Background. This cross-sectional study investigated root caries prevalence among older adults in Miraj, India.

Background.Older adults in residential care homes in Hong Kong usually have multiple co-morbidities and need end-of-life (EOL) care.Repeated hospitalisations before death are common.The Hospital Admission Risk Reduction Program for the Elderly (HARRPE) score is correlated with mortality.We compared older adults identified by clinical referral with older adults identified by HARRPE score 0.4 in terms of EOL programme enrolment rate and mortality rates at 180 and 365 days.Methods.This retrospective cohort study included older adults aged 80 years residing in care homes from 1 July 2018 to 30 June 2019.We compared older adults identified by clinical referral with older adults identified by HARRPE score 0.4 in terms of EOL programme enrolment rate and mortality rates at 180 and 365 days.Results.Of 113 clinical referral patients and 735 patients with HARRPE score 0.4,102 and 96, respectively, fulfilled EOL programme criteria.Their mean age was 92 years, with female predominance (71%).Enrolment rates were similar (57% and 51%, respectively).Survival probability was higher among enrolled patients than among nonenrolled patients (p<0.001).The two groups were comparable in terms of the 180-day mortality rate and 365-day mortality rate.In both groups, survival probabilities were higher in patients who enrolled in the EOL programme, compared with patients who did not enrol (p<0.001).The median survival was longer in the HARRPE group (191 vs 155 days). Conclusions.Older adults in residential care homes requiring EOL care according to HARRPE score 0.4 have similar enrolment and mortality rates, compared with clinical referral.The HARRPE score is a feasible tool to supplement clinical referral for timely EOL care.

Objective.To evaluate the effect of mental practice (MP), mirror therapy (MT), and MP+MT on upper extremity function and activities of daily living performance in patients with stroke.Methods: A total of 25 participants were randomly assigned to receive MP (n=8), MT (n=8), or MP+MT (n=9).Outcomes were assessed before, during, and after intervention using the Fugl-Meyer Assessment (FMA) and the Action Research Arm Test (ARAT) for upper extremity function as well as the Korean version of the modified Barthel Index (K-MBI) and the Motor Activity Log (MAL) for activities of daily living performance.Results: After intervention, MP, MT, and MP+MT groups had significant improvement in scores of FMA, ARAT, MBI, MAL (all p<0.05).The improvement in scores of FMA, ARAT, MBI, MAL did not differ significantly among the three groups.Nonetheless, the improvement in scores was largest in the MP+MT group. Conclusion:MP, MT, and MP+MT can improve upper extremity function and activities of daily living performance in patients with stroke.The improvement is largest after MP+MT.

Background.During the fifth wave of the COVID-19 pandemic in Hong Kong, a geriatric team was established to provide interdisciplinary intervention and discharge planning for older patients in a community treatment facility (CTF) at the AsiaWorld-Expo.This study examined clinical outcomes among these older patients and identified key determinants of these outcomes.Methods.Medical records of patients aged 60 years who were admitted to the CTF for management of COVID-19 by a geriatric team between 24 March 2022 and 4 May 2022 were retrospectively reviewed.Baseline characteristics, geriatric syndrome statuses, laboratory results, treatments, and clinical outcomes were collected.Risk factors for transfer to an acute care hospital, 28-day mortality, and 28-day readmission were examined.Results.Among 257 patients admitted to the CTF, 29.6% had geriatric syndromes; poor oral feeding was most common.The proportion of patients with frailty increased by 14.4% upon discharge.The 28-day mortality rate was 12.5%; risk factors were dexamethasone use and transfer to an acute care hospital.The 28-day readmission rate was 33.9%; risk factors were higher Charlson Comorbidity Index, dementia, and moderate to severe hyponatraemia.Conclusions.Geriatric syndromes (particularly poor oral feeding) were common in older patients with COVID-19 who were associated with significant post-hospitalisation mortality, readmission, and worsened frailty with functional decline.These findings highlight the importance of a geriatric care model in the management of older patients with COVID-19.

Older patients are vulnerable to complications from hospitalisation, particularly during the COVID-19 pandemic.We report four cases of complications (psychological distress, deconditioning and pressure injuries, delirium, and poor feeding) that occurred during the stay in the community treatment facility.These complications are common and tend to be overlooked during the pandemic because of the isolation policy with decreased contact between healthcare workers and patients, increased patient load, and shortage of healthcare manpower.The usual preventive measure should be implemented despite the difficulties during the pandemic.Early mobilisation with decreased bedrest and early discharge arrangement should be considered once medical condition stabilised and isolation period completed.

Amlodipine is an oral dihydropyridine calcium channel blocker.It is widely used to treat hypertension.This report describes four cases of amlodipine-induced gingival overgrowth in older patients.

We discuss the epidemiology, risk factors, diagnosis, and fragility fracture of osteoporosis as well as pharmacological treatments (including bisphosphonates, hormonal replacement therapy, selective oestrogen receptor modulator, denosumab, teriparatide, and romosozumab), adverse effects, drug holiday, vitamin D and calcium supplementation, change of treatment, and non-pharmacological managements (physical exercise, fall prevention intervention, and lifestyle measures) for osteoporosis.

Objective. To assess the prevalence, patterns, and associated factors of self-medication among Malaysian older adults, and to investigate the impact of COVID-19 pandemic on self-medication. Methods: Between January and June 2021, Malaysian older adults aged ≥60 years were invited to participate in this cross-sectional study. A self-administered questionnaire was used to assess self-medication knowledge, perceptions, and practices before and during the pandemic. Results: Of 170 participants, 122 (71.8%) reported self-medication. Common reasons for self-medication were a perception that the condition was minor and previous experience with the same problem. The main symptoms managed by self-medication were sore throat (56.9%), fever (56%), and headache (53.2%). The most commonly used medications were paracetamol (79.8%), analgesic patches (52.3%), and cough medications (47.7%). Most participants were unaware of possible drug-drug/drug-food interactions involving their medications. 33.6% of participants changed their self-medication practices during the pandemic; 65% of them consumed more vitamins and supplements to boost their health. Self-medication for minor ailments is prevalent among Malaysian older adults. Analgesics were the most commonly used medication. 33.6% of participants modified their self-medication practices during the COVID-19 pandemic; 65% of them consumed more vitamins and supplements to boost their health.

We report a case of sudden onset of breathlessness secondary to diaphragmatic hernia in a 98-year-old woman admitted for recurrent falls.