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Kawano S, Eguchi Y, Oosumi A, Takeuchi H, Takubo M, Kimura N, Nakano N, Ryuzaki T, Hayashida K, Ieda M, Uchida H, Mimura M, Fujisawa D. Establishment and clinical impacts of decision-support system for older patients with aortic valve stenosis: A retrospective observational study. Gen Hosp Psychiatry 2025; 92:106-111. [PMID: 39754826 DOI: 10.1016/j.genhosppsych.2024.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 12/27/2024] [Accepted: 12/27/2024] [Indexed: 01/06/2025]
Abstract
OBJECTIVES Treatment decisions for severe aortic stenosis (AS) are complex, since there are two active and comparable options: transcatheter aortic valve implantation and surgical aortic valve replacement. The disease predominantly affects older individuals, who are frequently comorbid with from cognitive impairment. This study aimed to establish a screening-triggered system to assess the decision-making capacity of patients with AS, support their decision-making, and facilitate referrals to specialists when necessary. METHODS This is a retrospective pre-post observational study. Relevant healthcare professionals were trained to assess and support patients' decision-making capacities. RESULTS Subtotals of 203 and 244 patients were enrolled before and after the implementation of the system, respectively. The requests for decision-making support significantly increased (from 1.5 % to 14.8 % of the patients). 11.5 % of the patients were identified as with declined decision-making capacity. The proportion of patients who received active treatments for AS significantly decreased from 95.0 % to 83.0 %. The nurses' documentation of patients' decision-making capacities significantly increased. CONCLUSION This screening-triggered system identified a substantial proportion of patients with declined decision-making capacity. A significant decrease in patients receiving active treatments for AS and increased documentation of patients' decision-making capacities in nursing records were observed. A future randomized controlled is warranted.
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Affiliation(s)
- Sayoko Kawano
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - Yoko Eguchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Azusa Oosumi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyoshi Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Michiyo Takubo
- Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Noriko Kimura
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - Naomi Nakano
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - Toshinobu Ryuzaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masaki Ieda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Center for Preventive Medicine, Keio University, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan.
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Pizarro-Mena R, Rotarou ES, Chavarro-Carvajal D, Wachholz PA, López MF, Perdomo Delgado C, Parra-Soto S, Barrientos-Calvo I, Retamal-Walter F, Riveros-Basoalto G. Comprehensive Gerontological Assessment: An Update on the Concept and Its Evaluation Tools in Latin America and the Caribbean-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1697. [PMID: 39767536 PMCID: PMC11727758 DOI: 10.3390/ijerph21121697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 11/23/2024] [Accepted: 12/13/2024] [Indexed: 01/16/2025]
Abstract
In recent decades, Latin America and the Caribbean region have experienced accelerated aging. However, despite the significant progress of gerontology in the region, the number of geriatricians and professionals trained in the field is low; a notable gap in the training related to the assessment of older adults can also be observed. Therefore, in this literature review, we update the concept of Comprehensive Gerontological Assessment (CGA) for its application in the region. We compile the characteristics, validity, and reliability of CGA tools, and their usage in government documents across countries in the region. We also analyze the adaptations made to CGA during the COVID-19 pandemic, and discuss challenges related to CGA administration, academic training, research, innovation, and management. This study is particularly relevant as it proposes lines of action for decision-makers, academics, researchers, university students, and the general community, which will allow for more tailored interventions aimed at meeting the needs of older adults, their families, and caregivers. Such actions will positively impact functionality, autonomy, and quality of life, while promoting healthy, active, and successful aging in the region.
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Affiliation(s)
- Rafael Pizarro-Mena
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile;
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Núcleo Milenio Estudios en Discapacidad y Ciudadanía—DISCA (NCS2022_039), Santiago 7500000, Chile
| | - Elena S. Rotarou
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Núcleo Milenio Estudios en Discapacidad y Ciudadanía—DISCA (NCS2022_039), Santiago 7500000, Chile
- Facultad de Medicina y Ciencia, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile
| | - Diego Chavarro-Carvajal
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Instituto de envejecimiento de la Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá 110231, Colombia
| | - Patrick Alexander Wachholz
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista—Unesp, São Paulo CEP 18618-687, Brazil
| | - María Fernanda López
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Facultad de Psicología y Ciencias Sociales, Universidad Flores, Buenos Aires C1406EEE, Argentina
| | - Cristina Perdomo Delgado
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Sede Los Leones, Santiago 7500000, Chile;
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
| | - Solange Parra-Soto
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Departamento de Nutrición y Salud Pública, Facultad Ciencias de la Salud y de los Alimentos, Universidad del Bio-Bio, Chillán 3780000, Chile
| | - Isabel Barrientos-Calvo
- Red Interuniversitaria de Envejecimiento Saludable de Latinoamérica y Caribe (RIES-LAC); (E.S.R.); (D.C.-C.); (P.A.W.); (M.F.L.); (S.P.-S.); (I.B.-C.)
- Unidad de Investigación Hospital Nacional de Geriatría y Gerontología, Universidad de Costa Rica, San José 11501-2060, Costa Rica
| | - Felipe Retamal-Walter
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Gloria Riveros-Basoalto
- Bibliotecóloga Referencista, Vicerrectoría Académica, Universidad San Sebastián, Santiago 7500000, Chile;
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Jabłonowska-Babij P, Olszewska-Szopa M, Potoczek S, Majcherek M, Szeremet A, Kujawa K, Wróbel T, Czyż A. The Role of the Lawton Instrumental Activities of Daily Living (IADL) Scale in Predicting Adverse Events and Outcomes of R-CHOP Treatment in Elderly Patients with Diffuse Large B-Cell Lymphomas (DLBCLs) or Mantle Cell Lymphomas (MCLs): A Prospective Single-Center Study. Cancers (Basel) 2024; 16:4170. [PMID: 39766069 PMCID: PMC11674628 DOI: 10.3390/cancers16244170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 12/09/2024] [Accepted: 12/12/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND The prognostic value of the comprehensive geriatric assessment (CGA) is recognized by many in hematology. However, there is no consensus on the utilization of alternative abbreviated methods to assess disabilities in elderly patients with B-cell non-Hodgkin's lymphomas (B-NHLs). AIM The aim of this study was to prospectively analyze the prognostic value of selected CGA tools in predicting adverse events (AEs) and outcomes of R-CHOP or R-CHOP-like treatment in elderly patients with diffuse large B-cell lymphomas (DLBCLs) or mantle cell lymphomas (MCLs). METHODS All patients who participated in this study underwent the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living (iADL) scale, the Vulnerable Elders Survey-13 (VES-13), the Groningen Frailty Index (GFI), and the Mini Nutritional Assessment Short Form (MNA-SF) before starting anticancer treatment. Selected clinical predictors were also included in the study. RESULTS A total of 62 patients with newly diagnosed DLBCLs or MCLs, treated with R-CHOP in the Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation of Wroclaw University Hospital between 1 July 2018, and 1 July 2020, were included in the study. The median age upon initiation of the treatment was 72 years (range: 61-68). Multinomial logistic regression and Cox proportional hazard regression analysis demonstrated that the iADL scale was significantly associated with response to treatment (OR = 1.21, 95% CI: 1.02-1.44, p = 0.03), was inversely related to non-hematological AEs (OR = 0.81, 95% CI: 0.71-0.92, p = 0.001), and was a statistically significant predictor of longer overall survival (OS) (HR = 0.83, 95% CI: 0.79-0.89, p < 0.001) and longer progression-free survival (PFS) (HR = 0.91, 95% CI: 0.83-0.99, p = 0.03). CONCLUSIONS These results underscore the effectiveness of the iADL scale as a quick, easy-to-use, and universal CGA tool for evaluating crucial functional status before treatment in elderly hematological patients with DLBCLs or MCLs.
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Affiliation(s)
- Paula Jabłonowska-Babij
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Magdalena Olszewska-Szopa
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Stanisław Potoczek
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Maciej Majcherek
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Agnieszka Szeremet
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Krzysztof Kujawa
- Statistical Analysis Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Tomasz Wróbel
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
| | - Anna Czyż
- Clinical Department of Hematology, Cell Therapies and Internal Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.O.-S.); (S.P.); (M.M.); (A.S.); (T.W.); (A.C.)
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Dovjak P, Iglseder B, Rainer A, Dovjak G, Weber M, Pietschmann P. Prediction of Fragility Fractures and Mortality in a Cohort of Geriatric Patients. J Cachexia Sarcopenia Muscle 2024; 15:2803-2814. [PMID: 39513358 PMCID: PMC11634494 DOI: 10.1002/jcsm.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 09/04/2024] [Accepted: 09/25/2024] [Indexed: 11/15/2024] Open
Abstract
BACKGROUND Risk factors of refracture after fragility fractures include osteoporosis, female gender and advanced age among others. We hypothesized that the assessment of functionality, muscle health and nutrition status contribute to the risk prediction for further fractures and death. METHODS We assessed 334 patients admitted to the department of acute geriatrics for sociodemographic data, bone fragility, selected laboratory tests, body composition and data on functionality using the comprehensive geriatric assessment. Patients had follow-ups until the occurrence of further fractures or death. Dual-energy X-ray absorptiometry and pulse echo measurements were performed to assess bone mineral density. Fracture risk was assessed using the FRAX score and muscle strength according to published guidelines on sarcopenia. RESULTS The mean age was 81 years (70-95), and 82.3% (275/334) were women. An incidence of 10.4% (35/334) new fragility fractures was observed within 24 months, and the mortality rate was 12.2% (41/334). A significantly higher rate of further fractures was associated with lower BMI (body mass index) (HR 0.925, CI 0.872-0.98; p = 0.009), lower parathyroid hormone levels (HR 0.986, CI 0.973-0.998; p = 0.026) and with the diagnosis of osteoporosis (HR 2.546, CI 1.192-5.438; p = 0.016). No significant associations were present in patients with previous fractures, with higher age, higher FRAX scores, sarcopenia, in women, sarcopenic obesity, frail patients, lower grip strength, lower walking speed, lower Barthel index or lower DI (density index) values. The predictive power for further fractures was 10.7% higher adding osteosarcopenia, BMI and parathyroid hormone levels to standard assessment parameters osteoporosis, age and the status of previous fractures. Mortality was significantly higher with advanced age (HR 1.101, CI 1.052-1.151; p < 0.001), in men (HR 6.464, CI 3.141-13.305; p < 0.001), in smokers (p = 0.002), higher FRAX score (HR 1.039, CI 1.009-1.070; p = 0.010), lower renal function (HR 0.987, CI 0.976-0.997; p = 0.010), lower Tinetti test scores (HR 0.943, CI 0.900-0.987; p = 0.012), lower walking speed (HR 0.084, CI 0.018-0.382; p = 0.001), lower hand grip (HR 0.876, CI 0.836-0.919; p < 0.001) and lower Barthel index scores (HR 0.984, CI 0.971-0.997; p = 0.015). CONCLUSIONS In a cohort of geriatric patients, the addition of BMI, low parathyroid hormone levels and osteosarcopenia increases the predictive power for further fractures by 10.7%. These parameters are a valuable addition to the standard assessment parameters age and history of sustained fractures. Mortality is partly associated with potentially treatable functional parameters.
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Affiliation(s)
- Peter Dovjak
- Department of Acute GeriatricsSalzkammergut Clinic GmundenGmundenAustria
| | - Bernhard Iglseder
- Department of Geriatric Medicine, Christian Doppler HospitalParacelsus Medical UniversitySalzburgAustria
| | - Anna Rainer
- Department of Acute GeriatricsSalzkammergut Clinic GmundenGmundenAustria
| | - Gregor Dovjak
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - Michael Weber
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - Peter Pietschmann
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
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Wu X, Freeman S, Miyagi M, Park U, Nomura K, Ebihara S. Comprehensive Geriatric Assessment in the era of telemedicine. Geriatr Gerontol Int 2024; 24 Suppl 1:67-73. [PMID: 37846612 DOI: 10.1111/ggi.14705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
The aging global population poses significant medical and social challenges, necessitating efforts to promote healthy aging. Comprehensive Geriatric Assessment (CGA) is a multidimensional diagnostic approach for older adults that aims to improve overall health. Remote CGA, facilitated by technological advancements, offers convenience and other potential advantages. It enables early disease detection, monitors chronic disease progression, delivers personalized care, and optimizes healthcare resources for better health outcomes in older individuals. However, remote CGA also has limitations, including technological requirements, data security, and the need for comprehensive evaluation and simplicity. Collaborative efforts are essential to developing a digital home-based CGA platform that addresses accessibility issues and tailors the assessment process to meet the needs of older adults. Continuous optimization of remote CGA can become a pivotal tool for advancing geriatric care and ensuring the well-being of the aging population. Geriatr Gerontol Int 2024; 24: 67-73.
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Affiliation(s)
- Xinze Wu
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shannon Freeman
- School of Nursing, University of North British Columbia, Prince George, Canada
- Center for Technology Adoption for Aging in the North, Prince George, Canada
| | - Midori Miyagi
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Uijin Park
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
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Terziotti C, Ceolin C, Devita M, Raffaelli C, Antenucci S, Bazzano S, Capasso A, Castellino M, Signore SD, Lubian F, Maiotti M, Monacelli F, Mormile MT, Sgarito C, Vella F, Sergi G, Gareri P, Trevisan C, Bellio A, Fini F, Malara A, Mossello E, Fumagalli S, Volpato S, Monzani F, Bellelli G, Zia G, Incalzi RA, Coin A. Frailty, psychological well-being, and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative. Psychogeriatrics 2023; 23:1007-1018. [PMID: 37679953 DOI: 10.1111/psyg.13021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/26/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown. MATERIALS AND METHODS Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale. RESULTS The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL. CONCLUSIONS We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
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Affiliation(s)
- Camilla Terziotti
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Maria Devita
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of General Psychology, University of Padova, Padova, Italy
| | - Cecilia Raffaelli
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | | | | | - Andrea Capasso
- Territorial Care Department, ASL NA2 Nord, Naples, Italy
| | - Manuela Castellino
- "B.V. Consolata" Rehabilitation Hospital-Fatebenefratelli, San Maurizio Canavese, Italy
| | | | | | | | - Fiammetta Monacelli
- Section of Geriatrics, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | | | - Claudia Sgarito
- UOC Involutive Degenerative Diseases, Territorial Psychogeriatrics, ASP of Agrigento, Agrigento, Italy
| | | | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia-Catanzaro Lido ASP, Catanzaro, Italy
| | - Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Bellio
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Filippo Fini
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | | | - Enrico Mossello
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Stefano Fumagalli
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, Acute Geriatric Unit, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Alessandra Coin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
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Yu J, Lu SR, Wang Z, Yang Y, Zhang BS, Xu Q, Kan H. Role of comprehensive geriatric assessment in screening for mild cognitive disorders. World J Psychiatry 2023; 13:478-485. [PMID: 37547738 PMCID: PMC10401506 DOI: 10.5498/wjp.v13.i7.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The role of comprehensive geriatric assessment (CGA) in screening for mild cognitive disorders was not known.
AIM To evaluate the role of CGA in screening for mild cognitive disorders.
METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis. Using Petersen as the diagnostic gold standard, healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group. The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed. Patients' Montreal Cognitive Assessment (MoCA) and CGA screening results were compared, and the sensitivity and specificity were calculated to assess the screening role of CGA.
RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA. The results of the multivariate regression analysis showed no correlation of gender, age, body mass index and literacy with cognitive function. Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals (P < 0.05). In the CGA scale, patients with mild cognitive impairment showed significantly lower Mini-mental State Examination, Miniature Nutritional Assessment and Berg Balance Scale scores, and higher Activity of Daily Living, Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals (P < 0.05), whereas the other assessment scales showed no significant differences (P > 0.05). The CGA provides higher diagnostic sensitivity and specificity than the MoCA (P < 0.05).
CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity, facilitating timely and effective intervention, and is thus recommended for clinical use.
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Affiliation(s)
- Jie Yu
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Shou-Rong Lu
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Zhuo Wang
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Yin Yang
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Bin-Shan Zhang
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Qiao Xu
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
| | - Hong Kan
- Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
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Meza-Valderrama D, Marco E, Muñoz-Redondo E, Morgado-Pérez A, Sánchez MT, Curbelo Peña Y, De Jaime E, Canchucaja L, Meza Concepción F, Perkisas S, Sánchez-Rodríguez D. Musculoskeletal Ultrasound Shows Muscle Mass Changes during Post-Acute Care Hospitalization in Older Men: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15150. [PMID: 36429869 PMCID: PMC9690008 DOI: 10.3390/ijerph192215150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to prospectively assess changes in muscle thickness (MT) and the cross-sectional area (CSA) of the rectus femoris (RF) muscle in a cohort of older adults, using musculoskeletal ultrasound at admission and at a 2-week follow-up during hospitalization in a post-acute care unit. Differences in frailty status and correlations of MT-RF and CSA-RF with current sarcopenia diagnostic criteria were also studied. Forty adults aged 79.5 (SD 9.5) years (57.5% women) participated, including 14 with frailty and 26 with pre-frailty. In the first week follow-up, men had a significant increase in MT (0.9 mm [95%CI 0.3 to 1.4], p = 0.003) and CSA (0.4 cm2 [95%CI 0.1 to 0.6], p = 0.007). During the second week, men continued to have a significant increase in MT (0.7 mm [95%CI 0.0 to 1.4], p = 0.036) and CSA (0.6 cm2 [95%CI 0.01 to 1.2], p = 0.048). Patients with frailty had lower values of MT-RF and CSA-RF at admission and during the hospitalization period. A moderate-to-good correlation of MT-RF and CSA with handgrip strength, fat-free mass and gait speed was observed. Musculoskeletal ultrasound was able to detect MT-RF and CSA-RF changes in older adults admitted to a post-acute care unit.
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Affiliation(s)
- Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation, Vía Centenario, Diagonal a la Universidad Tecnológica de Panamá, Panama City 0819, Panama
- Physical Medicine and Rehabilitation Department, Caja de Seguro Social, Calle de Circunvalación, Panama City 0844, Panama
| | - Ester Marco
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
- School of Medicine, Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Catalonia, Spain
| | - Elena Muñoz-Redondo
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Andrea Morgado-Pérez
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Marta Tejero Sánchez
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Yulibeth Curbelo Peña
- Rehabilitation Research Group, Hospital del Mar Research Institute, Dr. Aiguader, 88, 08003 Barcelona, Catalonia, Spain
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elisabeth De Jaime
- Geriatric Department, Centre Fòrum-Hospital del Mar, Parc de Salut Mar, Llull, 410, 08029 Barcelona, Catalonia, Spain
| | - Lizzeth Canchucaja
- Geriatric Department, Centre Fòrum-Hospital del Mar, Parc de Salut Mar, Llull, 410, 08029 Barcelona, Catalonia, Spain
| | - Frank Meza Concepción
- Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Ave. Simón Bolívar, Panama City 07096, Panama
| | - Stany Perkisas
- University Center of Geriatrics, Antwerp University, Universiteitsplein 1, 2610 Antwerp, Belgium
- First Line and Interdisciplinary Care Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Dolores Sánchez-Rodríguez
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Place du 20 Août 7, 4000 Liege, Belgium
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