1,721,025 research outputs found
Anorexia of ageing and routinely collected ‘big data’: helpful insights and new challenges
No full textThe research interest in anorexia of ageing, broadly defined as appetite loss attributable to the ageing process, has been building momentum over the last decade. An increasing number of observational studies have demonstrated its importance in trajectories of healthy ageing and association with increased morbidity and mortality (1-5). The recent article “Anorexia in Medicare fee-for-service beneficiaries: A claims-based analysis of epidemiology and mortality” by Dagenais et al (6), now holds these observations true in a ‘real-world’ big data setting in the United States. The authors looked at health insurance claims over a 6-year period for people aged 65–115 years, equating to nearly 30 million people each year from a range of care and community settings and used the ICD-10 code R63.0 to identify anorexia. When compared to controls without anorexia the authors observed advanced age, female sex and higher comorbidity burden as covariates to anorexia diagnosis, alongside a substantially higher (up to ten-fold) 12-month mortality rate for anorexic individuals
Current clinical care of older adults with sarcopenia
No full textAs sarcopenia is common and associated with risk of adverse health consequences, strategies for clinical care of such patients are needed. Individuals with slow gait speed (<0.8 m/s) should be evaluated for low grip strength and low muscle mass. Progressive resistance exercise in patients with sarcopenia is beneficial, but evidence for protein or vitamin D supplementation is inconclusive. Comprehensive geriatric assessment with involvement of a multidisciplinary team enables clinicians to optimize treatment of complex older individuals with sarcopenia
Predicting the extent of recovery after stroke: how do patients and carers compare with health professionals?
No full textPatient's and carer's expectations of recovery can influence the success of rehabilitation. Healthcare professionals' prediction of recovery is important for discharge planning. We studied their accuracy of predicting functional outcome after stroke
Is there a relationship between handedness, side of onset or worst affected side and the use of cueing methods in patients with Parkinson's disease?
No full textFall frequency, predicting falls and participating in falls research: similarities among people with Parkinson's disease with and without cognitive impairment
No full textObjectiveWe compared fall frequency and prediction among People with Parkinson's Disease (PwP) with and without cognitive impairment (CI); researchers sometimes overlook the former, concerned about consent, recall and adherence and differences in fall frequency and predictability.MethodsWe recruited 101 PwP from one clinic, used the Montreal Cognitive Assessment to measure CI, noted repeated falls recalled retrospectively over 12 months and evaluated ‘repeated falls’ and ‘difficulty turning’ as predictors of falls over three months.ResultsParticipant median age was 76 years, and time since diagnosis 6 years. Of 40 participants without CI, 40% recalled falls and 55% fell during follow-up (1.9 (±3.8) falls/person), the sensitivity of fall history being 57% and of turning 36%. Of 36 participants with mild CI, 42% recalled falls and 42% fell during follow-up (1.2 (±1.8) falls/person), the sensitivity of fall history being 67% and of turning 69%. Of 25 participants with moderate CI, 60% recalled falls and 58% fell during follow-up (1.2 (±1.8) falls/person), the sensitivity of fall history being 71% and of turning 69%.ConclusionsResearchers need not exclude people with CI assuming falls are more frequent and less predictable than among those without. Fall rates (falls/person during follow-up) were similar among people with and without CI. Falls and difficulty turning were more sensitive predictors of falling in those with CI than those without: a simple mobility test may suggest an individual's risk of falling if a history is unavailable. Most PwP with moderate CI fall repeatedly: carer involvement facilitates their inclusion in research
Can the use of volunteers improve mealtime care of adult patients or residents? A comprehensive literature review
No full textScope: malnutrition among older people in care settings is common and associated withadverse outcomes. Poor standards of mealtime care are reported, with one in fivepatients not receiving help with eating when required. We assessed the evidencefor volunteers improving mealtime care.Search Methods: the literature was searched in August 2008 using databases; MEDLINE®, CINHAL®, BNI and EMBASE. This identified 21 potentially relevant studies. Studieswere selected if they described the use of volunteers to assist adults at mealtimes in institutions and the effect this had on outcomes including nutritional intake andsatisfaction.Appraisal: seven studies fulfilled the criteria for inclusion. The methodology of 5 of the 7 studies was unclear due to the brevity of the report bringing into question the validity.Results: generally the review suggested the use of volunteers in mealtime care increasedsatisfaction of patients, relatives, volunteers, and staff concerning meal-time assistance (assessed using methods such as questionnaires and focus groups). One study found that the mean meal intake of 34 patients assisted to eat by a volunteer was increased by 26% in comparison to a matched group assisted by nursing staff.Conclusions: there is some evidence that volunteers can improve mealtime care of patients, however few well designed studies are reported. A detailed evaluation of the use of volunteers to improve the mealtime care in institutions, and any impact on patient health is required
Emergency hospital admissions of older people for ill-defined conditions amongst older people
No full textTrends in older people's emergency hospital admissions for symptoms, signs and ill-defined conditions
No full textThe epidemiology of sarcopenia
No full textThe aim of this review is to describe the epidemiology of sarcopenia, specifically prevalence, health outcomes, and factors across the life course that have been linked to its development. Sarcopenia definitions involve a range of measures (muscle mass, strength, and physical performance), which tend to decline with age, and hence sarcopenia becomes increasingly prevalent with age. Less is known about prevalence in older people in hospital and care homes, although it is likely to be higher than in community settings. The range of measures used, and the cutpoints suggested for each, presents a challenge for comparing prevalence estimates between studies. The importance of sarcopenia is highlighted by the range of adverse health outcomes that strength and physical performance (and to a lesser extent, muscle mass) have been linked to. This is shown most strikingly by the finding of increased all-cause mortality rates among those with weaker grip strength and slower gait speed. A life course approach broadens the window for our understanding of the etiology of sarcopenia and hence the potential intervention. An example is physical activity, with increased levels across midadulthood appearing to increase muscle mass and strength in early old age. Epidemiologic studies will continue to make an important contribution to our understanding of sarcopenia and possible avenues for intervention and preventio
Understanding how we age: insights into inflammaging
No full textInflammaging is characterized by the upregulation of the inflammatory response that occurs with advancing age; its roots are strongly embedded in evolutionary theory.Inflammaging is believed to be a consequence of a remodelling of the innate and acquired immune system, resulting in chronic inflammatory cytokine production.Complex interrelated genetic, environmental and age-related factors determine an individual’s vulnerability or resilience to inflammaging. These factors include polymorphisms to the promoter regions of cytokines, cytokine receptors and antagonists, age-related decreases in autophagy and increased adiposity. Anti-inflammaging describes the upregulation of the hypothalamic-pituitary axis in response to inflammaging, leading to higher levels of cortisol, which in turn may be detrimental, contributing to less successful ageing and frailty. This may be countered by the adrenal steroid dehydroepiandrosterone, which itself declines with age, leaving certain individuals more vulnerable. Inflammaging and anti-inflammaging have both been linked with a number of age-related outcomes, including chronic morbidity, functional decline and mortality. This important area of research offers unique insights into the ageing process and the potential for screening and targeted interventions
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