Who will treat older patients? Should medical education focus more on activities aimed at displaying positive attitudes toward older people? The prevalence of ageism among students of medical and health sciences.

In the conditions of an aging society, a justification is found to explain the issue of the attitude of future health care workers, who are to care for elderly people in the future, toward these people, which will make it possible to predict in advance what problems related to the care of seniors may soon arise. After clarifying this issue, it will be important to distinguish the individual factors influencing this attitude in order to determine which social phenomena will require special attention. Eight hundred and three medical and health sciences students participated in the research from various fields of medical studies. A Survgo system was used, where an online questionnaire was placed and then posted in social media. Only students of medicine and healthcare facilities participated in the study. The first questionnaire contained socio-demographic questions. Then, the KOAP questionnaire and Welch's t-test were used, and finally the proprietary questionnaire on contact with seniors. Analyses were conducted using the R Statistical language. Scores on the KAOP questionnaire ranged from 122.4 to 134.57. The highest scores were shown for physiotherapy students and the lowest for pharmacy students. The highest level of attitude toward elderly was reported in students of 1st to 3rd year of study. For 4th-5th year or supplementary level students, attitude levels were decreasing. Welch's t-test showed that the level of attitude toward old people in men was significantly higher than in women. There was no significant correlation between the age factor on the quotient scale and the KOAP score. Married individuals had significantly higher KAOP scores compared to singles and those in an informal relationship. No significant differences between the study stage factor and KAOP score have been found. Those who live and/or have regular contact with the elderly were characterized by higher KAOP questionnaire scores. The attitude toward the elderly depends on many factors, such as the chosen field of study, stage of education, contact with the elderly, gender or marital status. In order to develop proper contact with seniors, the solution may be to influence modifiable factors, especially the correct education of future health care workers.

Empathy as a Factor Conditioning Attitudes towards the Elderly among Physiotherapists-Results from Poland.

Attitudes of healthcare workers towards the elderly significantly affect the quality of care dedicated to this group of patients. The purpose of this study was to assess the approach of Polish physiotherapists to the elderly and to analyze the factors influencing these attitudes. The study was based on a cross-sectional Internet-based survey that was conducted in the period from May to September 2021. It was completed by 252 subjects: 189 women and 63 men. The study was based on the involvement of physiotherapists with the right to practice their profession in accordance with the law in force in Poland. The tools used in the study were The Kogan Attitudes towards the Elderly (KAOP) score and The Jefferson Empathy Scale (JSE). To model the KOAP score as a function of the predictors, Bayesian linear regression was used. The average KOAP score in the sample was M (SD) = 100.7 (17.46), with the central 50% of the observations ranging from 81 to 113 points. We observed one statistically credible relationship: relevance of contacts with elderly people was positively and moderately related to KOAP. Additionally, we observed that the JSE scale was positively, but very weakly, associated with KOAP. Empathy and own experience of health care providers may protect against negative attitudes towards the elderly, meaning empathy in healthcare professionals is crucial.

Attitudes Towards the Elderly in Polish Society: Is Knowledge About Old Age and Personal Experiences a Predictor of Ageism?

PURPOSE: The aim of the study was to determine the prevalence and characteristics of ageism in Polish society. In addition, the relationships of opinions with demographic data, knowledge about aging and individual contact with the elderly, in the context of knowledge about their exclusion, were examined. PATIENTS AND METHODS: The study involved 923 individuals in Poland. Their demographic characteristics were recorded, and all subjects were assessed using Kogan's Attitudes toward Old People (KOAP) scale and asked to complete the Facts on Aging Quiz. Subjects were also asked about their knowledge of the definition of ageism and asked to explain it. RESULTS: The KOAP scale as a function of predictors was modeled using Bayesian robust linear regression with t distribution. The subjects had a mean (SD) KAOP score of 90.88 (17.41), with the central 50% of the observations ranging from 83 to 101 points. Three statistically credible relationships with responses to the questionnaires were observed. Respondents attending school had slightly lower average KAOP scores than respondents with other professional status. In addition, FAQ was negatively and moderately related to KAOP, whereas contacts with elderly people were positively and moderately related to KAOP. CONCLUSION: Knowledge of aging and contact with elderly individuals significantly affected attitudes and behaviors regarding ageism. Many study subjects were characterized by having unfavorable attitudes towards the elderly.

Health and Protective Measures for Seniors during the COVID-19 Pandemic in the Opinion of Polish Society.

The aim of the study was to determine the opinion of society on the individual care and protection measures towards seniors during the COVID-19 pandemic. In addition, the relationship of opinions with demographic data, knowledge about aging and own experience in contacts with the elderly was examined. The study involved 923 attendees from Poland. The tools used to assess the research problem were: demographic characteristics, a Facts on Aging Quiz (FAQ), the author's questionnaire about preventive and protective measures for seniors during the COVID-19 pandemic. We observed that over 50% of participants were against designating shopping hours for seniors. The analysis showed that negative attitudes were more often expressed by women than by men; younger people and those declaring that they do not spend too much time with the elderly. In the matter of vaccination priority for the elderly, over 70% participants replied "rather yes" or "definitely yes". The use of the age criterion in situations of limited access to medications and ventilators was supported mainly by learners, with high results of the FAQ, and professionals dealing with seniors. Finally, almost 56% of participants declared that their contacts with seniors were the same as before the pandemic, while merely 1.6% indicated that they avoid contact with them entirely.

Usefulness of the Polish versions of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination as screening instruments for the detection of mild neurocognitive disorder.

INTRODUCTION: Screening tests are a key step in the diagnosis of dementia and should therefore be highly sensitive to the detection of mild neurocognitive disorders (NCD). The Mini Mental State Examination (MMSE) is the most commonly used screening method. The Montreal Cognitive Assessment (MoCA) is a newer and less well-known screening tool, which has none of the limitations of the MMSE. AIM: The aim of this study was to analyse the reliability of the Polish versions of MoCA 7.2 vs MMSE in the detection of mild NCD among people aged over 60. MATERIAL AND METHODS: The study was carried out at the Department and Clinic of Geriatrics from September 2014 to March 2017. The study included 281 participants, 91 of whom were assigned to the group without NCD. The other 190 had been diagnosed with mild NCD. RESULTS: In the analysis of the ROC curve of the MoCA 7.2 results, the AUC was 0.925 (p < 0.001). The optimal cut-off point for mild NCD was 23/24 points, with sensitivity and specificity of 83.2% and 79.1%. In the ROC curve of MMSE results, the AUC was 0.847 (p < 0.001). The optimal cut-off point for mild NCD was 27/28 points, with sensitivity and specificity of 75.8% and 66.7%. The difference between AUC MoCA 7.2 and MMSE was 0.078 (p = 0.036). CONCLUSIONS: MoCA 7.2 detects mild NCD with more sensitivity than MMSE. We recommend using the cut-off point for MoCA of 23/24 points, because this is characterised by a higher sensitivity than the previously recommended cut-off point of 25/26 points. For the MMSE, the recommended cut-off point should be 27/28, which gives greater diagnostic accuracy than the previously recommended 25/26 points.

The Influence of Polyphenol Compounds on Human Gastrointestinal Tract Microbiota.

: Polyphenols form a diverse group of compounds containing at least two hydroxyl groups in their chemical structure. Because of the common presence in plant kingdom, polyphenols are considered a significant component of food and an important group of compounds with antioxidant properties. The absorption of polyphenols present in food depends mostly on the activity of intestinal microflora. However, little is known about the processes and interactions responsible for such phenomenon in guts ecosystem. There are only few available publications that examine the effect on polyphenols on intestinal microbiota. Therefore, this work will focus on describing the relationship between polyphenol compounds present in food and bacteria colonizing the intestines, their mechanism, and impact on human's health.

Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial.

OBJECTIVE: The purpose of this study is to assess the effectiveness of pelvic floor muscle training and extracorporeal magnetic innervation in treatment of urinary incontinence in women with stress urinary incontinence. METHODS: The randomized controlled trial enrolled 128 women with stress urinary incontinence who were randomly allocated to either one out of two experimental groups (EG1 or EG2) or the control group (CG). Subjects in the experimental group 1 (EG1) received 12 sessions of pelvic floor muscle training, whereas subjects in the experimental group 2 (EG2) received 12 sessions of extracorporeal magnetic innervation. Subjects in the control group (CG) did not receive any therapeutic intervention. The following instruments were used to measure results in all study groups at the initial and final assessments: Revised Urinary Incontinence Scale (RUIS), Beck Depression Inventory (BDI-II), General Self-Efficacy Scale (GSES), and King's Health Questionnaire (KHQ). RESULTS: In both experimental groups, a statistically significant decline in depressive symptoms (BDI-II) and an improvement in urinary incontinence severity (RUIS) and quality of life (KHQ) were found in the following domains: "social limitations," "emotions," "severity measures," and "symptom severity scale." Moreover, self-efficacy beliefs (GSES) improved in the experimental group that received ExMI (EG2). No statistically significant differences were found between all measured variables in the control group. Comparative analysis of the three study groups showed statistically significant differences at the final assessment in the quality of life in the following domains: "physical limitations," "social limitations," "personal relationships," and "emotions." Conclusion. Pelvic floor muscle training and extracorporeal magnetic innervation proved to be effective treatment methods for stress urinary incontinence in women. The authors observed an improvement in both the physical and psychosocial aspects.

Impact of Vitamin D on Physical Efficiency and Exercise Performance-A Review.

Vitamin D deficiency amongst athletes and the general population seems to be a prominent problem. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship between vitamin D and bone health. Moreover, its concentrations are associated with muscle function and immune response in both the general and athletic populations. Vitamin D level is strongly connected with the presence of VDRs (vitamin D receptors) in most human extraskeletal cells. Expression of multiple myogenic transcription factors enhancing muscle cell proliferation and differentiation is caused by an exposure of skeletal muscles to vitamin D. The aim of this review is to summarize current understanding of the significance of vitamin D on exercise performance and physical efficiency, as well to analyze the impact of vitamin D on multiple potential mechanisms. More high-quality research studies, considering free 25(OH)D as a better marker of vitamin D status, the baseline level of 25(OH)D and multiple pathways of vitamin D acting and usage in athletes are required.

Effects of virtual reality-based cognitive training in older adults living without and with mild dementia: a pretest-posttest design pilot study.

OBJECTIVE: Modern technologies are increasingly used in the development of cognitive interventions for older adults. Research into possible applications of virtual reality in such interventions has begun only recently. The aim of present study was to evaluate the effects of 8 sessions of VR-based cognitive training using the GRADYS game in healthy older adults (n = 72; aged 60-88) and older adults living with mild dementia (n = 27; aged 60-89). RESULTS: Older adults with mild dementia demonstrated worse baseline cognitive performance than participants without dementia. Both groups showed progress in training, which was greater in healthy older adults. There were also significant differences in cognitive functioning before and after the training. However, positive changes were revealed almost exclusively in the group of older adults without dementia. Based on the findings, we can recommend the GRADYS game for cognitive enhancement and as a possible counter-measure for cognitive decline experienced in normal cognitive ageing. Our results provide also support for the usefulness of VR technology in cognitive interventions in older adults. The use of the GRADYS game in persons living with dementia, however, would require several of the hardware and software modifications. Trial registration ISRCTN17613444, date of registration: 10.09.2019. Retrospectively registered.

A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women.

INTRODUCTION: Peri- and postmenopausal women frequently suffer from urinary incontinence (UI). Generally, UI becomes more severe with age. It impacts physical, mental, and social functioning as well as the quality of life, often leading to depression. Extracorporeal magnetic innervation (ExMI) is a relatively new conservative treatment method for UI. OBJECTIVE: The aim of the study was to assess the effectiveness of ExMI in the treatment of stress UI in women. METHODS: A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). The average age was 65.41 years (±SD 4.08). EG patients completed ExMI therapy. The treatment sessions lasted for 15 minutes, and occurred three times a week, for 4 weeks. No therapeutic intervention was applied to the CG. To objectify the treatment outcomes in both groups before and after the treatment, we measured myostatin concentration and performed the UI severity assessment (The Revised Urinary Incontinence Scale), perceived self-efficacy assessment (General Self-Efficacy Scale), and depression severity assessment (Beck Depression Inventory). RESULTS: The authors compared the EG results at the initial and final assessments and found a statistically significant improvement in severity of UI (P=0.001) and depression severity (P=0.006), and a decrease in myostatin concentration (P≤0.001). The authors did not find any statistically significant differences between all measured variables for the CG at the initial and final assessments. Furthermore, there were no statistically significant differences between all measured variables for the EG and the CG at the final assessment. CONCLUSION: Further trials are needed to determine optimal treatment protocols for various UI types and to evaluate long-term outcomes of the ExMI treatment.

Comparison of the effectiveness of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination in the detection of mild neurocognitive disorder in people over 60 years of age. Preliminary study. / Porównanie skutecznosci Montreal Cognitive Assessment 7.2 z Mini-Mental State Examination w wykrywaniu lagodnych zaburzen neuropoznawczych u osób po 60. roku zycia. Doniesienie wstepne.

OBJECTIVES: Analysis of reliability of the Polish version of the MoCA 7.2 vs. the MMSE in mild NCD detecting, while taking into consideration the sensitivity and specificity of cut-off points for each type of education. METHODS: Cross-sectional study was conducted at the Department of Geriatrics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun. The study was conducted between September 2014 and December 2015. The study involved 131 participants, including 54 people assigned to the group without NCD and 77 to the group with mild NCD. Recruitment for both groups was performed on the basis of specific inclusion and exclusion criteria. RESULTS: Mean scores of the MoCA 7.2 and the MMSE showed a statistically significant difference between the groups with and without mild NCD. The optimal cut-off point on the MoCA scale for mild NCD was 24/25. The optimal cut-off point on the MMSE scale for mild NCD was 28/29. In the ROC curve analysis, area under the curve (AUC) for the MoCA was significantly greater than the AUC for the MMSE. CONCLUSIONS: The MoCA 7.2 detect mild NCD with greater sensitivity than the MMSE. In the case of this tool, we propose the use of 24/25 cut-off point which has a higher sensitivity than the recommended 25/26 cut-off point. The MoCA 7.2 therefore can be used by primary healthcare and in the geriatric practice as a screening tool in detecting early cognitive impairment.

The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence - a pilot study.

OBJECTIVE: The aim of the study was to assess the myostatin concentration and an improvement in the severity of urinary incontinence (UI) after pelvic floor muscle training (PFMT) in a group of elderly women with stress UI. METHODS: A total of 74 participants were included in the analysis: 40 participants in the experimental group (EG) and 34 participants in the control group (CG). The EG underwent PFMT, whereas no therapeutic intervention was applied to the CG. Myostatin concentration and UI severity (Revised Urinary Incontinence Scale [RUIS]) were assessed in all women before and after the treatment. RESULTS: By comparing the results before and after the treatment, we have been able to demonstrate a statistically significant decrease in myostatin concentration (P<0.0001) and an improvement in the severity of UI (RUIS) (P<0.0001) in the EG. No statistically significant differences in all measured variables were reported before and after the treatment in the CG. A lower myostatin concentration (P=0.0084) and an improvement in the severity of UI (RUIS) (P=0.0008) were observed after the treatment in the EG compared to that in the CG. CONCLUSION: Effective PFMT causes downregulation of myostatin concentration and an improvement in the severity of UI in elderly women with stress UI. Further trials on a larger EG and an assessment of long-term treatment outcomes are required.

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. / Czy test Montreal Cognitive Assessment (MoCA) moze byc skuteczniejszy od powszechnie stosowanego Mini-Mental State Examination (MMSE) w wykrywaniu lagodnych zaburzen funkcji poznawczych u osób po 60. roku zycia? Metaanaliza.

OBJECTIVES: Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. METHODS: A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). RESULTS: ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). CONCLUSIONS: MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.