Mapping instruments for assessing and stratifying frailty among community-dwelling older people: a scoping review

ObjectiveTo map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context.DesignScoping review.Study selectionThe selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature.Data extractionA data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty.ResultsIn summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments.ConclusionsThis review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.

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Frailty Status and All-Cause Mortality in the Community-Dwelling Older People: An Umbrella Review

Innovation in Aging ◽

10.1093/geroni/igaa057.1580 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 488-489

Author(s):

A R M Saifuddin Ekram ◽

Joanne Ryan ◽

Carlene Britt ◽

Sara Espinoza ◽

Robyn Woods

Keyword(s):

Older People ◽

Systematic Reviews ◽

Community Dwelling ◽

Umbrella Review ◽

Frailty Phenotype ◽

Frailty Status ◽

Increased Risk ◽

All Cause Mortality ◽

Community Dwelling Older People ◽

Meta Analyses

Abstract Frailty is increasingly recognised for its association with adverse health outcomes including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aimed to map which frailty scale could best predict the relationship between frailty and all-cause mortality among community-dwelling older people. According to the PRISMA guidelines, Medline, Embase, EBSCOhost and Web of Science databases were searched to identify eligible systematic reviews and meta-analyses which examined the association between frailty and all-cause mortality in the community-dwelling older people. Relevant data were extracted and summarised qualitatively. Methodological quality was assessed by AMSTAR-2 checklist. Five moderate-quality systematic reviews with a total of 374,529 participants were identified. Of these, two examined the frailty phenotype and its derivatives, two examined the cumulative deficit models and the other predominantly included studies assessing frailty with the FRAIL scale. All of the reviews found a significant association between frailty status and all-cause mortality. The magnitude of association varied between individual studies, with no consistent pattern related to the frailty measures that were used. In conclusion, regardless of the measure used to assess frailty status, it is associated with an increased risk of all-cause mortality.

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Pediatric Hand Fracture Referring Practices: A Scoping Review

Plastic Surgery ◽

10.1177/2292550319876659 ◽

2019 ◽

Vol 27 (4) ◽

pp. 340-347 ◽

Cited By ~ 1

Author(s):

Rebecca L. Hartley ◽

Anna R. Todd ◽

Alan R. Harrop ◽

Frankie O. G. Fraulin

Keyword(s):

Primary Care ◽

Scoping Review ◽

Data Extraction ◽

Grey Literature ◽

Cross Sectional ◽

Hand Fractures ◽

Study Selection ◽

Primary Care Education ◽

Hand Fracture ◽

Study Designs

Background: Pediatric hand fractures are common, but few require surgery; therefore, these fractures are often perceived to be overreferred. Our objective is to systematically identify and describe pediatric hand fracture referring practices. Method: A scoping review was performed, searching electronic databases and grey literature up to January 2018 to identify referring practices for children (17 years and younger) with hand fractures (defined as radiographically confirmed fractures distal to the carpus) to hand surgeons. All study designs were included, and study selection and data extraction were independently performed in duplicate by 2 reviewers. Outcomes included referring rates, necessity of referral, referring criteria, and management of fractures. Results: Twenty (10 cross-sectional, 7 prospective cohorts, and 3 narrative reviews) studies reporting on referring practices or management of 21,624 pediatric hand fractures were included. Proportion of pediatric hand fractures referred to hand surgeons ranged from 6.5% to 100%. Unnecessary referral, defined as those fractures within the scope of primary care management, ranged from 27% to 78.1%. Ten studies reported referring criteria, with 14 unique criteria identified. The most common referring criteria were displacement (36.4%), loss of joint congruity (36.4%), and instability (36.4%). The most common justification for these criteria was increased likelihood of requiring surgery. The most common initial management was immobilization (66%-100%). Final management was provided by orthopedic or plastic hand surgeons with 0% to 32.9% of fractures requiring surgery. Conclusion: Referring practices vary widely in the literature. Major gaps in the literature include objective measures and justification for referring criteria and primary care education on hand fracture referring practices.

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Factors related to the adoption and adherence of physical activity mobile applications by older people: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2021-052414 ◽

2021 ◽

Vol 11 (10) ◽

pp. e052414

Author(s):

Lorena Jorge Lorenzi ◽

Letícia Fernanda Belo ◽

David Mark Frohlich ◽

Victor Zuniga Dourado ◽

Paula Costa Castro ◽

...

Keyword(s):

Physical Activity ◽

Older People ◽

Scoping Review ◽

Mobile Applications ◽

Full Text ◽

Data Extraction ◽

Grey Literature ◽

Ethical Approval ◽

Data Extraction Tool ◽

Review Protocol

IntroductionAgeing is a natural process marked by physiological changes and declines in functional capacity. One strategy to encourage healthy habits in older people is the use of applications on mobile devices to promote physical activity (PA). An immediate challenge is for these applications to be accessible to older people themselves, while a second challenge is to retain their interest and engagement in connection with PA itself. Therefore, the purpose of this review is to map the factors related to the adoption and adherence of PA mobile applications by older people.Methods and analysisFive databases will be searched where articles and reviews, available between 2010 and present, in English, Portuguese or Spanish, at full text, will be included. In addition, two additional strategies will be performed, including grey literature. The search terms adoption, adherence, factors, mobile application, PA, older people and other terms related to them will be used in the search strategy. This review will include studies that identify factors related to the adoption and adherence to PA mobile applications by people over 60 years. The selection of studies will be carried out by two reviewers in five stages: identification of studies and duplicate removal; pilot test; selection by reading abstracts; inclusion by reading the full text and search in additional sources. Disagreements will be resolved by a third reviewer. Data will be extracted using a data extraction tool. Quantitative data will be described in a narrative manner and qualitative data will be categorised through inductive thematic analysis.Ethics and disseminationEthical approval is not required for this scoping review. Plans for the dissemination of the review include the presentation of the results at relevant scientific conferences and the submission and publication in significant journals.

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Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People

Journal of Frailty & Aging ◽

10.14283/jfa.2021.10 ◽

2021 ◽

pp. 1-1

Author(s):

R.C. Castrejón-Pérez

Keyword(s):

Oral Health ◽

Older People ◽

Medical Record ◽

Frailty Index ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Frailty Status ◽

Community Dwelling Older People ◽

Oral Conditions

The studies exploring the association between oral conditions and Frailty status are increasing in number, and many manuscripts have been published during the last couple of years. Even when Everaars et al. (1) manuscript is cross-sectional, it contributes to the knowledge by confirming the association between oral conditions and Frailty despite the selected strategy for measuring Frailty since authors added the interview Groningen Frailty Index and the Frailty Index (computed with data extracted from the Electronic Medical Record) to the most frequently used Frailty Phenotype and Kihon checklist (2).

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Patient-centred infertility care: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-032266 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032266

Author(s):

Hana Hasan Webair ◽

Tengku Alina Tengku Ismail ◽

Shaiful Bahari Ismail ◽

Norhayati Mohd Noor

Keyword(s):

Scoping Review ◽

Literature Search ◽

Data Extraction ◽

Grey Literature ◽

Decision Makers ◽

Cochrane Library ◽

Quality Healthcare ◽

Study Selection ◽

History Of ◽

Review Protocol

IntroductionPatient-centred infertility care (PCIC) is one of the quality indicators of effective fertility care. The application of this indicator requires a clear definition from the patient’s perspective. This proposed scoping review aims to explore the extent and nature of published scientific literature on PCIC in the past decade, identify gaps in the literature and define PCIC from infertile patients’ perspectives.Methods and analysisWe will conduct the proposed scoping review following the method of Arksey and O’Malley. The literature search will include studies published from 2009 to 2019, and will be conducted on the MEDLINE, PsycINFO, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases; reference lists will be mined for literature not contained on these databases. A grey literature search will also be conducted. To be included in the review, studies should have been conducted on people with a history of infertility, with a focus on patient-centred fertility care. Studies that have not been published in full text and studies published in languages other than English will be excluded. After study selection, data will be charted in a prepared form. We will analyse the data using descriptive numerical and qualitative thematic analyses to answer the research questions. NVivo V.12 will be used for data extraction.Ethics and disseminationThis work does not warrant any ethical or safety concerns. This scoping review will synthesise existing literature on PCIC, and the results will be published to be readily available for clinical audiences and policymakers. These findings may support clinicians and decision-makers in applying PCIC, thereby promoting high-quality healthcare in the concerned population.

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Functional Independence in the Community Dwelling Older People: a Scoping Review

Journal of Population Ageing ◽

10.1007/s12062-020-09315-1 ◽

2020 ◽

Author(s):

E. A. L. M. Molenaar ◽

J. A. Barten ◽

S. te Velde ◽

L. van der Schoot ◽

N. Bleijenberg ◽

...

Keyword(s):

Older People ◽

Scoping Review ◽

Functional Independence ◽

Community Dwelling ◽

Physical Factors ◽

Contributing Factors ◽

Holistic View ◽

Stakeholder Consultation ◽

Community Dwelling Older People ◽

Definition Of

AbstractAgeing potentially poses a threat to independent functioning of older adults. Although clinicians commonly focus on physical factors limiting Functional Independence (FI), it is likely that personal and environmental interactions also seem important to maintain FI. Herewith, FI exceeds several professional borders and calls for a uniform, multidisciplinary interdisciplinary supported definition of FI. This study aims to provide such a definition of FI in community dwelling older people. A scoping review was performed. Pubmed/Medline, Psychinfo and CINAHL were searched for studies describing aspects of FI. A literature-based definition of FI was discussed by experts (n = 7), resulting in a formulated final definition of FI and insight into contributing factors to FI. A multidisciplinairy focusgroup a stakeholder consultation (n = 15) ensured clinical relevance for daily practice. Data from the focusgroup stakeholder consultation were analyzed by using Atlas.ti (version 8). Based on the literature search, 25 studies were included. FI was finally defined as “Functioning physically safely and independent from another person, within one’s own context”. The contributing factors of FI comprised physical capacity combined with coping, empowerment and health literacy. Moreover, the level of FI is influenced by someone’s own context. This study confirms the relevance of the physical aspect of FI, but additionally stresses the importance of psychological factors. In addition, this study shows that one’s context may affect the level of FI as well. This underlines the importance of a holistic view and calls for multidisciplinary interdisciplinary collaboration in community-dwelling older people.

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Optimising prescribing practices in older adults with multimorbidity: a scoping review of guidelines

BMJ Open ◽

10.1136/bmjopen-2021-049072 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049072

Author(s):

Penny Lun ◽

Felicia Law ◽

Esther Ho ◽

Keng Teng Tan ◽

Wendy Ang ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Scoping Review ◽

Data Extraction ◽

Grey Literature ◽

Cochrane Library ◽

Prescribing Practices ◽

Usable Knowledge ◽

Study Selection ◽

The Cochrane Library

ObjectiveInappropriate polypharmacy occurs when multiple medications are prescribed without clear indications or where harms outweigh their benefits. The aims of this scoping review are to (1) identify prescribing guidelines that are available for older adults with multimorbidity and (2) to identify cross-cutting themes used in these guidelines.DesignScoping review.Data sourcesPubMed, Embase, Web of Science, the Cochrane Library databases, Cumulative Index to Nursing and Allied Health Literature, grey literature sources, six key geriatrics journals, and reference lists of identified review papers. The search was conducted in November 2018 and updated in September 2019.Study selectionGeneral prescribing guidelines tailored to or for adults including older adults with multimorbidity.Data extractionData for publication description, guideline characteristics, information for users and criteria were extracted. The synthesis contains summarised qualitative descriptions of the studies and guideline characteristics as well as identified cross-cutting themes.ResultsOur search strategy yielded 10 427 unique citations, of which 70 fulfilled the inclusion criteria for synthesis. Among these, there were 61 unique guidelines and tools which used implicit, explicit, mixed or other approaches in the prescriber decision-making process. There are 11 cross-cutting themes identified in the guidelines. Prescriber-related themes are: conduct a comprehensive assessment before prescribing, identify patients’ needs, goals and priorities, adopt shared decision-making, consider evidence-based recommendations, use clinical prescribing tools, incorporate multidisciplinary inputs and embrace technology-enabled prescribing. Wider organisation-related and system-related themes related to education, training and the work environment are also identified.ConclusionsFrom guidelines and tools identified, eleven cross-cutting themes provide a usable knowledge base when seeking to optimise prescribing among older adults with multimorbidity. Incorporating these themes in an approach that uses mixed criteria and implementation information could facilitate greater uptake of published prescribing recommendations.

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Ethical issues related to the use of gerontechnology in older people care: A scoping review

Nursing Ethics ◽

10.1177/0969733019845132 ◽

2019 ◽

Vol 27 (1) ◽

pp. 88-103 ◽

Cited By ~ 3

Author(s):

Suvi Sundgren ◽

Minna Stolt ◽

Riitta Suhonen

Keyword(s):

Older People ◽

Scoping Review ◽

Ethical Issues ◽

Scientific Practice ◽

Empirical Studies ◽

Quality Care ◽

Healthcare Services ◽

Community Dwelling ◽

Main Theme ◽

Community Dwelling Older People

Background: Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out. Purpose: To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people. Methods: A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis. Ethical considerations: This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately. Results: A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied. Conclusion: These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.

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Location monitoring of physical activity and participation in community dwelling older people: a scoping review

Disability and Rehabilitation ◽

10.1080/09638288.2019.1618928 ◽

2019 ◽

Vol 43 (2) ◽

pp. 270-283 ◽

Cited By ~ 1

Author(s):

Claire Gough ◽

Heather Weber ◽

Stacey George ◽

Anthony Maeder ◽

Lucy Lewis

Keyword(s):

Physical Activity ◽

Older People ◽

Scoping Review ◽

Community Dwelling ◽

Community Dwelling Older People

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Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

CJEM ◽

10.1017/cem.2014.59 ◽

2015 ◽

Vol 17 (5) ◽

pp. 532-550 ◽

Cited By ~ 5

Author(s):

Jan L. Jensen ◽

Alix J.E. Carter ◽

Jennifer Rose ◽

Sarah Visintini ◽

Emmanuelle Bourdon ◽

...

Keyword(s):

Service Utilization ◽

Outcome Measures ◽

Scoping Review ◽

Data Extraction ◽

Grey Literature ◽

Reference List ◽

Inclusion Criteria ◽

Program Leaders ◽

Study Selection ◽

Bibliographic Search

AbstractObjectivesEmergency medical services (EMS) programs, which provide an alternative to traditional EMS dispatch or transport to the emergency department (ED), are becoming widely implemented. This scoping review identified and catalogued all outcomes used to measure such alternative EMS programs.Data SourceBroad systematized bibliographic and grey literature searches were conducted.Study SelectionInclusion criteria were 911 callers/EMS patients, reported on alternatives to traditional EMS dispatch OR traditional EMS transport to the ED, and reported an outcome measure.Data ExtractionThe reports were categorized as either alternative to dispatch or to EMS transport, and outcome measures were categorized and described.Data SynthesisThe bibliographic search retrieved 13,215 records, of which 34 articles met the inclusion criteria, with an additional 10 added from reference list hand-searching (n=44 included). In the grey literature search, 31 websites were identified, from which four met criteria and were retrieved (n=4 included). Fifteen reports (16 studies) described alternatives to EMS dispatch, and 33 reports described alternatives to EMS transport. The most common outcomes reported in the alternatives to EMS dispatch reports were service utilization and decision accuracy. Twenty-four different specific outcomes were reported. The most common outcomes reported in the alternatives to EMS transport reports were service utilization and safety, and 50 different specific outcomes were reported.ConclusionsNumerous outcome measures were identified in reports of alternative EMS programs, which were catalogued and described. Researchers and program leaders should achieve consensus on uniform outcome measures, to allow benchmarking and improve comparison across programs.

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