The journal of nutrition, health & aging, 2021
Objectives There is insufficient knowledge about the functional and medical recovery of older peo... more Objectives There is insufficient knowledge about the functional and medical recovery of older people infected with SARS-CoV-2. This study aims to gain insight into the course of functional and medical recovery of persons who receive geriatric rehabilitation (GR) following SARS-CoV-2 infection across Europe. Special attention will be paid to the recovery of activities of daily living (ADL) and to the GR services offered to these patients. Design A multi-center observational cohort study. Setting and participants This study will include several European countries (EuGMS member states) each providing at least 52 comparable routine datasets (core dataset) of persons recovering from a SARS-CoV-2 infection and receiving geriatric rehabilitation. The routine data will be anonymously collected in an online CASTOR database. The ethical regulations of each participating country will be followed. Primary outcome ADL functioning. Secondary outcomes Length of stay, discharge destination, hospita...
Background Routine screening for frailty at admission by nurses may be useful to detect geriatric... more Background Routine screening for frailty at admission by nurses may be useful to detect geriatric risks and problems at an early stage. However, the added value of this screening is not clear yet. Information about the opinions and attitudes of nurses towards this screening is also lacking. As they have a crucial role in conducting this screening, an exploratory study was performed to examine hospital nurses’ opinions and perspectives about this screening and how it influences their daily work. Methods A qualitative, exploratory approach was employed, using semi-structured interviews with 13 nurses working on different general medical wards (surgical and internal medicine) in three Dutch hospitals. Frailty screening had been implemented for several years in these hospitals. Results The participating nurses reported that frailty screening can be useful to structure their work, create more awareness of frail older patients and as starting point for pro-active nursing care. At the same...
Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone ... more Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID‐19 vaccines due to high risk of death. In very rare instances, the COVID‐19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA‐EAACI‐EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID‐19 vaccines. Anaphylaxis to COVID‐19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaph...
Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persistin... more Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate aftercare aimed at reducing the impact of persisting problems after discharge from a geriatric rehabilitation unit. Therefore, we developed an integrated multidisciplinary rehabilitation programme consisting of inpatient neurorehabilitation treatment using goal attainment scaling, home based self-management training, and group based stroke education for patients and informal caregivers. We performed a process evaluation to assess to what extent this programme was performed according to protocol. Furthermore, we assessed the participation of the patients in the programme, and the opinion of patients, informal caregivers and care professionals on the programme.Methods: In this multimethod study, process da...
Purpose Geriatric rehabilitation provides effective multidisciplinary treatment for older people ... more Purpose Geriatric rehabilitation provides effective multidisciplinary treatment for older people who show symptoms of relevant and potentially reversible functional decline. The aim of this study is to provide an overview on structures of geriatric rehabilitation across Europe. Methods All European Geriatric Medicine Society (EuGMS) Full board members, each representing one member state of the society, were asked to complete an online questionnaire about the current structure of geriatric rehabilitation in their country. Results Thirty-one out of 33 EuGMS Full Board members participated in this questionnaire. Geriatric rehabilitation was officially recognized in 65% (20/31) of participating countries while 29% (9/31) had no geriatric rehabilitation services in their country. In countries with geriatric rehabilitation, the number of available beds varied widely (0–70/100,000 inhabitants). Average length of stay varied from 7 to 65 days. The estimated mean age of the patients in geria...
Purpose In response to the growing recognition of geriatric rehabilitation and to support healthc... more Purpose In response to the growing recognition of geriatric rehabilitation and to support healthcare providers which need strategies to support older people with frailty who have experienced functional decline, we developed a consensus statement about core principles and future priorities for geriatric rehabilitation. Methods We used a three-stage approach to establish consensus—preparation, consensus and review. Results The consensus statement is grouped under 11 headings from (1) “Definition of GR” to (11) “Effective strategies to develop GR in Europe”, which define geriatric rehabilitation in a way that is compatible with existing service models across Europe. Additionally future goals around research and education are highlighted. Conclusion The definitions of the consensus statement can provide a starting point for those wishing to further develop geriatric rehabilitation in their jurisdiction and help to develop strategic alliances with other specialties, serving as a basis fo...
PurposeMany European countries have developed services to rehabilitate the increasing number of o... more PurposeMany European countries have developed services to rehabilitate the increasing number of older people who experience an acute or subacute decrease in function after a medical event such as a hip fracture or stroke. However, there are important differences between countries regarding patient selection, organization of services, length of stay, and content of the rehabilitation process. The lack of consensus around, and quality criteria for, geriatric rehabilitation limits opportunities for exchange of best practice and scientific research.Methods33 experts, mostly geriatricians with experience in geriatric rehabilitation, from 18 European countries were invited to participate in a modified Delphi study. They were asked to react to 68 statements using a five-point Likert scale. The statements were formulated on the basis of literature review and practice experience, and were initially piloted among Dutch elderly care physicians. Consensus was defined beforehand as an Interquart...
Aging clinical and experimental research, Jan 31, 2017
The sustainability of health and social care systems is threatened by a growing population of old... more The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed ...
The journal of nutrition, health & aging, 2021
Objectives There is insufficient knowledge about the functional and medical recovery of older peo... more Objectives There is insufficient knowledge about the functional and medical recovery of older people infected with SARS-CoV-2. This study aims to gain insight into the course of functional and medical recovery of persons who receive geriatric rehabilitation (GR) following SARS-CoV-2 infection across Europe. Special attention will be paid to the recovery of activities of daily living (ADL) and to the GR services offered to these patients. Design A multi-center observational cohort study. Setting and participants This study will include several European countries (EuGMS member states) each providing at least 52 comparable routine datasets (core dataset) of persons recovering from a SARS-CoV-2 infection and receiving geriatric rehabilitation. The routine data will be anonymously collected in an online CASTOR database. The ethical regulations of each participating country will be followed. Primary outcome ADL functioning. Secondary outcomes Length of stay, discharge destination, hospita...
Background Routine screening for frailty at admission by nurses may be useful to detect geriatric... more Background Routine screening for frailty at admission by nurses may be useful to detect geriatric risks and problems at an early stage. However, the added value of this screening is not clear yet. Information about the opinions and attitudes of nurses towards this screening is also lacking. As they have a crucial role in conducting this screening, an exploratory study was performed to examine hospital nurses’ opinions and perspectives about this screening and how it influences their daily work. Methods A qualitative, exploratory approach was employed, using semi-structured interviews with 13 nurses working on different general medical wards (surgical and internal medicine) in three Dutch hospitals. Frailty screening had been implemented for several years in these hospitals. Results The participating nurses reported that frailty screening can be useful to structure their work, create more awareness of frail older patients and as starting point for pro-active nursing care. At the same...
Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone ... more Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID‐19 vaccines due to high risk of death. In very rare instances, the COVID‐19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA‐EAACI‐EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID‐19 vaccines. Anaphylaxis to COVID‐19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaph...
Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persistin... more Background: Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate aftercare aimed at reducing the impact of persisting problems after discharge from a geriatric rehabilitation unit. Therefore, we developed an integrated multidisciplinary rehabilitation programme consisting of inpatient neurorehabilitation treatment using goal attainment scaling, home based self-management training, and group based stroke education for patients and informal caregivers. We performed a process evaluation to assess to what extent this programme was performed according to protocol. Furthermore, we assessed the participation of the patients in the programme, and the opinion of patients, informal caregivers and care professionals on the programme.Methods: In this multimethod study, process da...
Purpose Geriatric rehabilitation provides effective multidisciplinary treatment for older people ... more Purpose Geriatric rehabilitation provides effective multidisciplinary treatment for older people who show symptoms of relevant and potentially reversible functional decline. The aim of this study is to provide an overview on structures of geriatric rehabilitation across Europe. Methods All European Geriatric Medicine Society (EuGMS) Full board members, each representing one member state of the society, were asked to complete an online questionnaire about the current structure of geriatric rehabilitation in their country. Results Thirty-one out of 33 EuGMS Full Board members participated in this questionnaire. Geriatric rehabilitation was officially recognized in 65% (20/31) of participating countries while 29% (9/31) had no geriatric rehabilitation services in their country. In countries with geriatric rehabilitation, the number of available beds varied widely (0–70/100,000 inhabitants). Average length of stay varied from 7 to 65 days. The estimated mean age of the patients in geria...
Purpose In response to the growing recognition of geriatric rehabilitation and to support healthc... more Purpose In response to the growing recognition of geriatric rehabilitation and to support healthcare providers which need strategies to support older people with frailty who have experienced functional decline, we developed a consensus statement about core principles and future priorities for geriatric rehabilitation. Methods We used a three-stage approach to establish consensus—preparation, consensus and review. Results The consensus statement is grouped under 11 headings from (1) “Definition of GR” to (11) “Effective strategies to develop GR in Europe”, which define geriatric rehabilitation in a way that is compatible with existing service models across Europe. Additionally future goals around research and education are highlighted. Conclusion The definitions of the consensus statement can provide a starting point for those wishing to further develop geriatric rehabilitation in their jurisdiction and help to develop strategic alliances with other specialties, serving as a basis fo...
PurposeMany European countries have developed services to rehabilitate the increasing number of o... more PurposeMany European countries have developed services to rehabilitate the increasing number of older people who experience an acute or subacute decrease in function after a medical event such as a hip fracture or stroke. However, there are important differences between countries regarding patient selection, organization of services, length of stay, and content of the rehabilitation process. The lack of consensus around, and quality criteria for, geriatric rehabilitation limits opportunities for exchange of best practice and scientific research.Methods33 experts, mostly geriatricians with experience in geriatric rehabilitation, from 18 European countries were invited to participate in a modified Delphi study. They were asked to react to 68 statements using a five-point Likert scale. The statements were formulated on the basis of literature review and practice experience, and were initially piloted among Dutch elderly care physicians. Consensus was defined beforehand as an Interquart...
Aging clinical and experimental research, Jan 31, 2017
The sustainability of health and social care systems is threatened by a growing population of old... more The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed ...
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