Geriatric care-related outcomes in patients 75 years and older admitted to a pulmonary disease center and predictors for hospital-related complications.

Objective: The primary aim of this study was to evaluate the influence of targeted interventions, administered through comprehensive geriatric assessments on the incidence of hospitalization-related complications among older adults diagnosed with pulmonary diseases. Methods: A retrospective analysis of medical records encompassed individuals aged 75 years and older who were admitted to a lung center during the period spanning from March to June 2023. These admissions occurred in a context where standardized geriatric management protocols were systematically implemented. This study's scope extended to assessing the prevalence of hospital-related complications, encompassing delirium and pressure ulcers. A rigorous multivariate logistic regression analysis was conducted to discern and characterize associated factors. Results: The integration of comprehensive geriatric assessment yielded a substantial reduction in in-hospital complications among the cohort of 118 patients (mean age : 82.1 ± 5.6 years, 44.5% women). The incidence of delirium decreased from 53.3% to 21.8% [odds ratio (OR): 0.246, 95% confidence interval (CI): 0.134-0.450, p < 0.001], whereas the presence of pressure ulcers decreased from 43.9% to 25% (OR: 0.395, 95% CI: 0.217-0.715, p < 0.001). The multivariate analysis uncovered independent associations between delirium and variables including community-acquired pneumonia (OR: 4.417, 95% CI : 1.574-12.395, p = 0.005), severe disability (OR: 2.981, 95% CI: 1.140-7.798, p = 0.026), and hearing loss (OR: 3.219, 95% CI : 1.260-8.170, p = 0.014). Prolonged hospital stays emerged as the sole factor significantly associated with pressure ulcers (OR: 1.071, 95% CI: 1.033-1.109). Furthermore, an intricate bidirectional relationship was evident between delirium and pressure ulcers (OR: 7.158, 95% CI: 2.962-17.300, p < 0.01). Conclusion: In conjunction with its consequent interventions, geriatric evaluation assumes a pivotal role in ameliorating adverse outcomes stemming from hospitalization among older adults afflicted with pulmonary ailments. This role gains particular salience among subpopulations characterized by heightened susceptibility, such as individuals coping with hearing loss and severe disability.

Global Aging and Cancer: Advancing Care Through Innovation.

The oncology field, like many others, is digitalizing rapidly, a phenomenon that may have been accelerated by the COVID-19 pandemic. This movement is creating opportunities and challenges. Another rapidly developing change is the aging of the global population; because cancer is a disease of aging, there is a need for health systems to adapt to taking care of such patients. In this article, we address how these innovative technologies can be leveraged to improve the care of older patients with cancer beyond academic centers, such as in underserved areas and low- and middle-income countries. We review how digital technologies can be used to enhance the follow-up of patients in low- and middle-income countries. We also tackle the issue of training a global workforce to treat cancer in an aging population and how to leverage innovations in this matter. Finally, we review opportunities to expand the usefulness of big data and machine learning beyond academic centers to support private practices and underserved areas.

Higher Veterans Aging Cohort Study 2.0 Index Score Predicts Functional Decline Among Older Adults Living with HIV.

Living with HIV has been proposed as a risk factor for the early development of functional decline. Composite marker tools like the Veterans Aging Cohort Study (VACS) Index, which includes HIV-associated and non-HIV-related markers of disease may better reflect multiorgan system injury and potentially predict functional outcomes. Therefore, the objective of this work is to determine whether higher VACS 2.0 Index scores predicts functional decline among older adults living with HIV (OALWH). Longitudinal study, including 131 adults ages 50 or older who underwent a comprehensive geriatric assessment at baseline and follow-up, at least a year apart. Functional status was determined by the gait speed (seconds for a 4-m distance). Linear regression models were constructed to determine the relationship between VACS 2.0 Index at baseline with gait speed at follow-up adjusted for potential confounders. The median for age was 58.0 years (range 50-84), and 81.7% were male. At baseline, the median VACS 2.0 Index score was 50.4 (interquartile range 42.2-65.3). The adjusted linear regression analysis found that higher baseline VACS 2.0 Index scores were significantly associated with a decline in gait speed (p = .033) at follow-up. The results suggest that the VACS 2.0 Index works as a predictor of functional decline as showed by decline in gait speed and might serve as an easy tool to identify OALWH who might need additional resources or interventions to prevent it.