La eclosión de la sarcopenia: Informe preliminar del Observatorio de la Sarcopenia de la Sociedad Española de Geriatría y Gerontología

Sarcopenia is a common and prominent geriatric syndrome, of major interest for daily clinical practice of professionals working with older people. The number of affected individuals and its relation with disability, frailty, many chronic diseases, lifestyle and adverse outcomes are extremely relevant for geriatric care. Moreover, biological changes that lead to the loss of muscle mass and strength are intrinsically related to the mechanisms of aging. It is not therefore surprising that research in this field is growing exponentially in recent years, and sarcopenia has been placed in recent years in the forefront of research in geriatric medicine and gerontology.The Spanish Society of Geriatrics and Gerontology has recently created an Observatory of Sarcopenia, which aims to promote educational and research activities in this field. The first activity of the Observatory has been to offer the Spanish speaking scientific community a review of the current status of sarcopenia, that may allow unifying concepts and fostering interest in this promising field of geriatrics.     

The emergent role of sarcopenia: Preliminary Report of the Observatory of Sarcopenia of the Spanish Society of Geriatrics and Gerontology

Sarcopenia is a common and prominent geriatric syndrome, of major interest for daily clinical practice of professionals working with older people. The number of affected individuals and its relation with disability, frailty, many chronic diseases, lifestyle and adverse outcomes are extremely relevant for geriatric care. Moreover, biological changes that lead to the loss of muscle mass and strength are intrinsically related to the mechanisms of aging. It is not therefore surprising that research in this field is growing exponentially in recent years, and sarcopenia has been placed in recent years in the forefront of research in geriatric medicine and gerontology. The Spanish Society of Geriatrics and Gerontology has recently created an Observatory of Sarcopenia, which aims to promote educational and research activities in this field. The first activity of the Observatory has been to offer the Spanish speaking scientific community a review of the current status of sarcopenia, that may allow unifying concepts and fostering interest in this promising field of geriatrics.     

(M,R)-systems, (P,M,C)-nets, hierarchical decay, and biological aging: reminiscences of Robert Rosen

I have the pleasure to present a number of personal experiences that I had with Robert Rosen, both as his student and as a research colleague, and I will describe how this affected my academic career over the past decades. As a matter of fact, Rosen's work with (M,R)-systems as well as his continuing mentorship guided me into my own research in gerontology and geriatrics. Amazingly, this still continues to affect my work in complexity theory after 30 years.     

Edmund Vincent Cowdry and the Making of Gerontology as a Multidisciplinary Scientific Field in the United States

The Canadian–American biologist Edmund Vincent Cowdry played an important role in the birth and development of the science of aging, gerontology. In particular, he contributed to the growth of gerontology as a multidisciplinary scientific field in the United States during the 1930s and 1940s. With the support of the Josiah Macy, Jr. Foundation, he organized the first scientific conference on aging at Woods Hole, Massachusetts, where scientists from various fields gathered to discuss aging as a scientific research topic. He also edited Problems of Ageing (1939), the first handbook on the current state of aging research, to which specialists from diverse disciplines contributed. The authors of this book eventually formed the Gerontological Society in 1945 as a multidisciplinary scientific organization, and some of its members, under Cowdry’s leadership, formed the International Association of Gerontology in 1950. This article historically traces this development by focusing on Cowdry’s ideas and activities. I argue that the social and economic turmoil during the Great Depression along with Cowdry’s training and experience as a biologist – cytologist in particular – and as a textbook editor became an important basis of his efforts to construct gerontology in this direction.     

Senescence, Growth, and Gerontology in the United States

This paper discusses how growth and aging became interrelated phenomena with the creation of gerontology in the United States. I first show that the relation of growth to senescence, which had hardly attracted scientific attention before the twentieth century, started to be investigated by several experimental scientists around the 1900s. Subsequently, research on the connection between the two phenomena entered a new domain through the birth of gerontology as a scientific field comprised of various disciplines, many of which addressed growth. Due to gerontologists’ efforts, the association between aging and growth became stronger and more multifaceted within the discursive and organizational matrix constituting the new science, leading to a broader definition of senescence with an ambiguous connection to chronological age. Furthermore, as gerontologists borrowed the cultural agendas as well as research methods from studies of growth, aging began to be defined as a phenomenon that could be actively controlled and managed in both social arenas and laboratory environments.     

Geriatric-palliative care units model for improvement of elderly care

The aim of this research was to indicate the necessity of a new organizational model of health and social care system for the geriatric population in Croatia. Modern geriatrics puts special emphasis on the idea that the care of the elderly should be performed through home care or long-term care institutions, rather than in the acute care hospital departments. The social healthcare of the elderly requires a multidisciplinary approach, as well as teamwork and coordination of institutional and non-institutional departments. Founding of palliative care units is clearly absent from the existing elderly care system. 33% of the total deceased geriatric population within the target area (2000-2002) has passed away in institutions (Dubrovnik General Hospital and nursing homes), what clearly indicates a need for organized palliative care on the stationary level. Nursing homes in Croatia should accept about 4% of the total number of older population (according to the gerontology research). Nevertheless, this research shows that the available capacity of the nursing homes in the Dubrovansko-Neretvanska County is 50% of the projected percentage. The solution might be setting up of palliative-geriatric units in already existing institutions, as shown by the SWOT analysis.     

Memory lapses and memory: relationship between objective and subjective memory in old age

INTRODUCTION: research into memory in geriatrics and gerontology has become increasingly important in recent years. However, various studies have shown that not all aspects or types of memory are affected in the same way or with the same severity by old age. OBJECTIVES: the present study aimed to establish differential profiles in objective and subjective memory associated with old age with a view to establishing criteria that could be used to distinguish between age-associated memory loss and pathological memory loss, thus aiding diagnosis of cognitive impairment. MATERIAL AND METHODS: a total of 143 participants between 60 and 98 years of age were evaluated using a battery of tests comprising the validated Spanish version of the Mini-Mental State Examination [Lobo's Mini-Examen Cognoscitivo (MEC)], diverse tests for objective memory [the auditory verbal learning test of learning potential (AVLT-LP) and a working memory test], and the subjective memory questionnaire. Results and conclusions: significant differences were found between distinct age groups in different measures of subjective and objective memory. In general terms, persons who complained most about memory problems were not those with poorer performance on objective memory tests. The results show that measures of subjective and objective memory assess different aspects of memory.     

Actividad ortogeriátrica en los hospitales públicos de Castilla y León: descripción y revisión de la literatura

The benefits of the collaboration between orthopaedics and geriatrics in the management and care of elderly patients admitted with hip fracture have been widely demonstrated. A questionnaire was sent to all hospital geriatricians of Castilla y León in order to determine the characteristics this collaboration between orthopaedics and geriatrics in the public hospitals of Castilla y León. They were asked about the type of collaboration with orthopaedics in the care of the elderly patient admitted with hip fracture and details of the treatment of the complications. Most of the hospitals maintain a high level of orthogeriatric collaboration with geriatricians, and the geriatrician attends to most of the medical complications of these patients. The average hospital stay is 10 days, with a surgical delay of 3 days. Management of the most frequent clinical problems in hospitals of Castilla y León are detailed in this article, comparing them with the latest articles and current recommendations from clinical practice guides.     

Eficiencia del apoyo de Geriatría Transversal en el manejo de pacientes mayores de 80 años ingresados en el Servicio de Cirugía General. Resultados en la liberación de estancias y el coste asociado

ObjectiveTo determine the efficiency of «Cross-speciality Geriatrics» program in patients older than 80 years admitted to the Colorectal Pathology Unit of a General Surgery Department.Material and methodsA «before-after» study was conducted. The initial period (usual treatment for General Surgery) included patients admitted from 1^st January to 31^st August 2018, and the subsequent period (with support from geriatrics) from 1^st January to 31^st December 2019. Two types of patients were studied: Type 1, who were admitted to the Emergency Department, and Type 2, programmed admissions for colorectal cancer intervention. The Geriatrics intervention consisted of daily monitoring in the ward, collaboration in clinical management, and discharge planning. Furthermore, in Type 2 patients, a previous visit was made in the clinic, which included the detection and approach of frailty and pre-habilitation for surgery.ResultsA total of 175 patients were included, of whom 53 were treated by General Surgery and 122 with the co-management of geriatrics. The mean age was 84.9 years (SD 4.8). In the period with the Cross-speciality Geriatrics program, the mean stay was reduced by 10.6 days (39%), and 8.5 days (44%) in types 1 and 2, respectively (P < .01). This led to a decrease in bed occupancy (3.3 beds/day) and a cost reduction (1,215,970 € / year).ConclusionsThe support of Cross-speciality Geriatrics in patients older than 80 years admitted to General Surgery is an efficient care model. These data support its implementation in hospitals where this care line has not yet been developed     

Recent Clinical Research in Geriatric Dentistry1

Current increased interest in gerontology/geriatrics has extended to various areas of dental clinical research. Dental science is still at the stage of defining many problems in this field and much emphasis is placed on epidemiological studies. Contemporary trends in clinical research are reviewed, including radiographic studies of the jaw, masticatory studies, and studies on xerostomia, periodontal disease, and root caries. An emerging priority for this research is to distinguish normal functional and morphological changes with age from pathogenic processes. A cooperative and multidisciplinary approach, spanning various disciplines and methodologies, seems to be one which will yield the most comprehensive picture of clinical changes in the elderly. Of particular interest is the recently funded dual contract to Buffalo, NY and San Antonio, TX for the study of periodontal diseases in older adults. A major emphasis has been placed on a multidisciplinary/interdisciplinary approach with focus on clinical, radiological, immunological, microbiological, nutritional and psychological-social factors. While each may be considered separately, a greater emphasis is placed on the interaction of these parameters. Such a multidisciplinary project with two investigation sites needs detailed planning of the overall design and the cooperation of each discipline to insure the ultimate success of such a venture, particularly with regard to the reproducibility between the sites.     

Biological anthropology of aging--past,present and future

Biological anthropologists have a strong tradition of studying growth and development and research on aging has been limited. This paper explores the past and current contribution of biological anthropologists to the field of aging through an examination of the American Journal of Physical Anthropology (AJPA) and the American Journal of Human Biology (AJHB). It is clear from this survey that biological anthropologists and human biologists have predominantly studied growth and developmental processes relative to aging. However, there is a trend of increasing interest in aging over time. In the AJHB, papers discussing chronic disease were predominant, followed by reproductive aging (19%), bone aging (15%) and body composition (10%). Within the AJPA, the majority of articles were in the field of human biology (43%) and bioarchaelogy (42%) with a lesser contribution from primatology (14%) and dermatogliphics (1%). Biological anthropologists still have great potential to make contributions to gerontology with our evolutionary and holistic perspectives and focus on cross-cultural research.     

Use it or lose it--the hazards of bed rest and inactivity.

Professional experience and lay wisdom teach us the benefits of exercise and the hazards of idleness. Yet the myth persists that "bed rest is good for you" when ill or convalescing. Abundant scientific evidence in the past 50 years has demonstrated the specific damage done to each of the body''s organ systems by inactivity. Both aging and inactivity lead to strikingly similar kinds of deterioration. I summarize the data from military and veterans'' hospitals, rehabilitation experience, aerospace research, and gerontology and review the physiologic and metabolic changes of aging and inactivity, along with strategies to help prevent the iatrogenic complications of bed rest.     

Acute orthogeriatric care (I). Healthcare issues

The present article reviews the historical development of several collaborative care models between orthopaedic and geriatrics departments for the care of patients with hip fracture. Subacute orthogeriatric units are described and special emphasis is placed on geriatric consulting teams and acute orthogeriatric units, as well as on their benefits for the patient and the healthcare service. We also review evidence-based studies that support this type of care for patients with acute hip fracture and guidelines from scientific associations involved in the care of these patients. The cost of care is also analyzed. Lastly, the term "orthogeriatrics" is proposed as a common term for this activity and the need for improved future care is discussed.     

Epidemiología infecciosa en centros gerontológicos

Introduction

Infection processes in gerontology centres (GC) are one of the main causes of mortality and aggravation of concomitant chronic diseases. An epidemiological surveillance system was set up to find out their magnitude and distribution.

Material and methods

A prevalence study was conducted during the years 2006-2009 in 4 GCs of the Matia Foundation. Prevalence was measured by making an annual cut-off, recording: infection type, demographic data, risk factors and antibiotic use. The incidence was measured for two years in one GC as a pilot centre, recording: infection type and antibiotic use.

Results

The prevalence in the GCs varied between 4.8% and 6.44%. The infection incidence density in the pilot study was between 3.45-5.77 infections per 1,000 resident days. The most common infection location and in this order were, respiratory, urinary and cutaneous. The incidence of respiratory infection is more statistically significant in the presence of dysphagia, malnutrition and COPD. However, no significant relationship was seen in the incidence of urinary infection with the different risk factors analysed.

Conclusions

The frequency and repercussions of nosocomial infections in GCs demonstrate the need for intervention plans and the development of adequate prevention measures.     

The genius of E. E. metchnikoff— Discoveries over the centuries

On the 15 of May we celebrated the 150th anniversary of the outstanding Russian biologist Elias E. Metchnikoff (1845–1916)—Nobel Prize winner (1908), full and honorary member of many scientific academies of the world. His main works were applied to the zoology of invertebtates, evolution, embryology, immunology, microbiology, infectious pathology, gerontology, etc. Elias Metchnikoff published essays on anthropology, theory of orthobiosis, role of social and social-hygienic factors in solving the problems of old age and life elongation. On 30 May-2 June 1995 an International Symposium dedicated to Metchnikoff's 150th anniversary was held in Moscow. This is a text of the lecture given by us at the opening ceremony.     

Der Wolf in Ostpreußen 1900–1945

European Journal of Wildlife Research - Es werden Notizen über den Wolf in Ostpreußen veröffentlicht, die in langjährigen Bemühungen gesammelt wurden. Berichte von...     

Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics.Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner.The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.     

PBL教学法在老年医学科住院医师培训教学中的应用

目的:通过对比研究PBL(Problem-Based Learning)教学方法及LBL教学方法的特点,探索和总结PBL教学方法的特点,在老年医学科第一阶段住院医师规范化培训中的应用体会和效果评价。方法:将入老年医学科进行临床轮转的第一阶段住院医师30名,随机分为观察组(N=15)和对照组(N=15)。观察组采用PBL模式进行教学培训,对照组采用传统教学法(LBL),通过临床技能及理论知识考评、问卷形式评价及自我评价等方式来评估教学效果。结果:PBL教学组无论是笔试成绩还是问诊成绩均优于LBL组,差异具有统计学意义(P0.05);PBL教学组的课堂满意度明显优于LBL组,差异具有统计学意义(P0.05);两组培训医师对学习过程中的自我评价显示,PBL组培训医师对4个自我测评项目的结果显示均明显高于LBL组,具有显著性统计学差异(P0.01或0.05)。结论:PBL教学法有助于提高老年医学科住院医师的临床水平,有利于住院医师规范化培训的体系建设。