Fragility syndrome: determinant factors in institutionalized elderly

The aim of the study was to evaluate the frailty syndrome in residents of a Long-Term Care Facility for the Elderly. A cross-sectional study was carried out on 24 subjects over the age of 60 years. For the screening of frailty syndrome, the criteria of the Cardiovascular Study were used, which classifies the subjects into fragile, pre-fragile and non-fragile according to five criteria: decreased handgrip strength; self-reported fatigue; decrease in walking speed; unintentional weight loss; and low level of physical activity. The average age of the population studied was 81.13 years, with 54.20% being female. Among the elderly, 83.33% were frail, 12.50% were pre-frail and 4.17% were not frail. Elderly people over 80 years old had a higher incidence of frailty when compared to those aged 60 - 79 years, with 85.7% and 80%, respectively. Since 66.67% of the elderly had decreased handgrip muscle strength, 37.50% reported fatigue, 41.67% demonstrated decreased gait speed, 12.50% unintentional weight loss and 87.50% were physically inactive. We identified a high prevalence of DES among the elderly residing in the institution studied, thus reinforcing the importance of early screening for frailty in institutionalized elderly.

A Solution for the Remote Care of Frail Elderly Individuals via Exergames

Internet of Things (IoT) solutions are a concrete answer to many needs in the healthcare framework since they enable remote support for patients and foster continuity of care. Currently, frail elderly people are among end users who most need and would benefit from IoT solutions from both a social and a healthcare point of view. Indeed, IoT technologies can provide a set of services to monitor the healthcare of the elderly or support them in order to reduce the risk of injuries, and preserve their motor and cognitive abilities. The main feature of IoT solutions for the elderly population is ease of use. Indeed, to fully exploit the potential of an IoT solution, patients should be able to autonomously deal with it. The remote-monitoring validation engineering system (ReMoVES) described here is an IoT solution that caters to the specific needs of frail elderly individuals. Its architecture was designed for use at rehabilitation centers and at patients’ homes. The system is user-friendly and comfortably usable by persons who are not familiar with technology. In addition, exergames enhance patient engagement in order to curb therapy abandonment. Along with the technical presentation of the solution, a real-life scenario application is described referring to sit-to-stand activity.

Educational needs for the development of a simulation module of home visiting care for the frail elderly

Purpose: This study aimed to identify the educational needs of nurses and nursing students for the development of a simulation module of home visiting care for frail, elderly people.Methods: Focus group interviews were conducted with 15 home visiting nurses working in public health centers and 14 nursing students who experienced home visiting from September 10 to October 10, 2018.Results: Bloom’s taxonomy of learning objectives, namely, cognitive, affective, and psychomotor domains was used as a framework for data analysis. The defined educational needs for each domain were as follows: “understanding frail, elderly people” for the cognitive domain; “intervention for mental health” and “building a therapeutic relationship” for the affective domain; and “nursing skills”, “health education for healthy lifestyles”, “referral to the community resource connection”, “protection for visiting nurses” for the psychomotor domain.Conclusion: Based on the findings of this study, a simulation module of home visiting care for frail, elderly people can be developed and used for nursing students and nurses to strengthen the capacity for home visiting care.

Psychosocial Factors Related to Physical Activity in Frail and Prefrail Elderly People.

Background Increased physical activity (PA) is a very important factor in a healthy aging lifestyle. Psychosocial factors have also a main role in the initiation and maintenance of this behavior, but nowadays its implications for frailty elderly people are unknown, therefore, the aim of this study was to identify the psychosociological variables of behavior change that influence the practice of (PA) in frail and prefrail elderly. Methods A total of 103 frail and pre-frail elderly people (72 females) participated in this cross-sectional study, on the framework of the EXERNET-Elder3.0 project. Age ranged from 68–94 years (mean = 80.4 ± 5.9 years). Individualized face-to-face interviews according to the constructs of the Transtheoretical Model of Change (TTM) [(decisional balance (DB) and self-efficacy (SE)], social support (SS) (family and friends) and outcome expectations (OE) were administered to all participants. Results Significant differences were found in DB, perceived benefits (PBn), SE, family-related SS and OE as a function of stages of change (SoC) (p < 0.005), but no significant were found in perceived barriers (PBrr) (p = 0.259) and friends-related SS (p = 0.068). According to the Scheffé post-hoc test, those in advanced SoC (Action-Maintenance), scored higher than those in lower SoC (Precontemplation-Contemplation and Preparation). Conclusion The scores obtained from the study variables differed according to the SoC, supporting the external validity for the use of the TTM in frailty elderly. Further research is needed to determine the impact of PBrr and friends-related SS on this people, as well as to identify the validity of this model in the long-term in this population.

New Variations on the Theme of Multidimensional Geriatric Assessment

Geriatric assessment—broadly defined—has become foundational to systems of care for frail elderly people at risk for functional decline, death, intensification of services, and long-term institutionalization [...]

Measuring Quality of Service in a Robotized Comprehensive Geriatric Assessment Scenario

Comprehensive Geriatric Assessment (CGA) is an integrated clinical process to evaluate frail elderly people in order to create therapy plans that improve their quality and quantity of life. The whole process includes the completion of standardized questionnaires or specific movements, which are performed by the patient and do not necessarily require the presence of a medical expert. With the aim of automatizing these parts of the CGA, we have designed and developed CLARC (smart CLinic Assistant Robot for CGA), a mobile robot able to help the physician to capture and manage data during the CGA procedures, mainly by autonomously conducting a set of predefined evaluation tests. Using CLARC to conduct geriatric tests will reduce the time medical professionals have to spend on purely mechanical tasks, giving them more time to develop individualised care plans for their patients. In fact, ideally, CLARC will perform these tests on its own. In parallel with the effort to correctly address the functional aspects, i.e., the development of the robot tasks, the design of CLARC must also deal with non-functional properties such as the degree of interaction or the performance. We argue that satisfying user preferences can be a good way to improve the acceptance of the robot by the patients. This paper describes the integration into the software architecture of the CLARC robot of the modules that allow these properties to be monitored at run-time, providing information on the quality of its service. Experimental evaluation illustrates that the defined quality of service metrics correctly capture the evolution of the aspects of the robot’s activity and its interaction with the patient covered by the non-functional properties that have been considered.

Care needs of the elderly who live alone: an intersectoral perception

Objective: to understand the perception of health and law professionals regarding care for frail elderly people who live alone. Methods: qualitative research, carried out through interviews with health and law professionals, using a vignette as a trigger, presenting the description of the story of a frail elderly woman who lived alone. Data were submitted to the thematic analysis technique. Results: the 23 professionals pointed out that the family members should be the responsible ones for the elderly; that institutionalization should take place as the last option; stressed the importance of multi-professional and intersectoral work; and recognized the limitations of the state. The professionals reported the appropriate interventions for the case. Conclusion: in care for the elderly who live alone, there are limitations for families, social care, and health services for the elderly, as well as the State, with the need to strengthen legally guaranteed resources.

Exploitation of some natural products for prevention and/or nutritional treatment of SARS-CoV2 infection

Background and Objectives: Dietary habits strongly influence our health status, mostly, in terms of maintenance of the inflammatory/anti-inflammatory homeostasis. High fat and high sugar diets account for the development of a low-grade inflammation which is the pathogenic common denominator of various chronic disease. Severe Acute Respiratory Syndrome Coronavirus (SARS)-CoV2 (COVID-19) infection affects all ages and especially frail elderly people and a nutri-tional intervention seems to be crucial in the course of this pandemic. The present review describes the properties of some vegetal products and their derivatives, such as Lupin sp., garlic, salvia and extra virgin olive oil (EVOO) that can be exploit-ed for their beneficial effects, as preventive and/or nutritional treatment of coronavirus disease SARS-CoV2. Discussion: Lupin, salvia, garlic and EVOO share overlapping properties, such as anti-oxidant, anti-inflammatory and anti-viral activities. Quite importantly, these products and their derivatives are able to recover the expression of angiotensin con-verting enzyme expression 2 on cell membrane, otherwise suppressed by COVID-19 binding and entry into cytoplasm. Conclusion: Dietary administration of the above nutraceuticals or their extracts may play a preventive or nutritional role in the course of SARS-CoV2 infection, even including the effects of the lockdown and the condition of inflamm-ageing.