2524
Abstract
Malnutrition (MN) is widespread in nursing homes. Sometimes, but not always, nutritional interventions (NIs) are made, and the reasons for or against NIs are unknown. The aim of this cross-sectional study was to describe these reasons for residents with and without MN according [...] Read more.
Malnutrition (MN) is widespread in nursing homes. Sometimes, but not always, nutritional interventions (NIs) are made, and the reasons for or against NIs are unknown. The aim of this cross-sectional study was to describe these reasons for residents with and without MN according to nurses’ subjective judgement and according to objective signs of MN. The nutritional status of 246 nursing home residents was subjectively judged by nurses (MN, at risk of MN, no MN) and objectively assessed by body mass index (BMI), weight loss (WL), and low food intake. NIs (enriched meals and/or oral nutritional supplements) were recorded using a standardized questionnaire, and nurses’ main reasons for (not) giving NIs were obtained in an open question. Of the residents, 11.0% were subjectively malnourished, and 25.6% were at risk of MN; 32.9% were malnourished according to objective criteria. Overall, 29.7% of the residents received NIs, 70.4% of those with MN as assessed by the nurses, 53.0% of those with objective MN, and 11.0% and 18.0% of non-malnourished residents, respectively. Reasons for NIs most often stated were low intake (47.9%), WL (23.3%), and low BMI (13.7%). Reasons against NIs mostly mentioned were adequate BMI (32.9%) and sufficient intake (24.3%). The lack of NIs for residents with MN was partially—but not always—explained by valid reasons. As residents without MN frequently received NIs, criteria for both MN rating and providing NIs, require closer scrutiny. Full article
(This article belongs to the Section Geriatric Nutrition)
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10 pages, 912 KiB  
Article
Factors Associated with Volunteer Activities and Sleep Efficiency in Older Adults with Hypertension: A Sequential Model Study
by Ryoko Aonuma, Thomas Mayers, Katsuyoshi Mizukami, Kazutaka Aonuma and Hitomi Matsuda
Geriatrics 2021, 6(3), 89; https://doi.org/10.3390/geriatrics6030089 - 11 Sep 2021
Cited by 4 | Viewed by 2690
Abstract
The purpose of this study was to examine, using a sequential model, factors associated with volunteer participation and sleep efficiency in Japanese older adults receiving treatment for hypertensive disease. A questionnaire survey was conducted to collect data on participant demographics, lifestyle, health status, [...] Read more.
The purpose of this study was to examine, using a sequential model, factors associated with volunteer participation and sleep efficiency in Japanese older adults receiving treatment for hypertensive disease. A questionnaire survey was conducted to collect data on participant demographics, lifestyle, health status, and depression, and sleep activity monitors were used to objectively measure sleep status and sleep efficacy. Of the 167 respondents, the 59 being treated for hypertension were divided into two groups based on their participation in volunteering. Comparison between the groups showed significant differences in nocturnal awakening, sleep efficiency, and nap frequency. Volunteers had less nocturnal awakening, increased sleep efficiency, fewer naps, and decreased depression. Covariance structure analysis of the survey data and sleep measurements for hypertensive older adults in the volunteer group was performed by modeling the relationships between variables with a path diagram. Our model showed strong goodness of fit (χ2 test = 15.636, p = 0.111, GFI = 0.925, AGFI = 0.842, CFI = 0.925, RMSEA = 0.099). The findings of this study suggest that older adults with hypertension who participate in volunteer activities have less nocturnal awakening, improved sleep quality, and reduced risk of depression, and provides evidence to promote social participation in volunteering among older adults with hypertension. Full article
(This article belongs to the Section Geriatric Psychiatry and Psychology)
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11 pages, 647 KiB  
Article
The Use of Patient Reported Outcome Measures (PROMs) 6 Months Post-Stroke and Their Association with the National Institute of Health Stroke Scale (NIHSS) on Admission to Hospital
by Jonathan Hewitt, Natalie Bains, Katherine Wallis, Stephanie Gething, Anna Pennington and Ben Carter
Geriatrics 2021, 6(3), 88; https://doi.org/10.3390/geriatrics6030088 - 7 Sep 2021
Cited by 3 | Viewed by 3872
Abstract
Patient Reported Outcome Measures (PROMs) assess clinical outcomes from the perspective of the patient. The stroke community recommended fifteen questions for use in stroke survivors, based on the established PROMIS10 with five additional stroke-specific questions. This study aimed to determine its association with [...] Read more.
Patient Reported Outcome Measures (PROMs) assess clinical outcomes from the perspective of the patient. The stroke community recommended fifteen questions for use in stroke survivors, based on the established PROMIS10 with five additional stroke-specific questions. This study aimed to determine its association with the National Institute of Health Stroke Scale (NIHSS) on admission. PROM responses were taken from an existing randomised control trial and, using secondary analysis, the total score was calculated out of 100. The association between PROMs and NIHSS was estimated. Using a multivariable regression, an adjusted mean difference (aMD) in PROM total score for the baseline clinical characteristics was calculated. 343 participants (16.3%) completed the PROM; mean age 71.7 (30–94) years; 133 women (38.8%). There was a strong association between increasing NIHSS Scores on admission to hospital and worsening PROM scores at 6 months (p = 0.002). There was consistency between the NIHSS and modified Rankin score with the stroke-specific domain and total PROM scores. When adjusted, women had lower (worse) total PROM scores, with aMD = −3.85 (95% CI −6.30–−1.41; p = 0.002) and so did haemorrhagic strokes, with a reduction of 3.88 (95% CI −0.61–7.37; p = 0.097). This study contributes to the evaluation process of this stroke-specific PROM and emphasises that stroke severity on admission correlates with poorer patient outcomes 6 months following a stroke, especially in women and those suffering haemorrhagic stroke. Full article
(This article belongs to the Special Issue Feature Papers in Geriatrics)
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17 pages, 1160 KiB  
Article
The Spanish Intergenerational Study: Beliefs, Stereotypes, and Metacognition about Older People and Grandparents to Tackle Ageism
by Aida Muntsant, Paula Ramírez-Boix, Rocío Leal-Campanario, Francisco Javier Alcaín and Lydia Giménez-Llort
Geriatrics 2021, 6(3), 87; https://doi.org/10.3390/geriatrics6030087 - 3 Sep 2021
Cited by 5 | Viewed by 3539
Abstract
Ageism can be seen as systematic stereotypes, prejudice, and discrimination of people because of their age. For a long time, society has accepted negative stereotypes as a norm. When referring to older adults, the United Nations Global Report on Ageism warns about a [...] Read more.
Ageism can be seen as systematic stereotypes, prejudice, and discrimination of people because of their age. For a long time, society has accepted negative stereotypes as a norm. When referring to older adults, the United Nations Global Report on Ageism warns about a severe impact. The Intergenerational Study for a Healthy Aging, a questionnaire about believes, stereotypes, and knowledge about older people and grandparents, was administered to 326 Spanish biology and medical students. Here we report the results of stereotype analysis through adjective qualification of the youth and older people performed before the survey. Content analysis of two open questions about metacognition at the end of the survey is also presented. The results show that: (1) The questionnaire promoted metacognition; (2) Positive metacognition toward grandparents was higher than for the general old population; (3) Most participants were not conscious about ageism; (4) Gender was a key factor—male students were more ageist than females; (5) The feeling of guilt was higher in the questionnaire about older people; (6) The metacognition exercise elicited thoughts and, in few cases, the need to take action to tackle ageism. In conclusion, both activities promoted active thoughts about older people vs. grandparents and helped participants realize unconscious ageism—specifically toward the older population—serving as an awareness activity that may help tackle ageism. Full article
(This article belongs to the Collection Ageism, the Black Sheep of the Decade of Healthy Ageing)
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18 pages, 326 KiB  
Article
Functional Status among Polymedicated Geriatric Inpatients at Discharge: A Population-Based Hospital Register Analysis
by Filipa Pereira, Boris Wernli, Armin von Gunten, María del Rio Carral, Maria Manuela Martins and Henk Verloo
Geriatrics 2021, 6(3), 86; https://doi.org/10.3390/geriatrics6030086 - 3 Sep 2021
Cited by 5 | Viewed by 2579
Abstract
This study explored and compared the functional status of polymedicated and non-polymedicated geriatric inpatients at hospital discharge. We used a cross-sectional registry of geriatric patients’ hospital records from a multi-site public hospital center in Switzerland. The analysis included all inpatients aged 65 years [...] Read more.
This study explored and compared the functional status of polymedicated and non-polymedicated geriatric inpatients at hospital discharge. We used a cross-sectional registry of geriatric patients’ hospital records from a multi-site public hospital center in Switzerland. The analysis included all inpatients aged 65 years old or more admitted between 1 January 2015 and 31 December 2017 (n = 53,690), of whom 67.5% were polymedicated at hospital discharge, 52.1% were women (n = 18,909), and 42.7% were 75–84 years old (n = 15,485). On average, the polymedicated patients’ hospital lengths of stay were six days longer, they presented with more than three comorbidities, and they were prescribed more than nine medications at hospital discharge (p < 0.001). They showed more frequent general mobility decline (43.2% vs. 41.9%), gait disorders (46.2% vs. 43%), fatigue (48.6% vs. 43.4%) and dependence on lower-body care (49.7% vs. 47.6%), and presented a higher malnutrition risk (OR = 1.411; 95%CI 1.263–1.577; p < 0.001). However, the non-polymedicated inpatients had proportionally more physical and cognitive impairments. The comparison of the functional status of polymedicated and non-polymedicated geriatric inpatients at hospital discharge is important for clinicians trying to identify and monitor those who are most vulnerable to functional decline, and to design targeted strategies for the prevention of functional impairment and related adverse health outcomes. Full article
(This article belongs to the Section Geriatric Rehabilitation)
29 pages, 3837 KiB  
Article
SART and Individual Trial Mistake Thresholds: Predictive Model for Mobility Decline
by Rossella Rizzo, Silvin Paul Knight, James R. C. Davis, Louise Newman, Eoin Duggan, Rose Anne Kenny and Roman Romero-Ortuno
Geriatrics 2021, 6(3), 85; https://doi.org/10.3390/geriatrics6030085 - 31 Aug 2021
Cited by 5 | Viewed by 3596
Abstract
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful [...] Read more.
The Sustained Attention to Response Task (SART) has been used to measure neurocognitive functions in older adults. However, simplified average features of this complex dataset may result in loss of primary information and fail to express associations between test performance and clinically meaningful outcomes. Here, we describe a new method to visualise individual trial (raw) information obtained from the SART test, vis-à-vis age, and groups based on mobility status in a large population-based study of ageing in Ireland. A thresholding method, based on the individual trial number of mistakes, was employed to better visualise poorer SART performances, and was statistically validated with binary logistic regression models to predict mobility and cognitive decline after 4 years. Raw SART data were available for 4864 participants aged 50 years and over at baseline. The novel visualisation-derived feature bad performance, indicating the number of SART trials with at least 4 mistakes, was the most significant predictor of mobility decline expressed by the transition from Timed Up-and-Go (TUG) < 12 to TUG ≥ 12 s (OR = 1.29; 95% CI 1.14–1.46; p < 0.001), and the only significant predictor of new falls (OR = 1.11; 95% CI 1.03–1.21; p = 0.011), in models adjusted for multiple covariates. However, no SART-related variables resulted significant for the risk of cognitive decline, expressed by a decrease of ≥2 points in the Mini-Mental State Examination (MMSE) score. This novel multimodal visualisation could help clinicians easily develop clinical hypotheses. A threshold approach to the evaluation of SART performance in older adults may better identify subjects at higher risk of future mobility decline. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
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13 pages, 1740 KiB  
Article
The Importance of Age in the Prediction of Mortality by a Frailty Index: A Machine Learning Approach in the Irish Longitudinal Study on Ageing
by Sebastian Moguilner, Silvin P. Knight, James R. C. Davis, Aisling M. O’Halloran, Rose Anne Kenny and Roman Romero-Ortuno
Geriatrics 2021, 6(3), 84; https://doi.org/10.3390/geriatrics6030084 - 27 Aug 2021
Cited by 11 | Viewed by 4557
Abstract
The quantification of biological age in humans is an important scientific endeavor in the face of ageing populations. The frailty index (FI) methodology is based on the accumulation of health deficits and captures variations in health status within individuals of the same age. [...] Read more.
The quantification of biological age in humans is an important scientific endeavor in the face of ageing populations. The frailty index (FI) methodology is based on the accumulation of health deficits and captures variations in health status within individuals of the same age. The aims of this study were to assess whether the addition of age to an FI improves its mortality prediction and whether the associations of the individual FI items differ in strength. We utilized data from The Irish Longitudinal Study on Ageing to conduct, by sex, machine learning analyses of the ability of a 32-item FI to predict 8-year mortality in 8174 wave 1 participants aged 50 or more years. By wave 5, 559 men and 492 women had died. In the absence of age, the FI was an acceptable predictor of mortality with AUCs of 0.7. When age was included, AUCs improved to 0.8 in men and 0.9 in women. After age, deficits related to physical function and self-rated health tended to have higher importance scores. Not all FI variables seemed equally relevant to predict mortality, and age was by far the most relevant feature. Chronological age should remain an important consideration when interpreting the prognostic significance of an FI. Full article
(This article belongs to the Collection Frailty in Older Adults)
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10 pages, 400 KiB  
Article
Outpatient and Home-Based Treatment: Effective Settings for Hip Fracture Rehabilitation in Elderly Patients
by Margarida Mota Freitas, Sara Antunes, Diana Ascenso and Alda Silveira
Geriatrics 2021, 6(3), 83; https://doi.org/10.3390/geriatrics6030083 - 27 Aug 2021
Cited by 4 | Viewed by 3512
Abstract
Femoral neck fractures are a major source of disability in the elderly. Rehabilitation is fundamental to recover pre-fracture functionality. We conducted an observational cohort study with the aim of comparing the efficacy of rehabilitation programs in different therapeutic settings. We included elderly patients [...] Read more.
Femoral neck fractures are a major source of disability in the elderly. Rehabilitation is fundamental to recover pre-fracture functionality. We conducted an observational cohort study with the aim of comparing the efficacy of rehabilitation programs in different therapeutic settings. We included elderly patients who had undergone surgical stabilization of a hip fracture. The participants were divided into 3 groups: group 1, outpatient rehabilitation; group 2, inpatient rehabilitation; group 3, home-based rehabilitation. Patients were evaluated at baseline, at three months, and at six months after fracture. Our outcome measures were the Barthel Index (BI), Functional Ambulation Categories, passive and active range of motion of hip flexion and abduction, and muscle strength in hip flexion, abduction, and knee extension. At six months, all three groups showed an average statistically significant improvement (p < 0.05) in all outcome measures compared to the baseline. Considering the between-group analysis, final BI was significantly higher in outpatient than inpatient-treated patients (p = 0.018), but no statistical difference was found between outpatient and home-based patients. Our findings suggest that rehabilitation leads to significant functional recovery after hip fracture in elderly patients. Both outpatient and home-based rehabilitation seem to be reasonable options for hip fracture rehabilitation. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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8 pages, 365 KiB  
Review
Interventions against Social Isolation of Older Adults: A Systematic Review of Existing Literature and Interventions
by Jaya Manjunath, Nandita Manoj and Tania Alchalabi
Geriatrics 2021, 6(3), 82; https://doi.org/10.3390/geriatrics6030082 - 25 Aug 2021
Cited by 17 | Viewed by 7887
Abstract
Social isolation is widespread among older adults, especially those confined to living in nursing homes and long-term care facilities. We completed a systematic review evaluating the effectiveness of 20 interventions used to combat social isolation in older adults. A scoring mechanism based on [...] Read more.
Social isolation is widespread among older adults, especially those confined to living in nursing homes and long-term care facilities. We completed a systematic review evaluating the effectiveness of 20 interventions used to combat social isolation in older adults. A scoring mechanism based on the Joanna Briggs Appraisal Checklist was utilized to determine the quality of the studies. Searches were conducted in “MedLine”, “PubMed”, “PsycINFO” and “Aging and Mental Health”. Studies completed on group and person-centered interventions against social isolation were the highest quality as the social isolation experienced by older adults decreased after the intervention, and this effect continued in follow-up studies. Other interventions such as volunteering-based interventions also alleviated isolation; however, follow-up studies were not completed to determine long-term efficacy. Given the increase in social isolation faced by older persons during the pandemic, our review can be utilized to create effective interventions to reduce social isolation. Full article
(This article belongs to the Collection Responding to the Pandemic: Geriatric Care Models)
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18 pages, 833 KiB  
Article
Representing Route Familiarity Using the Abstraction Hierarchy Framework
by Rashmi P. Payyanadan and John D. Lee
Geriatrics 2021, 6(3), 81; https://doi.org/10.3390/geriatrics6030081 - 19 Aug 2021
Viewed by 2406
Abstract
Familiarity with a route is influenced by levels of dynamic and static knowledge about the route and the route network such as type of roads, infrastructure, traffic conditions, purpose of travel, weather, departure time, etc. To better understand and develop route choice models [...] Read more.
Familiarity with a route is influenced by levels of dynamic and static knowledge about the route and the route network such as type of roads, infrastructure, traffic conditions, purpose of travel, weather, departure time, etc. To better understand and develop route choice models that can incorporate more meaningful representations of route familiarity, OBDII devices were installed in the vehicles of 32 drivers, 65 years and older, for a period of three months. Personalized web-based trip diaries were used to provide older drivers with post-trip feedback reports about their risky driving behaviors, and collect feedback about their route familiarity, preferences, and reasons for choosing the route driven vs. an alternate low-risk route. Feedback responses were analyzed and mapped onto an abstraction hierarchy framework, which showed that among older drivers, route familiarity depends not only on higher abstraction levels such as trip goals, purpose, and driving strategies, but also on the lower levels of demand on driving skills, and characteristics of road type. Additionally, gender differences were identified at the lower levels of the familiarity abstraction model, especially for driving challenges and the driving environment. Results from the analyses helped highlight the multi-faceted nature of route familiarity, which can be used to build the necessary levels of granularity for modelling and interpretation of spatial and contextual route choice recommendation systems for specific population groups such as older drivers. Full article
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12 pages, 213 KiB  
Article
Dementia Caregiver Virtual Support—An Implementation Evaluation of Two Pragmatic Models during COVID-19
by Jacy A. Weems, Shana Rhodes and James S. Powers
Geriatrics 2021, 6(3), 80; https://doi.org/10.3390/geriatrics6030080 - 19 Aug 2021
Cited by 9 | Viewed by 3178
Abstract
Caregivers of people with Alzheimer’s and related dementias (ADRD) require support. Organizations have pivoted from traditional in-person support groups to virtual care in the face of the COVID-19 pandemic. We describe two model programs and their pragmatic implementation of virtual care platforms for [...] Read more.
Caregivers of people with Alzheimer’s and related dementias (ADRD) require support. Organizations have pivoted from traditional in-person support groups to virtual care in the face of the COVID-19 pandemic. We describe two model programs and their pragmatic implementation of virtual care platforms for ADRD caregiver support. A mixed methods analysis of quantitative outcomes as well as a thematic analysis from semi-structured interviews of facilitators was performed as part of a pragmatic quality improvement project to enhance delivery of virtual support services for ADRD caregivers. Implementation differed among individual organizations but was well received by facilitators and caregivers. While virtual platforms can present challenges, older adults appreciated the strength of group facilitators and reported enhanced connectedness related to virtual support. Barriers to success include the limitations of virtual programming, including technological issues and distractions from program delivery. Virtual support can extend outreach, addressing access and providing safe care during a pandemic. Implementation differs among organizations; however, some elements of virtual support may be long-lasting. Full article
(This article belongs to the Special Issue Responding to the Pandemic: Geriatric Care Models)
10 pages, 251 KiB  
Article
Ethnic and Gender Disparities in Healthy Ageing among People 50 Years and Older in South Africa
by Supa Pengpid and Karl Peltzer
Geriatrics 2021, 6(3), 79; https://doi.org/10.3390/geriatrics6030079 - 12 Aug 2021
Cited by 8 | Viewed by 2305
Abstract
Objective: this study aimed to determine the prevalence and correlates of healthy ageing in older adults living in the community in South Africa. Methods: the cross-sectional sample consisted of 3734 individuals (≥50 years) from the cross-sectional South African National Health and Nutrition Survey [...] Read more.
Objective: this study aimed to determine the prevalence and correlates of healthy ageing in older adults living in the community in South Africa. Methods: the cross-sectional sample consisted of 3734 individuals (≥50 years) from the cross-sectional South African National Health and Nutrition Survey (SANHANES-1) in 2011–2012. Healthy ageing was assessed using a multidimensional concept, which includes five components: (1) absence of major illness, (2) absence of disability, (3) good mental health, (4) social engagement and (5) well-being or good health. Results: in general, 36.6% had a healthy ageing, including 73.3% had no major diseases, 87.1% were free of disability, 62.3% had good mental health, 73.0% were socially engaged and 64.0% had a high well-being. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR: 1.33, 95% confidence interval-CI: 1.03–1.72), white population group (AOR: 3.46, 95% CI: 2.29–5.22) and coloured population group (AOR: 1.82, 95% CI: 1.34–2.47), were positively associated with healthy ageing, while increasing age (AOR: 0.96, 95% CI: 0.94–0.97), daily tobacco use (AOR: 0.56, 95% CI: 0.42–0.74), perceived underweight (AOR: 0.48, 95% CI: 0.34–0.66) and perceived overweight (AOR: 0.53, 95% CI: 0.34–0.81) were negatively associated with associated with healthy ageing. Conclusion: almost two in five older adults in South Africa were successfully ageing. Factors associated with healthy ageing included, younger age, male sex, population group (Whites, Coloureds), not daily tobacco users, not having underweight and overweight. Full article
(This article belongs to the Section Healthy Aging)
8 pages, 227 KiB  
Article
Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
by Kelsey J. Keverline, Steve J. Mow, Julianne Maire Cyr, Timothy Platts-Mills and Jane H. Brice
Geriatrics 2021, 6(3), 78; https://doi.org/10.3390/geriatrics6030078 - 11 Aug 2021
Cited by 2 | Viewed by 2312
Abstract
Background: This study describes long length of stay during emergency department (ED) visits and hospital admissions, barriers to discharge, and discharge solutions for geriatric patients. Methods: We conducted a retrospective medical record review of a random sample of 150 ED patients and 150 [...] Read more.
Background: This study describes long length of stay during emergency department (ED) visits and hospital admissions, barriers to discharge, and discharge solutions for geriatric patients. Methods: We conducted a retrospective medical record review of a random sample of 150 ED patients and 150 inpatients with long length of stay (LOS) encounters. Cohorts were characterized by demographics, social determinants of health (e.g., health insurance, housing), medical comorbidities at admission, discharge care coordination, and final disposition. Results: In the ED, the primary barrier to discharge was inadequate inpatient bed availability (63%). In the inpatient setting, barriers to discharge were predominantly due to a demonstrated medical requirement for continued hospitalization (55%), followed by difficulty with coordinating discharge to a skilled nursing facility or rehabilitation center (22%). Discussion: Among long LOS ED patients, discharge delays were often the result of unavailable inpatient beds and services. Reducing the LOS for ED patients may require further investigation as to which hospital services are most frequently utilized by geriatric patients and structuring inpatient bed allocation to prevent extended patient boarding in the ED. Reducing long inpatient LOS may require early identification of high-risk patients and strengthening of relationships with community-based services. Full article
10 pages, 606 KiB  
Article
Poor Lower Extremity Functioning Is Associated with Modest Increased Incidence of Probable Dementia
by Sergio L. Teruya, Cara Dimino, Kevin D. Silverman and Thelma Mielenz
Geriatrics 2021, 6(3), 77; https://doi.org/10.3390/geriatrics6030077 - 10 Aug 2021
Cited by 4 | Viewed by 2869
Abstract
Lower extremity functioning in older adults provides a measure of poor physical performance and can predict negative health outcomes. The consequences of reduced lower extremity functioning on cognitive decline, measured as time-varying variables, have not been well documented in previous studies. We aimed [...] Read more.
Lower extremity functioning in older adults provides a measure of poor physical performance and can predict negative health outcomes. The consequences of reduced lower extremity functioning on cognitive decline, measured as time-varying variables, have not been well documented in previous studies. We aimed to evaluate whether lower extremity functioning is associated with an increased incidence rate of probable dementia among older adults using data from the National Health and Aging Trends Study (NHATS). Participants (n = 6457) were followed for 8 years to examine the relationship between lower extremity functioning, as measured by the Short Physical Performance Battery (SPPB), and incident probable dementia. Using weighted data, a multivariable Poisson regression with generalized estimating equations (GEE) was used to calculate incidence rate ratios (IRR), adjusting for covariates and clustering. Participants with low SPPB scores (0–5) had a 5% increase in incident probable dementia when compared with those who had good SPPB scores (10–12) in the adjusted model (IRR = 1.05; 95% CI = 1.04–1.07). Lower extremity functioning is associated with a modest increase in incident probable dementia. The SPPB score may be helpful in identifying subjects at risk of dementia. Efforts aimed at improving physical functioning may lead to better cognitive outcomes. Full article
(This article belongs to the Section Geriatric Neurology)
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11 pages, 283 KiB  
Review
Common Medical and Dental Problems of Older Adults: A Narrative Review
by Alice Kit Ying Chan, Manisha Tamrakar, Chloe Meng Jiang, Edward Chin Man Lo, Katherine Chiu Man Leung and Chun-Hung Chu
Geriatrics 2021, 6(3), 76; https://doi.org/10.3390/geriatrics6030076 - 6 Aug 2021
Cited by 55 | Viewed by 10976
Abstract
The advancement of medicine has reduced the rate of mortality and older adult population is increasing. Among the 7,700,000,000 world population in 2019, 1 in 11 people were at the age of 65 or more. The population is expected to increase to 1 [...] Read more.
The advancement of medicine has reduced the rate of mortality and older adult population is increasing. Among the 7,700,000,000 world population in 2019, 1 in 11 people were at the age of 65 or more. The population is expected to increase to 1 in 6 people by 2050. Older adults have degenerative changes that become more severe with age. This study used the World Health Organization’s websites and PubMed and Google Scholar databases to review current global oral and systemic health issues. Studies generally reported that many older adults have no regular dental checkup. Common oral diseases such as dental caries particularly root caries and periodontal disease are highly prevalent among them. These oral diseases are often interrelated with their systemic problems. A meta-analysis reported diabetes increases the incidence and progression of periodontitis by 86%. A decrease in salivary output is common among older adults having polypharmacy. A review reported the caries risk in older adults increases by 60% with low resting pH and low stimulated salivary flow rate. Many older adults suffer from dementia and depression which complicates the delivery of dental treatment. Proper oral hygiene practice and dental care at supine position are often difficult to be carried out if they have rheumatoid arthritis. With the increasing need of elderly dental care, dentists and other dental personnel should understand interlaced oral and general health in order to provide a successful dental care plan for older adults. The aim of this study is to give an overview of the common medical conditions and dental problems and their impacts on older adults. Full article
7 pages, 228 KiB  
Article
Total Knee Arthroplasty for the Oldest Old
by Carmen da Casa, Helena Fidalgo, Javier Nieto, Enrique Cano-Lallave and Juan F. Blanco
Geriatrics 2021, 6(3), 75; https://doi.org/10.3390/geriatrics6030075 - 4 Aug 2021
Cited by 2 | Viewed by 2048
Abstract
The present study describes and compares the early functional results after total knee arthroplasty (TKA) of the oldest-old population (aged over 84 years) and a randomly matched younger septuagenarian cohort so treated. We aimed to evaluate the early functional outcomes after patients’ rehabilitation [...] Read more.
The present study describes and compares the early functional results after total knee arthroplasty (TKA) of the oldest-old population (aged over 84 years) and a randomly matched younger septuagenarian cohort so treated. We aimed to evaluate the early functional outcomes after patients’ rehabilitation and the yearly requirements for hospital readmission and emergency room visits after TKA. We noted a similar length of hospital stay for octogenarian and septuagenarian patients, and we determined that both groups of patients were improving ROM (both flexion and extension) after the rehabilitation program (p < 0.05, in all cases), but there were no significant differences between octogenarian and septuagenarian improvement of the knee function (p > 0.05, in all cases). Patients from both age groups behaved similarly in terms of mobility before starting rehabilitation and after completion of the rehabilitation program. We noted that older octogenarian patients showed a higher one-year hospital readmission rate than younger septuagenarian patients, but similar early emergency room visits for both age groups. The findings of this study allow us to conclude that advanced age in itself should not be a contraindication for TKA. Full article
(This article belongs to the Collection Joint Arthroplasty in the Oldest People)
17 pages, 300 KiB  
Article
Evaluating the Consistency of Subjective Activity Assessments and Their Relation to Cognition in Older Adults
by Cassandra R. Hatt, Christopher R. Brydges, Jacqueline A. Mogle, Martin J. Sliwinski and Allison A. M. Bielak
Geriatrics 2021, 6(3), 74; https://doi.org/10.3390/geriatrics6030074 - 28 Jul 2021
Cited by 5 | Viewed by 4890
Abstract
(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these [...] Read more.
(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these activity assessments were related to cognition in older adults; (2) Methods: Participants from US (n = 199) and Australian (n = 170) samples completed a weekly estimate of activity, followed by 7 consecutive days of daily reporting. Differences between weekly estimates and daily reports were found, such that estimations at the weekly level were lower than self-reported daily information. Multivariate multiple regression was used to determine whether total activity, activity domains and the discrepancy between assessment types (i.e., weekly/daily) predicted cognitive performance across three cognitive domains (fluid, verbal, memory); (3) Results: When activity assessments were totaled, neither predicted cognition; however, when activity was grouped by domain (cognitive, social, physical), different domains predicted different cognitive outcomes. Daily reported cognitive activity significantly predicted verbal performance (β = 1.63, p = 0.005), while weekly estimated social activity predicted memory performance (β = −1.81, p = 0.050). Further, while the magnitude of discrepancy in total activity did not significantly predict cognitive performance, domain specific differences did. Differences in physical activity reported across assessments predicted fluid performance (β = −1.16, p = 0.033); (4) Conclusions: The significant discrepancy between the measurement types shows that it is important to recognize potential biases in responding when conducting activity and cognition research. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
8 pages, 206 KiB  
Article
The Effect of High and Low Life Purpose on Ikigai (a Meaning for Life) among Community-Dwelling Older People—A Cross-Sectional Study
by Souma Tsuzishita and Tadaaki Wakui
Geriatrics 2021, 6(3), 73; https://doi.org/10.3390/geriatrics6030073 - 24 Jul 2021
Cited by 6 | Viewed by 3737
Abstract
The purpose of this study is to reveal how high or low life purpose is related to QOL and ikigai (a meaning for life). Ikigai is “a sense of purpose and motivation in the daily lives of older people, a sense that they [...] Read more.
The purpose of this study is to reveal how high or low life purpose is related to QOL and ikigai (a meaning for life). Ikigai is “a sense of purpose and motivation in the daily lives of older people, a sense that they are capable and meaningful to their families and others, and that they should be”. Eighty-one community-dwelling older people (23 male and 58 female, mean age 77 ± 5.2 years) participated of their own will. The following items were measured: dementia test, exercise habits, life purpose, ikigai, and QOL. In the multivariate analysis of high and low life purpose, only ikigai was found to be related. In the multivariate analysis of ikigai, life purpose was also the most relevant, indicating that life purpose and ikigai are strongly interrelated. To improve QOL, it is also necessary to take into account life purpose in addition to the current nursing care prevention. Full article
(This article belongs to the Section Geriatric Public Health)
16 pages, 4071 KiB  
Article
Enhancement of Anticipatory Postural Adjustments by Virtual Reality in Older Adults with Cognitive and Motor Deficits: A Randomised Trial
by Julien Bourrelier, Lilian Fautrelle, Etienne Haratyk, Patrick Manckoundia, Frédéric Mérienne, France Mourey and Alexandre Kubicki
Geriatrics 2021, 6(3), 72; https://doi.org/10.3390/geriatrics6030072 - 22 Jul 2021
Cited by 7 | Viewed by 3696
Abstract
Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) [...] Read more.
Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) exercises in frail older adults to decrease the anxiety of falling and to induce improvements in behavioural and cognitive abilities in rehabilitation processes. The aim of this study was thus to test the efficiency of a VR system on the enhancement of the APA period, compared to the use of a Nintendo Wii system. Methods: Frail older adults (n = 37) were included in this study who were randomized and divided into a VR exercises group (VR group) or a control group using the Nintendo Wii system (CTRL group). Finally, 22 patients were included in the data treatment. APA were studied through muscular activation timings measured with electromyographic activities. The functional reach test, the gait speed, and the time up and go were also evaluated before and after a 3-week training phase. Results and discussion: As the main results, the training phase with VR improved the APA and the functional reach test score along the antero-posterior axis. Together, these results highlight the ability of a VR training phase to induce neuromuscular adaptations during the APA period in frail older adults. Then, it underlines the effective transfer from learning carried out during the VR training movements to control balance abilities in a more daily life context. Full article
(This article belongs to the Section Geriatric Rehabilitation)
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11 pages, 230 KiB  
Article
Geriatric Conditions and Functional Disability among a National Community-Dwelling Sample of Older Adults in India in 2017–2018
by Supa Pengpid and Karl Peltzer
Geriatrics 2021, 6(3), 71; https://doi.org/10.3390/geriatrics6030071 - 21 Jul 2021
Cited by 6 | Viewed by 2526
Abstract
This study aimed to determine the prevalence of geriatric conditions and their association with disability in older community-dwelling adults in India. The cross-sectional sample consisted of 31,477 individuals (≥60 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Geriatric [...] Read more.
This study aimed to determine the prevalence of geriatric conditions and their association with disability in older community-dwelling adults in India. The cross-sectional sample consisted of 31,477 individuals (≥60 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Geriatric conditions assessed included injurious falls, impaired cognition, underweight, dizziness, incontinence, impaired vision and impaired hearing. More than two in five participants (44.3%) had no geriatric condition, 32.7% had one, 15.9% two and 7.1% had three or more geriatric conditions; 26.9% were underweight, 14.5% dizziness, 13.7% had impaired vision, 9.6% impaired hearing, 9.3% impaired cognition, 8.2% major depressive disorder, 5.7% injurious falls, 4.0% incontinence, and 7.4% had Activity of Daily Living (ADL) dependencies. In logistic regression analysis, adjusted by sociodemographic factors and the number of chronic conditions, we found a higher number of geriatric conditions, and a higher number of chronic conditions were associated with ADL dependencies. In a model adjusted for sociodemographic factors and the type of chronic conditions, we found that a higher number of geriatric conditions and heart disease, stroke, and bone or joint disorder were positively associated with ADL dependencies. The odds of ADL dependencies increased with impaired cognition, impaired vision, impaired hearing, and major depressive disorder. Impaired cognition, incontinence, impaired vision and major depressive disorder were positively associated with dressing, bathing, eating, transferring, and toileting dependency. In addition, impaired hearing was associated with transferring and toileting dependency. More than half of older adults in India had at least one geriatric condition. The prevalence of geriatric conditions was as high as the prevalence of chronic conditions, which in some cases were associated with disability. Geriatric conditions should be included in health care management. Full article
(This article belongs to the Section Geriatric Rehabilitation)
9 pages, 1014 KiB  
Article
Total Hip Arthroplasty (THA) for Femoral Neck Fractures: Comparison between Standard and Dual Mobility Implants
by Riccardo L. Alberio, Mattia Rusconi, Loris Martinetti, Diego Monzeglio and Federico A. Grassi
Geriatrics 2021, 6(3), 70; https://doi.org/10.3390/geriatrics6030070 - 7 Jul 2021
Cited by 11 | Viewed by 4085
Abstract
The purpose of this retrospective study is to compare the short-term clinical and radiological results between standard and dual mobility THA for femoral neck fractures (FNF) in older patients. The hypothesis is that the dual mobility cup (DMC) has the same outcomes but [...] Read more.
The purpose of this retrospective study is to compare the short-term clinical and radiological results between standard and dual mobility THA for femoral neck fractures (FNF) in older patients. The hypothesis is that the dual mobility cup (DMC) has the same outcomes but a lower dislocation rate than the standard THA. The study population included 56 patients (mean age 77.7 years, range 71–85) that underwent THA for displaced FNF. Patients were divided in two comparable groups for baseline characteristics (age, sex and comorbidities): 28 patients underwent THA with a standard cup (SC) and 28 THA with DMCs. The clinical records and radiograms were reviewed to search relevant data in their postoperative history. Two postoperative dislocations occurred in the SC group and none in the DMC group. At an average follow up of 23 months (12–40), 48 patients were available for the final evaluation. The WOMAC score for all patients averaged 6.26 (0–46) and was slightly better in the DMC group (4.94 vs. 7.58; p-value = 0.41); scores were significantly better in presence of neurological comorbidities (p-value = 0.04), in the absence of diabetes (p-value = 0.04) and in the case of psychiatric disorders (p-value = 0.02). Radiographic evaluation at one year showed signs of osteointegration in 42/48 (87.5%) acetabular components (20 DMCs, 22 SC). According to our experience, DMCs proved to be a valid option for the treatment of displaced FNF in older patients, since it allowed them to achieve short-term outcomes comparable to conventional THA, while decreasing the incidence of postoperative dislocations. Full article
(This article belongs to the Collection Joint Arthroplasty in the Oldest People)
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11 pages, 1369 KiB  
Article
Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents—A Pilot Study
by Daniel Haigis, Rebekka Pomiersky, Dorothée Altmeier, Annika Frahsa, Gorden Sudeck, Ansgar Thiel, Gerhard Eschweiler and Andreas Michael Nieß
Geriatrics 2021, 6(3), 69; https://doi.org/10.3390/geriatrics6030069 - 2 Jul 2021
Cited by 3 | Viewed by 2842
Abstract
Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, [...] Read more.
Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research. Full article
(This article belongs to the Section Geriatric Public Health)
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10 pages, 697 KiB  
Article
The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study
by Nathaniel Johnson, Adam Bradley, Lukus Klawitter, Jane Johnson, Lance Johnson, Grant R. Tomkinson, Kyle J. Hackney, Sherri Stastny, Diane K. Ehlers and Ryan McGrath
Geriatrics 2021, 6(3), 68; https://doi.org/10.3390/geriatrics6030068 - 30 Jun 2021
Cited by 6 | Viewed by 4103
Abstract
Background: Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention [...] Read more.
Background: Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic. Methods: There were n = 13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth intervention during the COVID-19 pandemic. The didactic intervention contents were shared online, and participants worked with trained interviewers over the telephone to discuss physical activity. At baseline and post-intervention, the Multimedia Activity Recall for Children and Adults examined activity profiles, while accelerometry estimated time spent sedentary and in physical activity. Results: Relative to the baseline measures, there was an 88 min/day (95% confidence interval (CI): 39, 137) increase in computer time and 36 min/day (CI: 10, 62) reduction in time spent in active transport at post-intervention. Moderate-to-vigorous physical activity participation also increased by an estimated 2 min/day (CI: −21, 26) and 12 min/week (CI: −154, 180), but this trend was not statistically significant. Conclusion: We recommend that support be provided to older adults transitioning to telehealth, especially as migration to telehealth progresses. Full article
(This article belongs to the Collection Responding to the Pandemic: Geriatric Care Models)
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8 pages, 424 KiB  
Article
Total Knee Arthroplasty in Octogenarians: Should We Still Be so Restrictive?
by Jose Maria Trigueros-Larrea, Maria Antonia Gonzalez-Bedia, Jose Maria Lomo-Garrote, Oscar Martin-de la Cal and Miguel Angel Martin-Ferrero
Geriatrics 2021, 6(3), 67; https://doi.org/10.3390/geriatrics6030067 - 30 Jun 2021
Cited by 8 | Viewed by 2750
Abstract
Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society Function [...] Read more.
Demand for total knee arthroplasty (TKA) in octogenarians will increase in subsequent years as society ages. We conducted a retrospective observational study in octogenarians operated on with TKA between 2015 and 2019, comparing preoperative and postoperative Knee Society Score (KSS), Knee Society Function Score (KSFS), extension and flexion balance, and radiologic alignment using a paired Student t-test. A chi-squared test was used to correlate mortality with Charlson comorbidities index score and with ASA scale. Kaplan–Meier analysis was performed to calculate patient survival. In this period 36 patients ≥80 years underwent TKA, with a mean age of 81.6 years. Of these, 24 patients (66.7%) were classified as ASA II and 12 (33.3%) as ASA III. Sixteen patients (44.4%) were Charlson 0, 14 (38.9%) Charlson 1, two (5.6%) Charlson 2, and four (11.1%) Charlson 3. KSS, KSFS, flexion and extension range, and radiologic alignment were statistically significant (p < 0.001) when comparing preoperatory and post-operatory data. No correlation (p > 0.05) was found between mortality and ASA or Charlson score. Seven patients (19.4%) suffered a medical complication and two patients experienced surgical complications. Four patient died (11.1%) during follow-up. The mean patient survival was 67.4 months. Patients ≥80 years achieve clinical improvement after TKA. Comorbidities, not age, are the burden for surgery in older patients. Full article
(This article belongs to the Collection Joint Arthroplasty in the Oldest People)
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27 pages, 41427 KiB  
Article
Proof of Concept of Novel Visuo-Spatial-Motor Fall Prevention Training for Old People
by Henk Koppelaar, Parastou Kordestani-Moghadam, Sareh Kouhkani, Farnoosh Irandoust, Gijs Segers, Lonneke de Haas, Thijmen Bantje and Martin van Warmerdam
Geriatrics 2021, 6(3), 66; https://doi.org/10.3390/geriatrics6030066 - 29 Jun 2021
Cited by 2 | Viewed by 6282
Abstract
Falls in the geriatric population are one of the most important causes of disabilities in this age group. Its consequences impose a great deal of economic burden on health and insurance systems. This study was conducted by a multidisciplinary team with the aim [...] Read more.
Falls in the geriatric population are one of the most important causes of disabilities in this age group. Its consequences impose a great deal of economic burden on health and insurance systems. This study was conducted by a multidisciplinary team with the aim of evaluating the effect of visuo-spatial-motor training for the prevention of falls in older adults. The subjects consisted of 31 volunteers aged 60 to 92 years who were studied in three groups: (1) A group under standard physical training, (2) a group under visuo-spatial-motor interventions, and (3) a control group (without any intervention). The results of the study showed that visual-spatial motor exercises significantly reduced the risk of falls of the subjects. Full article
(This article belongs to the Special Issue Movement Disorders in Older Adults)
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10 pages, 834 KiB  
Article
Long-Term Results of Joint Arthroplasty with Total Prosthesis for Trapeziometacarpal Osteoarthritis in Patients over 65 Years of Age
by Miguel Angel Martin-Ferrero, Jose Maria Trigueros-Larrea, Elsa Martin-de la Cal, Begoña Coco-Martin and Clarisa Simon-Perez
Geriatrics 2021, 6(3), 65; https://doi.org/10.3390/geriatrics6030065 - 29 Jun 2021
Cited by 7 | Viewed by 3310
Abstract
Trapeziometacarpal osteoarthritis (TMCOA) is a highly prevalent disease in the older population. Many different types of surgical treatments are possible, depending on the degree of joint involvement, the personal and professional circumstances of the patient and the preferences of the orthopedic surgeon. This [...] Read more.
Trapeziometacarpal osteoarthritis (TMCOA) is a highly prevalent disease in the older population. Many different types of surgical treatments are possible, depending on the degree of joint involvement, the personal and professional circumstances of the patient and the preferences of the orthopedic surgeon. This paper evaluated the clinical and radiological results of consecutive cohorts of patients over 65 years old treated with total joint arthroplasties (TJA) of the ball and socket type (B&S) for TMCOA, with a minimum of 10 years follow-up. The survival rate (Kaplan–Meier) of the functional prostheses at 10 years was 92.2% (95% CI (89.1%, 96.1%). These functional arthroplasty patients, after 10 years of follow-up, showed little or no pain, good function and good key pinch, without radiological alterations. TJAs of the B&S type are a long lasting, effective and reliable alternative to surgical treatment of TMCOA in patients over 65 years of age, when they are performed with the patient selection criteria and surgical technique described throughout this study. Full article
(This article belongs to the Collection Joint Arthroplasty in the Oldest People)
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