Inverted CD4:CD8 ratio is not associated with three-year mortality in a sample of community-dwelling oldest old: The octabaix immune study

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

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Polypharmacy in a Belgian cohort of community-dwelling oldest old: baseline observations and associated risk factors

Clinical Therapeutics ◽

10.1016/j.clinthera.2015.05.033 ◽

2015 ◽

Vol 37 (8) ◽

pp. e8 ◽

Cited By ~ 1

Author(s):

Maarten Wauters ◽

Monique Elseviers ◽

Bert Vaes ◽

Jan Degryse ◽

Olivia Dalleur ◽

...

Keyword(s):

Risk Factors ◽

Oldest Old ◽

Community Dwelling ◽

Associated Risk Factors

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Medication adherence in community-dwelling older people exposed to chronic polypharmacy

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214238 ◽

2021 ◽

pp. jech-2020-214238

Author(s):

Carlotta Franchi ◽

Ilaria Ardoino ◽

Monica Ludergnani ◽

Gjiliola Cukay ◽

Luca Merlino ◽

...

Keyword(s):

Medication Adherence ◽

Older People ◽

Oldest Old ◽

Medication Possession Ratio ◽

Community Dwelling ◽

Administrative Database ◽

Lombardy Region ◽

Drug Classes ◽

Community Dwelling Older People ◽

Lower Adherence

BackgroundTo evaluate medication adherence and associated factors of seven of the most common drug classes prescribed to community-dwelling older people.MethodsThis is a retrospective cohort study on medication adherence in community-dwelling older people (65–94 years old) on chronic polypharmacy and recorded from 2013 to 2015 in the administrative database of the Lombardy region (Northern Italy). Adherence was assessed for diabetic drugs, antithrombotic agents, drugs acting on the renin–angiotensin system, statins, bisphosphonates, antidepressants and drugs for obstructive airway diseases by calculating the medication possession ratio (MPR). Patients were then divided in fully (MPR ≥80%), partially (40%≤MPR<80%) and poorly adherent (10%<MPR<40%).ResultsAmong 140 537 patients included in the study, only 19.3% was fully adherent to all the therapies considered. Almost 40% of them were poorly adherent to at least one drug class, becoming 50% when patients exposed to four or more drug classes were considered. In adjusted regression model, being women (OR=1.14, 95% CI 1.13 to 1.16) and aged ≥80 years old (OR=1.22, 95% CI 1.20 to 1.24) were associated with an overall lower adherence. Instead, the participation to an experimental healthcare programme was associated with higher adherence (OR=0.92, 95% CI 0.87 to 0.96). Furthermore, being coprescribed with ≥10 drugs was associated with lower adherence to all the drug classes, with different effects (ORs from 0.42 to 0.73).ConclusionThis study overall shows a low medication adherence in community-dwelling older people on chronic polypharmacy, especially in women and oldest old. The implementation and promotion of healthcare programmes for these patients could help improve overall adherence to chronic drug therapies.

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Associations of coffee drinking with physical performance in the oldest-old community-dwelling men The Helsinki Businessmen Study (HBS)

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01645-6 ◽

2020 ◽

Author(s):

Satu K. Jyväkorpi ◽

Annele Urtamo ◽

Mika Kivimäki ◽

Timo E. Strandberg

Keyword(s):

Physical Performance ◽

Oldest Old ◽

Community Dwelling ◽

Coffee Drinking

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Validity of pervasive computing based continuous physical activity assessment in community-dwelling old and oldest-old

Scientific Reports ◽

10.1038/s41598-019-45733-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 6

Author(s):

Narayan Schütz ◽

Hugo Saner ◽

Beatrice Rudin ◽

Angela Botros ◽

Bruno Pais ◽

...

Keyword(s):

Physical Activity ◽

Pervasive Computing ◽

Oldest Old ◽

Community Dwelling ◽

Physical Activity Assessment ◽

Activity Assessment

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Prevalence of falls and associated factors in community-dwelling older Brazilians: a systematic review and meta-analysis

Cadernos de Saúde Pública ◽

10.1590/0102-311x00115718 ◽

2019 ◽

Vol 35 (8) ◽

Cited By ~ 1

Author(s):

José Elias Filho ◽

Wyngrid Porfirio Borel ◽

Juliano Bergamaschine Mata Diz ◽

Alexandre Wesley Carvalho Barbosa ◽

Raquel Rodrigues Britto ◽

...

Keyword(s):

Systematic Review ◽

Associated Factors ◽

Meta Analysis ◽

Oldest Old ◽

Risk Of Bias ◽

Community Dwelling ◽

Age Group ◽

Critical Appraisal Tool ◽

Prevalence Ratios ◽

Appraisal Tool

Falls determine huge epidemiological, clinical, and economic burden in the older population worldwide, presenting high odds of severe disability. The present study aimed to estimate the prevalence of falls and associated factors in older Brazilians using a systematic review with meta-analysis. Searches were performed in SciELO, PubMed, LILACS, Web of Science, Scopus and PsycINFO databases with no date or language restrictions. Studies on community-dwelling older persons aged ≥ 60 years from both sexes and with a sample size of ≥ 300 participants included. Exclusion criteria were studies conducted specifically for older adults diagnosed with chronic disabling diseases that predispose them to falls. Risk of bias of included studies was assessed using a critical appraisal tool focusing on prevalence designs. A random-effects meta-analysis was used to pool the prevalence of falls across studies. Exploratory analysis was conducted examining subgroup estimates, prevalence ratios and meta-regression. Thirty-seven studies involving 58,597 participants were included. Twelve-month prevalence of falls was 27% (95%CI: 24.3-30.0), with significantly higher estimates in female than male (PR = 1.57; 95%CI: 1.32-1.86), in age group ≥ 80 years than age group 60-69 years (PR = 1.46; 95%CI: 1.15-1.84), and in participants from the Central region than participants from the South region (PR = 1.36; 95%CI: 1.10-1.69) of Brazil. Risk of bias scores did not impact heterogeneity in the 12-month meta-analysis. These estimates strongly support evidence-based public interventions to prevent falls in older Brazilians, especially in women and the oldest-old population.

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Day-to-day blood pressure variability is associated with lower cognitive performance among the Japanese community-dwelling oldest-old population: the SONIC study

Hypertension Research ◽

10.1038/s41440-019-0377-5 ◽

2019 ◽

Vol 43 (5) ◽

pp. 404-411 ◽

Cited By ~ 2

Author(s):

Kayo Godai ◽

◽

Mai Kabayama ◽

Yasuyuki Gondo ◽

Saori Yasumoto ◽

...

Keyword(s):

Blood Pressure ◽

Cognitive Performance ◽

Blood Pressure Variability ◽

Oldest Old ◽

Community Dwelling

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ASSOCIATION BETWEEN BLOOD PRESSURE AND COGNITIVE FUNCTION OF COMMUNITY-DWELLING OLDEST OLD IN OKINAWA, JAPAN

Innovation in Aging ◽

10.1093/geroni/igz038.2391 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S643-S643

Author(s):

Yukihiro Namihira ◽

Takashi Tokashiki ◽

Akio Ishida ◽

Yusuke Ohya ◽

Hiroko H Dodge

Keyword(s):

Blood Pressure ◽

Cognitive Function ◽

Arterial Stiffness ◽

Cognitive Decline ◽

Pulse Pressure ◽

Cognitive Aging ◽

Oldest Old ◽

Community Dwelling ◽

Vascular Stiffness ◽

High Cognitive Function

Abstract Background: Adults 80 years and older are the fastest-growing segment of the Japanese population and face a high risk of cognitive decline. There are some evidences connecting hypertension to cognitive decline. In mid-life hypertension is known to have influence the cognitive decline in older age. However, a few study have examined the association between hypertension or vascular stiffness and cognitive function among elderly over 80 years old. We analyzed the associations between vascular stiffness and cognitive function among relatively healthy community-dwelling non-demented oldest old. Method: Data came from the Keys to Optimal Cognitive Aging (KOCOA) study; an ongoing cohort of relatively healthy volunteers aged over 80 years old, living in Okinawa, Japan. In 2017, 105 non-demented (Clinical Dementia Rating < 1) subjects completed three kinds of examination for vascular function (75 % female, mean age (SD) 84.0 (3.0)). We categorized subjects into low and high cognitive function groups using Montreal Cognitive Assessment (MoCA) (25/26 as a cutpoint). Logistic regression models were used to examine the association between cognitive and vascular functions. Results: Narrower pulse pressure, an indicator of lower arterial stiffness, was associated with better cognitive function among subjects, after adjusting for gender, age, and education (p≦0.05), although systolic and diastolic blood pressure were not. Conclusion: Our findings suggest that narrower pulse pressure is related with cognitive preservation. The present study supports the hypothesis that lower arterial stiffness is related with better cognitive function even among the oldest old.

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