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1.
Adv Gerontol ; 33(4): 616-624, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33342091

RESUMO

The article discusses the causal relationship between the low efficiency of state policy in extending the period of active longevity. It is characterized by the absence of a correlation between basic and applied research in the field of aging and the use of an unsystematic approach to the development, implementation of targeted federal and regional programs aimed improving the quality of life older citizens. It is shown that the current negative situation, characterized by an aggravating decline in the quality and accessibility of state medical, social and psychological assistance to elderly citizens, is largely due to the incompleteness of existing laws and regulations in the field of their social support. The lack of both scientific justification for programs and terminological correctness allows officials to use a formalized, extensive approach when planning the development of the healthcare and social protection sectors, which do not take into account population aging. The problem of positioning gerontology as a scientific discipline that provides a synthesis of natural science, applied and socio-humanitarian knowledge, a complex of four scientific areas: biology, medicine, psychology, sociology is considered. The unity of the components of gerontology provides scientific background for improving public policy aimed on adapting socio-economic development to the demographic processes of population aging.


Assuntos
Geriatria , Geriatria/tendências , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde para Idosos , Humanos , Política Pública , Qualidade de Vida , Federação Russa
2.
Z Gerontol Geriatr ; 53(8): 742-748, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-33185722

RESUMO

Health care and especially care of the elderly have come under massive pressure from the corona pandemic. Structural deficits and weak points that are not really new are now more apparent because COVID-19 has brought these back into focus. In the entire healthcare system new questions arise in the face of the current challenges. Problems and gaps now become obvious in the health care services and in the provision of care for the elderly-some of them specifically related to one area, but to a greater extent these are cross-sectoral. Based on relevant national and international studies and publications and from the perspective of social gerontology, this article focuses on the current situation in the 'long-term nursing care in Germany' in the context of the SARS-CoV­2 virus. The results of this analysis are used to derive and outline what a new professional orientation can look like with a view to the future and what possible knowledge can be gained from the corona pandemic.


Assuntos
Assistência à Saúde/tendências , Geriatria/tendências , Pandemias , Idoso , Alemanha , Humanos
5.
JAMA Netw Open ; 3(7): e2011645, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32716514

RESUMO

Importance: National guidelines balance risks and benefits of population-level cancer screening among adults with average risk. Older adults are not recommended to receive routine screening, but many continue to be screened (ie, are overscreened). Objective: To assess the prevalence of overscreening for colorectal, cervical, and breast cancers among older adults as well as differences in overscreening by metropolitan status. Design, Setting, and Participants: The cross-sectional study examined responses to a telephone survey of 176 348 community-dwelling adults. Participants were included if they met age and sex criteria, and they were excluded from each cancer-specific subsample if they had a history of that cancer. Data came from the 2018 Behavioral Risk Factor Surveillance System, administered by the US Centers for Disease Control and Prevention. Exposures: Metropolitan status, according to whether participants lived in a metropolitan statistical area. Main Outcomes and Measures: Overscreening was assessed using US Preventive Services Task Force definitions, ie, whether participants self-reported having a screening after the recommended upper age limit for colorectal (75 years), cervical (65 years), or breast (74 years) cancer. Results: Of 176 348 participants (155 411 [88.1%] women; mean [SE] age, 75.0 [0.04] years; 150 871 [85.6%] non-Hispanic white; 60 456 [34.3%] with nonmetropolitan residence) the cancer-specific subsamples contained 20 937 [11.9%] men and 34 244 [19.4%] women for colorectal cancer, 82 811 [47.0%] women for cervical cancer, and 38 356 [21.8%] women for breast cancer. Overall, 9461 men (59.3%; 95% CI, 57.6%-61.1%) were overscreened for colorectal cancer; 14 463 women (56.2%; 95% CI, 54.7%-57.6%), for colorectal cancer; 31 988 women (45.8%; 95% CI, 44.9%-46.7%), for cervical cancer; and 26 198 women (74.1%; 95% CI, 73.0%-75.3%), for breast cancer. Overscreening was more common in metropolitan than nonmetropolitan areas for colorectal cancer among women (adjusted odds ratio [aOR], 1.23; 95% CI, 1.08-1.39), cervical cancer (aOR, 1.20; 95% CI, 1.11-1.29), and breast cancer (aOR, 1.36; 95% CI, 1.17-1.57). Overscreening for cervical and breast cancers was also associated with having a usual source of care compared with not (eg, cervical cancer: aOR, 1.87; 95% CI, 1.56-2.25; breast cancer: aOR, 2.08; 95% CI, 1.58-2.76), good, very good, or excellent self-reported health compared with fair or poor self-reported health (eg, cervical cancer: aOR, 1.21; 95% CI, 1.11-1.32; breast cancer: aOR, 1.47; 95% CI, 1.28-1.69), an educational attainment greater than a high school diploma compared with a high school diploma or less (eg, cervical cancer: aOR, 1.14; 95% CI, 1.06-1.23; breast cancer: aOR, 1.30; 95% CI, 1.16-1.46), and being married or living as married compared with other marital status (eg, cervical cancer: OR, 1.36; 95% CI, 1.26-1.46; breast cancer: OR, 1.54; 95% CI, 1.34-1.77). Conclusions and Relevance: In this study, overscreening for cancer among older adults was high, particularly for women living in metropolitan areas. Overscreening could be associated with health care access and patient-clinician relationships. Additional research on why overscreening persists and how to reduce overscreening is needed to minimize risks associated with cancer screening among older adults.


Assuntos
Mapeamento Geográfico , Programas de Rastreamento/normas , Sobremedicalização/tendências , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias Colorretais/diagnóstico , Estudos Transversais , Feminino , Geriatria/métodos , Geriatria/tendências , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/tendências , Fatores de Risco , Inquéritos e Questionários , Neoplasias do Colo do Útero/diagnóstico
6.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-611800

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
7.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-607701

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
8.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 151-156, 2020 06 01.
Artigo em Francês | MEDLINE | ID: mdl-32554346

RESUMO

At the beginning of the Covid-19 epidemic, National forum for ethical reflection on Alzheimer's disease and neurodegenerative diseases conducted a national survey to identify the difficulties encountered by professionals working in the field of old age and autonomy, families and volunteers, and the initiatives they have implemented. Seven major difficulties were identified: the isolation induced by the prohibition of visits, the lack of protective equipment and tests, the difficulties of people with cognitive difficulties in understanding measures to avoid the spread of the epidemic, the sustainability of overwork for professionals, the concern of the families of residents, complex situations at home and difficulties in accessing care. Four initiatives are being implemented: information and training for teams, compensation for interrupted visits, consultations and exchanges between professionals, actions to benefit people living at home. The Covid-19 epidemic hit the elderly sector at a very special moment in its history, several years of effort by the sector to reinvent itself around strong values. They have been a resource during this period of crisis. An ambitious law on old age and autonomy therefore appears to be a necessity.


Assuntos
Infecções por Coronavirus/terapia , Geriatria/ética , Geriatria/tendências , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Técnicas de Laboratório Clínico/estatística & dados numéricos , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Família , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto , Isolamento de Pacientes/psicologia , Autonomia Pessoal , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
11.
Disaster Med Public Health Prep ; 14(3): e13-e14, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32379016

RESUMO

As the systems that people depend on are increasingly strained by the coronavirus disease-2019 (COVID-19) outbreak, public health impacts are manifesting in different ways beyond morbidity and mortality for elderly populations. Loneliness is already a chief public health concern that is being made worse by COVID-19. Agencies should recognize the prevalence of loneliness among elderly populations and the impacts that their interventions have on loneliness. This letter describes several ways that loneliness can be addressed to build resilience for elderly populations as part of the public health response to COVID-19.


Assuntos
Infecções por Coronavirus/psicologia , Geriatria/métodos , Solidão/psicologia , Pneumonia Viral/psicologia , Saúde Pública/métodos , Adaptação Psicológica , Infecções por Coronavirus/prevenção & controle , Geriatria/tendências , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/tendências
12.
Can J Aging ; 39(3): 344-347, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32423497

RESUMO

The COVID-19 global crisis is reshaping Canadian society in unexpected and profound ways. The significantly higher morbidity and mortality risks by age suggest that this is largely a "gero-pandemic," which has thrust the field of aging onto center stage. This editorial emphasizes that vulnerable older adults are also those most affected by COVID-19 in terms of infection risk, negative health effects, and the potential deleterious outcomes on a range of social, psychological, and economic contexts - from ageism to social isolation. We also contend that the pathogenic analysis of this pandemic needs to be balanced with a salutogenic approach that examines the positive adaptation of people, systems and society, termed COVID-19 resilience. This begs the question: how and why do some older adults and communities adapt and thrive better than others? This examination will lead to the identification and response to research and data gaps, challenges, and innovative opportunities as we plan for a future in which COVID-19 has become another endemic infection in the growing list of emerging and re-emerging pathogens.


Assuntos
Ageismo , Envelhecimento , Infecções por Coronavirus , Geriatria , Pandemias , Pneumonia Viral , Marginalização Social/psicologia , Idoso , Ageismo/ética , Ageismo/prevenção & controle , Ageismo/psicologia , Envelhecimento/fisiologia , Envelhecimento/psicologia , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Geriatria/métodos , Geriatria/tendências , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/ética , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Fatores de Risco , Estigma Social , Populações Vulneráveis
13.
Z Gerontol Geriatr ; 53(3): 228-232, 2020 May.
Artigo em Alemão | MEDLINE | ID: covidwho-26723

RESUMO

The current corona crisis affects older patients as well as the geriatric infrastructure in all sectors. This article provides an overview about the current state of knowledge on COVID-19 with special consideration of geriatric aspects and the consequences for the geriatric care system.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Geriatria , Pandemias , Pneumonia Viral , Idoso , Infecções por Coronavirus/epidemiologia , Geriatria/tendências , Humanos , Pneumonia Viral/epidemiologia
15.
Z Gerontol Geriatr ; 53(3): 228-232, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32236694

RESUMO

The current corona crisis affects older patients as well as the geriatric infrastructure in all sectors. This article provides an overview about the current state of knowledge on COVID-19 with special consideration of geriatric aspects and the consequences for the geriatric care system.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Geriatria , Pandemias , Pneumonia Viral , Idoso , Infecções por Coronavirus/epidemiologia , Geriatria/tendências , Humanos , Pneumonia Viral/epidemiologia
18.
Aust J Gen Pract ; 49(3): 100-106, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32113211

RESUMO

BACKGROUND: General practitioners are increasingly likely to encounter elderly patients who are receiving immunosuppressants for the management of autoimmune diseases or solid organ transplants. OBJECTIVE: The aim of this article is to provide an overview of the long-term management of the elderly patient treated with immunosuppressants. Recommendations for monitoring, preventing and managing adverse effects of immunosuppressants are summarised. DISCUSSION: Elderly patients prescribed immunosuppressants may present a number of unique challenges. Immunosenescence, altered pharmacokinetics and the presence of multiple comorbidities can all affect response to immunosuppressants. Through close collaboration with tertiary care providers and regular screening, the general physician is well placed to recognise medication-related complications.


Assuntos
Geriatria/métodos , Imunossupressores/uso terapêutico , Assistência de Longa Duração/métodos , Geriatria/tendências , Humanos , Imunossupressores/efeitos adversos , Assistência de Longa Duração/tendências , Programas de Rastreamento/métodos
19.
Am J Emerg Med ; 38(6): 1257-1269, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32222314

RESUMO

STUDY OBJECTIVE: To summarize interventions that impact the experience of older adults in the emergency department (ED) as measured by patient experience instruments. METHODS: This is a systematic review to evaluate interventions aimed to improve geriatric patient experience in the ED. We searched Ovid CENTRAL, Ovid EMBASE, Ovid MEDLINE and PsycINFO from inception to January 2019. The main outcome was patient experience measured through instruments to assess patient experience or satisfaction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the confidence in the evidence available. RESULTS: The search strategy identified 992 studies through comprehensive literature search and hand-search of reference lists. A total of 21 studies and 3163 older adults receiving an intervention strategy aimed at improve patient experience in the ED were included. Department-wide interventions, including geriatric ED and comprehensive geriatric assessment unit, focused care coordination with discharge planning and referral for community services, were associated with improved patient experience. Providing an assistive listening device to those with hearing loss and having a pharmacist reviewing the medication list showed an improved patient perception of quality of care provided. The confidence in the evidence available for the outcome of patient experience was deemed to be very low. CONCLUSION: While all studies reported an outcome of patient experience, there was significant heterogeneity in the tools used to measure it. The very low certainty in the evidence available highlights the need for more reliable tools to measure patient experience and studies designed to measure the effect of the interventions.


Assuntos
Serviço Hospitalar de Emergência/normas , Satisfação do Paciente , Idoso , Idoso de 80 Anos ou mais , Continuidade da Assistência ao Paciente , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Geriatria/métodos , Geriatria/normas , Geriatria/tendências , Humanos , Melhoria de Qualidade
20.
Maturitas ; 134: 47-53, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32143776

RESUMO

OBJECTIVES: We investigated trends in end-of-life hospitalizations among nursing home residents (NHR) over 10 years and looked at differences between age groups and sexes as well as the length of terminal hospital stays. STUDY DESIGN: Retrospective cohort study based on health insurance claims data of the AOK Bremen/Bremerhaven. All NHR aged 65 years or more who died between 2006 and 2015 were included. MAIN OUTCOME MEASURES: We assessed the proportions of decedents who were in hospital on the day of death and during the last 3, 7, 14 and 30 days of life, stratified by two-year periods. Multiple logistic regressions were conducted to study changes over time, adjusting for covariates. RESULTS: A total of 10,781 decedents were included (mean age 86.1 years, 72.1 % females). Overall, 29.2 % died in hospital, with a slight decrease from 30.3 % in 2006-2007 to 28.3 % in 2014-2015 (OR 0.86; 95 % CI 0.75-0.98). Of the 3150 terminal hospitalizations, 35.5 % lasted up to 3 days and the mean length of stay decreased from 9.0 (2006-2007) to 7.5 days (2014-2015). When looking at the last 7, 14 and 30 days of life, no changes over time were found. Male sex and younger age were associated with a higher chance of end-of-life hospitalization in almost all analyses. CONCLUSIONS: End-of-life hospitalizations of NHR are common in Germany. There has been a small decrease during recent years in the proportion of in-hospital deaths, but not of hospitalizations during the last 7, 14 and 30 days of life. This might be explained by shorter durations of hospital stays.


Assuntos
Geriatria/tendências , Tempo de Internação , Casas de Saúde/tendências , Assistência Terminal/tendências , Idoso , Idoso de 80 Anos ou mais , Feminino , Geriatria/estatística & dados numéricos , Alemanha/epidemiologia , Hospitais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , Análise de Regressão , Estudos Retrospectivos , Assistência Terminal/estatística & dados numéricos , Fatores de Tempo
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