Impact of Diet and Exercise on Weight and Cognition in Older Adults: A Rapid Review

Objective: To determine where the current literature stands in regard to diet/exercise interventions on cognition in overweight or obese individuals. Data Source: A rapid review was conducted of English-language studies published in Medline from January 1965 to January 2020. Study Inclusion and Exclusion Criteria: Included studies were intervention studies lasting ≥12 weeks, with participants aged ≥65 years, with a body mass index ≥25 kg/m2 Data Extraction: Data extracted included study population, duration, intervention design, outcomes, and results. Data Synthesis: Outcomes were qualitatively measured due to paucity of RTC. Results: 1845 citations were identified, 31 full-text articles were reviewed, and 5 studies were included. Studies had usual care control groups and combined exercise/diet intervention groups with 31-3,526 participants randomized to each arm. Mean age of participants was 69.2-83.4 years. Studies reporting on cognitive changes showed marginally significant positive changes in cognition, and those that reported BMI indicated potential improvements in cognition. Conclusions: The number of interventions assessing the combined effects of both diet and exercise is low. Future studies should evaluate the impact of combined effects to ascertain whether cognitive decline may be reversed in older adults with a BMI ≥25 kg/m2.

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Measuring frailty in younger populations: a rapid review of evidence

BMJ Open ◽

10.1136/bmjopen-2020-047051 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047051

Author(s):

Gemma F Spiers ◽

Tafadzwa Patience Kunonga ◽

Alex Hall ◽

Fiona Beyer ◽

Elisabeth Boulton ◽

...

Keyword(s):

Patient Outcomes ◽

Predictive Validity ◽

Data Extraction ◽

Grey Literature ◽

Frailty Index ◽

Study Data ◽

Rapid Review ◽

Eligibility Criteria ◽

Adult Age ◽

The Impact

ObjectivesFrailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.DesignA rapid review of primary studies was conducted.Data sourcesFour databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteriaEligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesisRecords were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.ResultsWe identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.ConclusionsLimited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups.

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Cancer services during the COVID-19 pandemic: systematic review of patients' and caregivers' experiences

10.1101/2021.03.19.21253949 ◽

2021 ◽

Author(s):

Symran Dhada ◽

Derek Stewart ◽

Ejaz Cheema ◽

Muhammed Abdul Hadi ◽

Vibhu Paudyal

Keyword(s):

Systematic Review ◽

Cancer Screening ◽

Cancer Patients ◽

English Language ◽

Resource Constraints ◽

Data Extraction ◽

Psychological Wellbeing ◽

Cancer Services ◽

Data Extraction Form ◽

The Impact

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients' and caregivers' experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing. Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears.

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Semi-Autonomous Vehicles as a Cognitive Assistive Device for Older Adults

Geriatrics ◽

10.3390/geriatrics4040063 ◽

2019 ◽

Vol 4 (4) ◽

pp. 63

Author(s):

Frank Knoefel ◽

Bruce Wallace ◽

Rafik Goubran ◽

Iman Sabra ◽

Shawn Marshall

Keyword(s):

Older Adults ◽

Autonomous Vehicles ◽

Cognitive Change ◽

Health Needs ◽

Assistive Device ◽

Cognitive Changes ◽

Age Related ◽

Vehicle Automation ◽

The Impact ◽

Aging Drivers

Losing the capacity to drive due to age-related cognitive decline can have a detrimental impact on the daily life functioning of older adults living alone and in remote areas. Semi-autonomous vehicles (SAVs) could have the potential to preserve driving independence of this population with high health needs. This paper explores if SAVs could be used as a cognitive assistive device for older aging drivers with cognitive challenges. We illustrate the impact of age-related changes of cognitive functions on driving capacity. Furthermore, following an overview on the current state of SAVs, we propose a model for connecting cognitive health needs of older drivers to SAVs. The model demonstrates the connections between cognitive changes experienced by aging drivers, their impact on actual driving, car sensors’ features, and vehicle automation. Finally, we present challenges that should be considered when using the constantly changing smart vehicle technology, adapting it to aging drivers and vice versa. This paper sheds light on age-related cognitive characteristics that should be considered when developing future SAVs manufacturing policies which may potentially help decrease the impact of cognitive change on older adult drivers.

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Islam and Mental Disorders of the Older Adults: Religious Text, Belief System and Caregiving Practices

Journal of Religion and Health ◽

10.1007/s10943-020-01094-5 ◽

2020 ◽

Author(s):

Suhad Daher-Nashif ◽

Suzanne H. Hammad ◽

Tanya Kane ◽

Noor Al-Wattary

Keyword(s):

Older Adults ◽

Mental Disorders ◽

Belief System ◽

Social Practices ◽

Cognitive Changes ◽

Religious Texts ◽

Elderly Parents ◽

Religious Text ◽

Arab Muslim ◽

The Impact

Abstract This paper illustrates the impact of Islamic religious texts on dementia care in the Middle East. It examines how old age and older adults mental disorders are framed in the Quran and Hadith, and how these texts are transformed to belief ideologies and caregiving practices. The study uses a qualitative research methods, which include a review of all Islamic holy texts that address mental and cognitive changes associated with ageing, along with interviews with eight Sharia scholars and 37-Arab-Muslim families living in Qatar. Islamic texts command compassion and honouring of elderly parents and give care instructions. These texts are transformed into social practices and used as diagnostic and treatment tools.

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Sleep Duration in Relation to Cognitive Function among Older Adults: A Systematic Review of Observational Studies

Neuroepidemiology ◽

10.1159/000442418 ◽

2016 ◽

Vol 46 (1) ◽

pp. 57-78 ◽

Cited By ~ 24

Author(s):

Elizabeth E. Devore ◽

Francine Grodstein ◽

Eva S. Schernhammer

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Function ◽

Sleep Duration ◽

Observational Studies ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Short Sleep ◽

Sleep Parameters

Context: Increasing evidence suggests that circadian and sleep parameters influence cognitive function with aging. Objective: To evaluate observational studies of sleep duration and cognition in older adults. Data Sources: A systematic review of OVID Medline and PsycINFO through September 2015, and review of bibliographies from studies identified. Study Selection: English-language articles reporting observational studies of sleep duration and cognitive function in older populations. Data Extraction: Data extraction by 2 authors using predefined categories of desired information. Results: Thirty-two studies met our inclusion criteria, with nearly two-thirds published in the past 4 years. One-third of studies indicated that extreme sleep durations were associated with worse cognition in older adults. More studies favored an association with long vs. short sleep durations (35 vs. 26% of studies, respectively). Four studies found that greater changes in sleep duration over time were related to lower cognition. Study design and analytic methods were very heterogeneous across studies; therefore, meta-analysis was not undertaken. Limitations: We reviewed English-language manuscripts only, with a qualitative summary of studies identified. Conclusions and Implications of Key Findings: Observational studies of sleep duration and cognitive function in older adults have produced mixed results, with more studies suggesting that long (rather than short) sleep durations are related to worse cognition. Studies more consistently indicate that greater changes in sleep duration are associated with poor cognition. Future studies should be prospectively designed, with objective sleep assessment and longer follow-up periods; intervention studies are also needed to identify strategies for promoting cognitive health with aging.

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Nilutamide: An Antiandrogen for the Treatment of Prostate Cancer

Annals of Pharmacotherapy ◽

10.1177/106002809703100112 ◽

1997 ◽

Vol 31 (1) ◽

pp. 65-75 ◽

Cited By ~ 33

Author(s):

Ernest J Dole ◽

Mark T Holdsworth

Keyword(s):

Prostate Cancer ◽

Adverse Effects ◽

Advanced Prostate Cancer ◽

English Language ◽

Data Extraction ◽

Performance Status ◽

Major Advance ◽

Improved Performance ◽

The Impact ◽

Nonsteroidal Antiandrogens

OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and adverse effects of nilutamide and to compare this agent with the currently marketed nonsteroidal antiandrogens (i.e., bicalutamide, flutamide) by critically analyzing the published literature. DATA SOURCES: MEDLINE (1980–1995) and CANCERLIT (1991–1995) were searched for English-language publications using the terms nilutamide, bicalutamide, and flutamide alone, and either nilutamide or androgen antagonists in combination with prostatic neoplasms. STUDY SELECTION AND DATA EXTRACTION: All articles with subject matter on nilutamide, bicalutamide, and flutamide were considered for inclusion. For studies published in more than one journal, the first publication was used unless a subsequent publication included additional or follow-up data, in which case the latter publication was cited instead. DATA SYNTHESIS: Nilutamide was effective in combination with orchiectomy in improving responses in patients with advanced prostate cancer. However, patient survival was not improved in these trials, and improvements in bone pain did not usually result in improved performance status in these patients. The few trials of nilutamide monotherapy or nilutamide in combination with a luteinizing hormone-releasing hormone analog are too small to draw meaningful conclusions regarding its efficacy or its role in the treatment of advanced prostate cancer. No comparative trials of nilutamide with other antiandrogens and no analysis of the impact of nilutamide on patient quality of life are currently available. Nilutamide appears to produce a higher frequency of adverse effects than the other currently marketed nonsteroidal antiandrogens, bicalutamide and flutamide. CONCLUSIONS: Nilutamide does not appear to represent a major advance in the treatment of advanced prostate cancer and appears to be somewhat inferior to both flutamide and bicalutamide with regard to adverse effects. Nilutamide should not be considered the antiandrogen of choice in the treatment of advanced prostate cancer.

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Combined Effects of Diet and Exercise or Diet to Improve Physical Function in Older Adults

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000485378.87810.ed ◽

2016 ◽

Vol 48 ◽

pp. 127

Author(s):

Maria Giné-Garriga ◽

Eulàlia Vidal-Garcia ◽

Natàlia Gómara-Toldrà ◽

Blanca Roman-Viñas ◽

Míriam Guerra-Balic ◽

...

Keyword(s):

Older Adults ◽

Physical Function ◽

Combined Effects ◽

Diet And Exercise

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Cancer Services During the COVID-19 Pandemic: Systematic Review of Patients’ and Caregivers’ Experiences

10.21203/rs.3.rs-294240/v1 ◽

2021 ◽

Author(s):

Symran Dhada ◽

Derek Stewart ◽

Ejaz Cheema ◽

Muhammed Abdul Hadi ◽

Vibhu Paudyal

Keyword(s):

Systematic Review ◽

Cancer Screening ◽

Cancer Patients ◽

English Language ◽

Resource Constraints ◽

Data Extraction ◽

Psychological Wellbeing ◽

Cancer Services ◽

Data Extraction Form ◽

The Impact

Abstract Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients’ and caregivers’ experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing.Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears. Protocol Registration Published protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906)

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Understanding the impact of professional motivation on the workforce crisis in medicine

BJGP Open ◽

10.3399/bjgpo.2021.0005 ◽

2021 ◽

pp. BJGPO.2021.0005

Author(s):

Efioanwan Andah ◽

Blessing Essang ◽

Charlotte Friend ◽

Sarah Greenley ◽

Kathryn Harvey ◽

...

Keyword(s):

Thematic Analysis ◽

English Language ◽

Medical Profession ◽

Secondary Analysis ◽

Final Analysis ◽

Rapid Review ◽

Medical Professionals ◽

Medical Workforce ◽

Design Quality ◽

The Impact

BackgroundThe NHS is facing a workforce crisis. Responses to date have focused on improving recruitment of staff, but with less attention paid to retention.AimTo conduct a rapid review using Moss Kanter’s 3M’s model of workforce motivation as a sensitising framework to examine the current medical workforce crisis. Our work considers how insights from research in other professions offers new thinking for understanding what motivates doctors to continue working.Design & settingRapid literature review with secondary analysis of existing research examining reasons for leaving medicine.MethodA systematic search strategy was developed with the aid of an Information Specialist. (Search terms: medical professionals, retention, NHS; exclusions: commentaries, non-medical professionals, non-English language etc; limited to post-1990). Applied to three electronic databases, MEDLINE, EMBASE and HMIC. This produced a dataset describing study design/quality; and factors related to motivation for leaving the medical profession. Comparative thematic analysis distilled core themes explaining the reasons for leaving and their relation to the 3M’s model.ResultsOf 3,389 abstracts identified, screening and assessment produced 82 papers included in the final analysis. Thematic analysis identified four key themes: low morale, disconnect, unmanageable change and lack of personal and professional support. The themes of mastery, membership and meaning were substantially present within the dataset.ConclusionThe 3M’s model of motivation can be applied to the medical workforce to understand retention issues. This work supports the development of targeted solutions to tackle the worsening workforce crisis.

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Technological interventions for loneliness and social isolation among older adults: a scoping review protocol

Systematic Reviews ◽

10.1186/s13643-021-01775-6 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Andrew Wister ◽

Ian Fyffe ◽

Eireann O’Dea

Keyword(s):

Older Adults ◽

Social Isolation ◽

Scoping Review ◽

English Language ◽

Data Extraction ◽

Community Dwelling ◽

Technological Interventions ◽

Information And Communication ◽

Evaluation Trial ◽

Community Dwelling Older Adults

Abstract Background Loneliness and social isolation are prevalent public health concerns among community-dwelling older adults. One approach that is becoming an increasingly popular method of reducing levels of loneliness and social isolation among older adults is through technology-driven solutions. This protocol outlines a research trajectory whereby a scoping review will be initiated in order to illustrate and map the existing technological approaches that have been utilized to diminish levels of loneliness and social isolation among community-dwelling older adults aged 60 years or older. We will address the question: what are the most common and less used technological approaches to reduce loneliness and social isolation among community-dwelling older adults? Methods A scoping review of Academic Search Premier, AGEline, Global Health, MEDLINE, PsycINFO, and Web of Science databases will take place using our search terms including the following: loneliness, social isolation, older adults, elderly, Aged, Aged 80 and over, program, evaluation, trial, intervention, technology, computer, information and communication technology, internet, and robot. The initial electronic search will be supplemented by reviewing the reference lists and review articles to identify any missing studies. To meet study inclusion criteria, intervention studies had to pertain to community-dwelling adults aged 60 years or older, include technological interventions, include loneliness and/or social isolation as outcome variables, and be written in the English language. Two parallel independent assessments of study eligibility will be conducted for the title, abstract, and full-text screens. Any disagreement will be resolved by consensus and a third reviewer consulted to make a decision if consensus is not achieved initially. Finally, the amalgamation of results will be an iterative process whereby reviewers will refine the plan for presenting results after data extraction is completed so that all of the contents of the extraction may be included in the results. Discussion The information gleaned in this scoping review will be essential to understand the degree to which technological interventions influence social isolation and loneliness among older adults and identify gaps for further research.

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