Geriatrics

Editorial

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3 pages, 156 KiB

Open AccessEditorial

A New Strategic Approach to Successful Aging and Healthy Aging

by Roger Y. Wong

Geriatrics 2018, 3(4), 86; https://doi.org/10.3390/geriatrics3040086 - 29 Nov 2018

Cited by 31 | Viewed by 8012

Abstract

Successful aging is not a new concept, although its definition remains controversial, because of its multi-dimensional nature. [...] Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

Research

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10 pages, 2245 KiB

Open AccessArticle

A Comprehensive Overview of Polypharmacy in Elderly Patients in Saudi Arabia

by Aseel Alsuwaidan, Norah Almedlej, Sawsan Alsabti, Omamah Daftardar, Fawzi Al Deaji, Ali Al Amri and Salem Alsuwaidan

Geriatrics 2019, 4(2), 36; https://doi.org/10.3390/geriatrics4020036 - 15 May 2019

Cited by 33 | Viewed by 10192

Abstract

Background/Objectives: Saudi Arabia has a great percentage of geriatric patients associated with multiple chronic diseases who require close attention and monitoring for their medications. The purpose of this study is to develop a full-framed picture about the utilization of medications for geriatric patients [...] Read more.

Background/Objectives: Saudi Arabia has a great percentage of geriatric patients associated with multiple chronic diseases who require close attention and monitoring for their medications. The purpose of this study is to develop a full-framed picture about the utilization of medications for geriatric patients and how to provide better health-care management. Methodology: A retrospective cross-sectional study targeting patients 65 years of age and older, who are taking multiple chronic medications for different indications. Descriptive analysis and frequency of the main variables were used as appropriate. Only qualified and professional candidates were chosen for data entry to present the quality and accuracy of data. Results: A total of 3009 patient profiles were analyzed, with the patients’ average age in years being 73.26 ± 6.6 (SD). It was found that 55% of the patients have polypharmacy. An average of 6.4 medications were prescribed for patients aged between 65 and 70 years compared with a significant difference for patients aged 71 years and above, while a linear correlation between age and comorbidity diseases associated with all elderly patients. Hypertension, hyperlipidemia, and diabetes mellitus are the most common comorbidity diseases for elderly patients aged 65 years and older. Conclusion: Polypharmacy in geriatrics is defined as a patient aged 65 years and older receiving five or more appropriate medications. It is the responsibility of health-care professionals to reduce the number of medications in elderly patients. Awareness of geriatric medications and diagnosed diseases will improve managing adverse drug reaction and other risk factors. Awareness of geriatric medications should elaborate on how to avoid adverse drug reaction and other risk factors. It is the responsibility of physicians and pharmacists to reduce the number of medications in elderly patients. We also prove that the number of medications will not necessarily increase with age. The main impact of this study is to follow the main recommendations to improve health care management in geriatrics. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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13 pages, 1448 KiB

Open AccessArticle

An IoT System for Remote Health Monitoring in Elderly Adults through a Wearable Device and Mobile Application

by Luis A. Durán-Vega, Pedro C. Santana-Mancilla, Raymundo Buenrostro-Mariscal, Juan Contreras-Castillo, Luis E. Anido-Rifón, Miguel A. García-Ruiz, Osval A. Montesinos-López and Fermín Estrada-González

Geriatrics 2019, 4(2), 34; https://doi.org/10.3390/geriatrics4020034 - 7 May 2019

Cited by 88 | Viewed by 12971

Abstract

With the increase in global life expectancy and the advance of technology, the creation of age-friendly environments is a priority in the design of new products for elderly people healthcare. This paper presents a proposal for a real-time health monitoring system of older [...] Read more.

With the increase in global life expectancy and the advance of technology, the creation of age-friendly environments is a priority in the design of new products for elderly people healthcare. This paper presents a proposal for a real-time health monitoring system of older adults living in geriatric residences. This system was developed to help caregivers to have a better control in monitoring the health of their patients and have closer communication with their patients’ family members. To validate the feasibility and effectiveness of this proposal, a prototype was built, using a biometric bracelet connected to a mobile application, which allows real-time visualization of all the information generated by the sensors (heart rate, body temperature, and blood oxygenation) in the bracelet. Using these data, caregivers can make decisions about the health status of their patients. The evaluation found that the users perceived the system to be easy to learn and use, providing initial evidence that our proposal could improve the quality of the adult’s healthcare. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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9 pages, 868 KiB

Open AccessArticle

Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic

by Rhena Yoo and Martha Spencer

Geriatrics 2018, 3(4), 91; https://doi.org/10.3390/geriatrics3040091 - 16 Dec 2018

Cited by 7 | Viewed by 6130

Abstract

Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in [...] Read more.

Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouver, Canada from January to December 2017 inclusive. Initial assessment was performed by the nurse continence advisor (NCA) or geriatrician depending on the source of referral. The pelvic floor physiotherapist (PFP) could then be consulted based on perceived need. The average age at assessment was 76 years old (range 29–102), with 82% of patients ≥65 years and 27% ≥85 years old. The majority of patients were referred for bladder incontinence (72%), with the remaining patients referred for bowel incontinence (28%) or pessary care (7%). Referrals came from a variety of sources including physicians (62%), nurses (22%), allied health care providers (12%) and self-referral (5%). Multimorbidity was common, with 40% of patients having a Charlson Comorbidity Index ≥6. The same proportion of patients (40%) were on ≥5 prescription medications. Many patients were functionally dependent for either instrumental activities of daily living (52%) or activities of daily living (25%). Non-pharmacologic treatments were commonly recommended, with the majority of patients counselled on lifestyle changes (88%) and taught Kegel exercises (70%). For patients seen by the geriatrician, modifications were made to non-continence medications in 50% of cases and medical comorbidities were optimized in 39% of cases. In terms of pharmacologic therapy, over-the-counter (OTC) medications were initiated in 45% of patients whereas continence-specific prescription medications were started in 17% of patients. A multidisciplinary continence clinic can play an important role in promoting successful aging by assessing and treating medical causes of incontinence in medically complex older adults. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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9 pages, 364 KiB

Open AccessFeature PaperCommunication

An Analysis of Geriatric Medicine in Malaysia-Riding the Wave of Political Change

by Maw Pin Tan, Shahrul B. Kamaruzzaman and Philip Jun Hua Poi

Geriatrics 2018, 3(4), 80; https://doi.org/10.3390/geriatrics3040080 - 15 Nov 2018

Cited by 11 | Viewed by 7650

Abstract

Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with a high-impact ageing icon by installing the oldest prime [...] Read more.

Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with a high-impact ageing icon by installing the oldest prime minister in the world. A wave of optimism for the expansion of geriatric services in Malaysia, which met with numerous challenges in the last two decades, has emerged as a result of this political change. The number of geriatrics specialists and services had begun to see slow expansions under the previous government. However, existing geriatricians will need to reassess the landscape of delivery and access to care in our rapidly growing ageing population and develop new strategies to truly expand their services. In addition to unrelenting efforts in the recruitment and training of future geriatricians, the steady expansion of the geriatric workforce should take into account the inclusion of geriatric medicine in the undergraduate training curricula of all healthcare professionals. Expansion of geriatric services will also be a cost-effective strategy to reduce the growing national healthcare budget incurred by the growing needs of an ageing population. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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Review

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10 pages, 352 KiB

Open AccessReview

Effect of Cognitive Training on Daily Function in Older People without Major Neurocognitive Disorder: A Systematic Review

by Brian J.Y. Fan and Roger Y.M. Wong

Geriatrics 2019, 4(3), 44; https://doi.org/10.3390/geriatrics4030044 - 18 Jul 2019

Cited by 10 | Viewed by 6281

Abstract

There is increasing interest in the effect of non-pharmacological treatments on preserving cognition and function in older adults without major neurocognitive disorder (dementia). However, its effect on everyday function in terms of instrumental activities of daily living (IADL) is unclear. We conducted a [...] Read more.

There is increasing interest in the effect of non-pharmacological treatments on preserving cognition and function in older adults without major neurocognitive disorder (dementia). However, its effect on everyday function in terms of instrumental activities of daily living (IADL) is unclear. We conducted a systematic review to examine whether cognitive training, independent of other interventions, can improve IADL function in older adults without major neurocognitive disorder. We searched multiple databases including MEDLINE, EMBASE, and PSYCINFO and found thirteen studies that met our inclusion criteria with 7130 participants in total. Six out of thirteen studies reported a significant change on validated IADL assessment. On subgroup analysis, five studies included older adults with normal cognition and one included mild cognitive impairment (MCI). Eleven out of twelve studies showed improvement in measures of cognition. None of the studies described changes in the ability to live independently. While variation in study protocol, outcome measurement, and effect size reporting precluded further inferential statistical analysis, our review found a sizable number of studies showing improvement in IADL. Cognitive training may have some benefit in improving IADL function in older adults without major neurocognitive disorder. Future long-term studies focusing on maintained IADL function and preserved independence are needed. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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8 pages, 205 KiB

Open AccessReview

Successful Ageing in Singapore

by Andrew Rogerson and Simon Stacey

Geriatrics 2018, 3(4), 81; https://doi.org/10.3390/geriatrics3040081 - 19 Nov 2018

Cited by 19 | Viewed by 13818

Abstract

Singapore has experienced rapid development in the past 50 years. This has presented unique challenges with regard to land space and a rapidly ageing population. The role of extrinsic factors in successful ageing is well documented, and places a degree of responsibility on [...] Read more.

Singapore has experienced rapid development in the past 50 years. This has presented unique challenges with regard to land space and a rapidly ageing population. The role of extrinsic factors in successful ageing is well documented, and places a degree of responsibility on the state and healthcare systems. Singapore has taken many proactive measures to meet this responsibility by implementing policy changes across multiple domains including housing, transport, education and research. One hospital in the north east of Singapore has undertaken a frailty screening program that aims to identify, prevent and reverse frailty at an early stage. This paper provides a review of these national and regional measures. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

12 pages, 221 KiB

Open AccessFeature PaperReview

Successful Aging and Frailty: A Systematic Review

by Darryl Rolfson

Geriatrics 2018, 3(4), 79; https://doi.org/10.3390/geriatrics3040079 - 15 Nov 2018

Cited by 22 | Viewed by 7535

Abstract

The terms successful aging (SA) and frailty appear to have much in common, both in terms of overlapping constructs and common challenges with consensus and operationalization. The aim of this review is to summarize existing literature that defines that relationship. Primary and secondary [...] Read more.

The terms successful aging (SA) and frailty appear to have much in common, both in terms of overlapping constructs and common challenges with consensus and operationalization. The aim of this review is to summarize existing literature that defines that relationship. Primary and secondary source articles that used either term in the title or abstract were systematically reviewed for relevance to the study objective. Of 61 articles that met these criteria, 30 were secondary source, and of these four were highly relevant. Four of the remaining 31 original research articles were selected, and the prevalence of frailty and SA in populations with different characteristics were described and compared. The same model of frailty was used in all primary studies, but definitions for successful aging were heterogeneous. The prevalence of frailty ranged from 11.8% to 44.0% and that of SA ranged from 10.4% to 47.2%. The definitions used for each, especially the extent of multidimensionality, appeared to reflect the degree of overlap between SA and frailty. Whether frailty and SA are part of the same or different constructs, there is a pressing need for an ordered taxonomy to advance research that translates into clinical practice. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

16 pages, 817 KiB

Open AccessReview

A Scoping Review: Social Participation as a Cornerstone of Successful Aging in Place among Rural Older Adults

by Lisa F. Carver, Rob Beamish, Susan P. Phillips and Michelle Villeneuve

Geriatrics 2018, 3(4), 75; https://doi.org/10.3390/geriatrics3040075 - 29 Oct 2018

Cited by 69 | Viewed by 17572

Abstract

Despite obstacles, many rural-dwelling older adults report that positive aspects of rural residence, such as attachment to community, social participation, and familiarity, create a sense of belonging that far outweighs the negative. By being part of a community where they are known and [...] Read more.

Despite obstacles, many rural-dwelling older adults report that positive aspects of rural residence, such as attachment to community, social participation, and familiarity, create a sense of belonging that far outweighs the negative. By being part of a community where they are known and they know people, rural elders continue to find meaning, the key to achieving successful aging in this last stage of life. This scoping review explored factors influencing social participation and, through it, successful aging among rural-dwelling older adults. We sought to answer the question: what factors enhance or detract from the ability of rural-dwelling older adults to engage in social participation in rural communities? The scoping review resulted in 19 articles that highlight the importance of supports to enable older people to spend time with others, including their pets, engage in volunteer and community activities, and help maintain their home and care for their pets. Overall, the lack of services, including local health care facilities, was less important than the attachment to place and social capital associated with aging in place. Full article

(This article belongs to the Special Issue Health Care and Successful Aging)

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