A Frailty Screening Questionnaire (FSQ) to Rapidly Predict Negative Health Outcomes of Older Adults in Emergency Care Settings

ABSTRACTThis study investigates novice and experienced student nurses’ attitudes about caring for patients across the lifespan. Students were also asked why they would enjoy or not enjoy caring for children and older adults. Both novice (n = 114) and advanced (n = 56) nursing students were relatively positive about caring for patients across the lifespan. However, novices were significantly more negative about working with older patients, particularly after experiencing a first clinical placement. In contrast, a significant quadratic effect was found for advanced students, indicating more negativity about working with both children and older adults. When giving reasons for why they would enjoy caring for older patients, novices were more likely than were advanced students to focus on stereotypical characteristics and on negative health outcomes of older adults as a group. Overall, results suggest that the attitudes driving career interests in nursing students change as training advances.

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Intrinsic capacity predicts negative health outcomes in older adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab279 ◽

2021 ◽

Author(s):

Erwin Stolz ◽

Hannes Mayerl ◽

Wolfgang Freidl ◽

Regina Roller-Wirnsberger ◽

Thomas M Gill

Keyword(s):

Older Adults ◽

Nursing Home ◽

Health Outcomes ◽

Warning System ◽

Repeated Measurements ◽

Intrinsic Capacity ◽

Adl Disability ◽

Nursing Home Stay ◽

Negative Health Outcomes

Abstract BACKGROUND Monitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the WHO as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes. METHODS Based on 4,751 repeated observations of IC (range=0-100) during 21 years of follow-up among 754 older adults 70+ years, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic ADL disability, long-term nursing home stay, and mortality using joint models. RESULTS Average IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for socio-demographics and chronic diseases, a one-point lower IC value was associated with a 7% increase in the risk of ADL disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to three repeated measurements of IC ranged between moderate and good (AUC = 0.76-0.82). DISCUSSION Our study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.

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Intrinsic capacity predicts negative health outcomes in older adults

10.1101/2021.05.26.21257829 ◽

2021 ◽

Author(s):

Erwin Stolz ◽

Hannes Mayerl ◽

Wolfgang Freidl ◽

Regina Roller-Wirnsberger ◽

Thomas M Gill

Keyword(s):

Older Adults ◽

Nursing Home ◽

Health Outcomes ◽

Warning System ◽

Repeated Measurements ◽

Intrinsic Capacity ◽

Adl Disability ◽

Nursing Home Stay ◽

Negative Health Outcomes

BACKGROUND: Monitoring trajectories of intrinsic capacity (IC) in older adults has been suggested by the WHO as a means to inform prevention to avoid or delay negative health outcomes. Due to a lack of longitudinal studies, it is currently unclear how IC changes over time and whether repeatedly measured IC predicts negative health outcomes. METHODS: Based on 4,751 repeated observations of IC (range=0-100) during 21 years of follow-up among 754 older adults 70+ years, we assessed longitudinal trajectories of IC, and whether time-varying IC predicted the risk of chronic ADL disability, long-term nursing home stay, and mortality using joint models for longitudinal and time-to-event data. RESULTS: Average IC declined progressively from 77 to 11 points during follow-up, with substantial heterogeneity between older adults. Adjusted for socio-demographics and chronic diseases, a one-point lower IC value was associated with a 7% increase in the risk of ADL disability, a 6% increase in the risk of a nursing home stay, and a 5% increase in mortality. Accuracy for 5- and 10-year predictions based on up to three repeated measurements of IC ranged between moderate and good (AUC = 0.76-0.82). DISCUSSION: Our study indicates that IC declines progressively and that it predicts negative health outcomes among older adults. Therefore, regular monitoring of IC could work as an early warning system informing preventive efforts.

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Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults

The Gerontologist ◽

10.1093/geront/gnz117 ◽

2019 ◽

Vol 60 (6) ◽

pp. 989-995 ◽

Cited By ~ 9

Author(s):

Bonnielin K Swenor ◽

Moon J Lee ◽

Varshini Varadaraj ◽

Heather E Whitson ◽

Pradeep Y Ramulu

Keyword(s):

Older Adults ◽

Health Outcomes ◽

Visual Impairment ◽

Successful Aging ◽

Vision Loss ◽

Common Causes ◽

The Impact ◽

The Relationship ◽

Negative Health Outcomes ◽

Multiple Intervention

Abstract There is limited research examining the impact of visual impairment (VI) on older adults while considering the complexities of aging, leaving gaps in our understanding of how health consequences of VI might be averted. We created a framework integrating concepts from disability, geriatrics, and ophthalmology that conceptualizes how VI challenges successful aging. Here, VI influences multiple functional domains, and increases the risk of negative health outcomes. This model acknowledges that common causes, such as risk factors that affect eyes and other systems simultaneously, may also drive the relationship between VI and health outcomes. Finally, the model highlights how the impact of VI on aging outcomes can be addressed at multiple intervention points.

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Polypharmacy and severe potential drug-drug interactions among older adults with cardiovascular disease in the United States

BMC Geriatrics ◽

10.1186/s12877-021-02183-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marwan Sheikh-Taha ◽

Myriam Asmar

Keyword(s):

Cardiovascular Disease ◽

Older Adults ◽

Health Outcomes ◽

Drug Interactions ◽

Tertiary Care ◽

The United States ◽

Potential Drug ◽

Potential Ddis ◽

Increased Risk ◽

Negative Health Outcomes

Abstract Background Polypharmacy continues to be a topic of concern among older adults and puts patients at increased risk of potential drug-drug interactions (DDIs) and negative health outcomes. The objective of this study was to assess the prevalence of polypharmacy among older adults with cardiovascular disease (CVD) and to identify severe potential DDIs. Methods A retrospective chart review was conducted in a tertiary care center over a three-month period where we reviewed home medications of older adults upon hospital admission. Inclusion criteria were age ≥ 65 years, history of CVD, and admission to the cardiology service. Polypharmacy was defined as 5 or more medications taken concomitantly, hyper-polypharmacy was defined as 10 or more medications taken concomitantly, and severe potential DDIs were considered to be those belonging to category D or X using Lexicomp® Drug Information Handbook. Category D interaction states that modification of therapy should be considered while category X states that the combination should be absolutely avoided. Results A total of 404 patients with a mean age of 76.6 ± 7.4 years were included. Patients were taking an average of 11.6 ± 4.5 medications at home and 385 (95%) received polypharmacy, 278 (69%) received hyper-polypharmacy, and 313 (77.5%) had at least one severe potential DDI. Under category D, the most common potential DDIs were drugs with additive central nervous system (CNS) depressant effect and drugs that increase the risk of QT prolongation. Under category X, the most common potential DDIs were non-selective β-blockers that may diminish the bronchodilator effect of β2 agonists and drugs with anticholinergic properties that enhance the ulcerogenic effect of oral solid potassium. Conclusions Polypharmacy, hyper-polypharmacy, and severe potential DDIs are very common in older adults with CVD. Clinicians should vigilantly review patients’ drug records and adjust therapy accordingly to prevent adverse drug reactions and negative health outcomes.

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Negative Clusters Associated With Cannabis Use: Tangled Up in Blues

Innovation in Aging ◽

10.1093/geroni/igab046.1964 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 511-511

Author(s):

Hyojung Kang

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Outcomes ◽

Cannabis Use ◽

Health Conditions ◽

Positive Outcomes ◽

Negative Outcomes ◽

Medical Cannabis ◽

Negative Health Outcomes ◽

Bell Shaped Curve

Abstract Previous studies concerning older adults have focused on whether cannabis use leads to positive or negative outcomes. In this study, we identified clusters of negative health outcomes associated with medical cannabis use. In total, we examined eight health outcomes: pain, sleep, falls, memory, digestive issues, mental health conditions, exercise, and general productivity reported by 2,968 persons over 60 who participated in the Illinois Medical Cannabis Program. We used association analysis to simultaneously identify groups of negative outcomes reported by participants. The distribution of non-positive outcomes shows a bell-shaped curve: 1.4% of participants responded that cannabis use improved all outcomes, while 4.1% of participants answered that cannabis use did not. When looking at negative outcomes, 86% of participants reported none worsened, and 11% reported one of the outcomes was affected. Only a small fraction of the participants (3%) claimed more than one negative outcomes after cannabis use.

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