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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 36279

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Special Issue Editors

Dr. Francisco José Tarazona-Santabalbina

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Guest Editor

1. Department of Geriatrics, Hospital Universitario de la Ribera, 46600 Alzira, Valencia, Spain
2. CIBERFES (Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable), 28029 Madrid, Spain
3. Catholic University of Valencia Sant Vicent Màrtir, 46001 València, Valencia, Spain
Interests: geriatric medicine; frailty; falls; orthogeriatrics; collaborative medicine; multicomponent exercise
Special Issues, Collections and Topics in MDPI journals

Dr. Sebastià Josep Santaeugènia González

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Assistant Guest Editor

Chronic Care Program, Health Department, Generalitat de Catalunya, 08002 Barcelona, Spain
Interests: geriatric and palliative medicine; integrated health and social care; intermediate care; nursing and care homes
Special Issues, Collections and Topics in MDPI journals

Dr. José Augusto García Navarro

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Assistant Guest Editor

Consorci de Salut i Social de Catalunya, 08022 Barcelona, Spain; Spanish Society of Geriatrics and Gerontology, 28006 Madrid, Spain
Interests: integrated health and social care; frailty; geriatric and palliative medicine
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. José Viña Ribes

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Assistant Guest Editor

Department of Physiology, Faculty of Medicine, University of Valencia, 46010 València, Valencia, Spain
Interests: aging; physical exercise; frailty; Alzheimer’s disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the 2nd Edition of Special Issue "Health Care for Older Adults":

https://www.mdpi.com/journal/ijerph/special_issues/_health_care_for_older_adults

The increase we have witnessed in life expectancy in recent years has been a historical milestone in the history of humanity, as we have never lived this long before. Nevertheless, this social success presents great clinical and social challenges. After the first successful Special Issue on this topic, the Guest Editors aim to explore different initiatives that result in the health promotion of older adults, such as multicomponent physical exercise programs, interventions that try to avoid loneliness and social isolation and multidisciplinary assessment, and the treatment of frailty and other geriatric syndromes in various settings, such as the emergency unit, orthogeriatrics, and oncogeriatrics.

Broadly, this Special Issue is seeking original submissions that examine (1) the method to detect and to reverse frailty, loneliness, and social isolation; (2) the method to diagnose early and prevent delirium and other geriatric syndromes; (3) best practices to manage the treatment of the elderly with specific situations, such as hip fracture or oncological disease; (4) best practices for designing, implementing, and/or evaluating integrated interventions to improve healthcare in older adults; and (5) best practices to develop healthcare and social interventions to improve quality of life in older adults living in care houses and nursing homes.

Special interest will be given to innovative practices that expand and build upon geriatric approaches with multidisciplinary models. Other manuscript types of interest include relevant position papers, meta-analyses, reviews, brief reports, and commentaries.

Dr. Francisco José Tarazona-Santabalbina
Dr. Sebastià Josep Santaeugènia González
Dr. José Augusto García Navarro
Prof. Dr. José Viña Ribes
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

frailty
comanagement
orthogeriatrics
elderly
oncogeriatrics
multidisciplinary teams
geriatric syndromes
delirium
malnutrition
falls

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Research

Jump to: Review

11 pages, 1068 KiB

Open AccessArticle

Association between Anemia Severity and Ischemic Stroke Incidence: A Retrospective Cohort Study

by Hui-Fen Chen, Tsing-Fen Ho, Yu-Hung Kuo and Ju-Huei Chien

Int. J. Environ. Res. Public Health 2023, 20(5), 3849; https://doi.org/10.3390/ijerph20053849 - 21 Feb 2023

Cited by 3 | Viewed by 2712

Abstract

Stroke patients presenting with anemia at the time of stroke onset had a higher risk of mortality and development of other cardiovascular diseases and comorbidities. The association between the severity of anemia and the risk of developing a stroke is still uncertain. This retrospective study aimed to evaluate the association between stroke incidence and anemia severity (by WHO criteria). A total of 71,787 patients were included, of whom 16,708 (23.27%) were identified as anemic and 55,079 patients were anemia-free. Female patients (62.98%) were more likely to have anemia than males (37.02%). The likelihood of having a stroke within eight years after anemia diagnosis was calculated using Cox proportional hazard regression. Patients with moderate anemia had a significant increase in stroke risk compared to the non-anemia group in univariate analyses (hazard ratios [HR] = 2.31, 95% confidence interval [CI], 1.97–2.71, p < 0.001) and in adjusted HRs (adj-HR = 1.20, 95% CI, 1.02–1.43, p = 0.032). The data reveal that patients with severe anemia received more anemia treatment, such as blood transfusion and nutritional supplementation, and maintaining blood homeostasis may be important to preventing stroke. Anemia is an important risk factor, but other risk factors, including diabetes and hyperlipidemia, also affect stroke development. There is a heightened awareness of anemia’s severity and the increasing risk of stroke development. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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16 pages, 973 KiB

Open AccessArticle

Effect of Familial Longevity on Frailty and Sarcopenia: A Case–Control Study

by Angel Belenguer-Varea, Juan Antonio Avellana-Zaragoza, Marta Inglés, Cristina Cunha-Pérez, David Cuesta-Peredo, Consuelo Borrás, José Viña and Francisco José Tarazona-Santabalbina

Int. J. Environ. Res. Public Health 2023, 20(2), 1534; https://doi.org/10.3390/ijerph20021534 - 14 Jan 2023

Cited by 1 | Viewed by 2582

Abstract

Familial longevity confers advantages in terms of health, functionality, and longevity. We sought to assess potential differences in frailty and sarcopenia in older adults according to a parental history of extraordinary longevity. A total of 176 community-dwelling subjects aged 65–80 years were recruited in this observational case–control study, pair-matched 1:1 for gender, age, and place of birth and residence: 88 centenarians’ offspring (case group) and 88 non-centenarians’ offspring (control group). The main variables were frailty and sarcopenia based on Fried’s phenotype and the European Working Group on Sarcopenia in Older People (EWGSOP) definitions, respectively. Sociodemographics, comorbidities, clinical and functional variables, the presence of geriatric syndromes, and laboratory parameters were also collected. Related sample tests were applied, and conditional logistic regression was performed. Cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower levels of IL-6 (p = 0.044) than controls. The robust adjusted OR for cases was 3.00 (95% CI = 1.06–8.47, p = 0.038). No significant differences in muscle mass were found. Familial longevity was also associated with less obesity, insomnia, pain, and polypharmacy and a higher education level and total and low-density lipoprotein cholesterol. The results suggest an inherited genetic component in the frailty phenotype, while the sarcopenia association with familial longevity remains challenging. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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11 pages, 381 KiB

Open AccessArticle

Before-and-After Study of the First Four Years of the Enhanced Recovery after Surgery (ERAS^®) Programme in Older Adults Undergoing Elective Colorectal Cancer Surgery

by Cristina Martínez-Escribano, Francisco Arteaga Moreno, David Cuesta Peredo, Francisco Javier Blanco Gonzalez, Juan Maria De la Cámara-de las Heras and Francisco J. Tarazona Santabalbina

Int. J. Environ. Res. Public Health 2022, 19(22), 15299; https://doi.org/10.3390/ijerph192215299 - 19 Nov 2022

Cited by 8 | Viewed by 1996

Abstract

Background: The aim of this study was to determine whether the inclusion of older patients undergoing elective colorectal cancer resection in the Enhanced Recovery After Surgery (ERAS^®) programme could improve clinical outcomes during hospital admission. Methods: A before-and-after study in ≥70-year-old patients electively admitted for colorectal cancer resection was designed. In total, 213 patients were included in the ERAS^® group, and 158 were included in the control group. Results: The average age was 77.9 years old (SD 5.31) and 57.14% of them were men, with a Charlson Index score of 3.42 (SD 3.32). The ERAS^® group presented a lower transfusion rate of 42 (19.7%), compared to 75 (47.5%) in the control group (p < 0.001). The crude odds ratio (OR) for transfusion was 0.27 (95% CI 0.17–0.43; p < 0.001), and the adjusted odds ratio was 0.26 (95% CI 0.14–0.48; p < 0.001). The ERAS^® group had a lower percentage of patients with moderate–severe malnutrition on admission, at 23.4% (37 patients) against 36.2% in the control group (42 patients) (p = 0.023), with an OR of 0.47 (95% CI 0.29–0.75; p < 0.002) and an adjusted OR of 0.48 (95% CI 0.29–0.78; p = 0.003). The number of patients who required admission to the intensive care unit (ICU) was also markedly lower: 54 from the ERAS^® group (25.4%) versus 71 from the control group (44.9%) (p < 0.001). Conclusions: The inclusion of ≥70-year-old adults in the ERAS^® programme resulted in a decrease in transfusions, number of erythrocyte concentrates transfused, and number of ICU admissions, along with improved nutritional status. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

11 pages, 1483 KiB

Open AccessFeature PaperArticle

Identification of Early Knee Osteoarthritis Based on Knee Joint Trajectory during Stair Climbing

by Ami Ogawa, Hirotaka Iijima and Masaki Takahashi

Int. J. Environ. Res. Public Health 2022, 19(22), 15023; https://doi.org/10.3390/ijerph192215023 - 15 Nov 2022

Cited by 2 | Viewed by 2357

Abstract

Patients with knee osteoarthritis show low stair climbing ability, but a diagnosis of stair performance time is not enough to identify the early stages of knee osteoarthritis. Therefore, we developed an indicator named range of the knee joint trajectory (RKJT) as a kinematic parameter to express more detailed characteristics than stair performance time. To achieve this, we used our developed “IR-Locomotion”, a markerless measurement system that can track the knee joint trajectory when climbing stairs. This study aimed to test whether the RKJT effectively identifies patients with early knee osteoarthritis even after controlling stair performance time. Forty-seven adults with moderate to severe knee pain (mean age 59.2 years; 68.1% women) underwent the radiographic examination (Kellgren and Lawrence grade) of both knees and a stair climbing test on 11 stairs. The RKJT during the stair climbing test was calculated by “IR-Locomotion”. A generalized linear mixed model was used to evaluate the discriminative capability of RKJT on early knee osteoarthritis (i.e., Kellgren and Lawrence grade of 1). As expected, patients with early knee osteoarthritis showed larger RKJT than non-radiographic controls (95% confidence interval: 1.007, 1.076). Notably, this finding was consistent even after adjusting stair performance time. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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9 pages, 358 KiB

Open AccessArticle

Fear of Falling in Older Adults Treated at a Geriatric Day Hospital: Results from a Cross-Sectional Study

by Eva M. Melendo-Azuela, Julia González-Vaca and Eva Cirera

Int. J. Environ. Res. Public Health 2022, 19(14), 8504; https://doi.org/10.3390/ijerph19148504 - 12 Jul 2022

Cited by 1 | Viewed by 1741

Abstract

(1) Background: The fear of falling (FOF) is a geriatric syndrome that causes a decrease in daily activities and personal autonomy. Its prevalence is highly variable as are the methodologies used to assess it. This study aimed at estimating the prevalence and describing the main determinants of FOF in older adults attending a geriatric day hospital. (2) Methods: Descriptive, cross-sectional study of individuals aged ≥70 years, who attended an ambulatory functional rehabilitation group in the metropolitan area of Barcelona. FOF was assessed using the Activities-Specific Balance Confidence (ABC) scale. Other recorded outcomes were: sex, age, marital status, living alone, level of education, degree of autonomy, pain, previous falls, visual acuity, and signs of depression. Prevalence was estimated overall and according to the possible determinants. (3) Results: The study included 62 individuals (66.1% women), with a prevalence of fear of falling of 38.7% (95% CI 26.2–51.2%). The identified determinants were pain (OR = 7.4, 95% CI 1.4–39.7), a history of falls (OR = 25.3, 95% CI 2.1–303.4), poor visual acuity (OR = 5.6, 95% CI 1.0–29.8), and signs of depression (OR = 19.3, 95% CI 1.4–264.3). (4) Conclusions: The prevalence and determinants of fear of falling in older adults attending geriatric day hospitals were similar to those described in those dwelling in the community. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

14 pages, 660 KiB

Open AccessArticle

Study of a Quasi-Experimental Trial to Compare Two Models of Home Care for the Elderly in an Urban Primary Care Setting in Spain: Results of Intermediate Analysis

by Carolina Burgos Díez, Rosa Maria Sequera Requero, Jose Ferrer Costa, Francisco José Tarazona-Santabalbina, Marià Monzó Planella, Cristina Cunha-Pérez, Sebastià Josep Santaeugènia González and Grupo ATDOM

Int. J. Environ. Res. Public Health 2022, 19(4), 2329; https://doi.org/10.3390/ijerph19042329 - 17 Feb 2022

Cited by 2 | Viewed by 2430

Abstract

Functional dependence is associated with an increase in need for resources, mortality, and institutionalization. Different models of home care have been developed to improve these results, but very few studies contain relevant information. This quasi-experimental study was conducted to evaluate two models of home care (HC) in a Primary Care setting: an Integrated Model (IM) (control model) and a Functional Model (FM) (study model). Material and Methods: Two years follow-up of patients 65 years old and older from two Primary Health Care Centres (58 IM, 68 FM) was carried out, recruited between June-October 2018 in Badalona (Barcelona, Spain). Results of the mid-term evaluation are presented in this article. Health status, quality of care, and resource utilization have been evaluated through comprehensive geriatric assessment, quality of life and perception of health care scales, consumption of resources and complementary tests. Results: A significant difference was detected in the number of hospital admissions (FM/IM 0.71 (1.24)/1.35 (1.90), p: 0.031) in the Accident and Emergency department (FM/IM 2.01 (2.12)/3.53 (3.59), p: 0.006) and cumulative days of admission per year (FM/IM 5.43 (10.92)/14.69 (20.90), p: 0.003). Conclusions: FM offers greater continuity of care at home for the patient and reduces hospital admissions, as well as admission time, thereby saving on costs. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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13 pages, 1062 KiB

Open AccessArticle

Health Service Needs from a Household Perspective: An Empirical Study in Rural Empty Nest Families in Sinan and Dangyang, China

by Xueyan Cheng and Liang Zhang

Int. J. Environ. Res. Public Health 2022, 19(2), 628; https://doi.org/10.3390/ijerph19020628 - 6 Jan 2022

Cited by 2 | Viewed by 2073

Abstract

This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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12 pages, 380 KiB

Open AccessArticle

The Paradoxical Effect of Living Alone on Cognitive Reserve and Mild Cognitive Impairment among Women Aged 60+ in Mexico City

by Antonio R. Villa, Elsa Guerrero, Ana M. Villa, Rosalinda Sánchez-Arenas, María Araceli Ortiz-Rodríguez, Vania Contreras-Sánchez, María Alonso-Catalán, Benjamín Guerrero-López, Ingrid Vargas-Huicochea, Germán E. Fajardo-Dolci and Claudia Díaz-Olavarrieta

Int. J. Environ. Res. Public Health 2021, 18(20), 10939; https://doi.org/10.3390/ijerph182010939 - 18 Oct 2021

Cited by 5 | Viewed by 2371

Abstract

An elderly person who lives alone must often be autonomous and self-sufficient in daily living activities. We explored if living alone and marital status were associated with mild cognitive impairment and low cognitive reserve in a sample of Mexican women aged 60+ attending continuing education courses using a cross-sectional design. Objective cognitive functions were assessed using the MMSE and Blessed Dementia Scale. We administered the Cognitive Reserve Questionnaire. Independence skills were assessed with the Katz index and Lawton index. Multivariate logistic regression analysis was used. We recruited 269 participants (

\bar{x}

= 69.0 ± 5.8 years). Single, widowed, separated, and divorced women comprised 73% of the participants. A third lived alone and 84% had completed high school. Mild cognitive deficit was observed among 24.5–29.0%; the upper range for cognitive reserve was 61.7%. Living alone versus living with someone was associated with cognitive impairment (OR = 0.51, p = 0.04) and with low to medium cognitive reserve (OR = 0.51, p = 0.02) after adjusting for confounding variables. Living alone was an independent factor associated with a lower probability of displaying mild cognitive impairment and a higher probability of displaying high cognitive reserve. Women living alone in this study had a more robust cognitive framework and had built their own support networks. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

20 pages, 20936 KiB

Open AccessArticle

Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program

by Sebastià J. Santaeugènia, Joan C. Contel, Emili Vela, Montserrat Cleries, Paloma Amil, Eva M. Melendo-Azuela, Esther Gil-Sánchez, Victoria Mir and Jordi Amblàs-Novellas

Int. J. Environ. Res. Public Health 2021, 18(18), 9473; https://doi.org/10.3390/ijerph18189473 - 8 Sep 2021

Cited by 14 | Viewed by 3708

Abstract

The Chronic Care Program introduced in Catalonia in 2011 focuses on improving the identification and management of complex chronic (CCPs) and advanced chronic patients (ACPs) by implementing an individualized care model. Its first stage is their identification based on chronicity, difficult clinical management (i.e., complexity), and, in ACPs, limited life prognosis. Subsequent stages are individual evaluation and implementation of a shared personalized care plan. This retrospective study, including all CCPs and ACPs identified in Catalonia between 2013 and 2019, was aimed at describing the characteristics and healthcare service utilization among these patients. Data were obtained from an administrative database and included sociodemographic, clinical, and service utilization variables and morbidity-associated risk according to the Adjusted Morbidity Groups (GMA) stratification. During the study period, CCPs’ and ACPs’ prevalence increased and was higher in lower-income populations; most cases were women. CCPs and ACPs had all comorbidities at higher frequencies, higher utilization of healthcare services, and were more frequently at high risk (63% and 71%, respectively) than age-, sex-, and income level-adjusted non-CCP (23%) and non-ACP populations (30%). These results show effective identification of the program’s target population and demonstrate that CCPs and ACPs have a higher burden of multimorbidity and healthcare needs. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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13 pages, 537 KiB

Open AccessArticle

Primary Care Professionals’ Self-Efficacy Surrounding Advance Care Planning and Its Link to Sociodemographics, Background and Perceptions: A Cross-Sectional Study

by Cristina Lasmarías, Amor Aradilla-Herrero, Cristina Esquinas, Sebastià Santaeugènia, Francisco Cegri, Esther Limón and Mireia Subirana-Casacuberta

Int. J. Environ. Res. Public Health 2021, 18(17), 9034; https://doi.org/10.3390/ijerph18179034 - 27 Aug 2021

Cited by 10 | Viewed by 2690

Abstract

Primary care (PC) professionals have been considered the most appropriate practitioners for leading Advance care planning (ACP) processes with advanced chronic patients. Aim: To explore how PC doctors’ and nurses’ self-efficacy surrounding ACP is linked to their sociodemographic characteristics, background and perceptions of ACP practices. Methods: A cross-sectional study was performed. Sociodemographics, background and perceptions about ACP in practice were collected using an online survey. The Advance Care Planning Self-Efficacy Spanish (ACP-SEs) scale was used for the self-efficacy measurement. Statistical analysis: Bivariate, multivariate and backward stepwise logistic regression analyses were performed to identify variables independently related to a higher score on the ACP-SEs. Results: N = 465 participants, 70.04% doctors, 81.47% female. The participants had a mean age of 46.45 years and 66.16% had spent >15 years in their current practice. The logistic regression model showed that scoring ≤ 75 on the ACP-SEs was related to a higher score on feeling sufficiently trained, having participated in ACP processes, perceiving that ACP facilitates knowledge of preferences and values, and perceiving that ACP improves patients’ quality of life. Conclusion: Professionals with previous background and those who have a positive perception of ACP are more likely to feel able to carry out ACP processes with patients. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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Review

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11 pages, 805 KiB

Open AccessReview

Differentiating between Seronegative Elderly-Onset Rheumatoid Arthritis and Polymyalgia Rheumatica: A Qualitative Synthesis of Narrative Reviews

by Ryuichi Ohta and Chiaki Sano

Int. J. Environ. Res. Public Health 2023, 20(3), 1789; https://doi.org/10.3390/ijerph20031789 - 18 Jan 2023

Cited by 20 | Viewed by 2803

Abstract

Elderly-onset rheumatoid arthritis (EORA) is prevalent among older patients, and its incidence is increasing due to aging societies. However, differentiating between EORA and polymyalgia rheumatica (PMR) is challenging for clinicians and hinders the initiation of effective treatment for rheumatoid arthritis among older generations, thereby allowing its progression. Therefore, we conducted a qualitative synthesis of narrative reviews via meta-ethnography regarding seronegative EORA diagnosis to clarify the methods to differentiate seronegative EORA from PMR. Three databases (PubMed, EMBASE, and Web of Science) were searched for relevant reviews published between January 2011 and October 2022. The extracted articles were synthesized using meta-ethnography, and 185 studies were selected following the protocol. Seven reviews were analyzed, and four themes and nine concepts were identified. The four themes included difficulty in differentiation, mandatory follow-up, and factors favoring rheumatoid arthritis and those favoring PMR. Factors favoring seronegative EORA and PMR should be considered for effective diagnosis and prompt initiation of disease-modifying anti-rheumatic drugs. Mandatory and long follow-ups of suspected patients are essential for differentiating the two diseases. The attitude of rheumatologists toward tentatively diagnosing seronegative EORA and flexibly modifying their hypotheses based on new or altered symptoms can aid in effective management and avoiding misdiagnosis. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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18 pages, 925 KiB

Open AccessReview

Is Frailty Diagnosis Important in Patients with COPD? A Narrative Review of the Literature

by Francisco José Tarazona-Santabalbina, Elsa Naval, Juan María De la Cámara-de las Heras, Cristina Cunha-Pérez and José Viña

Int. J. Environ. Res. Public Health 2023, 20(3), 1678; https://doi.org/10.3390/ijerph20031678 - 17 Jan 2023

Cited by 8 | Viewed by 2545

Abstract

Frailty is prevalent in older adults and is related to a worsening functionality, quality of life, and health outcomes. Though there is an increasing interest in this field, the relationship between frailty and worsening COPD outcomes remains unknown. A narrative review of the literature with studies published between 2018 and 2022 was carried out to address three questions: the prevalence of frailty and other geriatric syndromes in COPD patients, the link between frailty and worsening health outcomes in COPD patients, and the non-pharmacological interventions performed in order to reverse frailty in these patients. A total of 25 articles were selected. Frailty prevalence ranged from 6% and 85.9%, depending on the COPD severity and the frailty measurement tool used. Frailty in COPD patients was related to a high prevalence of geriatric syndromes and to a high incidence of adverse events such as exacerbations, admissions, readmissions, and mortality. One study showed improvements in functionality after physical intervention. In conclusion, the prevalence of frailty is associated with a high incidence of geriatric syndromes and adverse events in COPD patients. The use of frailty screenings and a comprehensive geriatric assessment of COPD patients is advisable in order to detect associated problems and to establish individualized approaches for better outcomes. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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8 pages, 501 KiB

Open AccessReview

Challenges in Help-Seeking Behaviors among Rural Older People Mitigated through Family Physician-Driven Outreach: A Systematic Review

by Ryuichi Ohta, Takuji Katsube and Chiaki Sano

Int. J. Environ. Res. Public Health 2022, 19(24), 17004; https://doi.org/10.3390/ijerph192417004 - 18 Dec 2022

Cited by 10 | Viewed by 1639

Abstract

Help-seeking behaviors (HSBs) refer to approaches taken by individuals towards their health and symptoms, and they are supported by healthcare professionals. Outreach interventions aimed at older people in rural communities can mitigate difficulties in implementing HSBs and help them remain healthy. This systematic review investigated evidence regarding family medicine-involved outreach aimed at HSBs among older individuals in rural areas. We searched three databases (PubMed, EMBASE, and Web of Science) for international and original interventional articles regarding family physicians involved in outreach to older people in rural or underserved areas between April 2000 and October 2022. The articles were analyzed and summarized based on the setting, country, health issues, and outreach outcomes. Of the 376 studies identified, four were included in this review. Our findings showed that family physician-involved outreach to rural and underserved areas improved health outcomes, including anxiety, subjective physical function, and diabetic care. The challenges of outreach interventions include the duration and continuity of outreach, the active participation of family physicians and patients in the outreach programs, and the focus of outreach participants. Although the number of studies included was small, family physician-involved outreach to rural and underserved areas was shown to improve various health outcomes. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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17 pages, 695 KiB

Open AccessReview

Pharmacists’ Role in Older Adults’ Medication Regimen Complexity: A Systematic Review

by Catharine Falch and Gilberto Alves

Int. J. Environ. Res. Public Health 2021, 18(16), 8824; https://doi.org/10.3390/ijerph18168824 - 21 Aug 2021

Cited by 11 | Viewed by 3216

Abstract

Medication regimen complexity (MRC) may influence health outcomes, such as hospitalisation, hospital readmission and medication adherence. Pharmacists have been referred to as health professionals with the opportunity to act on MRC reduction. This study aimed to investigate pharmacists’ role in studies about older adults’ medication regimen complexity. A literature search was performed in PubMed, Web of Science and the Cochrane Library—CENTRAL—up to October 2019. Out of 653 potentially relevant studies, 17 articles met the inclusion criteria for this review. Most studies used the 65-item medication regimen complexity index (MRCI) to assess medication complexity. Pharmacists’ role was mainly confined to data collection. It seems that pharmacists’ active role in older adults’ medication complexity has not been studied in depth so far. However, the few existing interventional ones suggest that, after previous training, regimen simplification is feasible. Full article

(This article belongs to the Special Issue 2nd Edition: Frontiers in Health Care for Older Adults)

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