Geriatric Department Research Articles

Identifikacija terapijskih problema tokom uvođenja usluga farmaceuta na Odeljenju gerijatrije Kliničko-bolnickog centra

Introduction: Patients with multiple comorbidities and undergoing polypharmacy are at a high risk of experiencing drug-related problems (DRPs). These DRPs can lead to increased morbidity, mortality, and healthcare costs. Objective: This study aims to identify the prevalence and causes of DRPs in geriatric inpatients, as well as the factors that contribute to them. Additionally, the study intends to evaluate the implementation of ward-based pharmacy services in the geriatric department. Method: The pharmacist analyzed inpatient therapy, identified DRPs, and formulated recommendations. DRPs were categorized according to the PCNE-DRP classification, version 9. A total of 100 patients, of which 52% were men, average age of 79.7±7.88 years, were included in the study. Results: Our study found that on average, each patient had 2.36 drug-related problems (DRPs). The most common DRP was related to treatment safety, accounting for 44.9% of cases, followed by treatment effectiveness (33.1%) and unnecessary drug treatment (22%). The main cause of DRPs was inadequate drug selection (61%) and inadequate dose selection (38.1%). Patients with atrial fibrillation and chronic renal failure had more DRPs than those without these conditions. In total, we identified 229 interventions to address these DRPs. However, the acceptance rate of these recommended interventions was low at 25.9%. Conclusion: The rate of drug-related issues in elderly hospital patients was found to be high, but the rate of acceptance of interventions to address these issues was low. In order to enhance the implementation of pharmaceutical services and improve healthcare for elderly patients, it is crucial to improve the collaboration between healthcare providers and pharmacists. Recognizing the unique skills and expertise that pharmacists bring to the table can facilitate their integration as a valuable member of a multidisciplinary healthcare team.

Are Primary Health Care Visits Associated With Reduced Risk of Hospital Readmissions After Discharge From Geriatric Inpatient Departments? Evidence From Stockholm County.

Primary health care visits post-discharge could potentially play an important role in efforts of reducing hospital readmission. Focusing on a single or a particular type of visit obscures nuances in types of primary care contacts over time and fails to quantify the intensity of primary health care visits during the follow-up period. The aim of this study was to explore associations between the number and type of primary health care visits post-discharge and the risk of hospital readmission within 30 days. A register-based closed cohort study. The study population of 6135 individuals were residents of Stockholm who were discharged home from any of the 3 geriatric inpatient departments, excluding those who were readmitted within the next 24 h. The dependent variable was hospital readmission within 30 days of discharge. The key independent variable was the number and type of primary health care visits in 30 days post-discharge. Cox-regression with time-varying covariates was employed for data analyses. Approximately, 12% of the participants were readmitted to hospital within 30 days. There was no statistically significant association between number of primary care visits post-discharge and readmission (HR 1.00; 95% CI 1.00-1.01). Compared to no primary health care visit, no statistically significant association were found for administrative care related visits (HR 0.33, 95%CI 0.08-1.33), clinic visits (HR 0.93, 95%CI 0.71-1.21), home visits (HR 1.03, 95%CI 0.84-1.27), or team visits (HR 0.76, 95%CI 0.54-1.07). There were no associations between primary health care visits post-discharge and hospital readmission after geriatric inpatient care. Further studies using survey or qualitative approaches can provide insights into the factors that are relevant to post-discharge care but are unavailable in this type of register data studies.

The role of Ottawa ankle rules in geriatric emergency department visits.

Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED). Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR. The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%. This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.

Study on psychological well-being and its determinants among elderly people attending geriatric clinic at Medical College, Kolkata

Background: Significant growth in the proportion of older people in India will lead to changes in the country’s society. If common psychological problems such as depression and anxiety are not addressed, they can have lasting effects on individuals, particularly older individuals. It has the potential to impair the management of ongoing chronic illnesses and result in both physical and mental limitations. Aims and Objectives: The objective was to assess the psychological well-being (PWB) of the study participants attending the geriatric outpatient department and its contributing factor(s). Materials and Methods: A descriptive, cross-sectional, hospital-based study was conducted in the Geriatric Clinic of Medical College, Kolkata, among 301 geriatric people during a 1-year time period. The assessment of PWB was done using Ryff’s PWB scales, 42-item version. The analysis of the data was done using SPSS version 16. Results: The mean age of the participants was 66.68 (±6.48) years. The mean PWB score was 156.2 ± 18.6 according to Ryff’s PWB scales. The minimum score was 94, and the maximum score was 226. Poor PWB was seen among 50.8% of the elderly. Conclusion: Poor PWB among seniors and several factors such as current living arrangements, socioeconomic status, employment history, history of recent injury, and patients’ spiritual history play an important role. To handle the issue, new and modified geriatric health policies are very much needed.

Enhancing medication management of older adults in Qatar: healthcare professionals' perspectives on challenges, barriers and enabling solutions.

Polypharmacy and potentially inappropriate medications are significant challenges in older adults' medication management. The Consolidated Framework for Implementation Research (CFIR) is a comprehensive approach used to explore barriers and enablers to the healthcare system in guiding the effective implementation of evidence-based practices. This study examines the barriers and enablers to promote safe medication management among older adults in Qatar from healthcare professionals' perspectives. This includes identifying critical factors within the healthcare system influencing medication management and suggesting practical solutions to improve it. The study employs a qualitative design. Focus Groups (FGs) were conducted with healthcare professionals from the geriatric, mental health and medicine departments of Hamad Medical Corporation (HMC), the leading governmental sector in Qatar serving the older adult population. Utilising the CFIR, this study analysed feedback from healthcare professionals through FGs at HMC. A combined inductive and deductive thematic analysis was applied to transcripts from five FGs, focusing on identifying barriers and enablers to safe medication management among older adults. Two researchers transcribed the audio-recorded FG discussions verbatim, and two researchers analysed the data using a mixed inductive and deductive thematic analysis approach utilising CFIR constructs. We engaged 53 healthcare professionals (31 physicians, 10 nurses and 12 clinical pharmacists) in FGs. The analysis identified current barriers and enabler themes under different CFIR constructs, including inner settings, outer settings, individual characteristics and intervention characteristics. We identified 44 themes, with 25 classifieds as barriers and 19 as enablers. The findings revealed that barriers and enablers within the inner settings were primarily related to structural characteristics, resources, policies, communication and culture. On the other hand, barriers and enablers from the outer settings included patients and caregivers, care coordination, policies and laws, and resources. This study identified several barriers and enablers to promote medication management for older adults using the CFIR constructs from the perspective of healthcare professionals. The multifaceted findings emphasise involving stakeholders like clinical leaders, policymakers and decision-makers to address medication safety factors. A robust action plan, continuously monitored under Qatar's national strategy, is vital. Further research is needed to implement recommended interventions.

A Study of the Relationship Between the Triglyceride-Glucose Index and Skeletal Muscle Mass in a General Chinese Population.

There is no study on the relationship between triglyceride-glucose index (TyG index) and skeletal muscle mass in middle-aged and elderly C population. Therefore, the aim of the study is to investigate the relationship between the TyG index and weight-adjusted relative skeletal muscle index (RSMI) in middle-aged and elderly C population. We retrospectively studied 947 aged ⩾40 years subjects who got a routine medical examination in the Department of Geriatrics of R Hospital from May 2021 to March 2023. The RSMI was designed to evaluate skeletal muscle mass and calculated based on lean mass of the limbs(kg)/body weight(kg) × 100%. Skeletal muscle mass reduction was defined as a RSMI of 1-2 standard deviations (SD) below of healthy adults aged 30-49 years old. Considering the quartile groups of the TyG index, the subjects were assigned to 4 groups: Q1 (less than or equal to 8.171), Q2 (from 8.172 to 8.569), Q3 (from 8.570 to 8.992), and Q4 (greater than or equal to 8.993). With TyG index increased, RSMI levels significantly reduced(P < .001). Spearman's correlation analysis showed that the TyG index was negatively correlated with RSMI in males (r = -0.320) and females (r = -0.240). The TyG index was positively correlated with body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) (P < .05). Besides, binary logistic regression analysis showed that the risk of developing reduced skeletal muscle mass in the group Q4 was 2.131 (95%CI:1.118-4.064) in males; and was 2.472 (95%CI:1.581-3.867) in females compared to the Q1 group. TyG index was negatively correlated with relative skeletal muscle index, and a higher TyG index was associated with the development of reduced skeletal muscle mass independently of other influencing factors. Therefore, the TyG index promises to be a predictor of skeletal muscle mass loss.

Turkish Adaptation, Validity and Reliability Study of Treatment Burden Questionnaire in Geriatric Patients

Introduction: This study aimed to adapt the Turkish Treatment Burden Questionnaire, test its validity and reliability, and predict the treatment burden in the geriatric population. Materials and Method: This methodological study included individuals aged 65 years and older from the geriatric population attending routine outpatient clinic examinations at the Ankara Bilkent City Hospital Geriatrics Department between June 1, 2022, and June 1, 2023. The sample consisted of 150 geriatric individuals who spoke and understood Turkish, could managed their illness, had no disease complications, were communicative, and did not have any physical or mental illnesses that would hinder their participation. The study data were collected using the ‘Individual Information Form’ and the Turkish version of the ‘Treatment Burden Questionnaire.’ Descriptive and confirmatory factor analysis were performed, and Cronbach’s α coefficient was calculated for the Turkish version of the scale. Results: Analyzing the factor structure of the Treatment Burden Questionnaire, a three-factor, 11-item structure with an eigenvalue above 1 explained 53.227% of the variance. In the assessment of the internal consistency of the scale, four items were eliminated because of low item-total correlations and inter-item correlations. The reliability analysis for the 11-item Treatment Burden Scale yielded a Cronbach’s α coefficient of 0.645. Conclusion: The Turkish adaptation of the Treatment Burden Questionnaire demonstrated validity and reliability in for assessing the extent of treatment burden in the geriatric population. Keywords: Treatment; Geriatrics; Chronic Disease; Questionnaire.

Nutritional Status and Inflammation as Mediators of Physical Performance and Delirium in Elderly Community-Acquired Pneumonia Patients: A Retrospective Cohort Study.

This study proposesa multiple mediation model to evaluate the association among diminished physical performance, malnutrition, inflammation, and delirium in seniors with community-acquired pneumonia. This retrospective cohort study included elderly patients hospitalized for community-acquired pneumonia at the Geriatrics Department of the Second People's Hospital of Lianyungang from January 1, 2020, to January 1, 2024. Logistic regression analysis was conducted to examine the associations among physical performance, nutritional status, C-reactive protein (CRP) levels, and delirium. Mediation models assessed the effects of nutritional status and CRP on the relationship between physical performance and delirium, with subgroup analyses based on diabetes status. A total of379 patients were included, with a mean age of 80.0±7.4 years, and 51.7% were male. The incidence of delirium during hospitalization was 28.5% (n=108). Subgroup analyses revealed significant correlations between physical performance, nutritional status, and CRP (P<0.001), regardless of diabetes status.After adjusting for confounding variables, CRP was positively associated with delirium, while MNA-SF and SPPB scores showed negative correlations with delirium risk (OR=0.852, 95% CI: 0.730-0.995; OR=0.580, 95% CI: 0.464-0.727, P<0.05).Mediation analyses indicated that MNA-SF scores and CRP significantly mediated the association between SPPB and delirium. Specifically, pathways "SPPB→ MNA-SF→ delirium", "SPPB→ CRP→ delirium", and "SPPB→ MNA-SF→ CRP→ delirium" demonstrated significant mediating effects in patients without diabetes, whileonly the pathway "SPPB→ MNA-SF→ CRP→ delirium" was significant in those with diabetes. Older patients with community-acquired pneumonia and poor physical performance are more susceptible to delirium, with nutritional status and inflammation as key mediators.

Re-Hospitalization of Elderly Patients in the Geriatrics Department of Hospital National Center of Fann

Re-Hospitalization of Elderly Patients in the Geriatrics Department of Hospital National Center of Fann

Frailty assessment tools in the emergency department: A geriatric emergency department guidelines 2.0 scoping review.

Given the aging population and growing burden of frailty, we conducted this scoping review to describe the available literature regarding the use and impact of frailty assessment tools in the assessment and care of emergency department (ED) patients older than 60 years. A search was made of the available literature using the Covidence system using various search terms. Inclusion criteria comprised peer-reviewed literature focusing on frailty screening tools used for a geriatric population (60+ years of age) presenting to EDs. An additional search of PubMed, EBSCO, and CINAHL for articles published in the last 5 years was conducted toward the end of the review process (January 2023) to search specifically for literature describing interventions for frailty, yielding additional articles for review. Exclusion criteria comprised articles focusing on an age category other than geriatric and care environments outside the emergency care setting. A total of 135 articles were screened for inclusion and 48 duplicates were removed. Of the 87 remaining articles, 20 were deemed irrelevant, leaving 67 articles for full-text review. Twenty-eight were excluded for not meeting inclusion criteria, leaving 39 full-text studies. Use of frailty screening tools were reported in the triage, care, and discharge decision-making phases of the ED care trajectory, with varying reports of usefulness for clinical decision-making. The literature reports tools, scales, and instruments for identifying frailty in older patients at ED triage; multiple frailty scores or tools exist with varying levels of utilization. Interventions for frailty directed at the ED environment were scant. Further research is needed to determine the usefulness of frailty identification in the context of emergency care, the effects of care delivery interventions or educational initiatives for front-line medical professionalson patient-oriented outcomes, and to ensure these initiatives are acceptable for patients.

Factors related to the attitudes towards the older adults and emphatic skills of gerontology students

Aim: In this study, we aimed to determine the factors related to the attitudes and empathic skill levels of gerontology students towards the older adults. Methods: 167 Gerontology students participated in our study. Data were collected by Google online survey method using personal information form, Kogan's Attitude towards Elderly Scale and Basic Empathy Scale. Results: Mean age of the students is 21.41 ± 2 year, 80% were female. A statistically significant difference was found between the students' grade level, their mother's education level, whether they lived with an older adult at any time in their lives, the duration of living with an older adult and the total score of the attitude towards the elderly scale (p &lt; 0.001, 0.002, 0.017, 0.044, respectively). There was a statistically significant difference between gender, mother's education level, the place where they lived for the longest time and the positive attitude score towards the elderly (p = 0.008, 0.005, 0.019, respectively). There was a statistically significant difference between the students' grade level, number of siblings, whether they lived with an older adult at any time in their lives and the negative attitude score towards the elderly (p&lt;0.001, 0.016, 0.028, respectively). A statistically significant difference was found between gender, mother's education level and the total score of the basic empathy scale (p&lt;0.001, 0.005, respectively), emotional subscale (p&lt;0.001, 0.041, respectively) and cognitive subscale scores (p = 0.007, 0.005, respectively). The mean Attitudes Towards Elderly Scale Total Score, Positive Attitude Sub-scale Score and Negative Attitude Sub-scale Score of the students were 156.52 ± 17.54, 72.59 ± 11.02 and 83.93 ± 11.89, respectively. The mean scores of Basic Empathy Scale Total Score, Cognitive Sub-scale Score and Emotional Sub-scale Score were 78.05 ± 10.19, 37.04 ± 4.94 and 41.02 ± 7.13, respectively. Conclusions: In our study, it was determined that the gerontology department students had high attitudes and empathic skills towards the older adults.

The Prevalence of the Frailty Syndrome in a Hospital Setting-Is Its Diagnosis a Challenge? A Comparison of Four Frailty Scales in a Cross-Sectional Study.

The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility; 416 patients (81.2 ± 6.91 years) admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% (FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%) and the lowest for the Fried scale (79.8%). The highest level of agreement was found between the CFS and Frailty Index, with 80.3% consistent ratings (Cohen Kappa 0.6). Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients.

IT WORKS FOR US: BRIDGING THE GAP BETWEEN EDUCATION, PRACTICE, AND POLICY IN GERONTOLOGY AT MIAMI UNIVERSITY

Abstract We describe a unique and successful partnership between the Department of Sociology and Gerontology and the Scripps Gerontology Center at Miami University in Oxford, Ohio. This partnership concurrently facilitates research that informs aging policy and gerontological training for students. After a brief description of the partnership, examples of current research that contributes to public policy at the federal, state, and local/provider levels are presented, along with students’ roles in these efforts. Next, we share factors that contribute to our success (e.g., attracting students from diverse backgrounds, using a shared mentorship model) and challenges (e.g., that research and policy move at different paces). We conclude with a look to the future, specifically, the need to engage students in our academic programs, maintain our long-standing relationships, and build new, cross-organizational ties so that future gerontologists will continue our mission of doing work that positively impacts older people.

DEVELOPING A GERIATRIC EMERGENCY DEPARTMENT BY FOCUSING ON THE THREE PS: PEOPLE, PROCESSES, AND PLACE

Abstract Older patients’ emergency department (ED) visits in the U.S. rose a surprising 30% during the period 2015-2019 to about 28 million visits annually. Many EDs are now examining emerging geriatric emergency department (GED) models of care to address the care needs of this population. This paper provides a practical overview of how to develop a GED and introduces the 3 Ps model focusing attention on the ED’s People, Processes, and the Place thereby providing a clear framework for practical GED development. Key resources facilitating GED development includes: the national GED Collaborative (GEDC) organization, the nationally endorsed GED Guidelines, and resources associated with the Geriatric Emergency Department Accreditation process. Core clinical elements needed to create a GED’s operations are found in its care processes including: 1) General approaches to the patient; 2) Screening for high-risk conditions; 3) Enhanced assessment for older patients; 4) potential workflow alterations; and 5) Attention to transitions into and out of the ED. The paper concludes by provides additional practical guidance to EDs seeking to enhance the ED experience of older people and improve the quality of their outcomes.

HOW ORGANIZATIONS CAN ADDRESS AGEISM AS PART OF THEIR DIVERSITY, EQUITY, AND INCLUSION INITIATIVES AND PROGRAMS

Abstract The Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Health System created a diverse inter-disciplinary committee to advance and promote DEI activities centered in advocating for a socially just, diverse, equitable, inclusive, and anti-racist workplace. Research shows that anti-ageism is a largely neglected component of diversity, equity, and inclusion programs. Thus, many institutions are not learning how age biases and discrimination show up in the workplace and the intersection of age across other dimensions of diversity. Ageism is a vital workplace issue as over a third (37.3%) of the U.S. workforce are aged 50 and older. We aimed to address this by incorporating the topic of anti-ageism via our various DEI initiatives available to all faculty and staff: “Humanities, Arts, and Books Initiative” on Combatting Ageism - structured workday sessions designed to provide a safe virtual space for reflection, discussion, and learning. We also held “Learning Pathway series” on Reframing Aging as well as Caring for Older Adults with HIV – structured sessions focused on knowledge building, and expert-led discussion. Attendance ranged from 40 to 60 participants at each session. Quantitative and qualitative assessment revealed a steadfast interest to address ageism and bias; appreciation of the semi-structured format for dialogue and reflection on relevant topics and finally ongoing education to create a more informed and collegial department. This type of programming can potentially serve as an additional resource for other institutions that are planning in incorporating anti-ageism activities in their DEI programs and everyday practices.

THE RELATIONSHIPS BETWEEN INTRINSIC CAPACITY AND FRAILTY AND DISABILITY IN OLDER OUTPATIENTS

Abstract The ICOPE scale is developed by the WHO to assess intrinsic capacity, including cognition, mobility, nutrition, hearing, vision, and depression. However, the relationships between intrinsic capacity and frailty and disability were unknown. The purposes of this study were to explore the cut-off points of the ICOPE scale for frailty and disability in older outpatients, and the significant intrinsic capacities for frailty and disability. This study employed a cross-sectional research design. The participants were patients aged 65 and above attending the geriatric department of a medical center (n=397). The ICOPE scale, Clinical Frailty Scale (CFS), and Activity of Daily Living (ADL) scale were used. ROC curve analysis was used to determine the optimal cut-off points of the ICOPE scale for frailty and disability, and logistic regression for the significant intrinsic capacities related to frailty and disability. For frailty, the AUC value of abnormal intrinsic capacity was 0.79 (p &amp;lt; 0.001), with an optimal cut-off point of 2/3. For disability the AUC value of abnormal intrinsic capacity was 0.82 (p &amp;lt; 0.001), with an optimal cut-off point of 2/3. Logistic regression showed cognition, mobility, and nutrition related to frailty significantly; whereas cognition, mobility, nutrition, and hearing related to disability significantly. Older adults with three or more abnormal intrinsic capacities have a higher risk of frailty and disability. The problems of cognition, mobility, and nutrition were the risk factors of frailty and disability. Healthcare staff can pay attention to older outpatients with the problems of intrinsic capacities.

CUMULATIVE EFFECTS OF COGNITIVE IMPAIRMENT AND FRAILTY ON GERIATRIC SYNDROMES IN A GERIATRIC OUTPATIENT SETTING

Abstract Aim With underlying geriatric syndromes, only few studies emphasized on the aspect of co-occurrence of frailty and cognitive impairment, though they are independently associated with several geriatric syndromes. Methods The participants were recruited from the outpatient clinic of geriatric department in a medical center. Frailty was assessed by a modified version of Fried’s criteria, while cognitive impairment was defined by cutoff scores of the Mini Mental State Examination. Demographic characteristics, self-assessed health status, and geriatric assessment were collected. Polytomous logistic regression model was used to evaluate factors correlated with frailty alone, cognitive impairment alone, and co-occurrence of frailty and cognitive impairment. Results The mean age of the 323 participants (60.1% women) was 80.4 ± 7.3 years. The prevalence of non-frailty, frailty alone, cognitive impairment alone and co-occurrence were 34.4%, 16.7%, 23.8% and 25.1%, respectively. When compared to the not-frail group, the odds ratios (OR) of having activity of daily living impairment (aOR 1.44, 95% CI 1.28-1.63), instrumental activities of daily living impairment (aOR 1.61, 95% CI 1.45-1.81), urinary incontinence (aOR 1.61, 95% CI 1.45-1.81) and with lower mini-nutritional assessment score (aOR 148, 95% CI 1.30-1.69) were significantly higher in the co-occurrence group after adjusted with demographic variables and Charlson comorbidity index. Conclusions Co-occurrence of frailty and cognitive impairment was associated with higher prevalence of disability, incontinence and malnutrition. It is crucial to approach frailty and cognitive impairment simultaneously in daily geriatric clinical practice due to the correlations of several geriatric syndromes to the co-occurrence of physical frailty and cognitive impairment.

Relationship between Pharmacological Treatment Strategy and Cognitive Function in Geriatric Patients with Atrial Fibrillation.

In this monocentric, prospective, observational study, data including chronic medication as well as demographic parameters were collected from all patients in a geriatric department between April 2021 and April 2022. A 12-lead ECG as well as the Mini Mental Status were recorded for all patients as part of the admission routine, and a 24 h ECG was performed in selected patients on the basis of clinical indication. At baseline, 715 out of 1914 patients (37.4%) had a known history of AF. Of these patients, 43 patients (6%) were on rhythm control therapy (RHY) and 672 (94%) were on rate control therapy (RATE). No difference in respect to MMS could be detected between RHY and RATE. However, linear regression analyses showed that age, HASBLED score, creatinine serum level, and an existing antiplatelet medication were associated with a negative influence on MMS, whereas oral anticoagulation (OAC) was associated with improved MMS, respectively (p < 0.05 for all). The vast majority of geriatric patients with AF are treated with a rate control strategy. Oral anticoagulation is associated with better results in MMS, whereas patients who are treated with antiplatelet medication show worse results in MMS instead.

고령자의 자기효능감이 돌봄로봇 수용에 미치는 영향

This study verified the effect of the older adults’ self-efficacy on acceptance of care robots according to the gender groups. This study used the data of the ’2022 Korea Older Adults Technology Acceptance Panel Survey’ conducted by the Department of Gerontology, Kyung Hee University, and multiple regression analysis was conducted by the all and gender groups on 506 older adults (203 males, 276 females) aged 60 or older nationwide. STATA 17.0 statistical program was used for analysis. As a result of the analysis by gender, in the case of men, the higher the technology self-efficacy and general self-efficacy, the higher the acceptance of care robot. In women, it was found that the higher the technology self-efficacy, the higher the education level and household income, and the better the Activities of Daily Living, the higher the acceptance of care robot. This study divided self-efficacy into general self-efficacy and technical self-efficacy and verified the impact of the two self-efficacy on the acceptance of care robots. This study has academic implications in that it divided self-efficacy into general self-efficacy and technical self-efficacy and verified the impact of the two self-efficacy on the acceptance of care robots. In addition, this study has practical implications in that it suggests separate action plans to increase the acceptance of care robots depending on the gender group of the older adults.

Patent Ductus Arteriosus (PDA) in Geriatrics: A Case Report of a 74-Year-Old Patient in the Geriatrics Department of the Center Hospital National University of Fann in Dakar (Senegal)

Patent Ductus Arteriosus (PDA) in Geriatrics: A Case Report of a 74-Year-Old Patient in the Geriatrics Department of the Center Hospital National University of Fann in Dakar (Senegal)