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Wu X, Freeman S, Miyagi M, Park U, Nomura K, Ebihara S. Comprehensive Geriatric Assessment in the era of telemedicine. Geriatr Gerontol Int 2024; 24 Suppl 1:67-73. [PMID: 37846612 DOI: 10.1111/ggi.14705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
The aging global population poses significant medical and social challenges, necessitating efforts to promote healthy aging. Comprehensive Geriatric Assessment (CGA) is a multidimensional diagnostic approach for older adults that aims to improve overall health. Remote CGA, facilitated by technological advancements, offers convenience and other potential advantages. It enables early disease detection, monitors chronic disease progression, delivers personalized care, and optimizes healthcare resources for better health outcomes in older individuals. However, remote CGA also has limitations, including technological requirements, data security, and the need for comprehensive evaluation and simplicity. Collaborative efforts are essential to developing a digital home-based CGA platform that addresses accessibility issues and tailors the assessment process to meet the needs of older adults. Continuous optimization of remote CGA can become a pivotal tool for advancing geriatric care and ensuring the well-being of the aging population. Geriatr Gerontol Int 2024; 24: 67-73.
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Affiliation(s)
- Xinze Wu
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shannon Freeman
- School of Nursing, University of North British Columbia, Prince George, Canada
- Center for Technology Adoption for Aging in the North, Prince George, Canada
| | - Midori Miyagi
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Uijin Park
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
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Pilotto A, Barbagelata M, Morganti W, Seminerio E, Iaccarino G, Genazzani A, Trompetto C, Arabia G, Illario M, Volta E, Custodero C, Cella A. Development and implementation of multicomponent homecare interventions for multimorbid and frail older people based on Information and Communication Technologies: The MULTIPLAT_AGE project. Arch Gerontol Geriatr 2024; 117:105252. [PMID: 37972433 DOI: 10.1016/j.archger.2023.105252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
The prevention and treatment of frailty condition among multimorbid older adults, in community and hospital settings, is becoming a healthcare priority. Growing evidence suggests that a multidimensional approach could help not only in the early identification of older patients' needs but also in designing personalized preventive interventions. However, in clinical practice, the effectiveness of such interventions is limited by a lack of continuity of care and poor compliance of patients. The widespread diffusion of the information and communication technology (ICT) could offer an excellent way to implement and monitor multidimensional and personalized interventions for multimorbid older adults. In this scenario, the MULTIPLAT_AGE, is a network project involving five research centers with the main objective to supply multidimensional interventions targeted to cognitive, motor, pharmacological, and functional domains including ICT-based: i) transitional care model from the hospital to a protected home area; ii) automatic home-care system to improve activities of daily living; iii) program to improve appropriate drug prescription in nursing-home residents; iv) tele-rehabilitation program to reduce the risk of falls and v) cognitive stimulation delivered by remote in older adults with neurological disorders. Each project is linked to the others by employing a shared online platform, in a perspective of technological-supplied multicomponent interventions according to the concept of "aging in place" as the best solution for the treatment and healthcare of older people. Here we describe the general framework of the MULTIPLAT_AGE, and we examine every single project, pointing out innovative aspects, and discussing the expected results.
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Affiliation(s)
- Alberto Pilotto
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy; Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Marina Barbagelata
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Wanda Morganti
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Emanuele Seminerio
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Guido Iaccarino
- Department of Clinical Medicine and Surgery, University "Federico II" of Naples, Naples, Italy
| | - Armando Genazzani
- Department of Pharmaceutical Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gennarina Arabia
- Neurologic Department, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Maddalena Illario
- Public Health Department, University Federico II of Naples, Naples, Italy
| | - Erica Volta
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Alberto Cella
- Geriatrics Unit, Department Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
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Salis F, Cossu E, Mandas A. The multidimensional prognostic index (MPI) predicts long-term mortality in old type 2 diabetes mellitus patients: a 13-year follow-up study. J Endocrinol Invest 2024; 47:191-200. [PMID: 37332086 PMCID: PMC10776747 DOI: 10.1007/s40618-023-02135-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE The Multidimensional Prognostic Index (MPI) is a tool capable of holistically frame older patients in different settings and affected by different pathologies, establishing a risk of adverse events. Among them, type 2 diabetes mellitus (T2DM), a common metabolic disease in the elderly, is responsible for complications and deaths. Few previous works have focused specifically on MPI and DM, and none have followed up the patients for more than 3 years. The aim of the present study is to analyze MPI accuracy in predicting mortality in a cohort of T2DM patients followed-up for 13 years. METHODS The enrolled subjects were evaluated with MPI, identifying three levels of risk: MPI1 (low risk, 0.0-0.33), MPI2 (moderate risk, 0.34-0.66), and MPI3 (severe risk, 0.67-1.0), and with glycated hemoglobin, and years since T2DM diagnosis. RESULTS One hundred and seven patients met the inclusion criteria. MPI3 was excluded by further analysis since it was made up of only three patients. Overall, cognitive performances, autonomies in daily living, nutritional status, risk of pressure injuries, comorbidities, and taken drugs were better (p ≤ 0.0077) in MPI1 than MPI2; moreover, the story of T2DM was shorter (p = 0.0026). Cox model showed an overall 13-year survival of 51.9%, and survival rates were significantly smaller in MPI2 (HR: 4.71, p = 0.0007). Finally, increased age (HR: 1.15), poorer cognitive abilities (HR: 1.26), vascular (HR: 2.15), and kidney (HR: 2.17) diseases were independently associated with death. CONCLUSION Our results prove that MPI predicts short-, mid-, and even long-term mortality in T2DM patients, whose death seems to be related to age and cognitive status, and even more to vascular and kidney diseases.
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Affiliation(s)
- F Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 bivio Sestu, 09042, Monserrato, Cagliari, Italy.
| | - E Cossu
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, Cagliari, Italy
| | - A Mandas
- Department of Medical Sciences, and Public Health, University of Cagliari, SS 554 bivio Sestu, 09042, Monserrato, Cagliari, Italy
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, Cagliari, Italy
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Pilotto A, Custodero C, Palmer K, Sanchez-Garcia EM, Topinkova E, Polidori MC. A multidimensional approach to older patients during COVID-19 pandemic: a position paper of the Special Interest Group on Comprehensive Geriatric Assessment of the European Geriatric Medicine Society (EuGMS). Eur Geriatr Med 2023; 14:33-41. [PMID: 36656486 PMCID: PMC9851592 DOI: 10.1007/s41999-022-00740-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/24/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. METHODS A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. RESULTS Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. CONCLUSION Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic.
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Affiliation(s)
- Alberto Pilotto
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy.,Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, P.zza Giulio Cesare, 11, 70124, Bari, Italy.
| | - Katie Palmer
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
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Ji W, Shi W, Li X, Shan X, Zhou J, Liu F, Qi F. Evaluation of the Effectiveness of Remote Monitoring to Establish a Community Health Intervention During COVID-19: A Community Intervention Trial. Telemed J E Health 2023; 29:253-260. [PMID: 35671521 PMCID: PMC9940801 DOI: 10.1089/tmj.2022.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The widespread use of telemedicine systems and medical information networks has made telemedicine one of the current trends in health care. The purpose of this article is to propose a community health intervention with remote monitoring and teleconsultation during COVID-19 for the prevention and control of COVID-19 at the rural level. Methods: In this intervention study, a randomized group of 1,500 community residents was selected. A questionnaire with acceptable validity and reliability was used to collect data. The study was conducted with the test group itself as a control, and the questionnaire was completed again 6 months after the health intervention through remote monitoring. The extent of the effect of the remote monitoring intervention on community health during COVID-19 was measured. The data were entered into SPSS 26, and the data were analyzed using the K-S normality test, t-test, and chi-square test. Results: After 6 months of the intervention, the differences in mean scores of the test group were statistically significant (p < 0.05) in cognition, perceived benefits, self-efficacy, and behavioral outcomes, with a substantial increase in mean scores for all variables. Conclusions: The application of remote monitoring during COVID-19 in rural communities can influence the health perception, benefit perception, self-efficacy, and behavior of community residents, thus effectively preventing and controlling the spread of COVID-19 in rural communities. It reduces medical barriers for rural areas while meeting.
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Affiliation(s)
- Wanyu Ji
- Xinglin College, Nantong University, Nantong, China
| | - Wenjing Shi
- Xinglin College, Nantong University, Nantong, China
| | - Xiaodong Li
- School of Public Health, and Nantong University, Nantong, China
| | - Xia Shan
- Xinglin College, Nantong University, Nantong, China
| | - Junchao Zhou
- Medical School, Nantong University, Nantong, China
| | - Fengyuan Liu
- Xinglin College, Nantong University, Nantong, China
| | - Feng Qi
- Department of Pharmacy, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
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Pilotto A, Custodero C, Zora S, Poli S, Senesi B, Prete C, Tavella E, Veronese N, Zini E, Torrigiani C, Sabbà C, Cella A. Frailty trajectories in community-dwelling older adults during COVID-19 pandemic: The PRESTIGE study. Eur J Clin Invest 2022; 52:e13838. [PMID: 35842830 PMCID: PMC9350279 DOI: 10.1111/eci.13838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/03/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Frailty has been recognized as potential surrogate of biological age and relevant risk factor for COVID-19 severity. Thus, it is important to explore the frailty trajectories during COVID-19 pandemic and understand how COVID-19 directly and indirectly impacts on frailty condition. METHODS We enrolled 217 community-dwelling older adults with available information on frailty condition as assessed by multidimensional frailty model both at baseline and at one-year follow-up using Multidimensional Prognostic Index (MPI) tools. Pre-frail/frail subjects were identified at baseline as those with MPI score >0.33 (MPI grades 2-3). Frailty worsening was defined by MPI difference between 12 months follow-up and baseline ≥0.1. Multivariable logistic regression was modelled to identify predictors of worsening of frailty condition. RESULTS Frailer subjects at baseline (MPI grades 2-3 = 48.4%) were older, more frequently female and had higher rates of hospitalization and Sars-CoV-2 infection compared to robust ones (MPI grade 1). Having MPI grades 2-3 at baseline was associated with higher risk of further worsening of frailty condition (adjusted odd ratio (aOR): 13.60, 95% confidence interval (CI): 4.01-46.09), independently by age, gender and Sars-CoV-2 infection. Specifically, frail subjects without COVID-19 (aOR: 14.84, 95% CI: 4.26-51.74) as well as those with COVID-19 (aOR: 12.77, 95% CI: 2.66-61.40, p = 0.001) had significantly higher risk of worsening of frailty condition. CONCLUSIONS Effects of COVID-19 pandemic among community-dwelling frailer individuals are far beyond the mere infection and disease, determining a significant deterioration of frailty status both in infected and non-infected subjects.
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Affiliation(s)
- Alberto Pilotto
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy.,Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
| | - Sabrina Zora
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy
| | - Stefano Poli
- Department of Education, University of Genoa, Genoa, Italy
| | - Barbara Senesi
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy
| | - Camilla Prete
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy
| | - Erica Tavella
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy
| | - Nicola Veronese
- Department of Geriatrics, University of Palermo, Palermo, Italy
| | - Elena Zini
- Department of Education, University of Genoa, Genoa, Italy
| | | | - Carlo Sabbà
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari "Aldo Moro", Bari, Italy
| | - Alberto Cella
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Genoa, Italy
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Rodrigues ED, Gonsalves D, Teixeira L, López E. Frailty-the missing constraint in radiotherapy treatment planning for older adults. Aging Clin Exp Res 2022; 34:2295-2304. [PMID: 36056189 DOI: 10.1007/s40520-022-02200-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/13/2022] [Indexed: 11/01/2022]
Abstract
Current demographic changes translate into an increased frequency of cancer in older adults. Available data show that about 45-55% of the new cancer patients will need RT treatments, with an expected increase of 20-30% in the future. To provide the best cancer care it is mandatory to assess frailty, offer appropriate curative treatments to patients and personalise them for the frail. Based on published data, the median prevalence of frailty in older population is about 42%. Recently, the free radical theory of frailty has been proposed stating that oxidative damage is more prevalent in frail patients. In parallel, RT is one of the most frequent cancer treatments offered to older adults and is a source of external free radicals. RT dose constraints correlate with toxicity rates, so we open the question whether frailty should be considered when defining these constraints. Thus, for this paper, we will highlight the importance of frailty evaluation for RT treatment decisions and outcomes.
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Affiliation(s)
- Edna Darlene Rodrigues
- Departamento de Estudo de Populações, ICBAS, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, n° 228, 4050-313, Porto, Portugal. .,Center for Health Technology and Services Research, CINTESIS, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal. .,EIT Health Ageing PhD School, Munich, Germany.
| | - Daniela Gonsalves
- GenesisCare en Madrid, Hospital San Francisco de Asís, Calle de Joaquín Costa, 28, 28002, Madrid, Spain
| | - Laetitia Teixeira
- Departamento de Estudo de Populações, ICBAS, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, n° 228, 4050-313, Porto, Portugal.,Center for Health Technology and Services Research, CINTESIS, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal
| | - Escarlata López
- GenesisCare en Madrid, Hospital Vithas La Milagrosa, Calle de Modesto Lafuente, 14, 28010, Madrid, Spain
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Campani D, De Luca E, Bassi E, Busca E, Airoldi C, Barisone M, Canonico M, Contaldi E, Capello D, De Marchi F, Magistrelli L, Mazzini L, Panella M, Scotti L, Invernizzi M, Dal Molin A. The prevention of falls in patients with Parkinson's disease with in-home monitoring using a wearable system: a pilot study protocol. Aging Clin Exp Res 2022; 34:3017-3024. [PMID: 36053444 DOI: 10.1007/s40520-022-02238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a chronic, progressive neurodegenerative condition that gradually worsens motor function and leads to postural instability and, eventually, falls. Several factors may influence the frequency of future falls, such as slowness, freezing of gait, loss of balance, and mobility problems, cognitive impairments, and the number of previous falls. The TED bracelet is an advanced technological wearable device able to predict falls. AIMS This principal aim is to investigate the feasibility of a full-scale research project that uses the TED bracelet to identify whether individuals with PD are at risk of falling. METHODS This study will involve a pilot prospective observational study design; the subjects will include 26 patients suffering from mild PD and 26 others with no PD and no gait problems. Data will be collected from the TED bracelet and then compared to a paper-based fall diary. The enrolled participants will have a scheduled outpatient evaluation to collect both clinical and instrumental data as well as biological samples. DISCUSSION This pilot study could then be implemented in a larger form to further evaluate the effectiveness of the TED device. Finally, it will help further develop gait monitoring systems for people with Parkinson's disease and other neurodegenerative diseases that can affect physical function and mobility, such as dementia and Alzheimer's. CONCLUSIONS Preventing falls and their complications could lead to major advancements in the quality of home care for patients with PD, which would significantly impact the quality of life of both these patients and their caregivers.
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Affiliation(s)
- Daiana Campani
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Enrico De Luca
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Erika Bassi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Health Professions' Direction, Maggiore Della Carità Hospital, Novara, Italy
| | - Erica Busca
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Chiara Airoldi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Michela Barisone
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Massimo Canonico
- Computer Science Institute, Department of Sciences and Technological Innovation, University of Piemonte Orientale, Alessandria, Italy
| | - Elena Contaldi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,Movement Disorders Centre, Maggiore Della Carità Hospital, Novara, Italy
| | - Daniela Capello
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Fabiola De Marchi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,ALS Center, Neurology Unit, Maggiore Della Carità Hospital, Novara, Italy
| | - Luca Magistrelli
- Movement Disorders Centre, Maggiore Della Carità Hospital, Novara, Italy
| | - Letizia Mazzini
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,ALS Center, Neurology Unit, Maggiore Della Carità Hospital, Novara, Italy
| | - Massimiliano Panella
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. .,Health Professions' Direction, Maggiore Della Carità Hospital, Novara, Italy.
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Smolić Š, Blaževski N, Fabijančić M. Remote Healthcare During the COVID-19 Pandemic: Findings for Older Adults in 27 European Countries and Israel. Front Public Health 2022; 10:921379. [PMID: 35910874 PMCID: PMC9337840 DOI: 10.3389/fpubh.2022.921379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/15/2022] [Indexed: 12/01/2022] Open
Abstract
The COVID-19 pandemic exacerbated issues regarding access to healthcare for older people, by far the most vulnerable population group. In particular, older adults avoided seeking medical treatment for fear of infection or had their medical treatments postponed or denied by health facilities or health professionals. In response, remote medical services were recognized as an essential adjustment mechanism to maintain the continuity of healthcare provision. Using the SHARE Corona Survey data, we estimate logistic and multilevel regression models for the remote care of 44,152 persons aged 50 and over in 27 European countries and Israel. Our findings suggest that those aged 80+ were the least likely to use remote healthcare. However, women, better educated individuals, older adults who lived in urban areas, those with no financial strain, and active Internet users used remote medical consultations more often. Those who reported poor or fair health status, two or more chronic diseases, or hospitalization in the last 12 months were significantly more likely to use remote healthcare. Furthermore, remote medical consultations were more frequent for those who had their healthcare postponed or went without it due to fear of coronavirus infection. Finally, older adults used remote care more frequently in countries with less healthcare coverage and lower health expenditures. Health systems should prioritize vulnerable groups in maintaining continuity in access to healthcare, despite the availability of remote care. Policymakers should improve telemedicine regulation and offer incentives for providers of remote healthcare services by adapting reimbursement policies. Remote medical care could play an important role in maintaining healthcare access for older adults and increasing health systems' preparedness in future health emergencies.
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Zampino M, Polidori MC, Ferrucci L, O’Neill D, Pilotto A, Gogol M, Rubenstein L. Biomarkers of aging in real life: three questions on aging and the comprehensive geriatric assessment. GeroScience 2022; 44:2611-2622. [PMID: 35796977 PMCID: PMC9261220 DOI: 10.1007/s11357-022-00613-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/19/2022] [Indexed: 01/07/2023] Open
Abstract
Measuring intrinsic, biological age is a central question in medicine, which scientists have been trying to answer for decades. Age manifests itself differently in different individuals, and chronological age often does not reflect such heterogeneity of health and function. We discuss here the value of measuring age and aging using the comprehensive geriatric assessment (CGA), cornerstone of geriatric medicine, and operationalized assessment tools for prognosis. Specifically, we review the benefits of employing the multidimensional prognostic index (MPI), which collects information about eight domains relevant for the global assessment of the older person (functional and cognitive status, nutrition, mobility and risk of pressure sores, multi-morbidity, polypharmacy, and co-habitation), in the evaluation of the functional status, and in the prediction of health outcomes for older adults. Further integration of biological markers of aging into multidimensional prognostic tools is warranted, as well as actions which could facilitate prognostic assessments for older persons in all healthcare settings.
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Affiliation(s)
- Marta Zampino
- grid.94365.3d0000 0001 2297 5165Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD USA
| | - M. Cristina Polidori
- grid.6190.e0000 0000 8580 3777Aging Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany ,grid.6190.e0000 0000 8580 3777Cologne Excellence Cluster On Cellular Stress- Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Luigi Ferrucci
- grid.94365.3d0000 0001 2297 5165Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD USA
| | - Desmond O’Neill
- grid.413305.00000 0004 0617 5936Tallaght University Hospital and Trinity College Dublin, Tallaght University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Alberto Pilotto
- grid.450697.90000 0004 1757 8650Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy ,grid.7644.10000 0001 0120 3326Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Manfred Gogol
- grid.10423.340000 0000 9529 9877Trauma Department, Orthogeriatric Unit, Hannover Medical School, Hannover, Germany ,grid.7700.00000 0001 2190 4373Institute of Gerontology, University of Heidelberg, Heidelberg, Germany
| | - Laurence Rubenstein
- grid.266900.b0000 0004 0447 0018Department of Geriatric Medicine, University of Oklahoma, Oklahoma City, OK USA
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