Geriatrics

12 pages, 236 KiB

Open AccessArticle

Understanding Kinesiophobia: Predictors and Influence on Early Functional Outcomes in Patients with Total Knee Arthroplasty

by Milica Aleksić, Ivan Selaković, Sanja Tomanović Vujadinović, Marko Kadija, Darko Milovanović, Winfried Meissner, Ruth Zaslansky, Svetlana Srećković and Emilija Dubljanin-Raspopović

Geriatrics 2024, 9(4), 103; https://doi.org/10.3390/geriatrics9040103 - 13 Aug 2024

Viewed by 305

Abstract

This observational study aimed to identify predictors of kinesiophobia and examine its correlation with early functional outcomes in TKA recipients. On the first and fifth postoperative days (POD1 and POD5), we evaluated pain using the International Pain Outcomes Questionnaire (IPO-Q) and created multidimensional [...] Read more.

This observational study aimed to identify predictors of kinesiophobia and examine its correlation with early functional outcomes in TKA recipients. On the first and fifth postoperative days (POD1 and POD5), we evaluated pain using the International Pain Outcomes Questionnaire (IPO-Q) and created multidimensional pain composite scores (PCSs). The Total Pain Composite Score (PCStotal) assesses the overall impact of pain, taking into account outcomes of pain intensity, pain-related interference with function, and emotions and side effects. Functional status on POD 5 was determined by the Barthel index, 6 min walking test, and knee range of motion. Kinesiophobia was assessed on POD5 using the Tampa Scale for Kinesiophobia (TSK). Among 75 TKA patients, 27% exhibited kinesiophobia. The final regression model highlighted PCStotal on POD5 (OR = 6.2, CI = 1.9–19.9), PCStotal (OR = 2.1, CI = 1.2–3.8) on POD1, and the intensity of chronic pain before surgery (OR = 1.4, CI = 1.1–2.1) as significant kinesiophobia predictors. On POD5, those with kinesiophobia showed increased dependency, slower gait, and poorer knee extension recovery. This study emphasizes the need to identify and address kinesiophobia in TKA patients for better functional outcomes and recovery. Additionally, it is vital to assess different domains of pain, not just pain intensity, as it can lead to kinesiophobia development. Full article

(This article belongs to the Topic Personality, Health and Well-Being among Different Age Groups)

17 pages, 903 KiB

Open AccessFeature PaperArticle

Circadian Rhythm of Distal Skin Temperature in Healthy Older and Young Women and Its Relationship with Sleep–Wake Rhythm and Environmental Factors under Natural Living Conditions

by Manuela Dittmar, Tina Stark and Stefanie Wedell

Geriatrics 2024, 9(4), 102; https://doi.org/10.3390/geriatrics9040102 - 6 Aug 2024

Viewed by 352

Abstract

Little is known about the healthy aging of the circadian timing system under natural living conditions. This study explores changes in the circadian rhythm of distal skin temperature (DST) with aging and relates these changes to sleep–wake timing and environmental influences. DST, sleep–wake [...] Read more.

Little is known about the healthy aging of the circadian timing system under natural living conditions. This study explores changes in the circadian rhythm of distal skin temperature (DST) with aging and relates these changes to sleep–wake timing and environmental influences. DST, sleep–wake timing, 24-h light exposure, and physical activity were measured and averaged over seven consecutive days using temperature sensors, actigraphy with a light meter, and sleep diaries in 35 healthy older women (60–79 years) and 30 young women (20–34 years). Circadian rhythm characteristics, describing strength (amplitude) and timing (acrophase) of the DST rhythm, were calculated using cosinor analysis. The older adults displayed an 18–19% smaller amplitude and a 66–73 min earlier acrophase (peak time) for DST rhythm than the young adults, indicating a weaker and phase-advanced DST rhythm. The phase advance for DST was not due to an earlier evening increase, but to a shorter nocturnal plateau period. Daytime light exposure inversely affected strength (amplitude) but not phasing of the DST rhythm in older adults. The DST rhythm was 3.5 times more advanced than the sleep–wake rhythm, showing an altered phase relationship (phase angle) between both rhythms with aging. The phase angle was more heterogeneous among older adults, showing differential aging. The phase advance for DST rhythm and the altered and heterogeneous phase relationship between DST and sleep–wake rhythms were not related to ambient light exposure and the physical activity of older adults. This suggests that healthy aging of the circadian system might be due to endogenous mechanisms such as an internal rearrangement rather than external influences. Full article

(This article belongs to the Section Healthy Aging)

► Show Figures

Figure 1

Figure 1
Circadian rhythm of distal skin temperature of hand (a) and foot (b), recorded at 10 min intervals over a five-day period in 65 healthy participants (35 older and 30 young women). Data points are mean fitted values and 95% confidence limits, calculated with Chronos-Fit software. Black and grey horizontal bars represent mean total sleep time in older and young women, respectively. Full article ">Figure 2
Phase relationship between the acrophase (peak time) of distal skin temperature (DST) rhythm and sleep-onset time of sleep–wake rhythm, averaged over seven consecutive days. Black arrows (older women) and grey arrows (young women) represent the time points of the sleep-onset time and the acrophase of DST rhythm. The sleep-onset time was 21 min and the acrophase for DST rhythm was approximately 70 min advanced in the older women relative to young women. Black (older women) and grey horizontal bars (young women) represent the mean phase angle (PA, time interval) between the sleep-onset time and the acrophase of DST rhythm, separately for hand DST and foot DST. The mean PA of older women was shorter by approximately 50 min compared with young women, both for hand DST (p = 0.058) and foot DST (p = 0.005). This indicates that the circadian rhythm for DST is phase-advanced relative to the sleep–wake rhythm in older women by approximately 50 min, when compared with young women. Full article ">Figure 3
Variation in the phase angle, calculated as the time interval between the sleep-onset time of the sleep–wake cycle and the acrophase of the distal skin temperature rhythm of (a) hand and (b) foot, averaged over seven consecutive days in 35 healthy older women and 30 young women. Horizontal lines indicate mean values. The variation in the phase angle is greater among the older women (black circles) than among the young women (grey circles); foot: p = 0.014; hand, p = 0.055. Full article ">

19 pages, 340 KiB

Open AccessReview

Lung Cancer: New Directions in Senior Patients Assessment

by Anca Iuliana Pîslaru, Sabinne-Marie Albișteanu, Adina Carmen Ilie, Ramona Ștefaniu, Aurelia Mârza, Ștefan Moscaliuc, Mălina Nicoară, Ana-Maria Turcu, Gabriela Grigoraș and Ioana Dana Alexa

Geriatrics 2024, 9(4), 101; https://doi.org/10.3390/geriatrics9040101 - 1 Aug 2024

Viewed by 344

Abstract

Age is but one significant prognostic factor in lung cancer, influencing survival, treatment response, and outcomes. This narrative review synthesizes findings from searches of 11 leading databases of research studies, systematic reviews, book chapters, and clinical trial reports on lung cancer in senior [...] Read more.

Age is but one significant prognostic factor in lung cancer, influencing survival, treatment response, and outcomes. This narrative review synthesizes findings from searches of 11 leading databases of research studies, systematic reviews, book chapters, and clinical trial reports on lung cancer in senior patients, with a focus on geriatric assessment as well as biomarkers. Key prognostic factors for lung cancer in seniors include biological age, functional capability, physical and psychological comorbidities, frailty, nutrition, status, and biomarkers like DNA methylation age. We identified the most valuable assessments that balance efficacy with quality of life. Optimizing care and improving outcomes with senior lung cancer patients benefits from a tailored therapeutic approach incorporating a complex geriatric assessment. A multidisciplinary collaboration between geriatricians, oncologists, and pulmonologists is crucial. Full article

(This article belongs to the Section Geriatric Oncology)

14 pages, 488 KiB

Open AccessArticle

Clinical Factors and Biomarkers Associated with Depressive Disorders in Older Patients Affected by Chronic Kidney Disease (CKD): Does the Advanced Glycation End Products (AGEs)/RAGE (Receptor for AGEs) System Play Any Role?

by Massimiliano Buoli, Elena Dozio, Lara Caldiroli, Silvia Armelloni, Elena Vianello, Massimiliano Corsi Romanelli, Giuseppe Castellano and Simone Vettoretti

Geriatrics 2024, 9(4), 99; https://doi.org/10.3390/geriatrics9040099 - 30 Jul 2024

Viewed by 298

Abstract

Depressive disorders are highly prevalent among subjects suffering from chronic kidney disease (CKD). The aim of the present study is to evaluate clinical and biochemical factors associated with depressive disorders in a sample of older CKD patients, with a focus on advanced glycation [...] Read more.

Depressive disorders are highly prevalent among subjects suffering from chronic kidney disease (CKD). The aim of the present study is to evaluate clinical and biochemical factors associated with depressive disorders in a sample of older CKD patients, with a focus on advanced glycation end products (AGEs) and their soluble receptors (sRAGEs). A total of 115 older subjects affected by CKD (stages 3 to 5, not in dialysis) were selected for this study. These patients were divided into two groups according to the presence of depressive disorders defined by a score ≥ 10 on the 30-item Geriatric Depression Scale (GDS). The two groups were compared by independent sample t tests for continuous variables and χ² tests for qualitative ones. Significant variables at univariate analyses were then inserted as predictors of a binary logistic regression model, with the presence or absence of depressive disorders as a dependent variable. The binary logistic regression model showed that patients with concomitant depressive disorders were more frequently of female gender (p < 0.01) and had lower MCP1 (p < 0.01) and AGE circulating levels (p < 0.01) than their counterparts. Depressive disorders in older CKD patients are more prevalent in women and seem to be inversely associated with systemic inflammation and circulating AGEs. Full article

► Show Figures

Figure 1

29 pages, 1649 KiB

Open AccessReview

Pisa Syndrome Secondary to Drugs: A Scope Review

by Jamir Pitton Rissardo, Nilofar Murtaza Vora, Naseeb Danaf, Saivignesh Ramesh, Sanobar Shariff and Ana Letícia Fornari Caprara

Geriatrics 2024, 9(4), 100; https://doi.org/10.3390/geriatrics9040100 - 30 Jul 2024

Viewed by 326

Abstract

Background: Pisa syndrome, also known as pleurothotonus, is a neurological condition characterized by more than ten degrees of constant lateral curvature of the spine when upright. In this way, the present manuscript aims to systematically review Pisa syndrome secondary to drugs. Methods: Two [...] Read more.

Background: Pisa syndrome, also known as pleurothotonus, is a neurological condition characterized by more than ten degrees of constant lateral curvature of the spine when upright. In this way, the present manuscript aims to systematically review Pisa syndrome secondary to drugs. Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between January 1990 and June 2024. Results: The prevalence of Pisa syndrome varied from 0.037 to 9.3%. We found 109 articles containing 191 cases of drug-induced Pisa syndrome reported in the literature. The mean and median ages were 59.70 (SD = 19.02) and 67 (range = 12–98 years). The most prevalent sex was female, 56.91% (107/188). The most frequent medications associated with Pisa syndrome were acetylcholinesterase inhibitors in 87 individuals. Of 112 individuals in which the onset time from the medication to the movement disorder occurrence was reported, 59 took place within a month. In this way, a return to baseline was observed in 45.50% of the cases, and partial recovery was observed in 14.28%. Conclusion: We proposed new diagnostic criteria for Pisa syndrome based on previous findings in the literature. Moreover, multiple mechanisms are probably involved in balance control and the development of lateral trunk flexions. Full article

► Show Figures

Figure 1

14 pages, 889 KiB

Open AccessSystematic Review

The Impact of Regular Physical Activity on the Mental Health and Well-Being of Dementia Patients in High-Income Countries—A Systematic Scoping Review

by Simranjeet Kaur, Sai Hyma Sree Cherukuri, Sheikh Mahbub Murshed, Adiyasuren Purev-Ochir, Erini Abdelmassih and Fahad Hanna

Geriatrics 2024, 9(4), 98; https://doi.org/10.3390/geriatrics9040098 - 29 Jul 2024

Viewed by 365

Abstract

Background: Dementia is a term used to describe a group of symptoms impacting memory, thinking, and social abilities. Evidence suggests a positive role of physical activity in physical and mental well-being in general. This systematic scoping review aimed to gather, summarise, and analyse [...] Read more.

Background: Dementia is a term used to describe a group of symptoms impacting memory, thinking, and social abilities. Evidence suggests a positive role of physical activity in physical and mental well-being in general. This systematic scoping review aimed to gather, summarise, and analyse evidence of the impact of physical activity on the mental health and well-being of dementia patients. Methods: A comprehensive systematic search of mainly primary research was conducted using several databases. Peer-reviewed studies in high-income countries published between 2005 and 2023 were included. The systematic scoping review was performed using the framework outlined by the Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement. Results: Twenty-four articles (including 93,984 participants) were included in the analysis. Most articles (21) reported that physical activity (particularly regular physical activity) is associated with decreased depression score, decreased cognition impairment, and fewer falls, all of which contributed to improved well-being among dementia patients. These studies showed that there is a significant positive relationship between the level of physical activity and the level of improvement in the mental health and well-being of dementia patients. Conclusions: Findings from this systematic scoping review provide relatively reliable evidence that regular physical activity may improve the mental health and well-being of dementia patients. Systematic reviews and meta-analyses may be required to further confirm these findings. Full article

(This article belongs to the Section Geriatric Public Health)

► Show Figures

Figure 1

12 pages, 426 KiB

Open AccessArticle

Frailty as a Risk Factor for Depression after COVID-19 Hospital Admission

by Isabel María Soler-Moratalla, Sergio Salmerón, Silvia Lozoya-Moreno, Ana María Hermosilla-Pasamar, Antonio Henández-Martínez, Julián Solís-García del Pozo, Margarita Escribano-Talaya, Maria Antonia Font-Payeras and Francisco García-Alcaraz

Geriatrics 2024, 9(4), 97; https://doi.org/10.3390/geriatrics9040097 - 22 Jul 2024

Viewed by 546

Abstract

Background: This work aims to establish the relationship between depression and epidemiological or imaging variables, frailty, and cognitive status in patients who suffered hospital admission for COVID-19. Methods: A longitudinal observational study investigated 72 patients admitted for COVID-19 to a hospital in Spain. [...] Read more.

Background: This work aims to establish the relationship between depression and epidemiological or imaging variables, frailty, and cognitive status in patients who suffered hospital admission for COVID-19. Methods: A longitudinal observational study investigated 72 patients admitted for COVID-19 to a hospital in Spain. Patients were evaluated at discharge and six months later. Clinical, analytical, and imaging variables were collected. A neurocognitive, nutritional, and frailty (FRAIL scale) assessment of the included patients was carried out. The risk of depression was considered for a result above 5 points on the PHQ-9 scale. Results: The variables that were significantly related to the risk of depression 6 months after admission for COVID-19 were frailty (p = 0.006 for pre-frail and p = 0.001 for frail), small-vessel vascular disease in imaging tests (p = 0.033), vitamin D level (p = 0.006), and taking antidepressants (p = 0.011). Factors that were negatively associated with the presence of depression 6 months after discharge were a higher score on the CAMCOG cognitive scale (p = 0.041) and older age (p = 0.006). Conclusions: Frailty worsened the score on the PHQ-9 depression scale in patients who required hospital admission for SARS-CoV-2 infection. It is important to implement prevention measures both for frailty and depression in these patients. Full article

(This article belongs to the Collection Frailty in Older Adults)

► Show Figures

Figure 1

11 pages, 239 KiB

Open AccessArticle

Correlates of Loneliness and Social Isolation among Older Adults during the COVID-19 Outbreak: A Comprehensive Assessment from a National United States Sample

by Miguel G. Pica, Jason R. Grullon and Roger Wong

Geriatrics 2024, 9(4), 96; https://doi.org/10.3390/geriatrics9040096 - 19 Jul 2024

Viewed by 613

Abstract

This study examined the correlates of loneliness and social isolation among older adults in the United States (U.S.) during the COVID-19 outbreak. We analyzed data from the 2020 National Health and Aging Trends Study, a nationally representative sample of 3257 U.S. older adults [...] Read more.

This study examined the correlates of loneliness and social isolation among older adults in the United States (U.S.) during the COVID-19 outbreak. We analyzed data from the 2020 National Health and Aging Trends Study, a nationally representative sample of 3257 U.S. older adults aged 65 years and older. We analyzed and identified the sociodemographic, health, social support, and community correlates of loneliness, higher loneliness during versus before the COVID-19 outbreak, and social isolation using weighted multiple logistic regression models. About 35.2% of U.S. older adults reported loneliness during the COVID-19 outbreak, 21.9% reported higher loneliness compared to before the COVID-19 outbreak, and 32.8% were socially isolated during the outbreak. Correlates for increased odds of loneliness included female gender, higher education, physical activity, depression, anxiety, functional limitations, and virtual communication access (only for higher loneliness during COVID-19 outbreak). Correlates for increased odds of social isolation included higher age, non-Hispanic Black, Hispanic, higher number of household children, and metropolitan residence. Our findings provide insights into evidence-based approaches to address social disconnection among U.S. older adults. The wide range of sociodemographic, health, social support, and community correlates identified in this study warrants multifaceted interventions that traverse individual, community, and societal levels to address the loneliness and social isolation epidemic. Full article

(This article belongs to the Section Geriatric Public Health)

11 pages, 2728 KiB

Open AccessReview

Gait Assessment Using Smartphone Applications in Older Adults: A Scoping Review

by Lorenzo Brognara

Geriatrics 2024, 9(4), 95; https://doi.org/10.3390/geriatrics9040095 - 18 Jul 2024

Viewed by 485

Abstract

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the [...] Read more.

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the diagnosis and rehabilitation processes in frail people. The aim of this study was to review articles published in the last 20 years (from 2004 to 2024) concerning the application of smartphones to assess the spatiotemporal parameters of gait in older adults. This systematic review was performed in line with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), and original articles were identified by searching seven electronic databases: SciVerse (ScienceDirect), Excerpta Medica Database (EMBASE), Medline, Scopus, PubMed, Web of Science and the Cochrane Library. Studies were rigorously screened using the inclusion criteria of smartphones and mobile apps, older adults and spatiotemporal gait parameters, and results were narratively synthesized. Seventy-three articles were initially identified while searching the scientific literature regarding this topic. Eleven articles were selected and included in this review. Analysis of these studies covered information about gait assessment using mobile apps recorded in 723 older adults and 164 control cases. Analysis of data related to the application of smartphones to assess spatiotemporal parameters of gait in older adults showed moderate-to-excellent test–retest reliability and validity (ICCs around 0.9) of gait speed, the most common parameter reported. Additionally, gait speeds recorded with mobile apps showed excellent agreement when compared to gold standard systems. Smartphones and mobile apps are useful, non-invasive, low-cost and objective tools that are being extensively used to perform gait analysis in older adults. Smartphones and mobile apps can reliably identify spatiotemporal parameters related to adverse outcomes, such as a slow gait speed, as predictors and outcomes in clinical practice and research involving older adults. Full article

► Show Figures

Figure 1

21 pages, 491 KiB

Open AccessSystematic Review

The Positive Effects of Physical Activity on Quality of Life in Parkinson’s Disease: A Systematic Review

by Dharah P. C. F. Bispo, Carla C. S. A. Lins, Kelly L. Hawkes, Shae Tripp and Tien K. Khoo

Geriatrics 2024, 9(4), 94; https://doi.org/10.3390/geriatrics9040094 - 15 Jul 2024

Viewed by 681

Abstract

Background: Physical activity can have positive effects on motor and non-motor symptoms in Parkinson’s disease, but its benefits in terms of quality of life and function are uncertain and vary based on the specific forms of activities and interventions. Objective: We sought to [...] Read more.

Background: Physical activity can have positive effects on motor and non-motor symptoms in Parkinson’s disease, but its benefits in terms of quality of life and function are uncertain and vary based on the specific forms of activities and interventions. Objective: We sought to assess the current evidence on the positive effects of physical activity in people with Parkinson’s disease and more specifically in relation to its potential benefits for quality of life. Methods: This systematic review was conducted between January and April 2024 via the PubMed, Medline, and Scopus databases. Predetermined search criteria were used that included the following terms: “Parkinson’s disease”, “quality of life” and “physical activity”. Results: A total of 1669 articles were identified. After utilizing predetermined criteria, a total of fifteen articles met the selection criteria. Statistically significant improvements in quality of life were found in seven studies. Seven studies demonstrated a significant improvement in non-motor symptoms, while nine studies showed an improvement in motor symptoms. Conclusions: Despite heterogeneity in the study designs, interventions and clinical assessments, the articles identified in this review yielded mostly positive results in relation to physical activities. The findings reflect an improvement in motor and non-motor symptoms may translate to a better quality of life in people with Parkinson’s disease. Full article

(This article belongs to the Section Geriatric Neurology)

► Show Figures

Figure 1

17 pages, 1371 KiB

Open AccessViewpoint

Longevity as a Responsibility: Constructing Healthy Aging by Enacting within Contexts over the Entire Lifespan

by Francesca Morganti

Geriatrics 2024, 9(4), 93; https://doi.org/10.3390/geriatrics9040093 - 12 Jul 2024

Viewed by 417

Abstract

Studying aging now requires going beyond the bio-psycho-social model and incorporating a broader multidisciplinary view capable of capturing the ultimate complexity of being human that is expressed as individuals age. Current demographic trends and the lengthening of life expectancies allow the observation of [...] Read more.

Studying aging now requires going beyond the bio-psycho-social model and incorporating a broader multidisciplinary view capable of capturing the ultimate complexity of being human that is expressed as individuals age. Current demographic trends and the lengthening of life expectancies allow the observation of long-lived individuals in full health. These super-agers are no longer an exception. Indeed, individuals can have a good quality of life even over age 70 and living with chronic or neurodegenerative diseases. This change is driven in part by the cohort effect observed in people who are about to age today (e.g., better schooling, more advanced health conditions, and technologization) but more so by the gradual overcoming of ageist views. An aged person is no longer seen as a quitter but rather as one empowered to direct their own trajectory of potentially healthy longevity. According to this vision, this article proposes a situated lifespan perspective for the study of aging that integrates pedagogical models of developmental ecology with psychological theories of optimal experience to understand the individual motivational perspective on aging. At the same time, it does not disregard analyzing the daily and cultural contexts in which everyone situates and that guide aging trajectories. Nor does it forget that aging people are body-mind (embodied) organisms that, with contexts and through motivations, seize opportunities for action (affordances) to evolve in an optimal way during their lifespan. This theoretical reflection sheds new light on the aging process and on future trends in healthy longevity research. Full article

(This article belongs to the Section Healthy Aging)

► Show Figures

Figure 1

15 pages, 251 KiB

Open AccessArticle

“Exercise… to Me, It’s Freedom”: Motivation, Support, and Self-Management to Keep Physically Active with Parkinson’s Disease: A Qualitative Study

by Leanne Ahern, Catriona Curtin, Suzanne Timmons, Sarah E. Lamb and Ruth McCullagh

Geriatrics 2024, 9(4), 92; https://doi.org/10.3390/geriatrics9040092 - 11 Jul 2024

Viewed by 674

Abstract

The benefits of exercise have been widely explored among people with Parkinson’s (PwP). Exercise can improve non-motor (fatigue, pain, sleep, etc.) and motor features (balance, muscle strength, gait speed, etc.), maintain function, as well as prevent disease progression. Although the benefits are well [...] Read more.

The benefits of exercise have been widely explored among people with Parkinson’s (PwP). Exercise can improve non-motor (fatigue, pain, sleep, etc.) and motor features (balance, muscle strength, gait speed, etc.), maintain function, as well as prevent disease progression. Although the benefits are well known, PwP continue to show difficulty adhering to physical activity and exercise. This study aims to explore motivation to exercise, support, and self-management needs among people with Parkinson’s, their family members, and physiotherapists. Purposeful and maximum-variation sampling methods (age, sex, geographical setting, and disease severity) were employed. PwP and family members were recruited through physiotherapy services and local support groups. Twelve semi-structured interviews with PwP and two group interviews, one with family members (n = 4) and one with physiotherapists (n = 5), were conducted. Interview guides were informed by patient–public input and a recent systematic review. Interviews were recorded, transcribed, and analysed using thematic analysis informed by the Grounded Theory methodology. Four common themes emerged: (1) The value of an intrinsic connection with exercise, for which there are challenges. A greater connection to exercise led to long-term adherence. (2) Adapting exercise to the needs and preferences of a person is essential. Preferred exercises and environments were mixed, with differences emerging between sexes. (3) Physiotherapists’ aim to only maintain physical function led to frustration. Limited self-management opportunities, stigma, and dehumanisation were discussed. (4) Non-motor symptoms, stigma, fear, and determination as well as apathy, pain, and low mood were discussed. Exercise provided physical, emotional, and social rewards. Supports are necessary; however, challenges arise when PwP’s motivations are mismatched to family members’ and physiotherapists’ goals. Co-created goals, tailored to their preferences, and exercise plans with supported self-management are recommended. Full article

(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)

16 pages, 492 KiB

Open AccessArticle

Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project

by Bonnie D. Dawson, Hallie E. Keller, Linda M. Sawyer, Shannon Gorman, Jerome A. Sabangan, Adam McPartlin, Sarah Payne, Karl J. Brown, Gail Li and Dennis H. Sullivan

Geriatrics 2024, 9(4), 91; https://doi.org/10.3390/geriatrics9040091 - 9 Jul 2024

Viewed by 540

Abstract

This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes [...] Read more.

This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs’ satisfaction and adherence. Of 109 OVs who enrolled, 74 completed the program with a mean attendance rate of 84%. Completers demonstrated a statistically significant improvement in the 30CST, and those who were moderately or severely lonely at baseline saw a statistically significant improvement in the DJGS. Course evaluations were generally very positive. Results suggest that a virtual Tai Chi program is an effective and very satisfying intervention for OVs at risk of loneliness or physical deconditioning. Full article

(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)

► Show Figures

Graphical abstract

7 pages, 2810 KiB

Open AccessCase Report

Isolated Acute Dysphagia as a Probable Rare Presentation of Guillain–Barré Syndrome with Complete Recovery: A Case Report

by Soo Ho Lee, Ji Yoon Jung, Mi-Jeong Yoon, Joon-Sung Kim, Bo Young Hong, Sun Im and Yeun Jie Yoo

Geriatrics 2024, 9(4), 90; https://doi.org/10.3390/geriatrics9040090 - 28 Jun 2024

Viewed by 560

Abstract

Dysphagia is prevalent among the elderly and can lead to serious complications, often manifesting as a clinical symptom of various neurological or muscular pathologies, including Guillain–Barré Syndrome (GBS). GBS is an acute immune-mediated polyradiculoneuropathy, and dysphagia may arise during its course due to [...] Read more.

Dysphagia is prevalent among the elderly and can lead to serious complications, often manifesting as a clinical symptom of various neurological or muscular pathologies, including Guillain–Barré Syndrome (GBS). GBS is an acute immune-mediated polyradiculoneuropathy, and dysphagia may arise during its course due to cranial nerve involvement. In rare GBS variants, dysphagia may present as the initial or sole clinical manifestation, posing diagnostic challenges. In this study, we present the case of an elderly female patient with dysphagia, eventually diagnosed with an atypical variant of GBS. Initially, the patient required nasogastric tube feeding; however, complete recovery was achieved through immunotherapy. This case underscores the importance of clinicians conducting thorough evaluations of factors influencing the swallowing mechanism and remaining vigilant about identifying uncommon causative factors. Such approaches enable the implementation of effective disease-modifying therapies, potentially leading to the resolution of dysphagic symptoms. Full article

(This article belongs to the Section Dysphagia)

► Show Figures

Figure 1

19 pages, 685 KiB

Open AccessArticle

Physical Performance, Body Composition, and Oral Health in Community-Residing Older Adults: A Cross-Sectional Study

by Maria Esther Irigoyen-Camacho, Maria Consuelo Velazquez-Alva, Marco Antonio Zepeda-Zepeda, Irina Lazarevich, Antonio Castano-Seiquer and Javier Flores-Fraile

Geriatrics 2024, 9(4), 89; https://doi.org/10.3390/geriatrics9040089 - 26 Jun 2024

Viewed by 913

Abstract

Physical activity is essential for healthy aging. This study aimed to identify an association between physical performance, body fat percentage (%BF), and the perception of oral health-related quality of life (OHRQoL) in independent older adults. Method: A group of active older adults was [...] Read more.

Physical activity is essential for healthy aging. This study aimed to identify an association between physical performance, body fat percentage (%BF), and the perception of oral health-related quality of life (OHRQoL) in independent older adults. Method: A group of active older adults was selected from a government-sponsored reunion center in Mexico City. OHRQoL was assessed using the General Oral Health Index (GOHAI), and nutritional status was assessed using the Mini Nutritional Assessment (MNA) tool. A short physical performance battery (SPPB) was applied, and, for body composition, DXA (dual X-ray absorptiometry) was conducted. Data were analyzed using logistic regression models, and marginal probabilities were obtained. Results: This study involved 366 participants; their mean age was 73.9 (±6.2) years, and 24.9% had type 2 diabetes mellitus (T2DM). OHRQoL information revealed that pain or discomfort in the oral cavity was perceived by 63.9% of the older adults during the previous three months. The SPPB score was low in 159 (43.44%) participants. The logistic regression model revealed that age (OR = 1.13, p < 0.001), T2DM (OR = 2.10, p = 0.009), the risk of malnutrition/malnutrition (OR = 1.76, p = 0.047), high %BF (OR = 1.09, <0.001), and poor OHRQoL (OR = 1.96, p = 0.009) were associated with deteriorated physical performance. Conclusion: OHRQoL self-perception, excess body fat, and nutritional status impacted physical performance. Aging well requires a comprehensive approach. Full article

(This article belongs to the Special Issue Physical Activity and Exercise in Older Adults)

► Show Figures

Figure 1

14 pages, 781 KiB

Open AccessArticle

Can We Steer Nursing Home Residents Away from Loneliness? A Qualitative Study of Cycling without Age

by Sara Kruse Lange, Maiken Hauge Stig, Martin Eghøj and Christina Bjørk Petersen

Geriatrics 2024, 9(4), 88; https://doi.org/10.3390/geriatrics9040088 - 25 Jun 2024

Viewed by 856

Abstract

Background: Loneliness among nursing home residents is an increasing public health issue and consists of a combination of social, emotional, and existential loneliness. Cycling Without Age (CWA) involves taking nursing home residents on trishaw rides pedaled by trained volunteer ‘pilots’. This study aims [...] Read more.

Background: Loneliness among nursing home residents is an increasing public health issue and consists of a combination of social, emotional, and existential loneliness. Cycling Without Age (CWA) involves taking nursing home residents on trishaw rides pedaled by trained volunteer ‘pilots’. This study aims to explore nursing home residents’ lived experiences of CWA and whether participation in CWA can mitigate experiences of loneliness. Methods: A qualitative phenomenological design was used. We conducted three observations and eight interviews: semi-structured interviews (n = 5) and informal interviews (n = 3) with passengers in CWA. Data were analyzed using reflexive thematic analysis. Results: Three themes were developed: 1. creating meaningful communities (related to the social mechanism connected to participating in CWA), 2. breaking the monotony of everyday life (related to how the passengers experience CWA as a meaningful activity), and 3. reconnecting to oneself (related to the meaningful experience the passengers have when they are connected to their local communities and reminiscence). Conclusion: Taking part in CWA may mitigate loneliness, as passengers perceive it as being meaningful. These results strengthen the notion that participating in meaningful activities hold the potential to mitigate feelings of loneliness among nursing home residents. Full article

► Show Figures

Figure 1

19 pages, 2832 KiB

Open AccessFeature PaperReview

Neural Functioning in Late-Life Depression: An Activation Likelihood Estimation Meta-Analysis

by Antonio Del Casale, Serena Mancino, Jan Francesco Arena, Grazia Fernanda Spitoni, Elisa Campanini, Barbara Adriani, Laura Tafaro, Alessandro Alcibiade, Giacomo Ciocca, Andrea Romano, Alessandro Bozzao and Stefano Ferracuti

Geriatrics 2024, 9(4), 87; https://doi.org/10.3390/geriatrics9040087 - 25 Jun 2024

Viewed by 531

Abstract

Late-life depression (LLD) is a relatively common and debilitating mental disorder, also associated with cognitive dysfunctions and an increased risk of mortality. Considering the growing elderly population worldwide, LLD is increasingly emerging as a significant public health issue, also due to the rise [...] Read more.

Late-life depression (LLD) is a relatively common and debilitating mental disorder, also associated with cognitive dysfunctions and an increased risk of mortality. Considering the growing elderly population worldwide, LLD is increasingly emerging as a significant public health issue, also due to the rise in direct and indirect costs borne by healthcare systems. Understanding the neuroanatomical and neurofunctional correlates of LLD is crucial for developing more targeted and effective interventions, both from a preventive and therapeutic standpoint. This ALE meta-analysis aims to evaluate the involvement of specific neurofunctional changes in the neurophysiopathology of LLD by analysing functional neuroimaging studies conducted on patients with LLD compared to healthy subjects (HCs). We included 19 studies conducted on 844 subjects, divided into 439 patients with LLD and 405 HCs. Patients with LLD, compared to HCs, showed significant hypoactivation of the right superior and medial frontal gyri (Brodmann areas (Bas) 8, 9), left cingulate cortex (BA 24), left putamen, and left caudate body. The same patients exhibited significant hyperactivation of the left superior temporal gyrus (BA 42), left inferior frontal gyrus (BA 45), right anterior cingulate cortex (BA 24), right cerebellar culmen, and left cerebellar declive. In summary, we found significant changes in activation patterns and brain functioning in areas encompassed in the cortico–limbic–striatal network in LLD. Furthermore, our results suggest a potential role for areas within the cortico–striatal–cerebellar network in the neurophysiopathology of LLD. Full article

(This article belongs to the Section Geriatric Psychiatry and Psychology)

► Show Figures

Figure 1

14 pages, 1443 KiB

Open AccessReview

Alzheimer’s Disease: Cellular and Pharmacological Aspects

by Gonzalo Emiliano Aranda-Abreu, Fausto Rojas-Durán, María Elena Hernández-Aguilar, Deissy Herrera-Covarrubias, Lizbeth Donají Chí-Castañeda, María Rebeca Toledo-Cárdenas and Jorge Manuel Suárez-Medellín

Geriatrics 2024, 9(4), 86; https://doi.org/10.3390/geriatrics9040086 - 22 Jun 2024

Viewed by 777

Abstract

Alzheimer’s disease was described more than 100 years ago and despite the fact that several molecules are being tested for its treatment, which are in phase III trials, the disease continues to progress. The main problem is that these molecules function properly in [...] Read more.

Alzheimer’s disease was described more than 100 years ago and despite the fact that several molecules are being tested for its treatment, which are in phase III trials, the disease continues to progress. The main problem is that these molecules function properly in healthy neurons, while neuronal pathology includes plasma membrane disruption, malfunction of various organelles, and hyperphosphorylation of Tau and amyloid plaques. The main objective of this article is the discussion of a neuronal restoration therapy, where molecules designed for the treatment of Alzheimer’s disease would probably be more effective, and the quality of life of people would be better. Full article

► Show Figures

Figure 1

9 pages, 780 KiB

Open AccessReview

Existing Digital Health Technology Index Summary Report for Older Adults Living with Neurocognitive Disorders (Mild and Major) and Their Informal Caregivers: An Environmental Scan

by Ambily Jose, Maxime Sasseville, Ellen Gorus, Anik Giguère, Anne Bourbonnais, Samira Abbasgholizadeh Rahimi, Clémence Balley, Ronald Buyl and Marie-Pierre Gagnon

Geriatrics 2024, 9(4), 85; https://doi.org/10.3390/geriatrics9040085 - 22 Jun 2024

Viewed by 542

Abstract

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers. (1) Background: It is important to obtain a comprehensive view of currently available technologies, their outcomes, and conditions of success [...] Read more.

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers. (1) Background: It is important to obtain a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will aid the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences based on trustable information. (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in the grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized the findings. (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed for identifying current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers. Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

Geriatrics, Volume 9, Issue 4 (August 2024) – 19 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI