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  • 1
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    Barriers to prescribing oral anticoagulants to inpatients aged 80 years and older with nonvalvular atrial fibrillation: a cross-sectional study
    Springer Science and Business Media LLC ; 2022
    In:  BMC Geriatrics Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: To investigate the temporal trend of the prevalence of underprescription of anticoagulation treatment and explore the factors associated with underprescription of oral anticoagulants (OACs) among inpatients aged ≥ 80 years with nonvalvular atrial fibrillation (NVAF). Methods We retrospectively reviewed the medical records of inpatients with a discharge diagnosis of NVAF from a medical database. We used the Pearson chi-square or Fisher’s exact test to compare categorical variables between patients with and without OAC prescriptions during hospitalization. Logistic regression analysis was used to assess the association between risk factors and underprescription of OACs. Results A total of 4375 patients aged ≥ 80 years with AF were assessed in the largest academic hospital in China from August 1, 2016, to July 31, 2020, and 3165 NVAF patients were included. The prevalence of underprescription of OACs was 79.1% in 2017, 71.3% in 2018, 64.4% in 2019, and 56.1% in 2020. Of all participants, 2138 (67.6%) were not prescribed OACs; 66.3% and 68.2% of patients with and without prior stroke did not receive OACs, respectively. Age (85–89 vs 80–84, OR = 1.48, 95% CI (1.25–1.74); 90 + vs 80–84, OR = 2.66, 95% CI: 2.09–3.42), clinical department where patients were discharged (Reference = Cardiology, Geriatrics: OR = 2.97, 95% CI: 2.45- 3.61; neurology: OR = 1.25, 95% CI: 0.96, 1.63; others: OR = 4.23, 95% CI: 3.43- 5.24), use of antiplatelets (OR = 1.69, 95% CI: 1.45- 1.97), and history of stroke (OR = 0.83, 95% CI: 0.71- 0.98 adjusted age), and dementia (OR = 2.16, 95% CI: 1.60- 2.96) were significantly associated with not prescribing OACs. Conclusions The prevalence of underprescription of OACs has decreased over the past several years. The rate of underprescription of OACs was higher among NVAF patients who were older, prescribed antiplatelets, discharged from nondepartmental cardiology, and suffered from comorbidities. This study found iatrogenic factors affecting the underprescription of OACs in inpatients aged ≥ 80 years, providing clues and a basis for the standardized use of OACs in inpatients.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-022-02965-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059865-8
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  • 2
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    A novel semiautomatic Chinese keywords instrument screening delirium based on electronic medical records
    Springer Science and Business Media LLC ; 2022
    In:  BMC Geriatrics Vol. 22, No. 1 ( 2022-10-04)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-10-04)
    Abstract: Delirium is frequently unrecognized due to the absence of regular screening. In addition to validated bedside tools, the computer-assisted instrument based on clinical notes from electronic medical records may be useful. Aims To assess the psychometric properties of a Chinese-chart-based keyword instrument for semiautomatically screening delirium using Natural language processing (NLP) based on clinical notes from electronic medical records. Methods The patients were admitted to West China Hospital from January 2015 to December 2017. Grouping patients based on the medical notes, those with accessible physician documents but no nurse documents were classified as the physician & no-nurse (PNN) group, while those with accessible physician and nurse documents were classified as the physician & nurse (PN) group. The psychometric properties, test–retest reliability, internal consistency reliability (Cronbach's α), and criterion validity were calculated. Using receiver operating characteristic (ROC) analysis, the criterion validity of delirium was evaluated in comparison to the results of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results A total of 779 patients were enrolled in the study. Their ages ranged from 65 to 103 years (82.5 ± 6.5), with men accounting for 71.9% of the total. A total of 312 patients had access to only physician documents in the physician & no-nurse (PNN) group, whereas 467 patients had access to both physician and nurse documents in the physician & nurse (PN) group. All 779 patients had a Cronbach's alpha of 0.728 in terms of reliability, with 100% test–retest reliability. The area under the ROC curve (AUC) values of the delirium screening instrument for criterion validity were 0.76 (all patients, n  = 779), 0.72 (PNN, n  = 312), and 0.79 (PN, n  = 467), respectively. Conclusion A delirium screening instrument composed of Chinese keywords that can be easily and quickly obtained from electronic medical records was developed, which improved delirium detection in older people. Trial registration Not applicable.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-022-03474-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 3
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    Table_1.pdf
    Frontiers Media SA ; 2023
    In:  Frontiers in Public Health Vol. 11 ( 2023-5-2)
    Details
    In: Frontiers in Public Health, Frontiers Media SA, Vol. 11 ( 2023-5-2)
    Abstract: While both vitamin D deficiency and cognitive impairment have individually been linked to a greater risk of all-cause mortality, the combined effects of these two different conditions have not previously been explored in this context. We aimed to investigate the combined impact of vitamin D concentration and cognitive impairment on all-cause mortality in older adults. Methods The analyzed data were collected from community-dwelling adults ≥65 years of age that were enrolled in the Chinese Longitudinal Healthy Longevity Survey ( n  = 1,673). The Mini-Mental Status Examination (MMSE) was used to assess cognitive function, while the plasma 25-hydroxyvitamin D [25(OH)D] test was used to assess vitamin D status. The associations between vitamin D concentration, cognitive function, and all-cause mortality were assessed with Cox proportional hazards models. We used restricted cubic splines to examine the dose–response relationship between vitamin D and the risk of all-cause mortality and used joint effect testing to explore interactions between vitamin D concentration and cognitive function. Results During a mean (SD) follow-up of 3.8 (1.9) years, 899 (53.7%) deaths occurred. A negative dose–response relationship was observed between 25(OH)D concentration and cognition impairment at baseline, as well as the odds of all-cause mortality during follow-up. Similarly, cognitive impairment was significantly related to all-cause mortality risk (HR 1.81, 95% CI: 1.54 to 2.12). The combined analyses showed positive associations, with the highest mortality risk observed in older adults with both low vitamin D and cognitive impairment (HR 3.04, 95% CI: 2.40 to 3.86). Moreover, the interaction between 25(OH)D concentration and cognitive function was found to be significant in relation to the risk of mortality ( p for interaction & lt;0.001). Conclusion Lower plasma 25(OH)D and cognitive impairment were, respectively, associated with increased all-cause mortality risks. The 25(OH)D concentration and cognitive impairment exhibited a combined additive effect on all-cause mortality among older Chinese adults.
    Type of Medium: Online Resource
    ISSN: 2296-2565
    URL: Article
    URL: Article
    DOI: 10.3389/fpubh.2023.1024341
    DOI: 10.3389/fpubh.2023.1024341.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2711781-9
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  • 4
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    Relationship between malnutrition and adverse outcomes – reply to “Assessing performance of the Geriatric Nutritional Risk Index for the prediction of postoperative delirium and length of hospital stay in older surgical patients”
    Wiley ; 2020
    In:  Geriatrics & Gerontology International Vol. 20, No. 11 ( 2020-11), p. 1098-1098
    Details
    In: Geriatrics & Gerontology International, Wiley, Vol. 20, No. 11 ( 2020-11), p. 1098-1098
    Type of Medium: Online Resource
    ISSN: 1444-1586 , 1447-0594
    URL: Issue
    URL: Article
    DOI: 10.1111/ggi.v20.11
    DOI: 10.1111/ggi.14041
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2078308-5
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  • 5
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    The accuracy of screening instruments for sarcopenia: a diagnostic systematic review and meta-analysis
    Oxford University Press (OUP) ; 2023
    In:  Age and Ageing Vol. 52, No. 8 ( 2023-08-01)
    Details
    In: Age and Ageing, Oxford University Press (OUP), Vol. 52, No. 8 ( 2023-08-01)
    Abstract: This review aimed to summarise the diagnostic accuracy of screening tools for sarcopenia. Methods We conducted a systematic review along with a critical appraisal of published studies on screening tools for sarcopenia. We assessed the measurement properties of screening instruments using the consensus-based standards for selecting health measurement instruments (COSMIN) checklist. We evaluated the risk bias of the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The diagnostic test accuracy of instruments for sarcopenia was reported using sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR). Results We screened 7,120 titles and abstracts; 42 studies including five screening tools for sarcopenia were included. The overall study quality assessed by the QUADAS-2 tool was moderate to good. Of the five screening tools, three instruments had specificities ≥85%: 92% [95% confidence interval (CI): 63–99%] for the SARC-F modified version, 87% (95% CI: 82–90%) for the SARC-F and 85% (95% CI: 77–90%) for the Ishii score. Three tools had sensitivity ≥75%, namely, MSRA 82% (95% CI: 69–90%), Ishii score 79% (95% CI: 62–89%) and U-TEST 76%. PLR higher than 5.0 were present for the Ishii score and SARC-F modified versions; the Ishii score also had the best NLR of 0.25 of all scales. Conclusion The MSRA and Ishii score had excellent sensitivity for sarcopenia screening at an early stage; SARC-F modified versions and Ishii score had superior specificity for sarcopenia diagnosis.
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    URL: Article
    DOI: 10.1093/ageing/afad152
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2065766-3
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  • 6
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    Association between sarcopenia grade and fall history among older adults in West China: A retrospective study
    BMJ ; 2024
    In:  BMJ Open Vol. 14, No. 2 ( 2024-02), p. e080426-
    Details
    In: BMJ Open, BMJ, Vol. 14, No. 2 ( 2024-02), p. e080426-
    Abstract: The association between sarcopenia severity and fall history remains under-researched at present. Accordingly, this study was developed to evaluate the relationship between sarcopenic status and prior fall events in a multiethnic group of older community-dwelling adults in Western China. Design A retrospective survey study, the data comes from the West China Health and Aging Trend study. Setting The study was based in Western China. Participants In total, this retrospective analysis incorporated data from 2719 older adults (59.2% women). Primary and secondary outcome measures Grip strength, gait speed and skeletal muscle mass index values were analysed for all participants, and the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 consensus criteria were leveraged to assess sarcopenia status in these individuals. Prior fall history was defined by any incidents in which an individual unintentionally came to rest on the floor within the past year. The association between sarcopenia status and fall history was examined through a binary logistic regression approach, with p 〈 0.05 as the threshold for significance. Results Using the AWGS2014 and AWGS2019 diagnostic criteria, of the individuals included in this study cohort 1851 (68.1%) were free of sarcopenia, 160 (5.9%) and 56 (2.1%) showed only muscle-mass loss, 322 (11.8%) and 267 (9.8%) exhibited non-severe sarcopenia and the remaining 386 (14.2%) and 545 (20.0%) exhibited severe sarcopenia, respectively. Previous fall events were reported for 14.8% of study cohort members. After full adjustment for potential confounders, a significant link between severe sarcopenia diagnosed by the AWGS2014 diagnostic criteria and fall history was observed (OR 1.397, 95% CI 1.029 to 1.896, p=0.032), while the AWGS2019 diagnostic criteria did not (OR 1.29, 95% CI 0.982 to 1.694, p=0.068). Conclusions Severe sarcopenia, as defined per the AWGS2014 criteria, was associated with a significantly higher risk of falls in this multiethnic cohort of older adults from Western China, while the AWGS2019 diagnostic criteria did not. However, this relationship was not observed for individuals who experienced muscle mass loss or had non-severe sarcopenia, according to both the AWGS2014 and AWGS2019 diagnostic criteria.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2023-080426
    Language: English
    Publisher: BMJ
    Publication Date: 2024
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  • 7
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    Exploring the impact of interleukins on sarcopenia development: A systematic review and meta-analysis
    Elsevier BV ; 2024
    In:  Experimental Gerontology Vol. 193 ( 2024-08), p. 112480-
    Details
    In: Experimental Gerontology, Elsevier BV, Vol. 193 ( 2024-08), p. 112480-
    Type of Medium: Online Resource
    ISSN: 0531-5565
    URL: Article
    DOI: 10.1016/j.exger.2024.112480
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2005397-6
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  • 8
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    Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years
    Springer Science and Business Media LLC ; 2022
    In:  BMC Geriatrics Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: The Jamar hydraulic dynamometer is a widely recognized tool for measuring grip strength. Nevertheless, the devices used most often in Asian countries are spring-type dynamometers, represented by the CAMRY dynamometer or Smedley dynamometer. We aimed to evaluate the reliability and validity of the CAMRY dynamometer compared with the Jamar dynamometer. Methods This was a cross-sectional study using a random crossover design in the grip strength test with two dynamometers. A total of 1064 healthy community-dwelling older adults aged 50–90 years old, which included 686 minorities and 378 Han Chinese, were recruited into the study from July to September 2021. We assessed the reliability and validity of the CAMRY EH101 dynamometer, and the Jamar dynamometer was regarded as the reference device. The order of testing with two dynamometers was randomized in a 1:1 ratio, with a 10-min gap between the two devices. Intraclass correlation coefficients (ICCs) and Bland–Altman analysis were calculated to assess reliability and validity between the two devices. Results The average handgrip strength (HGS) values at six times by the Jamar and CAMRY devices were 25.0 ± 7.9 kg and 24.6 ± 7.5 kg, respectively. The ICC values between the two devices were 0.815–0.854, and the systematic bias underestimated by the CAMRY dynamometer was 0.5 kg in men and 0.6 kg in women. We carried out a linear regression equation by sex, and their relationship was found as follows: male HGS (kg) Jamar  = 8.001 + 0.765 × HGS (kg) CAMRY ; female HGS (kg) Jamar  = 3.681 + 0.840 × HGS (kg) CAMRY . Conclusions The CAMRY EH101 dynamometer provides excellent reliability and validity. This device can serve as a reliable, inexpensive, and practical device to assess grip strength in geriatric clinical practice. Clinical trial registration Chinese Clinical Trial Registry: ChiCTR2100046367 ; Date of clinical trial reistration: 15/05/2021.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-022-03270-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 9
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    Sarcopenia in systemic sclerosis: prevalence and impact—a systematic review and meta-analysis
    BMJ ; 2024
    In:  BMJ Open Vol. 14, No. 3 ( 2024-03), p. e078034-
    Details
    In: BMJ Open, BMJ, Vol. 14, No. 3 ( 2024-03), p. e078034-
    Abstract: This review aims to provide an estimate of sarcopenia prevalence and its impact on clinical characteristics in patients with systemic sclerosis (SSc). Design Systematic review and meta-analysis. Data sources Embase, Medline, Web of Science and the Cochrane Central Register of Controlled Trials were systemically searched from inception to 24 May 2023. Eligibility criteria for selecting studies We included observational studies that reported the prevalence of sarcopenia in patients with SSc. Data extraction and synthesis Two reviewers independently performed study selection and data extraction using standardised methods. Risk of bias was assessed using the Agency for Healthcare Research and Quality Scale and the Newcastle–Ottawa Scale. Meta-analysis was conducted using random effects models. Results A total of 4583 articles were screened and 9 studies with data from 815 patients were included in the analysis (8 cross-sectional studies and 1 retrospective cohort study). The overall prevalence of sarcopenia in patients with SSc was 22% (95% CI 17% to 28%). Patients with SSc with sarcopenia had a poorer quality of life (mean difference −12.02; 95% CI −19.11 to −4.93) and higher C reactive protein (CRP) levels (standardised mean difference 0.67; 95% CI 0.35 to 1.00). Conclusions Sarcopenia is common in patients with SSc. Patients with SSc with sarcopenia had a worse quality of life and higher CRP levels, based on our findings. Given the detrimental impact of sarcopenia on quality of life, future efforts aimed at early identification of sarcopenia in the clinical assessment of patients with SSc may have significance. PROSPERO registration number CRD42022368326.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2023-078034
    DOI: 10.1136/bmjopen-2023-078034.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2024
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  • 10
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    Transformation of a Geriatric Department in China
    Wiley ; 2018
    In:  Journal of the American Geriatrics Society Vol. 66, No. 1 ( 2018-01), p. 184-190
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 66, No. 1 ( 2018-01), p. 184-190
    Abstract: China has the world's largest elderly population, and the oldest‐old population, with a current disability rate greater than 50%, will triple in the next 35 years. The field of geriatrics is young, because almost all geriatric departments were established after 2000, and so faces many challenges. Management of diseases and hospital care is the focus. Senior physicians were trained in other subspecialties, such as pulmonary or cardiology, and junior physicians entered geriatrics departments as masters or doctorate students after medical school. The inadequacy of post‐acute and long‐term care facilities has caused long hospital stays. There are no national systematic geriatric training programs, national board examinations, or qualifications in geriatrics. These challenges were used as a framework for guiding changes in the Department of Geriatrics at West China Hospital, Sichuan University. These changes have included international experiences and collaboration for physicians and nurses, revision of departmental conferences, and special training for a unique group of caregivers called hugong (untrained caregivers hired by families to be at the bedside of hospitalized individuals). The most significant yet challenging part of the transformation has been to develop and modify Western‐based geriatric models of care (e.g., Acute Care of the Elderly unit, delirium prevention and management models, palliative care). Lastly, the department established Tianxia (in the sky) Doctors, an internet‐based platform to connect the department's interdisciplinary team to other hospitals, nursing institutions, home‐based care service stations, community health service centers, and pharmacies throughout the region.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2018.66.issue-1
    DOI: 10.1111/jgs.15217
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2040494-3
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