Parkslake7967
A 78-year-old woman presented with an atypical femoral fracture of her right femur associated with a left thigh stress fracture following 9 years of bisphosphonate therapy. The fracture was managed with femoral nailing. However, she represented 3 years later with peri-prosthetic infection, worsening of the left-side stress fracture, and low bone turnover in a bone metabolic study, consistent with an ongoing bisphosphonate effect. This case highlights the increased rate of postoperative complications in atypical femoral fractures even years after surgery as well as the challenging management issues for contralateral fracture and the risk of missing bilateral fractures.
We aimed to analyse the trends in ageism among health care providers and medical students in the Republic of Korea.
We used the Fraboni Scale of Ageism (FSA), Relating to Older People Evaluation (ROPE) questionnaire, Anxiety about Aging Scale (AAS), and the Facts on Aging Quiz II to assess ageism in medical students (n=90), nurses (n=114), and physicians (n=83). We grouped health care providers based on the percentage of aged patients (over 65 years) that they treated.
Compared to the other groups, physicians had more knowledge about aging and the highest and lowest total scores in the FSA and ROPE, respectively. The total FSA scores were negatively correlated with the percentage of aged patients treated. Regarding the ROPE score, negative and positive ageist behaviors were positively correlated with the percentage of aged patients.
Ageism and ageist behavior among physicians differed from previous reports and those of the other groups mentioned in the present study. Although physicians had more knowledge of aging, they had expressed a high levels of ageism. However, they did not act ageistically. Health care providers who treat a large number of older patients had minimal ageism but more ageist behavior. These findings indicate that continued education of geriatrics and ageism for medical staff and prospective medical personnel could help improve this situation.
Ageism and ageist behavior among physicians differed from previous reports and those of the other groups mentioned in the present study. Although physicians had more knowledge of aging, they had expressed a high levels of ageism. However, they did not act ageistically. Health care providers who treat a large number of older patients had minimal ageism but more ageist behavior. These findings indicate that continued education of geriatrics and ageism for medical staff and prospective medical personnel could help improve this situation.
The Lawton Instrumental Activities of Daily Living (IADL) scale is the most widely used scale for the assessment of IADL in the elderly population. The aim of this study was to adapt the Lawton IADL Scale in Turkish and to investigate the validity and the reliability of the scale in older adults.
A total of 80 participants with a mean age of 71.6±5.8 years were included in the study. The independent living skills of the older adults were measured using Lawton IADL, Hodkinson Mental Test, Functional Independence Scale, Barthel Index, Katz Index, and visual analog scale. Lawton IADL was translated into Turkish, validated by professional reviewers, translated back into English, and then tested. Cronbach's alpha was used to measure reliability in a group of 34 participants and test-retest was performed 1 week after the first test. Cariprazine Pearson correlation analysis was used to show the relationship between Lawton IADL and other scales and indexes.
Internal consistency (Cronbach's alpha) value was 0.843 for the whole scale. The intraclass correlation coefficient value of the scale was 0.915.
These results confirm that the Turkish version of the Lawton IADL scale has excellent reliability and validity.
These results confirm that the Turkish version of the Lawton IADL scale has excellent reliability and validity.
Korea, as one of the fastest-aging countries worldwide, requires an improved healthcare service model for older adults. We evaluated the current healthcare system and developed a service model based on information and communication technologies (ICT) for use in older patients in long-term care facilities (LTCF).
We conducted a qualitative literature review, focus group interviews (FGIs), and structured survey to identify the current technology use and status of healthcare systems. We then developed a web-based platform with necessary, high-priority, and usable content for the care of older patients in LTCF.
We reviewed 60 (23 hypertension, 18 diabetes, and 19 heart failure) articles on information and communication technologies (ICT)-based disease management for clinical effectiveness and improved patient satisfaction. FGIs and structured surveys were used to evaluate the inconvenience in patient and medical information transfer between hospitals and cost and time required for its process. Accordingly, nalized patients. However, the Health-RESPECT service model requires further validation.
With the increasing prevalence of chronic disease due to aging, many older adults experience multimorbidity and polypharmacy. Medications with anticholinergic properties are particularly associated with adverse cognitive outcomes, including functional decline and mortality. We assessed the clinical impact of anticholinergic cognitive burden (ACB) on clinical outcomes of older patients acutely admitted to a single, hospitalist-operated medical unit of a tertiary hospital in Korea.
This retrospective study reviewed electronic medical records of 318 patients aged 65 years or older admitted to the hospitalist-operated medical unit through the emergency department of Seoul National University Hospital. The analyzed clinical outcomes were the length of hospital stay, in-hospital mortality, unplanned intensive care unit admission, and unexpected readmission within 30 days.
The clinical outcomes did not differ between patients who took five or more drugs and those who did not. Patients with an ACB score of 3 or higher had a higher in-hospital mortality rate and longer hospital stay than those who did not. After adjusting for confounding factors, an ACB score of 3 or higher was an independent predictive factor for in-hospital mortality (odds ratio=3.09; 95% confidence interval, 1.18-8.06).
ACB rather than the number of medications was associated with in-hospital mortality in acutely ill older patients. Further analytic and interventional studies are required to assess potentially inappropriate medication use and ACB in older inpatients.
ACB rather than the number of medications was associated with in-hospital mortality in acutely ill older patients. Further analytic and interventional studies are required to assess potentially inappropriate medication use and ACB in older inpatients.