Geriatric Health Research Articles

A Qualitative Assessment of Preventive Geriatric Care

There was a projected growth of up to 80% between 1990 and 2025 in an older adult of Nigeria above 60 years of age. This projected growth assumes an increased workload for almost every healthcare provider to ensure optimal geriatric care. This study aimed to assess preventive geriatrics as a way of geriatric health care. Self-administered questionnaires were distributed among elderly people (60 years and above) residing in the Akure South Local Government Area for at least a year. The survey included several sections to assess multiple aspects such as sociodemographic information, assessment of primary preventive geriatrics, secondary preventive geriatrics as well as tertiary preventive geriatrics as methods of receiving geriatric health care. The response rate was around 96% of the respondents. The mean (± standard deviation) age of the cohort was 72.3 (±8.4) years. The primary (χ² =39.498, df = 12 p-value=0.000), secondary (χ² =58.5003, df = 12, p-value=0.000), and tertiary (χ² =35.8994, df = 12, p-value=0.000) preventive geriatrics were shown to be a way of geriatric health care. Geriatric health care should focus on prevention, medication use, personalized health management, fall prevention, and vaccination uptake. The study thus recommends that institutions in geriatric care provide educational programs, gratuitous medical evaluations, and social support strategies that can reduce the burden of preventive geriatric care for Nigerian elderly.

Evaluating Oral and Dental Health and the RelatedFactors regarding the Elderly in Aliabad City of Golestan Province in 2022


 
 
 Introduction: Considering the increasing growth of the elderly population, the importance of their life quality e, and the impact of oral and dental health on their quality of life, this study was conducted with the aim of evaluating oral and dental health and the factors affecting it in the elderly of Aliabad city, Golestan province, in 1400.
 Methods: This was a descriptive and analytical cross-sectional study. The research population consisted of 216 elderly of over 60 living in Aliabad city of Golestan province in 2022; they were selected through cluster random sampling method. 128 people (59/3 percent) were women and 88 people (40/ 7 percent) were men. This study was conducted from May to September 2022. To collect data, demographic information questionnaire and Geriatric Oral Health Assessment Index (GOHAI) were used, whose Persian version was valid and reliable. In addition, the last dental visit, the number of times the mouth was washed, the need for dental treatment, and personal assessment of the individual's oral and dental health status were among the items that were collected and recorded in the form of dental information regarding the elderly. After completing the questionnaires, data were entered into SPSS version 20 software and the analysis was done through descriptive statistics (frequency distribution calculation and central and dispersion indices), one way ANOVA, and t-test.
 Results: In the present study, the score of oral and dental health questionnaire regarding the elderly was 49/51±8/67, which was considered satisfactory. This variable had a statistically significant relationship with the number of mouth washes (p=0/02) , personal evaluation of mouth condition (p=0/01), and the number of teeth (p<0/001). While there was no significant relationship regarding education level (p=0/26), place of residence (p=0/072), gender (p=0/56), employment status (p=0/63), income level (p=0/062), smoking (p=0/23) and the last dental visit (p=0/28),and the presence or absence of dentures (p=0/62) did not show a significant difference.
 Conclusion: Although the quality of life score related to the oral health of the elderly in Aliabad city was satisfactory, there is still roome to improve this score. Prevention strategies for chronic diseases and high blood pressure, re-emphasizing oral and dental hygiene, and improving related health behaviors should be considered as the most important future programs in this city. Integrating oral and dental health program in the country's public health program and creating a team to promote oral and dental health at primary care level are considered effective and low-cost solutions.
 
 

A clinical study of Geriatric dermatoses at Tertiary care center in South India

Geriatric health care has become a worldwide concern as advance in medical science has contributed to increase in average life span of an individual. Cutaneous dermatoses constitute one of the major comorbidities of elderly. To determine the prevalence of various skin conditions in elderly patients. A Total of 200 patients aged 60 and above attending Dermatology OPD at tertiary care centre for a period of six months from March to August were assessed for cutaneous dermatosis, routine investigations and histopathological examination done for relevant cases. Out of 200 patients included in study group 128 were males (64%) and 72females (36%), majority were in age group of 65 to70 yrs. All patients recruited were from rural area. wrinkling was seen in >95% of cases , Generalized pruritus and xerosis was seen in 56patient(28%) and 85 patients(42.5%) respectively, eczematous skin condition seen in 41 patients(21%)and psoriasis in 17 patients(8.5%) fissure foot in 15(7.5%) patients .Fungal infection is the most common infection noted(7.5% ) followed by viral infection herpes zoster and post herpetic neuralgia ( 4%), pyoderma (3.5%) and scabies(2.5% ).Benign tumors like acrochordons, Dermatosis Papulosis nigra and seborrheic keratosis seen in 28% of cases. Nails changes was seen in 45% of patients. The increasing prevalence of skin condition in elderly especially ruritus and eczema, emphasizes the importance of health education regarding skin care concerning appropriate use of emollients, foot care, proper hygiene, sun protection and for early diagnosis and management of the same, such that the process of senescence allowed to live hail and healthy.

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey.

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understandingand addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significantassociations between OHRQoL and factors such asethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoLof seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoLof older adults, especially those not living infacilities like nursing homes or assisted living centers,tailored oral healthcare plans and strategies arecrucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

The relationship and affecting factors between oral health and frailty in the older people: A cross-sectional study.

To investigate the connection between oral health and frailty in older people and to determine the affecting factors. The research was a community-based cross-sectional study. A Family Health Center conducted a study on 321 older people. Data were collected face-to-face using the Personal Information Form, Geriatric Oral Health Assessment Index, and Edmonton Frailty Scale. Factors affecting oral health and frailty were examined using the MANOVA test and the relationship between them was examined using Pearson's correlation test. It was determined that 52.6% of the participants had poor oral health and 56.1% had different levels of frailty. Education was effective on the Geriatric Oral Health Assessment Index scale score. The presence of chronic disease, frequency of tooth/denture brushing, age, education, and sex were effective on the Edmonton Frailty Scale. When the partial eta square values were examined, it was determined that the variable that had the highest impact on the GOHAI and EFS scale scores was educational status. It was determined that there was a significant negative relationship between participants' oral health and frailty scores (r=-0.539, p<.001). It was determined that more than half of the older individuals included in the study had poor subjective oral health and varying levels of frailty. The influencing factors were determined through multivariate advanced analysis. This relationship and affecting factors are important in providing appropriate early detection and care to older people.

Self-perceived oral health

Aim: This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods: Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results: Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p &gt; 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873- 0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085- 8.602). Conclusions: The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures.

Growing Trends in Conceptualizing Geriatric Mental Health within a Neural Context.

Growing Trends in Conceptualizing Geriatric Mental Health within a Neural Context.

A Comprehensive Approach to Geriatric Patient Care Based on Geriatric Assessment

Background Care for geriatric patients must consider several factors. It is critical to conduct a thorough examination of elderly patients to develop an ideal treatment plan for patients using a series of geriatric assessments. Case report The first patient was a 63-year-old male complaining of an open wound on several loose upper left teeth. It is suspected that he had undiagnosed diabetes mellitus. The second patient was a 70-year-old female having difficulty eating due to a loose upper left tooth with generalized enlarged gingiva. The patient had hypertension and was taking the medication without any supervision. Geriatric Assessment was performed, which included the GOHAI (Geriatric Oral Health Assessment Index) examination, the Barthel Index of Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini Nutritional Assessment (MNA), and Mini-Cognitive. The two patients consulted with the internist before receiving further treatment. Conclusion A comprehensive examination with Geriatric Assessment can help dentists determine the best treatment plan for geriatric patients

Nutraceuticals rich in zinc and branched chain amino acids for improving quality of life in patients with chronic liver disease, hepatic encephalopathy, and geriatrics

The current paper aimed to highlight the role of nutraceuticals rich in zinc and branched chain amino acids (BCAAs) for improving the quality of life (QoL) in patients with chronic liver disease (CLD), hepatic encephalopathy (HE), and geriatrics. Well-done works based on evidence-based approach were studied thoroughly in order to define the CLD and HE and extract an informative and concise report with valuable knowledge about the important role of zinc and BCAAs as an adjuvant nutraceutical therapy included in the treatment protocol of the CLD and HE, with many health benefits for geriatrics health. Novel nutraceutical formulations structured on scientific basis according to official guidelines were outlined as beneficial dietary supplements containing whey protein as a functional food of milk derivatives with proven health benefits and valuable content (18%) of BCAAs, fortified with a bunch of vitamins, minerals, steviol glycosides (SGs) and natural flavors. It could be concluded the valuable role of zinc and BCAAs in improving QoL in patients with CLD, HE, and geriatrics.

Incorporating frailty to address the key challenges to geriatric economic evaluation

BackgroundThe multidimensional and dynamically complex process of ageing presents key challenges to economic evaluation of geriatric interventions, including: (1) accounting for indirect, long-term effects of a geriatric shock such as a fall; (2) incorporating a wide range of societal, non-health outcomes such as informal caregiver burden; and (3) accounting for heterogeneity within the demographic group. Measures of frailty aim to capture the multidimensional and syndromic nature of geriatric health. Using a case study of community-based falls prevention, this article explores how incorporating a multivariate frailty index in a decision model can help address the above key challenges.MethodsA conceptual structure of the relationship between geriatric shocks and frailty was developed. This included three key associations involving frailty: (A) the shock-frailty feedback loop; (B) the secondary effects of shock via frailty; and (C) association between frailty and intervention access. A case study of economic modelling of community-based falls prevention for older persons aged 60 + was used to show how parameterising these associations contributed to addressing the above three challenges. The English Longitudinal Study of Ageing (ELSA) was the main data source for parameterisation. A new 52-item multivariate frailty index was generated from ELSA. The main statistical methods were multivariate logistic and linear regressions. Estimated regression coefficients were inputted into a discrete individual simulation with annual cycles to calculate the continuous variable value or probability of binary event given individuals’ characteristics.ResultsAll three conceptual associations, in their parameterised forms, contributed to addressing challenge (1). Specifically, by worsening the frailty progression, falls incidence in the model increased the risk of falling in subsequent cycles and indirectly impacted the trajectories and levels of EQ-5D-3 L, mortality risk, and comorbidity care costs. Intervention access was positively associated with frailty such that the greater access to falls prevention by frailer individuals dampened the falls-frailty feedback loop. Association (B) concerning the secondary effects of falls via frailty was central to addressing challenge (2). Using this association, the model was able to estimate how falls prevention generated via its impact on frailty paid and unpaid productivity gains, out-of-pocket care expenditure reduction, and informal caregiving cost reduction. For challenge (3), frailty captured the variations within demographic groups of key model outcomes including EQ-5D-3 L, QALY, and all-cause care costs. Frailty itself was shown to have a social gradient such that it mediated socially inequitable distributions of frailty-associated outcomes.ConclusionThe frailty-based conceptual structure and parameterisation methods significantly improved upon the methods previously employed by falls prevention models to address the key challenges for geriatric economic evaluation. The conceptual structure is applicable to other geriatric and non-geriatric intervention areas and should inform the data selection and statistical methods to parameterise structurally valid economic models of geriatric interventions.

Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment.

With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.

SmartCasaplus - risk-based geriatric health coaching for multimorbid insured persons

The geriatric coaching program Casaplus of Medical Contact AG offers health coaching for multimorbid geriatric patients since 2007. Since then, around 30,000 patients have benefited from individual coaching. The critical success factors for geriatric coaching are the risk-based identification of candidates with high and impactable escalation risk as well as the recruitment and coaching of participants by specifically trained specialists. Together with VIACTIV and DCC Risk Analytics, the smartCasaplus program has been improved to include AI-based models in the prediction of influenceable risks for identi-fication and risk-adjusted propensity scores matching during evaluation. Actual results of the VIACTIV program evaluation show a significant return on investment of 1.7 dur-ing the first 4 program years

Bridging the Gap: Understanding Gender Disparities in Geriatric Health and Care

Bridging the Gap: Understanding Gender Disparities in Geriatric Health and Care

Challenges and Advancements in the Health-Related Quality of Life of Older People

Background. With the global trend of increasing life expectancy, the health-related quality of life of older people haspersonalised become an area of significant interest. It is crucial to comprehend the advancements and identify the ongoing challenges in this domain for better health management and policy formation. Objectives. This scoping review aimed to comprehensively investigate the existing challenges and recent advancements associated with the quality of health among older people. Methods. We utilized Arksey and O’Malley’s scoping review framework for this study. A systematic literature search was performed across multiple databases, namely, PubMed, Scopus, and Google Scholar, targeting publications from 2018 to 2023. Selected studies were then rigorously examined based on predefined inclusion and exclusion criteria, followed by an in-depth thematic analysis. Results. Of the initial 406 identified studies, 72 were included in the final review. The analysis underscored enduring challenges in physical and medical issues, psychological difficulties, socioeconomic obstacles, and policy-related challenges. Meanwhile, significant advancements were noted in several areas, including technology, medicine, social and societal facets, and policy. Conclusions. Despite noteworthy improvements in the health-related quality of life of older individuals, the continued presence of substantial challenges emphasizes the need for more targeted initiatives. These results suggest an immediate requirement for revising policies and implementing interventions that specifically address identified challenges, with a particular emphasis on ensuring equitable health care access, effectively managing chronic conditions, and enhancing the training of geriatric health care professionals. This comprehensive review serves as a roadmap for guiding future research and shaping policy directions in the health care of older people.

Cohort profile for the Tongji Cardiovascular Health Study: a prospective multiomics cohort study

PurposeThe Tongji Cardiovascular Health Study aimed to further explore the onset and progression mechanisms of cardiovascular disease (CVD) through a combination of traditional cohort studies and multiomics analysis, including genomics,...

The relationship between dysphagia and frailty among Chinese hospitalized older patients: a serial mediation model through self-perceived oral health and self-reported nutritional status

BackgroundFrailty contributes to adverse outcomes in older adults and places a heavy burden on healthcare resources. Dysphagia is associated with frailty, but the mechanisms by which dysphagia affects frailty in older adults are unclear. This study aimed to investigate a serial mediating effect of self-perceived oral health and self-reported nutritional status in the relationship between dysphagia and frailty among hospitalized older patients in China.MethodsThis cross-sectional study included 1200 patients aged ≥ 65 years in the Department of Geriatrics, Shaanxi Provincial People’s Hospital. A structured face-to-face interview was used to survey the following questionnaires: General Information Questionnaire, Tilburg Frailty Indicators (TFI), Eating Assessment Tool-10 (EAT-10), 30mL Water Swallow Test (WST), Geriatric Oral Health Assessment Index (GOHAI), and Short-Form Mini-Nutritional Assessment (MNA-SF). A total of 980 participants with complete data were included in the analysis. Statistical analysis was performed using SPSS 26.0 and Amos 28.0 software. Spearman’s correlation analysis was used for correlation analysis of study variables. The results of the multivariate linear regression analysis for frailty were used as covariates in the mediation analysis, and the structural equation model (SEM) was used to analyze the mediating effects among the study variables.ResultsDysphagia, self-perceived oral health, self-reported nutritional status, and frailty were significantly correlated (P<0.001). Dysphagia was found to directly affect frailty (β = 0.161, 95%CI = 0.089 to 0.235) and through three significant mediation pathways: (1) the path through self-perceived oral health (β = 0.169, 95%CI = 0.120 to 0.221), accounting for 36.98% of the total effect; (2) the path through self-reported nutritional status (β = 0.050, 95%CI = 0.023 to 0.082), accounting for 10.94% of the total effect; (3) the path through self-perceived oral health and self-reported nutritional status (β = 0.077, 95%CI = 0.058 to 0.102), accounting for 16.85% of the total effect. The total mediation effect was 64.77%.ConclusionsThis study indicated that dysphagia was significantly associated with frailty. Self-perceived oral health and self-reported nutritional status were serial mediators of this relationship. Improving the oral health and nutritional status of hospitalized older patients may prevent or delay the frailty caused by dysphagia.

Prevalence of depression and anxiety among elderly primary care patients in Palestine.

Depression and anxiety are common mental health disorders among the elderly worldwide. In this study, we estimated the prevalence of depression and anxiety and related risk factor among elderly attending Primary Health care (PHC) centers in Palestine. A cross-sectional study was conducted from February to July 2021 with a sample size of 380 participants aged ≥60 attending PHC centers in West Bank, using an interviewer-administered questionnaire. We used the Geriatric Depression Scale-15 and the Geriatric anxiety Scale to screen for depression and anxiety, respectively. Logistic regression models were used to identify predictors of depression and anxiety. The prevalence of depression and anxiety was 41.1 and 39.2%, respectively. Elderly people living in rural areas (aOR = 2.63; 95% CI: 1.72-4.20), uneducated (aOR = 2.92; 95% CI: 1.41-6.13), and without monthly income (aOR = 3.42; 95% CI: 1.52-7.61) were more likely to have depression. On the other hand, anxiety was independently associated with living in rural areas (aOR = 1.93, 95% CI: 1.23-3.04) and having non-communicable diseases (aOR = 2.01; 95% CI: 1.13-3.49). Depression and anxiety are common in Palestine, a developing country with a lack of elderly related services. This should be emphasized at the national and regional levels where geriatric health care services are scarce. Such information is required by policymakers and external funding agencies in order to develop future agendas.

Coming Up…

The American Association for Geriatric Psychiatry will hold its 2024 Annual Meeting, “Reimagining Geriatric Mental Health: Innovations to promote the well‐being of caregivers and patients,” March 15–18 in Atlanta. For more information, visit https://www.aagponline.org/education‐events/annual‐meeting.

Age-Related Orthostatic Hypotension: A Comprehensive Analysis of Prevalence, Mechanisms, and Management in the Geriatric Population.

Geriatric patients frequently encounter orthostatic hypotension (OH), a multifaceted condition characterized by a significant drop in blood pressure upon assuming an upright position. As the elderly population is particularly susceptible to OH, our review endeavors to comprehensively explore the complex nature of this condition and various factors contributing to its development. We investigate the impact of comorbidities, polypharmacy, age-related physiological changes, and autonomic dysfunction in the pathogenesis of OH. Geriatric patients with OH are faced with an elevated risk of falls, syncope, a decline in their overall quality of life, and hence increased mortality. These implications require careful consideration, necessitating a thorough examination of therapeutic strategies. We evaluate various pharmaceutical and nonpharmacological therapies, delving into the effectiveness and safety of each approach in managing OH within geriatric populations. We explore the role of pharmacotherapy in alleviating symptoms and mitigating OH-related complications, as well as the potential benefits of volume expansion techniques to augment blood volume and stabilize blood pressure. We place particular emphasis on the significance of lifestyle changes and nonpharmacological interventions in enhancing OH management among the elderly. These interventions encompass dietary modifications, regular physical activity, and postural training, all tailored to the unique needs of the individual patient. To optimize outcomes and ensure patient safety, we underscore the importance of individualized treatment plans that take into account the geriatric patient's overall health status, existing comorbidities, and potential interactions with other medications. This review aims to improve clinical practice and patient outcomes by advocating for early detection, properly tailored management, and targeted interventions to address OH in the elderly population. By raising awareness of OH's prevalence and complexities among healthcare professionals, we hope to foster a comprehensive understanding of OH and contribute to the overall wellness and quality of life of this vulnerable demographic.

Coming Up…

The American Association for Geriatric Psychiatry will hold its 2024 Annual Meeting, “Reimagining Geriatric Mental Health: Innovations to promote the well‐being of caregivers and patients,” March 15–18 in Atlanta. For more information, visit https://www.aagponline.org/education‐events/annual‐meeting.