scholarly journals Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study

2013 ◽  
Vol 42 (2) ◽  
pp. 203-209 ◽  
Author(s):  
F. Landi ◽  
A. J. Cruz-Jentoft ◽  
R. Liperoti ◽  
A. Russo ◽  
S. Giovannini ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Older Persons ◽  
Frail Older Persons ◽  
Ilsirente Study

scholarly journals Higher mortality in frail elderly with atrial fibrillation using oral anticoagulants

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J.J Walgers ◽  
L.A.R Zwart ◽  
S Simsek ◽  
T Germans ◽  
M.E.W Hemels ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Mortality Risk ◽  
Frail Elderly ◽  
Older Persons ◽  
Oral Anticoagulants ◽  
Frailty Index ◽  
Bleeding Complications ◽  
Elderly Persons ◽  
Frail Older Persons

Abstract Background/Introduction Frail older persons with falls are often undertreated for atrial fibrillation (AF) due to fear of bleeding complications of oral anticoagulants (OAC). However, the safety of OAC use in frail elderly with AF and falls is not investigated extensively. Purpose The aim of the study was to investigate whether frail older persons with falls and OAC for AF have more bleeding complications than patients without OAC and to investigate the association between frailty, OAC therapy (including bleeding complications), and mortality. Methods This observational study included frail patients aged 65 years or older who were evaluated for falls between November 2011 and December 2019. Patients using OAC for AF were compared with similar patients without using OAC. Primary outcomes were death, major bleeding and intracranial bleeding. Secondary outcomes were frailty measured by the Frailty Index and cause of death. Results Of the 645 included patients, 132 had AF and used OAC. Patients with AF were more often severely frail (67% vs. 47%, p<0.001) and had a higher mortality during follow up (39% vs. 27%, p=0.005). Patients using OAC had a higher mortality risk compared to the patients without OAC (crude analysis Hazard Ratio (HR) 1.7 (95% confidence interval (CI) 1.3–2.4), p=0.001; after adjustment for age, gender, and frailty index HR 1.4 (95% CI 0.99–1.9) p=0.056). No differences were found in the incidence of major bleedings (10% vs. 7%, p=0.204) or intracranial bleedings (5% vs. 4%, p=0.739) in both groups. The causes of death were similar in both groups, also the incidence of fatal bleedings did not differ (5% vs 7%, p=0.758). Conclusions Elderly with falls and AF using OAC are frailer and have a tendency to a higher mortality risk than patients without AF. These frail elderly patients with falls had no more bleeding complications during OAC treatment than comparable patients without OAC. Therefore, withholding OAC out of fear for major bleeding complications is not justified. It is unclear why elderly persons with AF and OAC are frailer and die sooner, since the incidence of major bleedings and fatal bleedings is equal. Further research should focus why older frail persons with AF are more prone to die. FUNDunding Acknowledgement Type of funding sources: None.

Self-determination among frail older persons – a desirable goal older persons’ conceptions of self-determination

2014 ◽  
Vol 15 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Christina Ekelund ◽  
Lena Mårtensson ◽  
Kajsa Eklund
Keyword(s):  
Older People ◽  
Older Persons ◽  
Well Being ◽  
Self Determination ◽  
Western Society ◽  
Legal Rights ◽  
Content Type ◽  
Frail Older Persons ◽  
Decision Making Processes ◽  
People First

Purpose – Self-determination is governed by ethical and legal rights in western society. In spite of that, older people are still restricted by others in their decision-making processes. The purpose of this paper is to explore older persons’ different conceptions of self-determination. Design/methodology/approach – A qualitative phenomenographic interview study on frail older persons (n=15). Findings – Three categories emerged, showing the variations of conception of self-determination as experienced by frail older people: first, self-determination changes throughout life; second, self-determination is being an agent in one's own life; and third, self-determination is conditional. In summary, while self-determination is changeable throughout life, and older persons want to be their own agents, and struggle to be that, certain conditions must be met to make it possible for them to be able to exercise self-determination. Practical implications – Suggestions for supporting and strengthening frail older persons’ self-determination, and indirectly their well-being and health: to have a person-centered approach, treat them with dignity and respect and give them opportunities to influence and to feel involved; to improve their health literacy by, for example, supporting them with enough knowledge to be able to exercise self-determination; to make them feel safe and secure in relationships, such as with family and caregivers. Originality/value – This study explores frail older persons’ own conceptions of self-determination to be able to gain knowledge of how professionals can support them so that they may experience self-determination in life.

scholarly journals Frail Older Persons’ Experiences of Information and Participation in Hospital Care

2019 ◽  
Vol 16 (16) ◽  
pp. 2829 ◽  
Author(s):  
Berit Forsman ◽  
Ann Svensson
Keyword(s):  
Health Literacy ◽  
Older Patients ◽  
Hospital Care ◽  
Older Persons ◽  
Qualitative Method ◽  
Healthcare Professionals ◽  
Frail Older People ◽  
Centered Care ◽  
Frail Older Persons ◽  
To Receive

The aim of this paper is to describe frail older persons’ experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives’ problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.

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