• Meincke Lam posted an update 1 week, 5 days ago

    Considering the Three Factor model, the most often reported themes were Information and Strategies upon being adherent. Stemming from the review findings and the patients’ narratives, a new integrated model was proposed. It reports the patient’s decisional flowchart describing barriers and facilitators (personal, social and environmental) to adherence. CONCLUSION Medication adherence is a complex and multifaceted process. The implementation of theoretical frameworks along with a patient-centred perspective may provide clinicians with useful suggestions for clinical practice, enhancing the patient’s ability to adhere.PURPOSE Readmissions are common and complicate recovery after hip fracture. The objective of this study was to study readmission rates, factors associated with readmissions and effects of orthogeriatric liaison service in a setting where patients are discharged typically on the first postoperative day from the operating tertiary care hospital to lower-level health care units. METHODS A regionally representative cohort of 763 surgically treated hip fracture patients aged ≥ 50 years was included in this retrospective study, based on hospital discharge records. Primary outcome was a 30-day readmission, while the secondary outcome was a composite outcome, defined as readmission or death with a follow-up of 1 year at maximum. RESULTS The 30-day readmission rate was 8.3% and 1-year mortality was 22.1%. Short length of stay did not lead to poorer outcomes. Delay from admission to surgery of ≥ 4 days and discharge to primary health care wards were associated with an increased 30-day readmission rate. Age ≥ 90 years, f patient characteristics rather than the care process.PURPOSE The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus definition introduced the concept of probable sarcopenia as a basis on which to begin treatment. Our aims were to describe the prevalence of probable sarcopenia in older adults and to investigate the utility of (1) the SARC-F tool and (2) clinical risk factors for the identification of those likely to have probable sarcopenia. METHODS We used data from the 1946 British birth cohort at age 69, with 1686 participants included in the analyses. We used the EWGSOP2 cut points for weak grip strength and slow chair rise time, with the presence of one or both indicating probable sarcopenia. We examined the sensitivity and specificity of the SARC-F tool for probable sarcopenia. We also examined associations between clinical risk factors and probable sarcopenia. RESULTS The prevalence of probable sarcopenia was 19%. A SARC-F score of ≥ 4 had low sensitivity (15%) and high specificity (99%) for probable sarcopenia, whereas a score of ≥ 1 had higher sensitivity (65%) and reasonable specificity (72%). see more Three clinical risk factors were independently associated with probable sarcopenia polypharmacy [OR 2.7 (95% CI 1.7, 4.2)], lower body osteoarthritis [OR 1.8 (95% CI 1.3, 2.6)] and physical inactivity [OR of 2.1 (95% CI 1.5, 2.8)]. CONCLUSION We have shown that EWGSOP2 probable sarcopenia is common in community-dwelling adults in early old age. Those with any positive responses to the questions in the SARC-F tool, a history of polypharmacy, lower body osteoarthritis or physical inactivity should be prioritised for the assessment of muscle strength.BACKGROUND AND PURPOSE Several biological mechanisms describing the pathway to mobility disability and functional decline in older adults with type 2 diabetes mellitus (T2DM) have been postulated, including skeletal muscle atrophy and the concurrent accumulation of fat mass. Therefore, we explored the association between adiposity, muscle strength and physical performance in community-dwelling older adults with T2DM. METHODS Adiposity was measured by waist circumference (WC) or body fat percentage (BF %) derived from dual-energy X-ray absorptiometry (DXA). The Short Physical Performance Battery (SPPB) and gait speed were used to evaluate lower extremity physical function. Muscle strength was assessed using hand-grip strength (HGS) or chair stands. Multiple regression analysis was used to examine the association between measures of adiposity, SPPB score, gait speed, HGS and chair stands adjusted for age, gender and total appendicular skeletal muscle (ASM). RESULTS A total of n = 87 participants (71.2 ± 8.2 yeations aimed at preserving muscle function in older adults with T2DM.PURPOSE Although obesity is an established risk factor for a number of diseases, several epidemiological studies have demonstrated that older obese patients have better survival rates than non-obese old patients in various disease states. In this context, the relationship between obesity and acute pancreatitis outcome in older patients is controversial. Therefore, the authors aimed to investigate the impact of obesity on acute pancreatitis outcomes in older patients. METHODS Patients aged > 65 years who had been hospitalized for acute pancreatitis were retrospectively analyzed. Among them, 190 patients were included. The median age was 73 (68-79) years, and 118 (62.1%) were women. Obesity was assessed according to body mass index, and patients were classified as either obese or non-obese. The primary endpoint of the study was in-hospital major adverse events (major in-hospital complications and death). The secondary endpoints were acute pancreatitis recurrence, 30-day all-cause mortality, and long-term all-cause mortality. RESULTS A total of 77 (40.5%) patients were obese. In-hospital major adverse events were observed in 40 (21.1%) patients. There was no statistical difference in major in-hospital adverse events between the two groups (27 [23.9%] in non-obese patients vs. 13 [16.9%] in obese patients, p = 0.24). Further, the 30-day mortality, long-term survival, and acute pancreatitis recurrence rates were similar (all p > 0.05). The median follow-up time was 18 (0-80) months. CONCLUSION Obesity does not result in higher mortality or complications in older patients with acute pancreatitis. Although the underlying mechanism needs to be elucidated, the deleterious effect of obesity seems to be diminished in older patients.