AGING MEDICINE

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ISSN / EISSN : 2475-0360 / 2475-0360
Published by: Wiley-Blackwell (10.1002)
Total articles ≅ 156
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Latest articles in this journal

Published: 19 September 2021
Abstract:
The purposes of this review are to describe the existing research on frailty measurement of older people and to understand their characteristics, with a focus on conceptual definitions, psychometric properties, and diagnostic accuracies. We reviewed the published literature to explore if cross-cultural studies of different types of frailty measurements have been conducted and to determine their applicability in the community setting. Narrative review with limited electronic database search and cross reference searching of included studies was performed. Studies published after year 2001 were searched for using MEDLINE and CINAHL Plus databases with keywords. A total of 5144 search results were obtained, but only 42 frailty measurements were identified in 68 studies. For the type, three different measurements were indicated, namely, self-report instrument (n = 17), clinical observation assessment (n = 19), and mixed frailty assessment instrument (n = 6). Only 12 (29%) measurements examined reliability and validity. Nevertheless, over 35% did not perform any psychometric testing before applying. For diagnosis accuracies, 35 (83%) frailty measurements reported the cut-off value(s) for determining level of the frailty. However, the sensitivity (56%-89.5%) and specificity (52%-91.3%) varied. The applicability was also diverse and some frailty instruments should be only used in some specific population and mode of administration. This review provides an overview of three major types of frailty measurements used in different settings with different purposes. For estimating the prevalence of frailty of older people in a community, the self-report type may be appropriate. The psychometric properties of many reviewed instruments are reported insufficiently. The cut-off value(s) are usually suggested with diverse sensitivity and specificity. Self-report instruments, such as Groningen Frailty Indicator (GFI) and Tilburg Frailty Indicator (TFI), are the most extensively examined in terms of satisfactory psychometric properties. Thus, GFI and TFI, with the current evidence, are recommended to be used in the community setting for frailty screening tools.
Jun Dai, Frank Liu, Deni Irwanto, Manoj Kumar, Nabaraj Tiwari, Jack Chen, Yinghua Xu, Matthew Smith,
Published: 5 September 2021
AGING MEDICINE, Volume 4, pp 169-174; https://doi.org/10.1002/agm2.12176

Abstract:
Introduction Residential aged care facility (RACF) residents frequently present to the emergency department (ED) and are often admitted to hospital. Some presentations and admissions may be avoidable. In 2013, Bankstown-Lidcombe Hospital introduced a subacute geriatric outreach service (SGOS), which had little impact on reducing ED presentations. In 2015, Bankstown-Lidcombe Hospital introduced an acute geriatric outreach service (AGOS), a geriatrician-led team that assesses and treats acutely unwell patients in RACFs. We aim to determine whether the AGOS reduces the risk of hospital admission for RACF residents. Methods Hospital admissions data from 2010 to 2019 were used to conduct an interrupted time series (ITS) analysis. AGOS activity data were also summarized. Results The average number of admissions from RACF per month declined from 42.8 during the SGOS period to 27.1 during the AGOS period. The difference of 15.7 admissions from RACF per month was statistically significant (95% CI 12.1–19.2; P < .001). After the introduction of the AGOS, the risk of admission to our geriatric department from RACFs was reduced by 36.1% (incidence rate ratio =0.64; 95% CI: 0.58–0.71; P < .001) compared to the SGOS period, adjusting for seasonality. Discussion The AGOS probably reduced the risk of hospital admission for RACF residents.
Dongni Yu, Mingyue Cheng, Lixin Guo, Wenli Liu, Ye Liu, Kang Ning, Yigang Tong, Xuejiao Yan, Lei Qiu,
Published: 31 August 2021
AGING MEDICINE, Volume 4, pp 162-168; https://doi.org/10.1002/agm2.12174

Abstract:
Objective Observe the influence of oral nutritional agents rich in soluble dietary (enteral nutritional suspension [TPF-DM]) on intestinal flora of elderly male subjects with malnutrition. Method Seventy-eight subjects with good nutrition were considered as the healthy control group. Twenty-eight male subjects who had malnutrition and were older than 70 years were included and randomly divided into the short-term (3 months) intervention group (n = 20) and the long-term (12 months) group (n = 8). They were provided with enteral nutritional suspension (TPF-DM) 500 mL/day or maximum tolerance dose, so as to observe the changes in nutrition-related indexes and intestinal flora after the elderly take enteral nutritional suspension (TPF-DM). Results (1) For elderly male subjects with malnutrition, their body weight, body mass index, hemoglobin, total protein, and albumin were significantly lower than the control group with favorable nutrition. (2) There were obvious differences in intestinal flora between healthy elderly male subjects and those with malnutrition. After the treatment of enteral nutritional suspension (TPF-DM), intestinal flora of the malnourished elderly subjects showed recovery toward the healthy elderly subjects. The obvious gradient changes of the flora were mainly in the bacteroidetes, firmicutes, and proteobacteria phyla, and the relative abundance of CAG2 clusters in the malnourished group was higher than that in the healthy control group, and the relative abundance decreased after long-term treatment, and the change approached the healthy control group. The relative abundance of CAG3 and CAG6 clusters in the malnourished group was lower than that in the healthy control group, and the relative abundance increased after long-term treatment, and the change approached the healthy control group. Conclusion Malnutrition has obvious impact on intestinal flora of the elderly. Enteral nutritional suspension (TPF-DM) not only prevents the further decline in the state of nutrition but also helps the recovery in intestinal flora of the elderly. Long-term application can produce better effects.
, Sarah C. Cameron, Lit Min Sam, Hugh Eigeland, Karen Hay, Eamonn Eeles, Kannan Natarajan
Published: 27 August 2021
AGING MEDICINE, Volume 4, pp 193-200; https://doi.org/10.1002/agm2.12175

Abstract:
Background Persons with dementia commonly experience a range of behavioural and psychological symptoms, including agitation, aggression, perceptual disturbances, and depression. While psychotropic medications are regularly prescribed to mitigate these symptoms, these agents also carry a broad adverse effect profile. This study aimed to characterize psychotropic medication use in patients with dementia, as well as identify prescribing factors associated with falls in this cohort. Methods This retrospective study collected longitudinal demographic and medication data from all patients admitted to a neuro-cognitive unit at an Australian metropolitan hospital over a 2-year period. Psychotropic polypharmacy and psychotropic agent use per patient-fortnight were investigated for their association with inpatient falls. Results All patients (n = 147) were prescribed at least one psychotropic medication, with 96% receiving anti-psychotic medications and 90% receiving benzodiazepines. Patient fall rate was significantly associated with anticholinergic drug use (Incidence rate ratio: 2.2; P < .001), as well as concomitant use of ≥5 daily psychotropic agents (Incidence rate ratio: 3.1; P = .001). Conclusions Patients with dementia are routinely prescribed a wide variety of psychotropic medications. Use of anticholinergic drugs and psychotropic polypharmacy are correlated with fall incidence in persons with dementia.
, Nezaket Eren, Asuman Orcun, Fatma Münevver Gokyigit, Fatma Turgay, Lale Gündogdu Celebi
Published: 22 August 2021
Abstract:
Objective We aimed to evaluate apelin-13 levels, total oxidant/antioxidant status in Alzheimer’s disease (AD) and to investigate the relationship between these parameters. Methods Patients newly diagnosed with AD were enrolled in the study. The control group consisted of age- and gender-matched healthy individuals. Serum levels of apelin-13, total antioxidant status (TAS), and total oxidant status (TOS) were measured. Oxidative stress index was calculated (TOS/TAS) for each participant. Results We reported that serum apelin-13 and TAS values were significantly lower in the AD group compared with controls, and they found a fair but insignificant relationship between Apelin-13 and TAS values. Conclusion According to our results, we suggested that insufficient apelin-13 and TAS levels may contribute to the pathogenesis of AD.
, Anand Shah, Foad Y. Mohamed, Raza Hassan
Published: 17 August 2021
Abstract:
Objective The purpose of our study was to analyze the effect of postoperative hemoglobin check on the day of surgery and 1 day postoperatively in elderly hip fracture patients with an aim to determine an optimum timing of postoperative hemoglobin check. Material and methods A retrospective study of 253 patients. Age, Charlson morbidity index, fracture type, time from admission to surgery, type of surgery, preoperative hemoglobin, postoperative hemoglobin, hemoglobin drop, day of postoperative hemoglobin measurement, blood transfusion, length of hospital stay, and 30-day mortality were recorded. Results One hundred and sixty-three patients (Group I) had postoperative hemoglobin check on the first postoperative day and 90 patients (Group II) on the day of surgery. Mean age in Group I was 82 years and 80 years in Group II. Mean Charlson morbidity index for Group I was 5.9 and Group II was 5.7. There was a significantly higher hemoglobin drop in Group I (P < .05) but no difference in blood transfusion requirement, length of stay, or 30-day mortality in the two groups (P > .05). Conclusion Our results suggest that postoperative hemoglobin measurement on the day of surgery is not a true reflection of hemoglobin drop and recommend estimation of hemoglobin on the first postoperative day.
, Liu Zhijie, Chen Wei
Published: 9 August 2021
AGING MEDICINE, Volume 4, pp 221-233; https://doi.org/10.1002/agm2.12168

Abstract:
Sarcopenia is a comprehensive degenerative disease with the progressive loss of skeletal muscle mass with age, accompanied by the loss of muscle strength and muscle dysfunction. As a new type of senile syndrome, sarcopenia seriously threatens the health of the elderly. The first-line treatment for sarcopenia is exercise and nutritional supplements. However, pharmacotherapy will provide more reliable and sustainable interventions in geriatric medicine. Clinical trials of new drugs targeting multiple molecules are ongoing. This article focuses on the latest progress in pharmacotherapeutic approaches of sarcopenia in recent years by comprehensively reviewing the clinical outcomes of the existing and emerging pharmacotherapies as well as the molecular mechanisms underlying their therapeutic benefits and side effects.
, Magdy Mahmoud Elnashar,
Published: 4 August 2021
AGING MEDICINE, Volume 4, pp 214-220; https://doi.org/10.1002/agm2.12170

Abstract:
Nicotinamide adenine dinucleotide (NAD) is a coenzyme found in every human cell and regulates a number of systems across multiple cellular compartments and tissue types via an endogenous and exogenous influence. NAD levels are demonstrated to decline with age and therefore measures to counteract the waning of NAD have been devised. A number of NAD precursor candidates such as nicotinamide riboside (NR), nicotinamide mononucleotide (NMN), the reduced form of nicotinamide mononucleotide (NMNH), nicotinic acid (NA) nicotinamide (NAM), and dihydronicotinamide riboside (DNR) increase NAD levels in vitro and in vivo. This discussion will focus on the precursors NR, NMN, NMNH, and DNR in the upregulation of NAD. There are many publications on NAD precursors as it has become popular for human consumption in recent years due to its vital importance to the general consumer. However, there is no consensus between researchers and this was the aim of this review, to determine and discuss their areas of agreement versus disagreement, to highlight the gaps in research, and to give recommendations for future work. Bioavailability and potency of NR, NMNH, NMN, and DNR is also examined on the light of the most recent literature.
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