ISSN / EISSN : 2475-0360 / 2475-0360
Current Publisher: Wiley (10.1002)Former Publisher:
Total articles ≅ 142
Latest articles in this journal
AGING MEDICINE; doi:10.1002/agm2.12151
Vascular senescence is one of the hotspots in current research. With global average life expectancy increasing, delaying or reducing aging and age-related diseases has become a pressing issue for improving quality of life. Vascular senescence is an independent risk factor for age-related cardiovascular diseases (CVD) and results in the deterioration of CVD. Nevertheless, the underlying mechanisms of the vascular senescence have not been expressly illustrated. In this review, we attempt to summarize the recent literature in the field and discuss the major mechanisms involved in vascular senescence. We also underline key molecular aspects of aging-associated vascular dysfunction in the attempt to highlight potential innovative therapeutic targets to delay the onset of age-related diseases.
AGING MEDICINE; doi:10.1002/agm2.12153
Objectives This study aimed to evaluate the validity and reliability of the Persian version of Health of the Nation Outcome Scales for Elderly People (HoNOS65+) in Iran's elderly population. Methods The scale English version translated to Persian using a forward and backward translation method. The scale was filled for two elderly population groups (inpatient and outpatients) (N = 300). Simultaneously with HoNOS+65, the Clinical Global Impressions Scale (CGI) was completed. Two separate therapists were filled HoNOS+65 for thirty‐one patients (inter‐rater reliability test). In general, content validity, consistency, confirmatory factor analyses (CFA), convergent validity, and criterion validity were examined. Results Using exploratory factor analysis, three factors were extracted. Inter‐rater reliability in some items has a slight agreement. Content validity ratio (0.75) and index (0.90) were calculated for each item. Cronbach's alpha total score was 0.82. According to the largest modification indices, CFA showed satisfactory fit indices. The convergent validity between HoNOS +65 and CGI was (r = 0/71, sig = 0.000). Finally, the optimal cut‐off point was achieved 13. Sensitivity and specificity for the HoNOS +65 were 88.89% and 81.16%, respectively, with the Youden index of 0.7005. Conclusion The Persian version of HoNOS65+ has high reliability, validity, specificity, and sensitivity in multidimensional assessment of Iranian geriatric mental health.
AGING MEDICINE; doi:10.1002/agm2.12150
Introduction Anemia in the older age (e.g., >60 years) is a major health problem in India and many parts of the world since it signifies an underlying disease and is associated with poor clinical outcome like increased morbidity and affects health‐related quality of life. Since symptoms like fatigue or shortness of breath related to anemia could also be attributed to the aging process, anemia is often easily overlooked in the elderly. Aims and objectives Clinico‐hematological patterns and morphological types of anemia in older age (e.g. >60 years) are manifold, hence this study was undertaken to determine them and to know more about associated disorders. Materials and methodology The present study was conducted on a sample size of 1257 patients who were 60 years and above and clinically diagnosed as anemic. Routine haematological investigations including peripheral blood smear examination and complete hemogram were done. Special investigations like bone‐marrow examination and iron studies were done whenever required. Results Males (aged >60 years) were more affected than females (aged >60 years) and patients in the age group of 60–69 years were affected the most. The most common presenting symptom was generalized weakness. The most common morphological type was normocytic normochromic anemia, and chronic diseases were the commonest etiological factors. Conclusion In spite of modern diagnostic advances, geriatric anemias still remain under‐reported and inadequately investigated, necessitating evaluation of even mild anemias. Prompt diagnosis and definite categorization helps in appropriate management of anemias.
AGING MEDICINE, Volume 4, pp 1-3; doi:10.1002/agm2.12116
AGING MEDICINE; doi:10.1002/agm2.12149
The global number of COVID‐19 infections, as of December 23, 2020, stood at approximately 79 million, with over 1.7 million deaths. The development of vascular inflammation may also contribute to a hypercoagulable state and endothelial dysfunction in such patients. It is known that multi‐organ damage is more likely in patients with sepsis if they develop coagulopathy and that inhibition of thrombin synthesis can have a positive impact in reducing mortality. In this review, we will focus on the protection of the most fragile groups of the population, such as the elderly. This segment of the population will be a key issue and probably of primary interest to all. Biomarkers appear to be extremely useful as an indicator of what is happening from a pathophysiological point of view in the heart, allowing us to better stratify the prognosis of our patients affected by COVID‐19, especially in the most severe cases and those with comorbidities.
AGING MEDICINE; doi:10.1002/agm2.12143
Background Malnutrition is an under recognized, but common issue in elderly patients. This study aimed to investigate the prevalence of poor nutritional status and identify comprehensive geriatric assessment‐based clinical factors associated with increased malnutrition risk to assessing malnutrition risk in hospitalized elderly patients in China. Methods A total of 365 elderly hospitalized patients (178 women, 76.37 ± 7.74 years) undertook a comprehensive geriatric assessment (CGA), and have their nutritional status assessed using the short‐form mini‐nutritional assessment. Results Among 365 patients, 32 (8.77%) were malnourished and 112 (30.68%) were at risk of malnutrition. A logistic regression analysis showed that age (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.13‐2.23), alcohol consumption (OR, 2.04; 95% CI, 1.19‐3.48), presence or history of cancer or heart failure (OR, 3.48 and 2.86; 95% CI, 1.49‐8.13 and 1.12‐7.27), depression (OR, 2.86; 95% CI, 1.97‐4.17), body mass index (OR, 5.62; 95% CI, 3.62‐8.71), being dependent in activity of daily living (OR, 3.81; 95% CI, 2.61‐5.57), a lower score in instrumental activities of daily living (OR, 3.01; 95% CI, 2.09‐4.33), recent fall(s) (OR, 2.22; 95% CI, 1.37‐2.91), cognitive impairment (OR, 1.81; 95% CI, 1.30‐2.53), insomnia (OR, 1.49; 95% CI, 1.07‐2.06), hemoglobin and albumin level (OR, 1.72 and 2.86; 95% CI, 1.17‐2.50 and 1.53‐5.36) were independent correlates of malnutrition in older patients. Conclusion Our study demonstrated that age, alcohol consumption, chronic diseases (cancer and heart failure), depression, body mass index, function status, recent fall(s), cognitive impairment, insomnia, and low hemoglobin and albumin levels were independently associated with malnutrition in these patients. Comprehensive geriatric assessment can provide detailed information of older patients and can be a useful tool for assessing malnutrition risk‐associated factors.
AGING MEDICINE, Volume 4, pp 61-65; doi:10.1002/agm2.12148
Amyloidosis, a disease with extracellular tissue deposition of fibrils, results in clinical manifestations based on deposition of these fibrils in multiple organ systems. Usual manifestations include nephrotic‐range proteinuria, cardiac failure, hepatosplenomegaly, and skin manifestations. Common neurological manifestations include peripheral and autonomic neuropathies. Cranial neuropathy has been seldom reported and is an unusual clinical feature of amyloidosis. Here, we report an older man who presented with cranial nerve palsies along with other clinical features, including heart failure, proteinuria, weight loss, anorexia and distal symmetric polyneuropathy and was diagnosed with immunoglobulin light‐chain (AL) amyloidosis.
AGING MEDICINE, Volume 4, pp 26-34; doi:10.1002/agm2.12146
Objective Insomnia is a common problem in older persons and is associated with poor prognosis from a functional or clinical perspective. The purpose of this study was to investigate the prevalence of insomnia and identify comprehensive geriatric assessment (CGA) based clinical factors associated with insomnia in elderly hospitalized patients. Methods Standardized face‐to‐face interviews were conducted and CGA data were collected from 356 Chinese hospitalized patients aged 60 years or older. Insomnia was defined as self‐reported sleep poor quality according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐Ⅴ). Multivariate logistic regression analysis was applied to assess the association between patient clinical factors together with domains within the CGA and insomnia. Results Among the 365 patients, insomnia was found in 48.31% of the participants. Difficulty in initiating sleep (DIS), early morning awakening (EMA), difficulty in maintaining sleep (DMS), and snoring were found in 33.99%, 9.55%, 13.48%, and 1.69% of patients, respectively. Significant associations were found between insomnia and several covariates: female gender (P = 0.034), depression (P = 0.001), activities of daily living (ADL) (P = 0.034), instrumental activities of daily living (IADL; P = 0.009), falling (P = 0.003), chronic pain (P = 0.001), and poor nutritional status (P = 0.038). According to the results of the adjustment multivariate logistic regression analysis, female sex (odds ratio [OR] = 2.057, confidence interval [CI] = 1.179‐3.588, P = 0.011), depression (OR = 1.889, CI = 1.080‐3.304, P = 0.026), and chronic pain (OR = 1.779, CI = 1.103‐2.868, P = 0.018) were significant independently predictors associated with insomnia. Conclusion Our study revealed that female sex, depression, and chronic pain were independently predictors of insomnia in hospitalized patients. Early identification of elderly patients with these risk factors using the CGA may improve the quality of life and treatment outcomes.
AGING MEDICINE, Volume 4, pp 42-46; doi:10.1002/agm2.12147
The efficacy and safety of immune checkpoint inhibitor (ICI) monotherapy in elderly patients with non‐small cell lung cancer (NSCLC) remain unclear, especially in patients older than 80 years. We retrospectively reviewed the records of 10 patients older than 80 years with NSCLCs treated by ICIs. The median age was 85 years (range, 82‐93 years), and 7 patients were men. The median length of follow‐up was 13 months (range, 4.5‐23 months). Eight patients had adenocarcinoma (3 of whom had exon 19 deletions), and two had squamous cell carcinoma. Expression of programmed cell death ligand 1 (PD‐L1) was ≥ 50% in 3 patients, between 1% and 49% in 4 patients, < 1% in 1 patient, and undetected in 2 patients. Patients with undetected PD‐L1 underwent transbronchial lung biopsy. Performance status was graded zero, one, and two in two, seven, and one patients, respectively. First‐, second‐, and third‐line treatments were administered to three, three, and four patients, respectively. The 2‐year overall survival rate was 30.0% (median, 285 days). Time to treatment failure rate on the 2 years was 10.0% (median, 167 days). One patient achieved a partial response, and one achieved a complete response. ICI‐associated adverse events occurred in five patients. In summary, ICIs were effective in some patients older than 80 years; however, some experienced adverse effects. Elderly patients must be selected carefully for ICI treatment.
AGING MEDICINE, Volume 4, pp 4-11; doi:10.1002/agm2.12144
Background Adopting a better understanding of how both older adults and health care providers view the community management of frailty is necessary for improving home health, especially facing the coronavirus disease 2019 (COVID‐19) pandemic. We conducted a qualitative focus group study to assess how both older adults and health care providers view frailty and virtual health care in home health. Methods Two focus groups enrolled home‐living older adults and health care professionals, respectively (n = 15). Questions targeting the use of virtual / telehealth technologies in‐home care for frail older adults were administered at audio‐recorded group interviews. Transcribed discussions were coded and analyzed using NVivo software. Results The older adult group emphasized the autonomy related to increasing frailty and social isolation and the need for transparent dissemination of health care planning. They were optimistic about remote technology‐based supports and suggested that telehealth / health‐monitoring/tracking were in high demand. Health care professionals emphasized the importance of a holistic biopsychosocial approach to frailty management. They highlighted the need for standardized early assessment and management of frailty. Conclusions The integrated perspectives provided an updated understanding of what older adults and practitioners value in home‐living supports. This knowledge is helpful to advancing virtual home care, providing better care for frail individuals with complex health care needs.