Predicting discharge location of hip fracture patients; the new discharge of hip fracture patients score

Purpose This paper reports on the development and validity of a new instrument, called the discharge of hip fracture patients score (DHP), that predicts at admission the discharge location in patients living in their own home prior to hip fracture surgery. Methods A total of 310 patients aged 50 years and above were included. Risk factors for discharge to an alternative location (DAL) were analysed with a multivariable regression analysis taking the admission variables into account with different weights based on the estimates. The score ranged from 0-100 points. The cut-off point for DAL was calculated using a ROC analysis. Reliability of the DHP was evaluated. Results Risk factors for DAL were higher age, female gender, dementia, absence of a partner and a limited level of mobility. The cut-off point was set at 30 points, with a sensitivity of 83.8%, a specificity of 64.7% and positive predictive value of 79.2%. Conclusion The DHP is a valid, simple and short instrument to be used at admission to predict discharge location of hip fracture patients

Combined medical-psychiatric inpatient units:Evaluation of the Centre for the Elderly

Considering the large number of elderly patients in acute hospitals who receive medical as well as psychiatric treatment because of relevant comorbidity, adequate interdisciplinary treatment models have to be developed and applied. The Centre for Elderly, a cooperation project between the departments of geriatric and psychogeriatric medicine in a community hospital in Germany, was founded in 2000. In addition to traditionally structured units, the centre consists of interdisciplinary units. Patient-, staff- and hospital-related characteristics influenced by the reformation of both departments were evaluated by comparing hospitalbased registry data records containing age, gender, main and minor diagnoses, length of stay and patient transferrals within the centre. Experts working at the centre were asked to take a stand on the development of the treatment quality, allocation of patients, diagnostic procedures, consultation services and information transmission. The number of admissions to the Centre for the Elderly increased within one year. The distribution of the main diagnose groups remained unchanged, with an overlap between the geriatric and psychogeriatric department consisting of the main diagnoses dementia and depression. The length of stay and the number of transferrals decreased significantly in both departments. The majority of the interviewed employees stated that the treatment quality and the allocation of patients were improved. We conclude that interdisciplinary treatment between the departments of psychiatry and geriatric medicine may contribute to the medical needs of subgroups of elderly inpatients suffering from medical-psychiatric comorbidity

Which preoperative screening tool should be applied to older patients undergoing elective surgery to predict short-term postoperative outcomes? Lessons from systematic reviews, meta-analyses and guidelines

10.1007/s11739-020-02415-yINTERNAL AND EMERGENCY MEDICINE16137-4

Targeting the molecular & cellular pillars of human aging with exercise

10.1111/febs.16337FEBS JOURNA

Targeting the molecular & cellular pillars of human aging with exercise

Biological aging is the main driver of age-associated chronic diseases. In 2014, the United States National Institute of Aging (NIA) sponsored a meeting between several investigators in the field of aging biology, who identified seven biological pillars of aging and a consensus review, “Geroscience: Linking Aging to Chronic Disease,” was published. The pillars of aging demonstrated the conservation of aging pathways in diverse model organisms and thus represent a useful framework with which to study human aging. In this present review, we revisit the seven pillars of aging from the perspective of exercise and discuss how regular physical exercise can modulate these pillars to stave off age-related chronic diseases and maintain functional capacity

Physical, motivational and environmental factors influencing physical activity promotion during hospitalization: Older patients’ perspective

10.1016/j.gerinurse.2021.02.013Geriatric Nursing422599-60

Tasks and responsibilities in physical activity promotion of older patients during hospitalization:A nurse perspective

Aim: To investigate how nurses perceive tasks and responsibilities in physical activity promotion of hospitalized older patients and which factors are of influence. Design: Mixed methods sequential explanatory design. Methods: One hundred and eight nurses participated in a questionnaire survey and 51 nurses in a subsequent in-depth interview. Data were collected on tasks and responsibilities in physical activity promotion and their influencing factors as perceived by nurses. Quantitative data were analysed using descriptive statistics and a deductive approach with directed content analysis was used for the data from the interviews. Results: Nurses perceived to have a dominant role in physical activity promotion of older patients during hospitalization. Ninety per cent of the nurses stated to be responsible for physical activity promotion and 32% stated to be satisfied with the actual level of physical activity of their patients. Nurses have specified to be responsible for signalling and performing physical activity promotion tasks and had final responsibility for transfers from bed to chair and promotion of daily activities. Influencing factors were low patient motivation, high workload causing priority shifts of tasks and the role of physicians

Distinct Trajectories of Individual Physical Performance Measures Across 9 Years in 60-to 70-Year-Old Adults

10.1093/gerona/glaa045JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES75101951-195

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: A systematic review 11 Medical and Health Sciences 1117 Public Health and Health Services

Background: To counteract decline in physical performance and physical activity in older patients during hospitalization, multiple physical interventions were developed. However, it is unknown whether these are effective in this particular population. This systematic review aimed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization. Methods: The systematic search included PubMed, EMBASE, Cinahl, the Trials database of The Cochrane Library and SPORTdiscus from inception to 22 November 2017. Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on physical performance or physical activity was evaluated during hospitalization. Results: Fifteen randomized controlled trials met the inclusion criteria. Overall, the effect of physical interventions on physical performance was inconsistent. Patient tailored interventions, i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not. Physical activity as outcome measure was not addressed. Reporting of intensity of the interventions and adherence were frequently lacking. Conclusions: Evidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain. Further research on the efficacy of the intervention is needed, comparing types of intervention with detailed reporting of frequency, intensity and duration

Tasks and responsibilities in physical activity promotion of older patients during hospitalization: A nurse perspective

10.1002/nop2.588NURSING OPEN761966-197