BMC geriatrics
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Comparative Study
Validity, responsiveness and the minimal clinically important difference for the de Morton Mobility Index (DEMMI) in an older acute medical population.
The de Morton Mobility Index (DEMMI) is a new mobility instrument that overcomes the limitations of existing instruments. It is the first mobility instrument that accurately measures the mobility of all older adults. The aim of this study was to provide a detailed report of investigations of the validity, responsiveness to change and minimal clinically important difference (MCID) of the DEMMI during its development in an older acute medical population. ⋯ This study has validated the DEMMI in two independent samples of older acute medical patients. Estimates of its responsiveness and MCID have also been established. This study confirms that the DEMMI overcomes the limitations of the BI and HABAM and provides an advanced method for objectively assessing mobility for older acute medical patients.
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There have been few studies of how personal and instrumental activities of daily living (P-ADL and I-ADL) develop over time in older people receiving domiciliary care. This study aimed at assessing variables associated with the development of P-ADL and I-ADL functioning over a 36-month follow-up period, with a particular focus on cognitive functioning. ⋯ P-ADL and I-ADL functioning in older people worsened over time. The worsening was associated with lower MMSE sum-score, diagnosed MCI and dementia, poorer medical health, neuropsychiatric symptoms, use of psychotropic medication and being transferred to nursing home care. Clinicians should pay close attention to the assessment and treatment of these factors to help older people maintain their level of functioning for as long as possible.
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Compared to the general elderly population, those institutionalized in LTC facilities have the highest prevalence of osteoporosis and subsequently have higher incidences of vertebral and hip fractures. The goal of this study is to determine how well nurses at LTC facilities are educated to properly administer bisphosphonates. A secondary question assessed was the nurse's and PSW's attitudes and beliefs regarding the role and benefits of vitamin D for LTC patients. ⋯ Bisphosphonates are quite effective in increasing the bone mineral density of LTC patients, and may reduce fracture rates, but it is only effective if properly administered. In our study, proper administration of bisphosphonate therapy was less than optimal. In summary, although the education of health providers has improved since the mid-1990's, this area still requires further attention and the subject of future quality assurance research.
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Mobility is a key outcome in geriatric rehabilitation. The de Morton Mobility Index (DEMMI) is an internationally well-established, unidimensional measure of mobility with good psychometric properties. The aim of this study was to examine the reliability and construct validity of the German translation of the DEMMI in geriatric inpatients. ⋯ The German translation of the DEMMI is a unidimensional instrument producing valid and reproducible measurement of mobility in an inpatient geriatric rehabilitation setting.
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Clinical Trial Observational Study
Interactive programs with preschool children bring smiles and conversation to older adults: time-sampling study.
Keeping older adults healthy and active is an emerging challenge of an aging society. Despite the importance of personal relationships to their health and well-being, changes in family structure have resulted in a lower frequency of intergenerational interactions. Limited studies have been conducted to compare different interaction style of intergenerational interaction. The present study aimed to compare the changes in visual attention, facial expression, engagement/behaviour, and intergenerational conversation in older adults brought about by a performance-based intergenerational (IG) program and a social-oriented IG program to determine a desirable interaction style for older adults. ⋯ Intergenerational programs with preschool children brought smiles and conversation to older adults. The social-oriented IG program allowed older adults to play more roles than the performance-based IG program. The intergenerational programs provide opportunities to fulfil basic human needs and reintegrate older adults into society. Further development of such beneficial programs is warranted.