Geriatric Care Research Articles

Status Quo of Mental Health and Influencing Factors Among Older Adults in Different Living Situations: A Random Forest Analysis Based on CHARLS Data.

To determine the status of depression and its key influencing factors among Chinese older adults in different living situations. Data of 7,092 older adults were obtained from the China Health and Retirement Longitudinal Survey. This study analyzed key variables influencing depressive symptoms using random forest modeling and logistic regression. The prevalence of depressive symptoms in older adults is 33.2%, with the highest prevalence of depression in older adults living alone (41.2%). Cognitive functioning and life satisfaction are psychological factors that affect older adults' mental health, whereas self-rated health and child relationship satisfaction are biological and social factors affecting their mental health, respectively. Furthermore, self-rated pain and limitations in activities of daily living were identified as risk factors for their mental health. Key factors affecting older adults' mental health differ between living situations. Key factors of depressive symptoms in older adults differ across living situations, providing a priority and reference for differential prevention and precise intervention of depressive symptoms to promote a healthy aging process. Results of the current study may help clinicians better understand the pathogenesis of depression in older adults, guide clinical diagnosis and treatment, and develop individualized depression prevention and management strategies. [Research in Gerontological Nursing, xx(x), xx-xx.].

Examining the Impact of Adverse Childhood Experiences and Active Coping in Black Older Adults: A Mixed Methods Study.

To gain a deeper understanding of Black older adults' (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course. Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process. Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results. Although participants faced ACEs including racism, they found strategies to help them actively cope. [Research in Gerontological Nursing, xx(x), xx-xx.].

Geriatric Syndromes in Older Adults With and Without Diabetes: A Systematic Review and Meta-Analysis.

Diabetes prevalence is increasing among older adults globally. The current study aimed to compare geriatric syndrome prevalence in older adults with and without diabetes. Primary research (2011 to 2024) in English, French, or Spanish was included. We used multiple databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled log odds ratios (ORs) and prevalence rates were calculated using random-effects models. Sensitivity analysis explored heterogeneity, and publication bias was assessed. Older adults with diabetes exhibited higher prevalence rates of cognitive impairment (9.13% vs. 4.22%, log OR: 0.1884), depression (8.96% vs. 5.44%, log OR: 0.3543), falls (11.5% vs. 4.47%, log OR: 0.4237), functional impairment (14.2% vs. 10.6%, log OR: 1.02), urinary incontinence (9.72% vs. 4.35%, log OR: 1.3668), frailty (22.8% vs. 12.1%, log OR: 1.3443), and polypharmacy (22.9% vs. 5.78%, log OR: 2.5420). Diabetes was also associated with a higher comorbidity burden. Multidisciplinary strategies addressing diabetes and associated conditions are crucial for older adults with diabetes. Future research should delve into underlying mechanisms and optimize care strategies. [Research in Gerontological Nursing, xx(x), xx-xx.].

The relationship between intrinsic capacity and functional ability in older adults

IntroductionIntrinsic Capacity in integrated geriatric care emphasizes the importance of a thorough functional assessment. Monitoring the intrinsic capacity of older individuals provides standardized and reliable information to prevent early disability. This study assessed the relationship between intrinsic capacity and functional ability in older adults.MethodThis cross-sectional study involved 210 older individuals aged 60 and above referred to Rasoul Akram Hospital. Data collection included ADL and IADL scales, the Snellen chart, the Hearing Handicap Inventory, the hand dynamometer, the TUG test, the AMT test, and the GDS. Data analysis was conducted using SPSS software v.26 via independent t-tests, ANOVA, Pearson correlation coefficient, and multiple regression analysis.ResultsThe participants were 70.13 ± 7.04 years. 57.6% were older females and 42.4% were older males. Age showed a significant and inverse correlation with both ADL (P < 0.001, r = -0.23) and IADL (P < 0.001, r = -0.39). The adjusted coefficient of determination (R²) for the five domains of intrinsic capacity (sensory, cognitive, locomotion, psychological, vitality) as well as age and BMI was 0.16 for ADL and 0.32 for IADL.ConclusionAge and TUG could only weakly explain ADL changes, while vision, hand grip strength, cognition, and age had moderate predictive ability of IADL. Therefore, by assessing these predictors, we can predict disability before it occurs and make necessary interventions.

Perioperative Supportive Care Interventions to Enhance Surgical Outcomes for Older Adults With Cancer: A Systematic Review.

Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023. We included randomized controlled trials (RCTs) focusing on supportive care interventions that enrolled adults older than 60 years with cancer. We included 11 RCTs with 2,177 patients in this review. Patients' age ranged from 60 to 95, and the median number of patients per study was 147 (range, 44-690). Most studies included patients with colorectal cancer (81.8%). Half of the studies (54.5%) evaluated exercise interventions, and the remaining assessed geriatric assessment-guided interventions (27.2%), nutrition optimization (9.1%), and patient empowerment (9.1%). Primary outcomes included postoperative complications, quality of life, feasibility of exercise programs, inspiratory muscle endurance, and hospital length of stay, among others. All studies had postoperative complications as a primary or secondary outcome. We found implementation challenges that influenced several studies, including high dropout rates and intervention fidelity. We found 11 studies focused on perioperative supportive care interventions in older adults with cancer undergoing surgery. Notably, interventions involved exercise, geriatric assessment-guided care, nutrition optimization, and patient empowerment. We also found heterogeneity in intervention modality and outcome assessment, thus demonstrating a need for ongoing work to address the unique needs of the geriatric oncology population.

Consequences of COVID-19 for geriatric patients during a pandemic

To investigate the outcomes of geriatric COVID-19 patients in a German academic setting during the pandemic. This study included 468 consecutive geriatric patients (≥ 70 years) who tested positive for SARS-CoV-2 and were treated at the University of Duisburg-Essen from 2/2020 to 3/2021. 74 patients were transferred to a geriatric hospital and a 12-month follow-up (prospective study) was performed in 51 patients. Clinical assessments evaluated depression (GDS), apathy (AES), cognitive status (MMST), mobility (TUG), health status (EQ-5D-5 L), and daily living activities (Barthel Index). Demographic and clinical data were also analyzed. Results showed that the mortality in this vulnerable group was 52% (n = 209). Long-term survival was higher in patients who received comprehensive geriatric treatment (74.3% vs. 51.8%). The duration of inpatient stay at the primary hospital was 13.3 ± 3.6 days, with 28.8% (n = 135) requiring intensive care. At the 12-month mark more patients with geriatric treatment lived in nursing homes. Barthel-Index/Timed-Up-and-Go-Test/MMST/AES/GDS, and EQ-5D-5 L indicated worse outcomes in the group who received geriatric treatment. Specialized geriatric care may improve survival in geriatric COVID-19 patients despite decreased long-term outcomes. Further research, including international studies like NAPKON, are encouraged to confirm these findings and explore potential interventions for improved outcomes in this vulnerable population.

Overcoming challenges to integration of oral health into geriatric primary care

The Age-Friendly Health System movement has been a unifying factor in caring for older adults at the University of Utah Health. Despite progress, challenges to efficient healthcare collaboration exist, particularly between geriatric primary care and oral health. This manuscript presents four of those challenges (lack of communication between medical and dental providers, the distance between medical and dental services, patient discomfort with the inclusion of oral health in primary health care, and provider discomfort in requesting oral health information in medical encounters) with the solutions derived at the University of Utah Health. Leaders at University of Utah Health developed five interventions to address these challenges (participation in the development of EPIC Wisdom©, a fully integrated oral health record in the electronic health record (EHR), co-location in new centers and oral health consultation in existing centers, implementing a geriatric health assessment that included oral health, widespread adoption of the 4 Ms framework). Applying the lessons learned from these challenges can benefit all older adults and may help prevent the conditions associated with periodontal disease.

From Gap to Implementation: Integrated Geriatrics and Palliative Care Leadership and Life Skills Course Pilot.

From Gap to Implementation: Integrated Geriatrics and Palliative Care Leadership and Life Skills Course Pilot.

Effectiveness and utilization of a cognitive screening program for primary geriatric care

BackgroundEffective detection of cognitive impairment in the primary care setting is limited by lack of time and specialized expertise to conduct detailed objective cognitive testing and few well-validated cognitive screening instruments that can be administered and evaluated quickly without expert supervision. We therefore developed a model cognitive screening program to provide relatively brief, objective assessment of a geriatric patient’s memory and other cognitive abilities in cases where the primary care physician suspects but is unsure of the presence of a deficit.MethodsReferred patients were tested during a 40-min session by a psychometrist or trained nurse in the clinic on a brief battery of neuropsychological tests that assessed multiple cognitive domains. Short questionnaires covering subjective cognitive complaints, symptoms of depression, and medical history were also administered. Results were conveyed to a dementia specialist who reviewed them and returned their judgement of the validity of the cognitive complaint to the primary care provider. Retrospective medical records review was carried out for a random (stratified) half of the sample to determine how screening results were utilized. Screening tests were repeated after two years in a subset of 69 patients.ResultsThe 638 patients screened (mean age = 75.9 years; mean education = 14.9 years; 58% women) were classified by screening as having normal cognition (n = 177), depression (with possible cognitive changes; n = 115), mild cognitive impairment (MCI; n = 107), or dementia (n = 239). Classification accuracy was shown by high agreement with the eventual clinical diagnosis in the medical record (69%; Cohen’s Kappa = .38; p < .001; 77% if MCI and dementia were collapsed; Cohen’s Kappa = .58; p < .001) and longitudinal decline in cognitive test scores only in those initially classified as having MCI or dementia. Medical records documented discussion of screening results with the patient in 69% of cases (80% if MCI or dementia was detected) and often referral to a specialist (62%), new brain imaging (54%), or change in medication (58%) when screening indicated potential cognitive impairment.ConclusionThe cognitive screening program was well accepted by primary care providers as an efficient and effective way to evaluate concerns about cognitive decline in older adults.

Healthcare Workers' Attitudes Toward Older Adults' Nutrition: A Descriptive Cross-Sectional Study in Italian Nursing Homes.

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers' attitudes toward older people's nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41-50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers' attitudes toward older adults' nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality.

Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation-Based Training for Patient Interaction and Education.

To explore the impact of simulation-based training on communication and empathy skills among nurses working with elderly patients in the Abha region of Saudi Arabia. The study also aimed to identify the barriers and facilitators to applying these skills in real-world clinical practice. A qualitative study. Semi-structured interviews were conducted between June and July 2024 with 17 nurses from urban and rural healthcare settings in the Abha region. Data were analysed using both deductive framework analysis, guided by social support theory, and inductive thematic analysis to identify key themes related to communication, empathy, and the application of simulation-based skills in practice. We adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The study involved 17 participants aged 22-50 years, with diverse educational backgrounds and work experience. The findings indicated that simulation-based training significantly improved nurses' confidence in delivering difficult news and their ability to empathise with elderly patients. Nurses working in urban settings with regular access to simulation training reported better outcomes compared to those in rural settings with less frequent training opportunities. Simulation-based training has a positive impact on enhancing communication and empathy skills among nurses, but challenges in real-world application remain. Efforts should be made to improve the accessibility of simulation training and address the barriers preventing its effective implementation in clinical practice. Healthcare practitioners and policymakers should prioritise simulation-based training in nursing education and professional development to improve the quality of care for elderly patients. The Consolidated Criteria for Reporting Qualitative Research (COREQ). The engagement and interview data from nursing participants provided valuable insights into the impact of simulation-based training on communication and empathy in elderly care.

Understanding trends in osteoporosis drug prescribing: implications for reducing futile biomedical research.

Osteoporosis is a significant geriatric condition, considering its impact on fracture-related morbidity and mortality, particularly among older women. The interplay of clinical evidence, diagnostic tools availability, and broader societal attitudes toward aging and treatment efficacy affect medical attitude and prescribing behaviors. Using the example of osteoporosis in France and England, the study aims to unravel the intricacies of medical decision-making in geriatric care, offering insights into the evolving landscape of healthcare policy and practice, which in turn can help reduce futile biomedical research. We employed documentary analysis and semi-structured interviews. Documentary analysis involved examining public policy documents related to osteoporosis management in England and France to identify trends in regulatory policies influencing prescribing practices. Semi-structured interviews with physicians explored prescriber decision-making processes, treatment initiation, and compliance management, providing insights into clinical practice complexities. The policy analysis uncovered 157 documents between 2015 and 2016, updated in 2018, revealing distinct policy clusters and outliers shaping osteoporosis management in England and France. Therapeutic indications generally mirrored marketing authorizations. Reimbursable therapeutic indications in France showed fluctuating availability, reflecting changes in policy priorities and patient demographics. Clinical guidelines evolved to encompass diverse osteoporosis types and treatment options, guided by evidence-based recommendations and healthcare system considerations. Trust dynamics between physicians, pharmaceutical companies, and health authorities influenced prescribing trends, with variations in reliance on standardized protocols and collaborative decision-making observed between England and France. Understanding trends in osteoporosis drug prescribing is crucial for optimizing healthcare policy and practice. Our study highlights the complex factors influencing prescribing patterns in England and France, emphasizing the role of trust in shaping physician behaviors. By addressing barriers to treatment uptake and enhancing patient outcomes, targeted interventions can be developed to reduce futile biomedical research and improve healthcare resource allocation.

COLLECTION OF RASAYANA DRUGS MENTIONED IN BRHATRAYI: A REVIEW

Ayurveda is one of the most ancient life sciences and has always been practised in the form of Ashtanga Ayurveda. Rasayana tantra (Geriatrics) is one of the eight major clinical disciplines aiming at rejuvenation and geriatric care. It fulfils both the aims of Ayurveda, i.e. maintaining &amp; promoting the positive health of healthy individuals and curing the diseases of the diseased . Descriptions of various single Rasayana drugs &amp; Rasayana formulations, along with their particular uses, are available in various texts of different periods, but no separate samhita or book is found for it. Hence, here, an effort has been made to compile the scattered Rasayana drugs (as single or formulations) mainly mentioned in Brihatrayi.

Prevalence and Factors Associated With Elder Self-Neglect Among Community-Dwelling Older Adults: A Cross-Sectional Study.

To report the prevalence and risk factors of elder self-neglect (ESN) among community-dwelling older adults (N = 604). The current cross-sectional study was conducted from July 2019 to October 2020 in Lanzhou City, China. ESN was determined by the Scale of Elderly Self-Neglect, which evaluates five dimensions: (a) medical health and care, (b) environmental sanitation and personal hygiene, (c) mental health, (d) safety, and (e) social engagement. Frailty was assessed using the Physical Frailty Phenotype scale. Participants were asked whether they had bothersome and activity-limiting pain over the past 1 month. Characteristics associated with ESN were identified through multiple linear regression analyses. Mean age of participants was 71.34 years (SD = 7.15 years), and 255 (57.8%) were female. The prevalence of ESN among participants was 16.2%. Among the five dimensions of ESN, medical health and care accounted for the largest proportion (44%). Approximately 58% of participants were pre-frail and 11.4% were frail, and 45% reported experiencing bothersome pain. Older adults with a household monthly income per capita <2,000 RMB (β = -0.112, p < 0.05), larger waist circumference (β = 0.185, p < 0.001), pre-frailty (β = 0.176, p < 0.001), frailty (β = 0.420, p < 0.001), and pain (β = 0.102, p < 0.05) were more prone to ESN. ESN is a prevalent issue among community-dwelling older adults. Frailty, pain, low economic status, and larger waist circumference are identified as independent risk factors for ESN. There is a need to improve the understanding of ESN among health care providers and policymakers. Personalized interventions aimed at preventing or addressing these risk factors may lead to improvements in ESN outcomes. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Caregiver Tasks and Life Changes Among Family Caregivers of Stroke Survivors.

Stroke family caregivers often struggle to provide care. The purpose of the current study was to determine: (a) ease or difficulty with caregiving tasks; (b) life changes because of providing care; and (c) relationship between caregiving tasks and life changes. A descriptive correlational design was used. Telephone interviews were conducted with 74 stroke caregivers. Tasks were measured using the Oberst Caregiving Burden Scale; life changes with the Bakas Caregiving Outcomes Scale. The most difficult tasks were managing survivor behaviors and the most negative life changes were lack of time for social activities. The easiest tasks were medical or nursing treatments, whereas the most positive life change was an improved relationship with the survivor. Tasks and life changes were different for each caregiver. Caregiver tasks and life changes were moderately correlated (r = 0.33, p < 0.01). Caregiver tasks and life changes are important for designing strategies to support stroke caregivers. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Addressing Dementia Care Needs During the COVID-19 Pandemic: Perspectives From Home Care Workers.

To uncover the barriers, facilitators, and adaptations that affected home care workers' care practices for their clients with dementia during the coronavirus disease 2019 (COVID-19) pandemic. Semi-structured interviews were conducted with home care workers employed during the COVID-19 pandemic in Southeast Michigan. Respondent-driven sampling was used to recruit participants who were interviewed using a guide informed by the Theoretical Domains Framework. To identify themes across interviews, the research team combined content analysis with coding software for qualitative data. Participants (N = 34) were predominantly female and ranged in age from 19 to 79 years. From the analyzed transcripts, five themes emerged: (1) Challenges in Complying With Pandemic Precautions; (2) Personal Protective Equipment-Related Disruption in Communication; (3) Client Fear and Agitation Exacerbated by Isolation; (4) Difficulties Necessitating Increased Patience; and (5) Continuation of Pre-Pandemic Holistic Care Practices Facilitating Well-Being. Home care workers adapted to meet their clients' health and well-being needs in the face of the demands of the pandemic. This study's findings are critical to informing the development of strategies to support home care workers and people living with dementia during future pandemics. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Improving Medication-Related Safety for Residents in Nursing Homes: A Qualitative Study.

To gain a better understanding of the perceptions of RNs on medication safety concerns and potential solutions for nursing home (NH) residents. This prospective, qualitative study used semi-structured phone interviews with a description approach. We used purposeful sampling to recruit 12 RNs employed at two NHs in the northeastern region of the United States. The Systems Engineering Initiative for Patient Safety constructs informed the interview guide, coding, and qualitative theme identification. We categorized non-user-friendly charting systems and gained insights into more experience with paper-based charting under the technology component. For the organization component, participants identified the importance of teamwork, communication, and leadership. Participants also mentioned how education and nationality of training impact medication administration (MA) safety. Task-related concerns revealed how different care approaches, extreme workload variation, and task prioritization during the day are perceived as critical issues that need to be addressed. Staff shortages were also expressed as an environment-related concern. Findings highlight the importance of appropriate nurse-to-patient ratio, the significance of user-friendly charting systems, and customizing the interface of MA in the charting system. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Paramedics and emergency medical technicians’ perceptions of geriatric trauma care in Saudi Arabia

BackgroundSaudi ambulance clinicians face unique challenges in providing prehospital care to older trauma patients. Limited geriatric-specific training and complex needs of this population hinder effective management, leading to adverse outcomes. This study explores the perceptions of Saudi ambulance clinicians regarding geriatric trauma care and identify facilitators and barriers to improved care.MethodsA qualitative study was conducted using a purposive sample of Saudi paramedics and ambulance technicians from Riyadh and Makkah using online semi-structured interviews and analysed using the framework method.ResultsThe qualitative study recruited twenty participants and identified that they reported age-related challenges including physiological changes, polypharmacy, and communication difficulties. They all wanted training and guidelines to improve their knowledge. They reported struggling with communication difficulties, inaccurate adverse outcomes predictions, difficult intravenous cannulations, and cultural restrictions affecting care provision for female patients. We identified organisational barriers (e.g. lack of shared patient records and lack of guidelines) and cultural barriers (e.g. barriers to assessing women, attitudes towards older people, and attitudes towards paramedics) that influenced implementation of knowledge.ConclusionAmbulance clinicians in Saudi Arabia want guidelines and training in managing older trauma patients but these need to take into account the organisational and cultural barriers that we identified to facilitate implementing knowledge and changing practice to providing improved care.

Malnutrition and Frailty Are Associated with a Higher Risk of Prolonged Hospitalization and Mortality in Hospitalized Older Adults.

Background/Objectives: Malnutrition and frailty are independent risk factors of prolonged hospitalization and mortality, respectively. However, the combined association of these conditions with the risk of prolonged hospitalization and mortality in hospitalized elderly patients remains unclear. Our object was to investigate the combined association of malnutrition and frailty on the risk of prolonged hospitalization and mortality in hospitalized elderly patients. Methods: The current study was a retrospective analysis of 470 patients admitted to the geriatric care unit of a tertiary hospital in Taiwan between 01 August 2019 and 31 March 2023. The Mini Nutritional Assessment-short form and Clinical Frailty Scale were used as evaluation tools for nutritional and frailty status, respectively. Patients were divided into four groups based on nutritional and frailty status. The association between these conditions and the risk of prolonged hospitalization and mortality was investigated using multivariate logistic and Cox proportional hazard models and adjusting for potential confounders. Results: Among 470 patients, 144 (31%) exhibited no malnutrition risk or frailty, 146 (31%) exhibited malnutrition risk but no frailty, 46 (10%) exhibited frailty but no malnutrition risk, and 134 (28%) exhibited both malnutrition risk and frailty. Compared to patients with neither condition, those with both conditions had higher risks of prolonged hospitalization (odds ratio 3.23, 95% confidence interval [CI] 1.68-6.12) and mortality (hazard ratio 4.33; 95% CI 2.01-9.34). Conclusion:: The co-occurrence of malnutrition and frailty has significant detrimental impacts on the risk of prolonged hospitalization and mortality in hospitalized older adults. The findings of this study emphasize the importance of early screening and intervention for malnutrition and frailty among hospitalized elderly patients.

Long-Term Trajectories of Older Adults Served by an Emergency Department/Hospital-Based Elder Mistreatment Response Program.

An emergency department (ED) visit or hospitalization provides an opportunity to identify elder mistreatment and initiate intervention, but this seldom occurs. To address this, we developed the Vulnerable Elder Protection Team (VEPT), a novel interdisciplinary consultation service. We explored the long-term trajectories of patients receiving VEPT evaluation and intervention. We followed up at multiple intervals for 12 months older adults seen by VEPT from 9/1/2020-3/27/2023 with high or moderate concern for mistreatment who were discharged to the community, an elder abuse shelter, or rehabilitation facilities. We collected information through telephone calls to the older adult and others involved. We also analyzed separately cases in which the patient re-presented to the ED/hospital with VEPT consultation during the follow-up period. A total of 157 older adults met criteria for follow-up, and 30 of these (16.4%) died within 12 months. At 1 month, elder mistreatment was no longer occurring in 47.5% and still occurring but reduced in 20.3%, with 29.7% having no contact with the perpetrator and 17.8% having reduced contact. At 12 months, elder mistreatment was no longer occurring in 60.9% and still occurring but reduced in 14.5%, with 34.8% having no contact with the perpetrator and 17.4% having reduced contact. During the 12-month follow-up period, 16 (10.2%) patients re-presented to the ED with VEPT consultation, with 12 having persistent concern for ongoing elder mistreatment. Reasons included older adults/caregivers not accepting intervention or being willing to separate as well as VEPT reliance on community-based agencies and programs after discharge. We observed improved post-discharge safety for elder mistreatment victims who engaged with the VEPT program, with this increased safety durable over 1 year. Re-presentations highlighted the complexity of elder mistreatment intervention. Overall, these findings demonstrate the potential value of an ED/hospital-based elder mistreatment response team, a promising new geriatric care model.