scholarly journals A Scoping Review of Community Based Geriatric Health Assessment and Screening Tools used in South Asia Region

2021 ◽  
Author(s):  
Sucharita Panigrahi ◽  
Trilochan Bhoi ◽  
Sanghamitra Pati ◽  
Jaya Singh Kshatri
Keyword(s):  
Older Adults ◽  
Health Status ◽  
South Asia ◽  
Scoping Review ◽  
Health Assessment ◽  
The Elderly ◽  
Holistic Health ◽  
Screening Tools ◽  
Older Population ◽  
Eligibility Criteria

AbstractThere have been many geriatric tools developed to assess health status targeting especially for older adults from developed nations but not context specific. Whereas finger count tools are available for LMICs, especially the South Asia population. CGA, as opposed to medical examination, uses multiple tools to capture a holistic health status of the older adults in line with the more comprehensive WHO definition of health. It includes a harmonized evaluation of the clinical, functional, psychological, environmental and social health status of older population. Although there is no standardized format for carrying out CGA, there is broad consensus on the domains that need to be measured. For the better caring of culturally diverse South Asian older population, we need to develop more culturally competent CGHA tools. So, this review summarised studies that describe validated tools for assessing geriatric health in community settings in South Asia. We followed Arksey and O’Malley’s five-stage scoping review framework, refined with the Joanna Briggs Institute methodology, to identify the research questions, identify relevant studies, select studies, chart the data, and collate and summarize the data. Using the PRISMA-ScR guidelines, a search of 3 databases (PubMed, Embase and PsychInfo was undertaken. After applying eligibility criteria to 607 articles, only 46 studies met the inclusion criteria. 7 studies reported on medical assessment, 4 studies assessed psychological condition,6 studies assessed functional issue,2 studies assessed social wellbeing and 9 studies reported on different domains. None study measured all domains. 24 tools calibrated with Gold standard measure, were validated and reliable by assessed with psychometric properties such as sensitivity, specificity, PPV, NPV and ROC-AUC. Meanwhile, 21 tools were validated exclusively for older adults, whereas there are no validated tools available for CGHA in South Asia. This review will guide us for development of CGHA tools or adaptation of existing tools in our context. As well, it will help practitioners to develop tools to measure comprehensive health of the elderly in their context.

scholarly journals Income support programmes for the older adults in South Asia: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050676
Author(s):  
Eti Rajwar ◽  
Prachi Pundir ◽  
Shradha S Parsekar ◽  
Bhumika Tumkur Venkatesh ◽  
Tobias Vogt
Keyword(s):  
Older Adults ◽  
South Asia ◽  
Scoping Review ◽  
Population Characteristics ◽  
Income Support ◽  
Eligibility Criteria ◽  
Advanced Search ◽  
Ethical Approval ◽  
Review Protocol ◽  
Support Programmes

IntroductionSouth Asian countries are ageing and experiencing a rapid increase in proportion of the older population. Income support programmes are of central importance for the older adults as they may help to mitigate the poverty risks associated with ageing and losing the ability to generate income from labour. Evidence related to the income support programmes can help in understanding whether the programmes have been impactful. This scoping review will map the evidence (and gaps) related to income support programmes and create a base to identify the feasibility of future primary research and/or the scope of systematic reviews in the areas where evidence is available.Methods and analysisThe Joanna Briggs Institute scoping review methodology will be followed. Eligibility criteria for the scoping review will be based on the ‘PCC’ or the ‘Population–Concept–Context’ concept. Advanced search for the relevant articles will be conducted in MEDLINE (via PubMed), Embase, Scopus, Campbell Collaboration, 3ie International Initiative for Impact Evaluation and Web of Science. Additional resources search will be conducted in important organisational websites. Findings of the scoping review will be summarised using descriptive information (frequencies and percentages) for the available evidence on concept (ie, income support programmes), population characteristics and other study variables.Ethics and disseminationThe review is based on data from available literature, hence an ethical approval is not necessary. With this review, we attempt to provide recommendations to the research community and the policymakers about the currently available evidence and the research required for income support of older adults in South Asia, so that resources can be directed towards addressing the same. We plan to disseminate the findings through presentation in international conference and publication in a peer-reviewed journal.Review registrationNot registered.

scholarly journals Screening tools for common mental disorders in older adults in South Asia: a systematic scoping review

2021 ◽  
pp. 1-12
Author(s):  
Lachlan Fotheringham ◽  
Stella-Maria Paddick ◽  
Evelyn Barron Millar ◽  
Claire Norman ◽  
Ammu Lukose ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Older People ◽  
Diagnostic Accuracy ◽  
South Asia ◽  
Scoping Review ◽  
Validation Studies ◽  
Common Mental Disorders ◽  
Global Mental Health ◽  
Depression Scale ◽  
Screening Tools

ABSTRACT Objectives: Common mental disorders (CMDs), particularly depression, are major contributors to the global mental health burden. South Asia, while diverse, has cultural, social, and economic challenges, which are common across the region, not least an aging population. This creates an imperative to better understand how CMD affects older people in this context, which relies on valid and culturally appropriate screening and research tools. This review aims to scope the availability of CMD screening tools for older people in South Asia. As a secondary aim, this review will summarize the use of these tools in epidemiology, and the extent to which they have been validated or adapted for this population. Design: A scoping review was performed, following PRISMA guidelines. The search strategy was developed iteratively in Medline and translated to Embase, PsychInfo, Scopus, and Web of Science. Data were extracted from papers in which a tool was used to identify CMD in a South Asian older population (50+), including validation, adaptation, and use in epidemiology. Validation studies meeting the criteria were critically appraised using the Quality Assessment of Diagnostic Accuracy Studies – version 2 (QUADAS-2) tool. Results: Of the 4694 papers identified, 176 met the selection criteria at full-text screening as relevant examples of diagnostic or screening tool use. There were 15 tool validation studies, which were critically appraised. Of these, 10 were appropriate to evaluate as diagnostic tests. All of these tools assessed for depression. Geriatric Depression Scale (GDS)-based tools were predominant with variable diagnostic accuracy across different settings. Methodological issues were substantial based on the QUADAS-2 criteria. In the epidemiological studies identified (n = 160), depression alone was assessed for 82% of the studies. Tools lacking cultural validation were commonly used (43%). Conclusions: This review identifies a number of current research gaps including a need for culturally relevant validation studies, and attention to other CMDs such as anxiety.

scholarly journals Malnutrition in older adults: screening and determinants

2018 ◽  
Vol 78 (3) ◽  
pp. 372-379 ◽  
Author(s):  
Clare A. Corish ◽  
Laura A. Bardon
Keyword(s):  
Older Adults ◽  
Residential Care ◽  
Nutritional Assessment ◽  
Short Form ◽  
Meta Analysis ◽  
Protein Energy Malnutrition ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Screening Tools ◽  
Climbing Stairs

Older adults are at risk of protein-energy malnutrition (PEM). PEM detrimentally impacts on health, cognitive and physical functioning and quality of life. Given these negative health outcomes in the context of an ageing global population, the Healthy Diet for a Healthy Life Joint Programming Initiative Malnutrition in the Elderly (MaNuEL) sought to create a knowledge hub on malnutrition in older adults. This review summarises the findings related to the screening and determinants of malnutrition. Based on a scoring system that incorporated validity, parameters used and practicability, recommendations on setting-specific screening tools for use with older adults were made. These are: DETERMINE your health checklist for the community, Nutritional Form for the Elderly for rehabilitation, Short Nutritional Assessment Questionnaire-Residential Care for residential care and Malnutrition Screening Tool or Mini Nutritional Assessment-Short Form for hospitals. A meta-analysis was conducted on six longitudinal studies from MaNuEL partner countries to identify the determinants of malnutrition. Increasing age, unmarried/separated/divorced status (vs.married but not widowed), difficulties walking 100 m or climbing stairs and hospitalisation in the year prior to baseline or during follow-up predicted malnutrition. The sex-specific predictors of malnutrition were explored within The Irish Longitudinal Study of Ageing dataset. For females, cognitive impairment or receiving social support predicted malnutrition. The predictors for males were falling in the previous 2 years, hospitalisation in the past year and self-reported difficulties in climbing stairs. Incorporation of these findings into public health policy and clinical practice would support the early identification and management of malnutrition.

scholarly journals Nonimmersive Brain Gaming for Older Adults With Cognitive Impairment: A Scoping Review

2019 ◽  
Vol 59 (6) ◽  
pp. e764-e781 ◽  
Author(s):  
Pallavi Sood ◽  
Sandra L Kletzel ◽  
Shilpa Krishnan ◽  
Hannes Devos ◽  
Ahmed Negm ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Scoping Review ◽  
Research Field ◽  
Cognitive Outcome ◽  
Future Research ◽  
Eligibility Criteria ◽  
Technological Advances ◽  
Design And Methods

Abstract Background Technological advances have allowed a variety of computerized cognitive training tools to be engineered in ways that are fun and entertaining yet challenging at a level that can maintain motivation and engagement. This revolution has created an opportunity for gerontological scientists to evaluate brain gaming approaches to improve cognitive and everyday function. The purpose of this scoping review is to provide a critical overview of the existing literature on nonimmersive, electronic brain gaming interventions in older adults with mild cognitive impairment or dementia. Research Design and Methods Systematic search was conducted using 7 electronic databases from inception through July 2017. A comprehensive 2-level eligibility process was used to identify studies for inclusion based on PRISMA guidelines. Results Seventeen studies met eligibility criteria. Majority of the studies were randomized controlled trials (n = 13) and incorporated an active control (n = 9). Intervention doses ranged from 4 to 24 weeks in duration with an average of 8.4 (±5.1 standard deviation [SD]) weeks. Session durations ranged from 30 to 100 min with an average of 54 (±25 SD) minutes. Nearly half of studies included a follow-up, ranging from 3 months to 5 years (n = 8). For most studies, brain gaming improved at least one cognitive outcome (n = 12); only one study reported improvement in activities of daily living. Discussion and Implications This scoping review conveys the breadth of an emerging research field, which will help guide future research to develop standards and recommendations for brain gaming interventions which are currently lacking.

scholarly journals Measuring the association of objective and perceived neighborhood environment with physical activity in older adults: challenges and implications from a systematic review

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Manuela Peters ◽  
Saskia Muellmann ◽  
Lara Christianson ◽  
Imke Stalling ◽  
Karin Bammann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Successful Aging ◽  
The Elderly ◽  
Neighborhood Environment ◽  
Sufficient Evidence ◽  
Measurement Instruments ◽  
Qualitative Synthesis ◽  
Eligibility Criteria ◽  
Methodological Approaches

Abstract Background A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence. Methods A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided. Results Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified. Conclusions The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.

scholarly journals Barriers to effective prescribing in older adults: applying the theoretical domains framework in the ambulatory setting – a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sabrina Lau ◽  
Penny Lun ◽  
Wendy Ang ◽  
Keng Teng Tan ◽  
Yew Yoong Ding
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Grey Literature ◽  
Inappropriate Prescribing ◽  
Theoretical Domains Framework ◽  
Ambulatory Setting ◽  
Eligibility Criteria ◽  
Related Factors ◽  
Prescribing Behaviour ◽  
The Impact

Abstract Background As the population ages, potentially inappropriate prescribing (PIP) in the older adults may become increasingly prevalent. This undermines patient safety and creates a potential source of major morbidity and mortality. Understanding the factors that influence prescribing behaviour may allow development of interventions to reduce PIP. The aim of this study is to apply the Theoretical Domains Framework (TDF) to explore barriers to effective prescribing for older adults in the ambulatory setting. Methods A scoping review was performed based on the five-stage methodological framework developed by Arksey and O’Malley. From 30 Aug 2018 to 5 Sep 2018, we conducted our search on PubMed, CINAHL, EMBASE, the Cochrane Database of Systematic Reviews, and Web of Science. We also searched five electronic journals, Google and Google Scholar to identify additional sources and grey literature. Two reviewers applied eligibility criteria to the title and abstract screening, followed by full text screening, before systematically charting the data. Results A total of 5731 articles were screened. Twenty-nine studies met the selection criteria for qualitative analysis. We mapped our results using the 14-domain TDF, eventually identifying 10 domains of interest for barriers to effective prescribing. Of these, significant domains include physician-related factors such as “Knowledge”, “Skills”, and “Social/Professional Role and Identity”; issues with “Environmental Context and Resources”; and the impact of “Social Influences” and “Emotion” on prescribing behaviour. Conclusion The TDF elicited multiple domains which both independently and collectively lead to barriers to effective prescribing for older adults in the ambulatory setting. Changing the prescribing climate will thus require interventions targeting multiple stakeholders, including physicians, patients and hospital/clinic systems. Further work is needed to explore individual domains and guide development of frameworks to aid guide prescribing for older adults in the ambulatory setting.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

Health Status Screening in Elderly Patients — Is this the Way Forward?

2012 ◽  
Vol 08 (01) ◽  
pp. 63
Author(s):  
Joanna Kazmierska ◽  
Keyword(s):  
Health Status ◽  
Health Assessment ◽  
European Population ◽  
Assessment Tools ◽  
Screening Tools ◽  
Screening Methods ◽  
Age Group ◽  
Cognitive Domains ◽  
Standard Assessment ◽  
Pre Treatment

The rapid ageing of the European population poses a challenge for healthcare systems. The incidence of cancers will rise as the number of adults aged 65 years and older increases. Moreover, the health status of individuals in this age group is diverse, and thus requires modern oncology to apply an individualised approach to treatment. There is a clear need to develop and validate health assessment tools enabling the identification of specific geriatric issues which might be overlooked by standard assessment methods. The Comprehensive Geriatric Assessment (CGA) is the ‘gold standard’ for geronto-oncology assessment. However, the complexity of this test has stimulated a search for pre-screening methods able to identify individuals with the potential to gain most from full pre-treatment CGA. Such tools consist of specific tests to evaluate health status in the important functional, psychological, social and cognitive domains. The choice of which tests are best to use within the various screening tools is still a subject of debate. This paper presents a review of the most commonly used tests within various health status domains as well as of the most valuable screening tools.

Autism spectrum disorder in older adults with intellectual disability: a scoping review

2021 ◽  
pp. 1-14
Author(s):  
E. Maguire ◽  
N. Mulryan ◽  
F. Sheerin ◽  
P. McCallion ◽  
M. McCarron
Keyword(s):  
Older Adults ◽  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Scoping Review ◽  
Functional Outcomes ◽  
Psychiatric Comorbidity ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Ageing Population ◽  
Older Population

Introduction: Ireland has an ageing population of persons with intellectual disability (ID), autism spectrum disorder (ASD) and both (ID/ASD). Despite this, little is known about the prevalence of ASD and its effect on functional outcomes, psychiatric comorbidity or diagnostic issues in an older population with ID. This article reviews the literature on older adults with ID/ASD and identifies opportunities for future research in this population. Method: The authors searched the Medline, Pubmed, Embase, CINAHL and PsychInfo databases using the search terms using key words: (older adults) AND (ID OR mental retardation OR learning disability) AND (autism OR ASD). After excluding articles for relevance, a scoping review was carried out on the results retrieved. Results: Of the 1227 articles retrieved from the literature on ID and autism/ASD in older adults, 85 articles were relevant to an adult population with ID/ASD. The data were collated and are presented covering domains of diagnosis, prevalence, psychiatric comorbidities and functional outcomes. Conclusions: Despite increased prevalence in childhood ASD in the last 20 years, there is a lack of research regarding adults, especially older adults, with ASD, up to half of whom will have some level of ID. The existing literature suggests that older adults with ID/ASD may have reduced functional independence, increased psychiatric comorbidity and psychotropic prescribing and more behavioural presentations than the older population generally or those with ID only. There is a need for longitudinal data to be collected on this ageing population so that care and management needs can be met in the future.

scholarly journals Mental Health Status of the Elderly Chinese Population During COVID-19: An Online Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Rui Zhou ◽  
Hao Chen ◽  
Lin Zhu ◽  
Ying Chen ◽  
Boyan Chen ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Older Adults ◽  
Health Status ◽  
Chinese Population ◽  
The Elderly ◽  
Mental Health Status ◽  
Psychological Status ◽  
Risk Level ◽  
Elderly Chinese

Background: COVID-19 not only threatened the public's physical health but also brought unbearable psychological pressure, especially for those vulnerable groups like the elderly. However, studies on the psychological status of older adults during this public health emergency remained scant. This study aims to investigate the mental health status among the elderly Chinese population during COVID-19 pandemic and determine the influencing factors of psychological symptoms.Methods: From February 19 to March 19, 2020, an online survey was administered to Chinese older adults using a convenience sampling method. Information on demographic data, health status and other epidemic related factors were collected. Specifically, the study defined the psychological status as five primary disorder–depression, neurasthenia, fear, anxiety, and hypochondria–which were assessed by the Psychological Questionnaire for Emergent Event of Public Health (PQEEPH). Standard descriptive statistics and multiple logistic regression analyses were conducted to analyze the data.Results: Of 1,501 participants recruited from 31 provinces in China, 1,278 were valid for further analysis. Participants' scores on each sub-scale were described in median and interquartile [M(Q)]: depression [0.00 (0.33)], neurasthenia [0.00 (0.40)], fear [1.00 (0.83)], anxiety [0.00 (0.17)], hypochondria [0.00 (0.50)]. Chronic diseases (depression p = 0.001; neurasthenia p < 0.001; fear p = 0.023; anxiety p < 0.001; hypochondria p = 0.001) and the BMI index (depression p = 0.015; neurasthenia p = 0.046; fear p = 0.016; anxiety p = 0.015; hypochondria p = 0.013) had significant impacts on all of the five sub-scales. Specifically, the rural dwellers had a higher level of neurasthenia, fear, and hypochondria. Besides, education level (p = 0.035) and outbreak risk level (p = 0.004) had significant impacts on the depression. Higher household monthly income per capita (p = 0.031), and the community-level entry/exit control (p = 0.011) are factors against anxiety.Conclusions: Most elderly residents reported mild negative emotions during COVID-19 and more attention should be paid to the recognition and alleviation of fear. Our findings also identified factors associated with the mental health status of the elderly, which is of practical significance in the design and implementation of psychological interventions for this vulnerable population during COVID-19 and future emerging diseases.

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