FRAILTY DETECTION WITH THE GERONTOPOLE FRAILTY SCREENING TOOL (GFST)

2013 ◽  
pp. 1-3
Author(s):  
L. DEMOUGEOT ◽  
G. ABELLAN VAN KAN ◽  
B. VELLAS ◽  
P. DE SOUTO BARRETO
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Early Detection ◽  
General Practitioners ◽  
Older Persons ◽  
Screening Tool ◽  
Research Field ◽  
Screening Tools ◽  
Frail Older Adults ◽  
Over Time

Frailty is commonly regarded as a pre-disability condition of older persons. Its importance in theelderly should be more carefully taken into account in the clinical practice. To implement interventions aimed atpreventing disability in frail older adults, screening tools for the early detection of this syndrome are needed. Inthis context, the Gérontopôle Frailty Screening Tool (GFST) has been recently proposed as an instrument forassisting general practitioners in the detection of non-disabled frail older adults. In the present paper, we brieflydiscuss about the difficulties of translating knowledge from the frailty research field to the clinical practice. Suchdifficulties are illustrated by presenting the evolution of the GFST over time. The use of frailty screening tools,such as the GFST, in the clinical practice is necessary to support the identification of older persons at risk ofadverse events and promote the implementation of individualized strategies against disability.

scholarly journals The effective screening tools for detecting hearing loss in elderly population: HHIE-ST Versus TSQ

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nichtima Chayaopas ◽  
Pornthep Kasemsiri ◽  
Panida Thanawirattananit ◽  
Patorn Piromchai ◽  
Kwanchanok Yimtae
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Screening Tool ◽  
Diagnostic Value ◽  
Screening Tools ◽  
Effective Screening ◽  
Hearing Disability ◽  
Test Study ◽  
Combined Test ◽  
Single Question

Abstract Background Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation. Trial registration The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.

scholarly journals Using cancer risk algorithms to improve risk estimates and referral decisions

2022 ◽  
Vol 2 (1) ◽  
Author(s):  
Olga Kostopoulou ◽  
Kavleen Arora ◽  
Bence Pálfi
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
Cancer Risk ◽  
General Practitioners ◽  
Learning Tools ◽  
Cancer Symptoms ◽  
Referral Decisions ◽  
Risk Estimates ◽  
Discernible Effect ◽  
Over Time

Abstract Background Cancer risk algorithms were introduced to clinical practice in the last decade, but they remain underused. We investigated whether General Practitioners (GPs) change their referral decisions in response to an unnamed algorithm, if decisions improve, and if changing decisions depends on having information about the algorithm and on whether GPs overestimated or underestimated risk. Methods 157 UK GPs were presented with 20 vignettes describing patients with possible colorectal cancer symptoms. GPs gave their risk estimates and inclination to refer. They then saw the risk score of an unnamed algorithm and could update their responses. Half of the sample was given information about the algorithm’s derivation, validation, and accuracy. At the end, we measured their algorithm disposition. We analysed the data using multilevel regressions with random intercepts by GP and vignette. Results We find that, after receiving the algorithm’s estimate, GPs’ inclination to refer changes 26% of the time and their decisions switch entirely 3% of the time. Decisions become more consistent with the NICE 3% referral threshold (OR 1.45 [1.27, 1.65], p < .001). The algorithm’s impact is greatest when GPs have underestimated risk. Information about the algorithm does not have a discernible effect on decisions but it results in a more positive GP disposition towards the algorithm. GPs’ risk estimates become better calibrated over time, i.e., move closer to the algorithm. Conclusions Cancer risk algorithms have the potential to improve cancer referral decisions. Their use as learning tools to improve risk estimates is promising and should be further investigated.

scholarly journals Screening Community-Living Older Adults for Protein Energy Malnutrition and Frailty: Update and Next Steps

2019 ◽  
Vol 45 (3) ◽  
pp. 640-660 ◽  
Author(s):  
Johanna T. Dwyer ◽  
Jaime J. Gahche ◽  
Mary Weiler ◽  
Mary Beth Arensberg
Keyword(s):  
Older Adults ◽  
Predictive Validity ◽  
Screening Tool ◽  
Protein Energy Malnutrition ◽  
The United States ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Community Settings ◽  
Protein Energy

Abstract Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.

scholarly journals Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rachel Deer ◽  
Mackenzie McCall ◽  
Elena Volpi
Keyword(s):  
Older Adults ◽  
Elderly Patients ◽  
Screening Tool ◽  
Screening Tools ◽  
Good Sensitivity ◽  
Predictive Values ◽  
Hospitalized Elderly ◽  
Nrs 2002 ◽  
Hospitalized Elderly Patients ◽  
Hospitalized Older Adults

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs

scholarly journals Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis

2020 ◽  
Vol 74 (11) ◽  
pp. 1519-1535 ◽  
Author(s):  
Alex F. Bullock ◽  
Sarah L. Greenley ◽  
Gordon A. G. McKenzie ◽  
Lewis W. Paton ◽  
Miriam J. Johnson
Keyword(s):  
Older Adults ◽  
Food Intake ◽  
Nutritional Status ◽  
Clinical Outcomes ◽  
Screening Tool ◽  
Meta Analysis ◽  
Screening Tools ◽  
Narrative Synthesis ◽  
Markers Of Inflammation ◽  
Risk Of Cancer

Abstract Malnutrition predicts poorer clinical outcomes for people with cancer. Older adults with cancer are a complex, growing population at high risk of weight-losing conditions. A number of malnutrition screening tools exist, however the best screening tool for this group is unknown. The aim was to systematically review the published evidence regarding markers and measures of nutritional status in older adults with cancer (age ≥ 70). A systematic search was performed in Ovid Medline, EMBASE, Web of Science, CINAHL, British Nursing Database and Cochrane CENTRAL; search terms related to malnutrition, cancer, older adults. Titles, abstracts and papers were screened and quality-appraised. Data evaluating ability of markers of nutritional status to predict patient outcomes were subjected to meta-analysis or narrative synthesis. Forty-two studies, describing 15 markers were included. Meta-analysis found decreased food intake was associated with mortality (OR 2.15 [2.03–4.20] p = < 0.00001) in univariate analysis. Prognostic Nutritional Index (PNI) was associated with overall survival (HR 1.89 [1.03–3.48] p = 0.04). PNI markers (albumin, total lymphocyte count) could be seen as markers of inflammation rather than nutrition. There a suggested relationship between very low body mass index (BMI) (<18 kg/m2) and clinical outcomes. No tool was identified as appropriate to screen for malnutrition, as distinct from inflammatory causes of weight-loss. Risk of cancer-cachexia and sarcopenia in older adults with cancer limits the tools analysed. Measures of food intake predicted mortality and should be included in clinical enquiry. A screening tool that distinguishes between malnutrition, cachexia and sarcopenia in older adults with cancer is needed.

scholarly journals Validation of the detection of elder abuse through emergency care technicians (DETECT) screening tool: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037170
Author(s):  
Brad Cannell ◽  
Julie Weitlauf ◽  
Melvin D Livingston ◽  
Jason Burnett ◽  
Megin Parayil ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Care ◽  
Screening Tool ◽  
Elder Abuse ◽  
Well Being ◽  
Living Environment ◽  
Community Dwelling ◽  
Screening Tools ◽  
Semistructured Interview

IntroductionElder mistreatment (EM) is a high prevalence threat to the health and well-being of older adults in the USA. Medics are well-positioned to help with identification of older adults at risk for EM, however, field robust screening tools appropriate for efficient, observation-based screening are lacking. Prior work by this team focused on the development and initial pilot testing of an observation-based EM screening tool named detection of elder abuse through emergency care technicians (DETECT), designed to be implemented by medics during the course of an emergency response (911) call. The objective of the present work is to validate and further refine this tool in preparation for clinical dissemination.Methods and analysisApproximately 59 400 community-dwelling older adults who place 911 calls during the 36-month study observation period will be screened by medics responding to the call using the DETECT tool. Next, a random subsample of 2520 of the 59 400 older adults screened will be selected to participate in a follow-up interview approximately 2 weeks following the completion of the screening. Follow-up interviews will consist of a medic-led semistructured interview designed to assess the older adult’s likelihood of abuse exposure, physical/mental health status, cognitive functioning, and to systematically evaluate the quality and condition of their physical and social living environment. The data from 25% (n=648) of these follow-up interviews will be presented to a longitudinal, experts and all data panel for a final determination of EM exposure status, representing the closest proxy to a ‘gold standard’ measure available.Ethics and disseminationThis study has been reviewed and approved by the Committee for the Protection of Human Subjects at the University of Texas School of Public Health. The results will be disseminated through formal presentations at local, national and international conferences and through publication in peer-reviewed scientific journals.

The Useful Depression Screening Tool for Older Adults: Psychometric Properties and Clinical Applicability

2015 ◽  
Vol 23 (2) ◽  
pp. 78E-87E
Author(s):  
N. Jennifer Klinedinst ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Rasch Analysis ◽  
Screening Tool ◽  
Reliability And Validity ◽  
Depression Screening ◽  
Validity And Reliability ◽  
Senior Housing ◽  
Test Retest Reliability ◽  
Over Time

Background and Purpose: The purpose of this study is to test the reliability and validity of the 3-item Useful Depression Screening Tool (UDST) for use with older adults in congregate living settings. Methods: There were 176 residents of senior housing or assisted living who completed the UDST. Rasch analysis and test criterion relationships with pain, physical activity, and depression diagnosis were used to determine validity. Test–retest reliability was conducted with 29 senior housing residents. Results: Rasch analysis demonstrated good fit of all items to the concept of depression. Criterion validity was supported, F(5) = 14.17, p < .001. Test–retest showed no significant differences in UDST scores over time (p = .29). Conclusions: The findings provide support for the validity and reliability of the UDST for use with older adults in congregate living settings.

scholarly journals Introducing CatchU TM : A Novel Multisensory Tool for Assessing Patients’ Risk of Falling †

2021 ◽  
Author(s):  
Jeannette R. Mahoney ◽  
Claudene J. George ◽  
Joe Verghese
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Multisensory Integration ◽  
Screening Tool ◽  
Mobility Limitations ◽  
Healthy Older Adults ◽  
Research Perspective ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Cognitive Attention

To date, only a few studies have investigated the clinical translational value of multisensory integration. Our previous research has linked the magnitude of visual-somatosensory integration (measured behaviorally using simple reaction time tasks) to important cognitive (attention) and motor (balance, gait, and falls) outcomes in healthy older adults. While multisensory integration effects have been measured across a wide array of populations using various sensory combinations and different neuroscience research approaches, multisensory integration tests have not been systematically implemented in clinical settings. We recently developed a step-by-step protocol for administering and calculating multisensory integration effects to facilitate innovative and novel translational research across diverse clinical populations and age-ranges. In recognizing that patients with severe medical conditions and/or mobility limitations often experience difficulty traveling to research facilities or joining time-demanding research protocols, we deemed it necessary for patients to be able to benefit from multisensory testing. Using an established protocol and methodology, we developed a multisensory falls-screening tool called CatchU TM (an iPhone app) to quantify multisensory integration performance in clinical practice that is currently undergoing validation studies. Our goal is to facilitate the identification of patients who are at increased risk of falls and promote physician-initiated falls counseling during clinical visits (e.g., annual wellness, sick, or follow-up visits). This will thereby raise falls-awareness and foster physician efforts to alleviate disability, promote independence, and increase quality of life for our older adults. This conceptual overview highlights the potential of multisensory integration in predicting clinical outcomes from a research perspective, while also showcasing the practical application of a multisensory screening tool in routine clinical practice.

scholarly journals Using Digital Speech Assessments to Detect Early Signs of Cognitive Impairment

2021 ◽  
Vol 3 ◽  
Author(s):  
Jessica Robin ◽  
Mengdan Xu ◽  
Liam D. Kaufman ◽  
William Simpson
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Screening Tools ◽  
Rapid Decline ◽  
Assessment Task ◽  
Early Signs ◽  
Over Time

Detecting early signs of cognitive decline is crucial for early detection and treatment of Alzheimer's Disease. Most of the current screening tools for Alzheimer's Disease represent a significant burden, requiring invasive procedures, or intensive and costly clinical testing. Recent findings have highlighted changes to speech and language patterns that occur in Alzheimer's Disease, and may be detectable prior to diagnosis. Automated tools to assess speech have been developed that can be used on a smartphone or tablet, from one's home, in under 10 min. In this study, we present the results of a study of older adults who completed a digital speech assessment task over a 6-month period. Participants were grouped according to those who scored above (N = 18) or below (N = 18) the recommended threshold for detecting cognitive impairment on the Montreal Cognitive Assessment (MoCA) and those with diagnoses of mild cognitive impairment (MCI) or early Alzheimer's Disease (AD) (N = 14). Older adults who scored above the MoCA threshold had better performance on speech composites reflecting language coherence, information richness, syntactic complexity, and word finding abilities. Those with MCI and AD showed more rapid decline in the coherence of language from baseline to 6-month follow-up, suggesting that this score may be useful both for detecting cognitive decline and monitoring change over time. This study demonstrates that automated speech assessments have potential as sensitive tools to detect early signs of cognitive impairment and monitor progression over time.

scholarly journals Validation of a Single Question Health Literacy Screening Tool for Older Adults

2017 ◽  
Vol 3 ◽  
pp. 233372141771309 ◽  
Author(s):  
Nikki Keene Woods ◽  
Amy K. Chesser
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Cognitive Skills ◽  
Screening Tool ◽  
Literacy Skills ◽  
Screening Tools ◽  
Functional Health ◽  
Literacy Assessment ◽  
Convenience Sample ◽  
Sample Age

Objectives: Health Literacy skills are important for people of all ages. Older adults have the lowest health literacy rates. The purpose of this study was to assess health literacy rates and validate the use of a screening tool with older adults. Methods: Participants included a convenience sample, age 65 years or older, English speaking with corrected vision of 20/100 or better and typical cognitive skills. Participants completed the 36-item Short Test of Functional Health Literacy Assessment (STOFHLA) and a single item screening (SIS) tool. Results of STOFHLA and SIS were compared using nonparametric statistics. Results: Of the 64 participants, 94% had adequate scores on the STOFHLA, while 64% self-reported confidence in filling out medical forms, p = .006, χ2 = 7.606, df(1). Conclusion: Results suggest that use of health literacy screening tools for older adults may be of value. Additional studies are needed to expand the study sample and validate the findings of this study.

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