Research Interests: Quality of life, Stratification, Linear models, Italy, Humans, and 19 moreOral Health Related Quality of Life, Negative Affect, Female, Male, Body Mass Index, Multiple Linear Regression, Aged, Cross Section, Public health systems and services research, Social Relationship, Geriatric Assessment, Chi Square Test, Older Adult, Cross sectional Study, Cross Sectional Studies, Energy Levels, Functional Status, Leisure Activities, and Health services for the aged
Elderly people make extensive use of the Emergency Department (ED). After discharge from the ED, these patients are at high risk of short-term adverse outcomes such as functional decline, readmission to the ED, hospitalization and death.... more
Elderly people make extensive use of the Emergency Department (ED). After discharge from the ED, these patients are at high risk of short-term adverse outcomes such as functional decline, readmission to the ED, hospitalization and death. We investigated whether a comprehensive geriatric evaluation (CGE) and follow-up of the elderly discharged from the ED can provide them with better diagnosis and treatment, and thus reduce adverse outcomes. Out of 423 elderly patients over 75 years of age discharged from an ED we evaluated 222 of them. The patients were evaluated and treated, based on testing for physical, functional, cognitive and emotional status. A comparison was made between scale scores at baseline and 3 months later. We observed a significant improvement in physical and emotional status in all the studied patients, a significant improvement in behavioural status in the elderly patients with cognitive dysfunction, and a reduction of distress in the caregivers of the elderly patients with cognitive dysfunction and behavioural disturbances. We also found that the rate of ED readmission or hospitalization was lower than in the 3 months preceding the CGE. The experience of older patients with the ED system can be greatly improved if their complex needs are given due attention by developing interdisciplinary programs between emergency physicians, geriatricians, and primary care physicians.
Research Interests:
Objective: To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. Method: Cross-sectional survey of 302... more
Objective: To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. Method: Cross-sectional survey of 302 community-dwelling outpatients aged 65+ (median age 82 years) consecutively referred to a geriatric medicine clinic in Italy from June to November 2009. Participants underwent a comprehensive geriatric assessment including frailty status evaluated by means of the study of osteoporotic fractures (SOF) criteria. Student's t-test and the chi-squared test were used to compare subjects ‘living alone’ and ‘not living alone’ as well as ‘frail’ and ‘not frail’ subjects among the participants living alone. Multiple logistic regression analyses were performed to find independent correlates of frailty among participants living alone. Results: Participants ‘living alone’ were 124 (41%). Compared to subjects ‘not living alone’ (n = 178), they were older, received less assistance from informal and formal caregivers, had poorer living and financial conditions, a better cognitive status and functional self-sufficiency but a worse emotional status. One-third of them (n = 41) were frail. Among frail elders (n = 116), subjects living alone also showed a higher prevalence of unexpected new diagnoses of dementia than those not living alone. Independent correlates of frailty among participants living alone were: having experienced a severe acute disease in the past year (odds ratio [OR] 303.9; 95% confidence interval [CI] 13–7091; p < 0.001), dependence in the bathing BADL ability (OR 62.74; 95% CI 12.17–323.32; p < 0.001), depression (OR 10.43; 95% CI 2.31–47.13; p = 0.002) and incontinence (OR 3.98; 95% CI 1.01–15.66; p = 0.048). Conclusion: In older outpatients living alone, including those who were frail, we found a lower availability of personal assistance, significantly more social and financial vulnerability and a higher risk of depression. In frail elders there was also a higher prevalence of underdiagnosed dementia. In order to better recognise frail subjects in this specific population, four independent correlates of frailty were identified.
Research Interests: Mental Health, Dementia, Social Support, Logistic Regression, Activities of Daily Living, and 17 moreItaly, Humans, Female, Male, Interpersonal Relations, Vulnerable Populations, Aged, Prevalence, Social Functioning, Outpatients, Cross Section, Geriatric Assessment, Chi Square Test, Cross Sectional Studies, Logistic Models, Confidence Interval, and Frail elderly
There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with... more
There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients.
Research Interests: Quality of life, Stratification, Linear models, Italy, Humans, and 20 moreNegative Affect, Health related Quality of Life, Female, Male, Body Mass Index, Multiple Linear Regression, Aged, Cross Section, Public health systems and services research, Social Relationship, Geriatric Assessment, Chi Square Test, Older Adult, Cross sectional Study, Cross Sectional Studies, Energy Levels, Functional Status, Leisure Activities, Health services for the aged, and Frail elderly
To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. Cross-sectional survey of 302 community-dwelling outpatients... more
To determine the main social, functional and clinical characteristics of community-dwelling older outpatients living alone and to find correlates of frailty in this population. Cross-sectional survey of 302 community-dwelling outpatients aged 65+ (median age 82 years) consecutively referred to a geriatric medicine clinic in Italy from June to November 2009. Participants underwent a comprehensive geriatric assessment including frailty status evaluated by means of the study of osteoporotic fractures (SOF) criteria. Student&amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test and the chi-squared test were used to compare subjects &amp;amp;amp;amp;amp;amp;amp;amp;#39;living alone&amp;amp;amp;amp;amp;amp;amp;amp;#39; and &amp;amp;amp;amp;amp;amp;amp;amp;#39;not living alone&amp;amp;amp;amp;amp;amp;amp;amp;#39; as well as &amp;amp;amp;amp;amp;amp;amp;amp;#39;frail&amp;amp;amp;amp;amp;amp;amp;amp;#39; and &amp;amp;amp;amp;amp;amp;amp;amp;#39;not frail&amp;amp;amp;amp;amp;amp;amp;amp;#39; subjects among the participants living alone. Multiple logistic regression analyses were performed to find independent correlates of frailty among participants living alone. Participants &amp;amp;amp;amp;amp;amp;amp;amp;#39;living alone&amp;amp;amp;amp;amp;amp;amp;amp;#39; were 124 (41%). Compared to subjects &amp;amp;amp;amp;amp;amp;amp;amp;#39;not living alone&amp;amp;amp;amp;amp;amp;amp;amp;#39; (n = 178), they were older, received less assistance from informal and formal caregivers, had poorer living and financial conditions, a better cognitive status and functional self-sufficiency but a worse emotional status. One-third of them (n = 41) were frail. Among frail elders (n = 116), subjects living alone also showed a higher prevalence of unexpected new diagnoses of dementia than those not living alone. Independent correlates of frailty among participants living alone were: having experienced a severe acute disease in the past year (odds ratio [OR] 303.9; 95% confidence interval [CI] 13-7091; p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), dependence in the bathing BADL ability (OR 62.74; 95% CI 12.17-323.32; p &amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), depression (OR 10.43; 95% CI 2.31-47.13; p = 0.002) and incontinence (OR 3.98; 95% CI 1.01-15.66; p = 0.048). In older outpatients living alone, including those who were frail, we found a lower availability of personal assistance, significantly more social and financial vulnerability and a higher risk of depression. In frail elders there was also a higher prevalence of underdiagnosed dementia. In order to better recognise frail subjects in this specific population, four independent correlates of frailty were identified.