1
|
Fagard K, Deschodt M, Geyskens L, Willems S, Boland B, Wolthuis A, Flamaing J. Geriatric care for surgical patients: results and reflections from a cross-sectional survey in acute Belgian hospitals. Eur Geriatr Med 2023; 14:239-249. [PMID: 36690884 PMCID: PMC9870777 DOI: 10.1007/s41999-023-00748-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE To explore geriatric care for surgical patients in Belgian hospitals and geriatricians' reflections on current practice. METHODS A web-based survey was developed based on literature review and local expertise, and was pretested with 4 participants. In June 2021, the 27-question survey was sent to 91 heads of geriatrics departments. Descriptive statistics and thematic analysis were performed. RESULTS Fifty-four surveys were completed, corresponding to a response rate of 59%. Preoperative geriatric risk screening is performed in 25 hospitals and systematically followed by geriatric assessment in 17 hospitals. During the perioperative hospitalisation, 91% of geriatric teams provide non-medical and 82% provide medical advice. To a lesser extent, they provide geriatric protocols, geriatric education and training, and attend multidisciplinary team meetings. Overall, time allocation of geriatric teams goes mainly to postoperative evaluations and interventions, rather than to preoperative assessment and care planning. Most surgical patients are hospitalised on surgical wards, with reactive (73%) or proactive (46%) geriatric consultation. In 36 hospitals, surgical patients are also admitted on geriatric wards, predominantly orthopaedic/trauma, abdominal and vascular surgery. Ninety-eight per cent of geriatricians feel that more geriatric input for surgical patients is needed. The most common reported barriers to further implement geriatric-surgical services are shortage of geriatricians and geriatric nurses, and unadjusted legislation and financing. CONCLUSION Geriatric care for surgical patients in Belgian hospitals is mainly reactive, although geriatricians favour more proactive services. The main opportunities and challenges for improvement are to resolve staff shortages in the geriatric work field and to update legislation and financing.
Collapse
Affiliation(s)
- Katleen Fagard
- Department of Geriatric Medicine, University Hospitals Leuven, Dienst Geriatrie UZ Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium.
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Mieke Deschodt
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Competence Centre of Nursing, University Hospitals Leuven, Leuven, Belgium
| | - Lisa Geyskens
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Sarah Willems
- Department of Geriatric Medicine, University Hospitals Leuven, Dienst Geriatrie UZ Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium
| | - Benoît Boland
- Department of Geriatric Medicine, University Hospital Saint-Luc, Brussels, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, Dienst Geriatrie UZ Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| |
Collapse
|
2
|
Furukawa K, Miyazawa I, Kaneko E, Ishiki A, Arai H, Ishikawa T, Ohnishi J, Kuzuya M. [Undergraduate geriatric education in foreign countries]. Nihon Ronen Igakkai Zasshi 2021; 58:570-578. [PMID: 34880176 DOI: 10.3143/geriatrics.58.570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In Japan, which has become a super-aged society, medical care for the elderly is more important than ever before. Geriatric education for medical students and young doctors is essential to ensure the best medical care possible for the elderly. In this paper, the Working Group for Education of the Japan Geriatrics Society collected and analyzed data and information on undergraduate education in the fields of geriatrics and gerontology at medical schools in various countries through the Internet, comparing the findings with those in Japan. Of the countries surveyed, 62% had undergraduate education in geriatrics and gerontology as mandatory subjects in medical school. Countries with advanced welfare programs, such as the United Kingdom, Germany, Austria, Denmark, Finland, Sweden, the Netherlands, Spain, Canada and New Zealand, performed substantial undergraduate education in geriatrics and gerontology. A lack of available staff and time for education was cited as a hurdle in many countries. The importance of education in geriatrics and gerontology is being emphasized in many countries, but few programs are satisfactory at present. The "struggle" to improve undergraduate education in geriatrics and gerontology therefore continues. We should endeavor to improve education in the fields of geriatrics and gerontology by working hand in hand with geriatricians and gerontologists around the world.
Collapse
Affiliation(s)
- Katsutoshi Furukawa
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Isabelle Miyazawa
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Eiji Kaneko
- Curricular Management Division, Institute of Education, Tokyo Medical and Dental University
| | - Aiko Ishiki
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
| | - Hiroyuki Arai
- Department of New Therapeutics Innovation for Alzheimer's and Dementia, Division of Brain Science, IDAC
| | - Takahiro Ishikawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Joji Ohnishi
- Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine
| | - Masafumi Kuzuya
- Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine
- Institutes of Innovation for Future Society, Nagoya University
| |
Collapse
|
3
|
Prud’homm J, Corvol A, Aguillon A, Olivieri M, Rousseau V, Somme D. Why choose geriatric medicine? A national survey among French postgraduate medical students. Age Ageing 2020; 49:1028-1033. [PMID: 32603405 DOI: 10.1093/ageing/afaa120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Indexed: 11/12/2022] Open
Abstract
Since 2017, geriatric medicine has been available as a postgraduate specialty to French year 7 medical students. We investigated the incentives of the 171 French medical students who opted for geriatric medicine as a postgraduate specialty subsequent to year 6 national qualifying examinations in 2017. A prospective quantitative survey-based study was conducted by means of a questionnaire compiled online and sent by email between December 2017 and May 2018. The questionnaire comprised 43 questions, including 14 single or multiple choice questions, 28 scaled questions evaluating factors of influence using a 5-point Likert scale, and one open-ended contingency question. Of the 171 students, 139 responses were received. The national response rate to this questionnaire was 81.2%. One hundred fourteen students (82.6%) had previous experience of training in geriatric medicine, which for 95 (84.0%) students took place between years 3 and 6 of medical training. This training influenced the choice of 102 respondents (90.2%). Factors reported as having exerted a strong or very strong influence were in particular the rewards of working with older adults; positive personal encounters with older adults in the past; the appeal of interprofessional teamwork; the challenge of cases involving complex diagnostic and therapeutic decisions; the challenge of patients with chronic conditions. The present study is the first to focus on the reasons why French students choose to specialise in geriatric medicine. The results emphasise the importance of training programs in geriatric medicine to promote enthusiasm for this specialty.
Collapse
Affiliation(s)
- Joaquim Prud’homm
- CHU de Rennes, Rennes, France
- Université Rennes 1, Faculté de Médecine, Rennes, France
| | - Aline Corvol
- CHU de Rennes, Rennes, France
- Université Rennes 1, Faculté de Médecine, Rennes, France
- Arènes, UMR 6051, Rennes, France
| | | | | | | | - Dominique Somme
- CHU de Rennes, Rennes, France
- Université Rennes 1, Faculté de Médecine, Rennes, France
- Arènes, UMR 6051, Rennes, France
| |
Collapse
|
4
|
Oksuzyan A, Höhn A, Krabbe Pedersen J, Rau R, Lindahl-Jacobsen R, Christensen K. Preparing for the future: The changing demographic composition of hospital patients in Denmark between 2013 and 2050. PLoS One 2020; 15:e0238912. [PMID: 32997671 PMCID: PMC7526879 DOI: 10.1371/journal.pone.0238912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 08/26/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Population aging will pose huge challenges for healthcare systems and will require a promotion of positive attitudes towards older people and the encouragement of careers in geriatrics to attract young professionals into the field and to meet the needs of a rapidly growing number of old-aged patients. We describe the current demographic profile of hospital care use in Denmark and make projections for changes in the patient profile up to 2050. METHODS The Danish population in 2013 (N = 5.63 million) was followed up for inpatient and emergency admissions recorded in Danish hospitals in 2013 using population-based registers. We combined age- and sex-specific hospital care use in 2013 with official population estimates to forecast the profile of hospital days up to 2050 with respect to age and sex. RESULTS The total number of hospital days per year is projected to increase by 42% between 2013 and 2050, from 4.66 to 6.72 million days. While small changes are projected for the population aged 0-69, the largest change is projected to occur for the population aged 70+. The 2013 levels were 0.82 and 0.93 million days for men and women aged 70+, respectively. By 2050, these levels are projected to have reached 1.94 and 1.84 million days. While the population aged 70+ accounted for 37.5% of all days in 2013, its contribution is projected to increase to 56.2% by 2050. CONCLUSION Our study shows one possible scenario for changes in the hospital days due to population aging by 2050: Assuming no changes in hospital care use over the forecast period, the absolute contribution of individuals aged 70+ to the total hospital days will more than double, and the relative contribution of persons aged 70+ will account for nearly 60% of all hospital days by 2050, being largest among men.
Collapse
Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Andreas Höhn
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Jacob Krabbe Pedersen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Roland Rau
- Max Planck Institute for Demographic Research, Rostock, Germany
- Department of Demography, University of Rostock, Rostock, Germany
| | - Rune Lindahl-Jacobsen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
- Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
5
|
Huenefeld D, Rodde S, Bureick G, Elkeles B, Hasebrook J. Improving Treatment of Elderly Patients by Interprofessional Education in a Quality Network of Geriatric Medicine: Protocol for Evaluating an Educational Initiative. JMIR Res Protoc 2019; 8:e11067. [PMID: 31066716 PMCID: PMC6524453 DOI: 10.2196/11067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/28/2018] [Accepted: 03/24/2019] [Indexed: 01/17/2023] Open
Abstract
Background All statistics on the development of demand for care for multimorbid elderly patients highlight the acute pressure to act to adequately respond to the expected increase in geriatric patient population in the next 15 years. Against this background, great importance must be attached to the improvement of cross-occupational group and cross-sector treatment of these patients. In addition, many professionals in the health care sector often have little knowledge about the special treatment and care needs of the elderly. Objective The Quality Network of Geriatric Medicine in north-west Germany is the body responsible for the project; with its member organizations, it provides care for over 400,000 inpatients and is thus one of the largest associations for geriatrics in Germany. The Quality Network conducts binding evaluated qualification measures for staff involved in the treatment and care of multimorbid elderly patients. The training offers are especially intended for staff who have not yet been trained in working with elderly patients. This approach is intended to improve the expertise of various occupational groups on different hierarchy levels, to include patients and their family members in the evaluation process, and to initiate changes within the organizations. Methods Various instruments are used in the evaluation of qualification measures: besides written surveys and questionnaires, structured work groups (consensus groups) and interviews are conducted. The evaluation starts before the qualification measures to determine the starting point and then continues during the measure and after its completion. This allows major findings to be integrated directly into the ongoing qualification program. At least 100 trainings on geriatric topics, 80 consensus groups, and 120 patients (and family members) are going to be included in the study. Results The evaluation of the educational initiative is funded by the State of Northrhine-Westfalia (Germany; LZG TG 71 001 / 2015 and LZG TG 71 002 / 2015). The results of the study will be published after review and approval by the state authorities – presumably by the end of 2019. The before and after comparison of the treatment-related outcomes at the beginning and near the completion of the educational initiative gives insights into how transfer-oriented education can improve the treatment of elderly patients across sector lines for inpatients as well as outpatients. The evaluation of the implementation of educational content in day-to-day work and occupational groups is to facilitate recommendations about economically sensible use of educational resources and about further adjustments to the training content. Conclusions The evaluation develops the foundation for targeted and needs-oriented qualification measures as well as transfer in cross-sector, multiprofessional networks. Instruments and results will be published and provided to other health care networks and institutions. The Quality Network will implement the results of the evaluation process in its member institutions. International Registered Report Identifier (IRRID) DERR1-10.2196/11067
Collapse
Affiliation(s)
- Daisy Huenefeld
- Board of the Foundation, St Franziskus Foundation, Muenster, Germany
| | - Sibyll Rodde
- zeb.healthcare, zeb.rolfes.schierenbeck.associates, Muenster, Germany
| | | | | | | |
Collapse
|
6
|
Calvo-Lobo C, Pacheco-da-Costa S, Hita-Herranz E. Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized, Controlled Clinical Trial Pilot Study. J Geriatr Phys Ther 2018; 40:63-73. [PMID: 25794307 PMCID: PMC5367514 DOI: 10.1519/jpt.0000000000000048] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background: Nonspecific shoulder pain has a high prevalence in older adults and causes functional alterations. Furthermore, there are difficulties in establishing a clinical diagnosis, effective treatments are lacking, and little evidence has been found regarding the use of invasive physical therapy techniques in this age group. Purpose: To determine the efficacy of a single physical therapy intervention with deep dry needling (DDN) on latent and active myofascial trigger points (MTrPs) in older adults with nonspecific shoulder pain. Methods: This pilot study is a single-blind, randomized, controlled clinical trial that included 20 participants, aged 65 years and older, who were diagnosed with nonspecific shoulder pain. The study was approved by the Clinical Research Ethics Committee of the area. Participants were recruited at their homes or at a care center and were randomly assigned into either an experimental group (n = 10), which received a session of DDN on 1 active and 1 latent MTrP of the infraspinatus muscle, or a control group (n = 10), which received a session of DDN on only 1 active MTrP. A blind examiner assessed the pain intensity, pain pressure threshold on the anterior deltoid, and extensor carpi radialis brevis muscles and grip strength before, immediately after, and 1 week after the intervention. Results: Statistically significant differences (P < .05) in the pressure pain thresholds (PPTs) of the extensor carpi radialis brevis were found in the experimental group in both posttreatment assessments. Moreover, the effect size values (d Cohen) varied from small for grip strength (0.017-0.36) to moderate for the pain intensity (0.46-0.78) and PPT in the anterior deltoid (0.49-0.66) and to large for the PPT in the extensor carpi radialis brevis (1.06-1.58). Conclusions: A single physical therapy intervention with DDN on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle may increase the PPT of the extensor carpi radialis brevis muscle area immediately following and 1 week after the intervention in older adults with nonspecific shoulder pain.
Collapse
Affiliation(s)
- César Calvo-Lobo
- 1Physiotherapy Department, Faculty of Health, Exercise and Sport, European University of Madrid, Villaviciosa de Odón, Madrid, Spain. 2Nursing and Physiotherapy Department, Physiotherapy Teaching Unit, University of Alcalá, Alcalá de Henares, Madrid, Spain. 3Nursing and Physiotherapy Department, Nursing Teaching Unit, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | | | | |
Collapse
|
7
|
Erstaunlich aktuell: „Geriatrie 1965 vorgedacht“. Z Gerontol Geriatr 2018. [DOI: 10.1007/s00391-018-1389-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
8
|
Pitkälä KH, Martin FC, Maggi S, Jyväkorpi SK, Strandberg TE. Status of Geriatrics in 22 Countries. J Nutr Health Aging 2018; 22:627-631. [PMID: 29717764 DOI: 10.1007/s12603-018-1023-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of this article is to describe the current status of geriatrics and position of geriatricians in 22 countries of three continents, and to portray their attitudes towards and resources allocated to geriatrics. METHODS An electronic survey was delivered to a convenience sample of 22 geriatricians in leading positions of their countries. RESULTS The time required in post graduation specialist training to become a geriatrician varied from one year (subspecialty in the USA) to six years (independent specialty in Belgium). The number in the population aged 80+ per geriatrician varied from 450 (Austria) to 25,000 (Turkey). Of respondents, 55% reported that geriatrics is not a popular specialty in their country. Acute geriatric wards, rehabilitation and outpatient clinics were the most common working places for geriatricians. Nearly half of the respondents had an opinion that older patients who were acutely ill, were receiving subacute rehabilitation or had dementia should be cared for by geriatricians whereas half of the respondents would place geriatricians also in charge of nursing home and orthogeriatric patients. The biggest problems affecting older people's clinical care in their countries were: lack of geriatric knowledge, lack of geriatricians, and attitudes towards older people. Half of respondents thought that older people's health promotion and comprehensive geriatric assessment were not well implemented in their countries, although a majority felt that they could promote good geriatric care in their present position as a geriatrician. CONCLUSION The position of geriatric, geriatricians' training and contents of work has wide international variety.
Collapse
Affiliation(s)
- K H Pitkälä
- Kaisu Pitkälä, Faculty of Medicine, Department of General Practice and Primary Health Care, PO BOX 20, 00014 University of Helsinki, Finland,
| | | | | | | | | |
Collapse
|
9
|
New horizons in geriatric medicine education and training: The need for pan-European education and training standards. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.07.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
10
|
Abstract
This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence. This certainly includes the increasing acquisition of decentralized joint treatment concepts and geriatric counselling services in the future, in addition to the classical assessment instruments. Keywords in association with this are: traumatology and othopedics of the elderly, geriatric neurology and geriatric oncology. Interdisciplinary geriatric expertise is increasingly being requested. Outpatient structures have so far not been prioritized in geriatrics. An independent research is under construction and it is gratifying that academic interest in geriatrics seems to be increasing and new professorial chairs have been established. It is not possible to imagine our hospital without geriatrics; however, there is still a certain imbalance between the clearly increased number of geriatric hospital beds, the representation of geriatrics in large hospitals (e.g. specialized and maximum care hospitals and university clinics), the secure establishment in further education regulations and the lack of a uniform nationwide concept of geriatrics.
Collapse
Affiliation(s)
- G F Kolb
- Abteilung für Innere Medizin, Fachbereich Geriatrie, Bonifatius Hospital Lingen, Medizinische Klinik, Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Universität Münster, Wilhelmstr. 13, 49808, Lingen (Ems), Deutschland.
| |
Collapse
|
11
|
Fisher JM, Garside MJ, Brock P, Gibson V, Hunt K, Briggs S, Gordon AL. Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine. Age Ageing 2017; 46:672-677. [PMID: 28164214 DOI: 10.1093/ageing/afx009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Indexed: 11/13/2022] Open
Abstract
Background there is concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field-in the decade since, UK postgraduate training has undergone a fundamental restructure. Objective to explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. Design an online survey was sent to all UK higher medical trainees in geriatric medicine. Methods survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. Results two hundred and sixty-nine responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. Conclusions there are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take.
Collapse
Affiliation(s)
- James Michael Fisher
- Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Mark J Garside
- Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Peter Brock
- Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Vicky Gibson
- Department of Geriatric Medicine, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Kelly Hunt
- Department of Medicine, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sally Briggs
- University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Adam Lee Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
- School of Health Sciences, City University, London, UK
| |
Collapse
|
12
|
European Interdisciplinary Council on Ageing (EICA): Coping better with ageing challenges in Europe. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
13
|
Romero Morales C, Calvo Lobo C, Rodríguez Sanz D, Sanz Corbalán I, Ruiz Ruiz B, López López D. The concurrent validity and reliability of the Leg Motion system for measuring ankle dorsiflexion range of motion in older adults. PeerJ 2017; 5:e2820. [PMID: 28070457 PMCID: PMC5214953 DOI: 10.7717/peerj.2820] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/22/2016] [Indexed: 12/13/2022] Open
Abstract
Background New reliable devices for range of motion (ROM) measures in older adults are necessary to improve knowledge about the functional capability in this population. Dorsiflexion ROM limitation is associated with ankle injuries, foot pain, lower limb disorders, loss of balance, gait control disorders and fall risk in older adults. The aim of the present study was to assess the validity and reliability of the Leg Motion device for measuring ankle dorsiflexion ROM in older adults. Methods Adescriptive repeated-measures study was designed to test the reliability of Leg Motion in thirty-three healthy elderly patients older than 65 years. The subjects had to meet the following inclusion and exclusion criteria in their medical records: older than 65 years; no lower extremity injury for at least one year prior to evaluation (meniscopathy, or fractures) and any chronic injuries (e.g., osteoarthritis); no previous hip, knee or ankle surgery; no neuropathic alterations and no cognitive conditions (e.g., Alzheimer’s disease or dementia). Participants were recruited through the person responsible for the physiotherapist area from a nursing center. The subjects were evaluated in two different sessions at the same time of day, and there was a break of two weeks between sessions. To test the validity of the Leg Motion system, the participants were measured in a weight-bearing lunge position using a classic goniometer with 1° increments, a smartphone with an inclinometer standard app (iPhone 5S®) with 1° increments and a measuring tape that could measure 0.1 cm. All testing was performed while the patients were barefoot. The researcher had ten years of experience as a physiotherapist using goniometer, tape measure and inclinometer devices. Results Mean values and standard deviations were as follows: Leg Motion (right 5.15 ± 3.08; left 5.19 ± 2.98), tape measure (right 5.12 ± 3.08; left 5.12 ± 2.80), goniometer (right 45.87° ± 4.98; left 44.50° ± 5.54) and inclinometer app (right 46.53° ± 4.79; left 45.27° ± 5.19). The paired t-test showed no significant differences between the limbs or between the test and re-test values. The test re-test reliability results for Leg Motion were as follows: the standard error of the measurement ranged from 0.29 to 0.43 cm, the minimal detectable difference ranged from 0.79 to 1.19 cm, and the intraclass correlation coefficients (ICC) values ranged from 0.97 to 0.98. Conclusions The results of the present study indicated that the Leg Motion device is a valid, reliable, accessible and portable tool as an alternative to the classic weight-bearing lunge test for measuring ankle dorsiflexion ROM in older adults.
Collapse
Affiliation(s)
- Carlos Romero Morales
- Physical Therapy & Health Science Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - César Calvo Lobo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La, Universidad Autónoma de Madrid, MadridEspaña
| | - David Rodríguez Sanz
- Physical Therapy & Health Science Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - Irene Sanz Corbalán
- School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, España
| | - Beatriz Ruiz Ruiz
- Physical Therapy & Health Science Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - Daniel López López
- Research, Health and Podiatry Unit, Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, A Coruña, Spain
| |
Collapse
|
14
|
Are even geriatric patients becoming older and older? : Changes in the age structure of geriatric inpatients in the course of two decades. Z Gerontol Geriatr 2016; 51:81-84. [PMID: 27986998 DOI: 10.1007/s00391-016-1162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/08/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The life expectancy of the German population has steadily risen in the course of the past decades. As especially the oldest members of the population are treated in geriatric clinics, it would be of interest to investigate whether the increase in population age can also be found among geriatric inpatients. PATIENTS AND METHODS The demographic data of inpatients of a geriatric clinic in Hannover in the years 1994, 2004 and 2014 were analyzed according to age, gender and classification as acute care or geriatric rehabilitation. RESULTS The mean patient age rose by 6 years in the past two decades. This was the case for both men and women but the age of men (+7.5 years) rose more than that of women (+4.9 years). Whereas the patient average age increased, especially in the first decade (+3.9 years), this increase slowed down in the following decade (+1.7 years). The 80 to 89-year-old patients remained the biggest and steadily increasing group (in 1994: 41.1%, 2004: 46.9% and 2014: 51.3%). The greatest increase, however, was found for those aged 90 years and older (1994: 4.8%, 2004: 12.2% and 2014: 17.7%). CONCLUSION The results confirm the professional experiences of many geriatricians in that they care for an increasingly aging clientele. Particularly very old male patients in geriatric clinics are increasing. All health professional groups involved will have to face this challenge.
Collapse
|
15
|
Kolb GF, Weißbach L. [Demographic change: Changes in society and medicine and developmental trends in geriatrics]. Urologe A 2016; 54:1701-9. [PMID: 26704273 DOI: 10.1007/s00120-015-4004-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increasing life expectancy means growing numbers of elderly survive the critical age for cardiac and vascular diseases only to later experience cancer and dementia. OBJECTIVES Of the types of cancer affecting men, prostate cancer continues to be diagnosed early by prostate-specific antigen (PSA) screening. The clinical relevance and quality of life of those affected must be critically judged. Depending on life expectancy, active surveillance (AS) and watchful waiting (WW) will be increasingly used in geriatric patients. Risk stratification as guided by CGA facilitates the therapeutic decisions of urologists and spares metastatic castration-resistant prostate cancer patients from unnecessary and adverse overtreatment. By 2030, approximately 1.8 million people will have dementia. CONCLUSIONS Thus, in the future, the health care system will have to treat an aging population, which will require the creation of increasing numbers of geriatric hospital departments and cooperative models between geriatrics and other specialties. The future training of medical students and continuing medical education must also be further developed to include aspects on aging. Only in this manner will it be possible to effectively confront the challenges associated with demographic change in the specialty of geriatrics.
Collapse
Affiliation(s)
- G F Kolb
- Medizinische Klinik, Abteilung für Innere Medizin, Fachbereich Geriatrie, Geriatrische Onkologie, Bonifatius-Hospital Lingen, Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Universität Münster, Wilhelmstraße 13, 49808, Lingen (Ems), Deutschland.
| | - L Weißbach
- Stiftung Männergesundheit, Berlin, Deutschland.
| |
Collapse
|
16
|
Michel JP, Cha HB. Filling the Geriatric Education Gap Around the World. J Am Med Dir Assoc 2015; 16:1010-3. [DOI: 10.1016/j.jamda.2015.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 12/13/2022]
|
17
|
Löppönen M, Heinonen P, Jartti L, Halminen M, Rajala T, Viitanen M, Pitkälä K, Strandberg T. Geriatricians feel growing external appreciation of their work. Survey among Finnish geriatricians in 2013. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2015.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
18
|
Püllen R, Dovjak P, Kolb GF. Journal Club. Z Gerontol Geriatr 2013. [DOI: 10.1007/s00391-013-0517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
19
|
[Geriatric medicine. Current status and perspectives for the future]. Hautarzt 2012. [PMID: 23183779 DOI: 10.1007/s00105-012-2463-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Geriatric medicine is one of the most rapidly growing medical subspecialties as a response to demographic changes seen in all western societies. One of the main problems of all aging populations is the increase in incidence and severity of comorbidities. Three epidemiological types of (co)morbidities can be identified: (1) Cardiac and vascular diseases including risk factors like diabetes mellitus, (2) malignancies of the elderly and (3) cognitive impairments defined as dementia. These epidemiologic-medical classes need different strategies. The first morbidity type is addressed by preventive medicine and modern therapy with great successes in recent years. In contrast, malignant diseases are continuously increasing in the elderly cohort, but a variety of new therapeutic measure shave turned some previously fatal disorders into chronic ones. In contrast, neither preventive nor therapeutic measures are available for dementia. Our response is better care and support, which demands specialized human resources that are becoming scarce. Better training of more individuals to care for elderly is a great challenge for our society.
Collapse
|
20
|
Ekdahl A, Fiorini A, Maggi S, Pils K, Michel JP, Kolb G. Geriatric care in Europe – the EUGMS Survey Part II: Malta, Sweden and Austria. Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|