Interprofessional student-led outreach to high-risk older adults during the COVID-19 pandemic

Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)

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High-risk surgery among older adults: Not-quite shared decision-making

Surgery ◽

10.1016/j.surg.2021.02.005 ◽

2021 ◽

Author(s):

Ana C. De Roo ◽

Crystal Ann Vitous ◽

Samantha J. Rivard ◽

Michaela C. Bamdad ◽

Sara M. Jafri ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

High Risk ◽

Shared Decision Making ◽

Shared Decision

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Intensive chemotherapy vs. hypomethylating agents in older adults with newly diagnosed high-risk acute myeloid leukemia: A single center experience

Leukemia Research ◽

10.1016/j.leukres.2018.10.011 ◽

2018 ◽

Vol 75 ◽

pp. 29-35 ◽

Cited By ~ 4

Author(s):

Pankit Vachhani ◽

Raed Al Yacoub ◽

Austin Miller ◽

Fan Zhang ◽

Tara L. Cronin ◽

...

Keyword(s):

Older Adults ◽

Acute Myeloid Leukemia ◽

High Risk ◽

Myeloid Leukemia ◽

Intensive Chemotherapy ◽

Hypomethylating Agents ◽

Newly Diagnosed ◽

Single Center ◽

Single Center Experience ◽

Acute Myeloid

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Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study

10.20944/preprints202111.0387.v1 ◽

2021 ◽

Author(s):

Matheus Almeida Souza ◽

Daniel Goble ◽

Paige Arney ◽

Edgar Ramos Vieira ◽

Gabriela Silveira-Nunes ◽

...

Keyword(s):

Older Adults ◽

High Risk ◽

North American ◽

Force Plate ◽

South American ◽

Risk Of Falling ◽

Men And Women ◽

Falls Risk ◽

South Americans ◽

North And South

This study aimed to characterize the risk of falling in low, moderate and high risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69 % and female: 61.87 %), with no differences between men and women. Also, no differences were found between North vs. South Americans, nor for falls risk levels when male and female groups were compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years’ normative age-range. The prevalence of low falls risk was ~ 61-65 % and the prevalence of moderate to high risk was ~ 16-19 %. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.

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Effectiveness of a 3-month antifalling program in the mobility, balance confidence, and muscle performance of older adults

Journal of Exercise Rehabilitation ◽

10.12965/jer.2142412.206 ◽

2021 ◽

Vol 17 (4) ◽

pp. 247-255

Author(s):

Rahim Nor ◽

Maria Justine ◽

Angelbeth Joanny ◽

Azrul Anuar Zolkafli

Keyword(s):

Older Adults ◽

High Risk ◽

Lower Limb ◽

Risk Group ◽

Exercise Program ◽

Muscle Performance ◽

Limb Function ◽

Balance Confidence ◽

Risk Of Fall ◽

Lower Limb Function

This study determined the effectiveness of a 3-month group-based multicomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, upper limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Significant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicomponent exercise program benefited the physical functions of older adults at low- or high risk of falls.

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Personality as a Moderator of Cognitive Stimulation in Older Adults at High Risk for Cognitive Decline

Research in Gerontological Nursing ◽

10.3928/19404921-20140311-01 ◽

2014 ◽

Vol 7 (4) ◽

pp. 159-170 ◽

Cited By ~ 4

Author(s):

Nikki L. Hill ◽

Ann M. Kolanowski ◽

Donna Fick ◽

Vernon M. Chinchilli ◽

Rita A. Jablonski

Keyword(s):

Older Adults ◽

High Risk ◽

Cognitive Decline ◽

Cognitive Stimulation

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Association of Integrated Care Coordination With Postsurgical Outcomes in High-Risk Older Adults

JAMA Surgery ◽

10.1001/jamasurg.2017.5513 ◽

2018 ◽

Vol 153 (5) ◽

pp. 454 ◽

Cited By ~ 34

Author(s):

Shelley R. McDonald ◽

Mitchell T. Heflin ◽

Heather E. Whitson ◽

Thomas O. Dalton ◽

Michael E. Lidsky ◽

...

Keyword(s):

Older Adults ◽

High Risk ◽

Integrated Care ◽

Care Coordination ◽

Postsurgical Outcomes

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Abstract 18787: Hypertension Treatment and Control Rates in United States Adults by Risk Group

Circulation ◽

10.1161/circ.130.suppl_2.18787 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Kunal N Karmali ◽

Hongyan Ning ◽

Donald M Lloyd-Jones

Keyword(s):

Older Adults ◽

High Risk ◽

Kidney Disease ◽

Risk Group ◽

Intensive Therapy ◽

Risk Groups ◽

Middle Aged ◽

Ascvd Risk ◽

Middle Aged Adults ◽

And Control

Introduction: Ten-year cardiovascular disease (CVD) risk and absolute benefit from antihypertensive therapy vary at any given BP based on associated risk factor levels. Thus, implications of treatment and control rates at a particular BP vary substantially in different risk groups. Objectives: We examined the prevalence, treatment, and control of hypertension (HTN) by risk group in US adults without prevalent CVD. Methods: We used data from the National Health and Nutrition Examination Survey 2005 to 2010 for adults age 40-79 years without prevalent CVD (n=4,066). We estimated 10-year risk for an atherosclerotic CVD (ASCVD) event using the ACC/AHA 2013 Pooled Cohort risk equations. We examined HTN treatment and control rates according to current guidelines in middle-aged (40-59 years) and older (60-79 years) adults with: 10-year ASCVD risk <7.5% (no diabetes/kidney disease); 10-year ASCVD risk ≥7.5% (no diabetes/kidney disease); and either diabetes or kidney disease. Results: The proportion of adults with treatment-eligible HTN was 39.3% for those with 10-year ASCVD risk <7.5%, 32.2% for those with 10-year ASCVD risk ≥7.5%, and 28.4% for those with either diabetes or kidney disease (see Table 1). Treatment rates across the risk groups varied from 51.5% to 79.0% for middle-aged adults and 81.8% to 90.2% for older adults. HTN control rates were highest (87.7%) in older adults with 10-year ASCVD risk <7.5% but were lowest (29.3%) in middle-aged individuals with 10-year ASCVD risk ≥7.5%. Conclusions: US HTN guidelines, based solely on BP thresholds, identify a higher proportion of low-risk adults and a lower proportion of high-risk adults as being eligible for treatment. Control rates remain suboptimal in high-risk individuals, particularly middle-aged adults. Future guidelines should consider pre-treatment risk stratification to identify those at increased pretreatment ASCVD risk who would benefit most from more intensive therapy.

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