Maturitas
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Ageing impairs body balance and increases older adults' fall risk. Balance training can improve intrinsic fall risk factors. However, age comparisons of muscle activity responses during balance tasks are lacking. ⋯ Older adults had higher electrophysiological costs for all stance conditions. Muscle coordination showed inverse activity patterns at the ankle and trunk. Optimal balance and strength training programs should take into account age-specific alterations in muscle activity.
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Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. ⋯ Most studies did not implement a standardised ACD, or measure the impact on quality of end-of-life care or on the death and dying experience. All studies had some risk of bias, with most scoring poorly on the Oxford Quality Scale. While ACP interventions are well received by older adults and generally have positive effects on outcomes, this review highlights the need for well-designed RCTs that examine the economic impact of ACP and its effect on quality of care in nursing homes and other sectors.