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  • 1
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    Online Resource
    Assessment of Functional Performance in Acute Geriatric Psychiatry – Time for New Strategies?
    SAGE Publications ; 2020
    In:  Journal of Geriatric Psychiatry and Neurology Vol. 33, No. 6 ( 2020-11), p. 316-323
    Details
    In: Journal of Geriatric Psychiatry and Neurology, SAGE Publications, Vol. 33, No. 6 ( 2020-11), p. 316-323
    Abstract: The aim of this study was to investigate the feasibility and reliability of functional performance tests in people living with dementia and depression. Method: A cross-sectional study was conducted in a geriatric psychiatry hospital. People living with dementia, depression, and healthy older adults were included. Feasibility of the timed up and go test (TUG), the short physical performance battery (SPPB), and the multisurface obstacle test for older adults (MSOT) was assessed based on valid test executions. Test-retest reliability was evaluated by mean difference (MD), coefficient of variation (CV), standardized MD, intraclass correlation coefficient (ICC), and correlation coefficient ( r s ). Results: A total of 53 people in acute geriatric psychiatry and 21 healthy older adults were included. In people living with dementia (n = 23), feasibility was 65.2% (MSOT), 8.7% (TUG), and 8.7% (SPPB). In people living with depression (n = 30), feasibility was 83.3% (MSOT), 80.0% (TUG), and 46.7% (SPPB). Intraclass correlation coefficients and r s for the MSOT were high (ICC 〉 0.70) in both groups. Coefficient of variations of the MSOT were between 10.7% and 18.0% (dementia) and 7.1% and 17.0% (depression). Reliability of the TUG and SPPB was not analyzed in people living with dementia, due to low feasibility. In people living with depression, ICCs and r s were between 0.86 and 0.87 with CVs of 7.2% (TUG) and 0.69 and 0.95 with CVs of 7.8% and 15.1% (SPPB). Conclusion: Feasibility and reliability of established functional performance tests in acute geriatric psychiatry are limited, especially in people living with dementia. New strategies, for example, sensor-based approaches, may allow measurement of functional performance apart from standardized instruction-based test procedures in this clinical population.
    Type of Medium: Online Resource
    ISSN: 0891-9887 , 1552-5708
    URL: Article
    DOI: 10.1177/0891988719882098
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2094096-8
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  • 2
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    Post-discharge Mortality in Patients With Delirium and Dementia: A 3-Year Follow Up Study
    Frontiers Media SA ; 2022
    In:  Frontiers in Psychiatry Vol. 13 ( 2022-2-28)
    Details
    In: Frontiers in Psychiatry, Frontiers Media SA, Vol. 13 ( 2022-2-28)
    Abstract: Delirium and dementia are prominent psychiatric diseases in old age and connected with poor outcomes for people affected. Nevertheless, there is a lack of knowledge concerning the long-term prognosis of patients with dementia and delirium. This study analyzes mortality, readmission rates and discharge destinations of patients with dementia or delirium superimposed on dementia (DSD) within 3 years after discharge from hospital. Methods A cross-sectional, monocentric cohort study was conducted at the department of geriatric psychiatry of the LVR hospital cologne, using structured telephone interviews and analyses from the clinical information system. All patients with dementia and DSD, admitted between December 2014 and November 2015, were screened for eligibility. Results In total, 113 patients were included, 49 patients with dementia ( M 80 years, female 49%) and 64 with DSD ( M 82 years, female 47%). Three years after discharge, 66 patients (58%) had died (95% CI 91.9–112.5; p = 0.53). Within the first 3 months, 9 patients (14%) with DSD deceased, but no patient from the dementia group (95% CI 11.3–12.7; p = 0.01). Out of all patients, 17 patients were readmitted and nursing homes were the predominant discharge destination (55%). Conclusions This analysis revealed a high post-discharge mortality rate of patients with dementia and DSD. For patients with DSD, a close clinical monitoring, mainly within the first 3 months after discharge, should challenge the significantly increased acute-mortality. These findings should set the pattern for a comprehensive analysis of long-term effects of dementia and DSD. More studies are required for better understanding and comparability in this field of research and healthcare.
    Type of Medium: Online Resource
    ISSN: 1664-0640
    URL: Article
    DOI: 10.3389/fpsyt.2022.835696
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2564218-2
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  • 3
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    Online Resource
    Quantifying Habitual Physical Activity and Sedentariness in Older Adults—Different Outcomes of Two Simultaneously Body-Worn Motion Sensor Approaches and a Self-Estimation
    MDPI AG ; 2020
    In:  Sensors Vol. 20, No. 7 ( 2020-03-28), p. 1877-
    Details
    In: Sensors, MDPI AG, Vol. 20, No. 7 ( 2020-03-28), p. 1877-
    Abstract: Applicable and accurate assessment methods are required for a clinically relevant quantification of habitual physical activity (PA) levels and sedentariness in older adults. The aim of this study is to compare habitual PA and sedentariness, as assessed with (1) a wrist-worn actigraph, (2) a hybrid motion sensor attached to the lower back, and (3) a self-estimation based on a questionnaire. Over the course of one week, PA of 58 community-dwelling subjectively healthy older adults was recorded. The results indicate that actigraphy overestimates the PA levels in older adults, whereas sedentariness is underestimated when compared to the hybrid motion sensor approach. Significantly longer durations (hh:mm/day) for all PA intensities were assessed with the actigraph (light: 04:19; moderate to vigorous: 05:08) when compared to the durations (hh:mm/day) that were assessed with the hybrid motion sensor (light: 01:24; moderate to vigorous: 02:21) and the self-estimated durations (hh:mm/day) (light: 02:33; moderate to vigorous: 03:04). Actigraphy-assessed durations of sedentariness (14:32 hh:mm/day) were significantly shorter when compared to the durations assessed with the hybrid motion sensor (20:15 hh:mm/day). Self-estimated duration of light intensity was significantly shorter when compared to the results of the hybrid motion sensor. The results of the present study highlight the importance of an accurate quantification of habitual PA levels and sedentariness in older adults. The use of hybrid motion sensors can offer important insights into the PA levels and PA types (e.g., sitting, lying) and it can increase the knowledge about mobility-related PA and patterns of sedentariness, while actigraphy appears to be not recommendable for this purpose.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    URL: Article
    DOI: 10.3390/s20071877
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2052857-7
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  • 4
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    Online Resource
    Short-term aerobic exercise for depression in acute geriatric psychiatry: study protocol for a randomized controlled trial
    Springer Science and Business Media LLC ; 2022
    In:  Trials Vol. 23, No. 1 ( 2022-12)
    Details
    In: Trials, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-12)
    Abstract: Major depression is one of the main mental illnesses in old age, with acute exacerbated episodes requiring treatment in geriatric psychiatry. A meta-analysis showed that aerobic exercise in moderate intensity has large effects in older adults with major depression, but there is no evidence of aerobic exercise in geriatric psychiatry. Therefore, this study aims to analyze the feasibility and effects of an ergometer-based aerobic exercise on depressive symptoms. Methods A single-center randomized controlled trial will be conducted in an acute geriatric psychiatric hospital. Inpatients allocated to the intervention group will receive a 2-week aerobic ergometer program. The control group will receive seated flexibility exercise in addition to usual care. The overall effects on the patients’ depressive symptoms will be measured by clinical global impression of change (CGI) as the primary outcome. Changes in depressive symptom domains, physical (in)activity, and aerobic performance as well as the dosage of applied antidepressants will be examined as secondary outcomes. Discussion This short-term aerobic exercise program is expected to decrease depressive symptoms in acute exacerbated periods in older adults. The results may increase the evidence for implementing physical activity interventions in acute hospital settings. The disease-related motivation for exercise in acute exacerbated depressive periods will be the most challenging aspect. The treatment of depression requires new cost-effective approaches, especially in acute geriatric psychiatry with potential benefits for patients, family members, and clinicians. Trial registration German Clinical Trial Register ID: DRKS00026117 Trial status Protocol Version 1.2 dated February 23, 2022. By February 23, 2022, the trial had recruited a total of 15 participants in two wards at the Department of Geriatric Psychiatry at the LVR-Hospital Cologne. Recruitment started on November 12, 2021. The recruitment is expected to continue for at least 12 months.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    URL: Article
    DOI: 10.1186/s13063-022-06567-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2040523-6
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  • 5
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    Online Resource
    Circadian aspects of mobility‐related behavior in patients with dementia: An exploratory analysis in acute geriatric psychiatry
    Wiley ; 2023
    In:  International Journal of Geriatric Psychiatry Vol. 38, No. 6 ( 2023-06)
    Details
    In: International Journal of Geriatric Psychiatry, Wiley, Vol. 38, No. 6 ( 2023-06)
    Abstract: This study aimed to analyze the timing of peak gait activity and nocturnal mobility‐related behavior of patients with dementia in acute geriatric psychiatry. The average timing of peak gait activity was measured in the early afternoon hours, however, for one third of the patient's peak gait activity was measured in the early evening hours. Nocturnal mobility‐related behavior was high, which was not reflected in the proxy‐based assessment of the patient's night‐time behavior. Analyzing the timing of peak gait activity and nocturnal step‐count can provide objective and clinical applicable information on the individual circadian aspects of mobility‐related behavior that may help to personalize treatment of behavioral symptoms in patients with dementia.
    Type of Medium: Online Resource
    ISSN: 0885-6230 , 1099-1166
    URL: Issue
    URL: Article
    DOI: 10.1002/gps.v38.6
    DOI: 10.1002/gps.5957
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1500455-7
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  • 6
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    Physical activity monitoring-based interventions in geriatric patients: a scoping review on intervention components and clinical applicability
    Springer Science and Business Media LLC ; 2023
    In:  European Review of Aging and Physical Activity Vol. 20, No. 1 ( 2023-05-18)
    Details
    In: European Review of Aging and Physical Activity, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2023-05-18)
    Abstract: To identify and analyze the components applied in interventions using physical activity (PA) monitoring in geriatric patients and determine their feasibility and applicability. Methods A systematic search in six databases (PubMed, Embase, SPORTDiscus, CINAHL, Web of Science, and GeroLit) was conducted to identify studies reporting interventions that included the application of a PA monitor in adults aged ≥ 60 years with a clinical diagnosis. PA monitor interventions were analyzed regarding their feedback, goal-setting and behavior change technique (BCT) components. To determine the feasibility and applicability of interventions, the participants’ adherence to the intervention, their experience as well as adverse events were analyzed. Results Seventeen eligible studies, applying 22 interventions, were identified. Studies included a total of 827 older patients with a median age of 70.2 years. In thirteen interventions (59%), the PA monitor was embedded in a structured behavioral intervention, an indication-specific intervention or usual care. Most frequently applied intervention components were goal setting and self-monitoring ( n  = 18), real-time PA monitor feedback complemented by feedback from the study team ( n  = 12), use of further BCTs ( n  = 18), and regular counseling with the study team ( n  = 19). Comprehensive information on the participants’ intervention adherence and experience were reported for 15 (68%) and 8 (36%) interventions, respectively. Conclusion The components included in PA monitoring-based interventions varied considerably especially regarding the extent, frequency, and content of feedback, goal setting and BCTs counseling. Future research should evaluate which components are most effective and clinically applicable to promote physical activity in geriatric patients. To be able to precisely analyze the effects, trials should seek to report details on intervention components, adherence and adverse events, while future reviews may use the findings of this scoping review to conduct analyses with less heterogeneity in study characteristics and intervention strategies.
    Type of Medium: Online Resource
    ISSN: 1861-6909
    URL: Article
    DOI: 10.1186/s11556-023-00320-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2236925-9
    SSG: 31
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  • 7
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    Online Resource
    Quantifying Circadian Aspects of Mobility-Related Behavior in Older Adults by Body-Worn Sensors—An “Active Period Analysis”
    MDPI AG ; 2021
    In:  Sensors Vol. 21, No. 6 ( 2021-03-18), p. 2121-
    Details
    In: Sensors, MDPI AG, Vol. 21, No. 6 ( 2021-03-18), p. 2121-
    Abstract: Disruptions of circadian motor behavior cause a significant burden for older adults as well as their caregivers and often lead to institutionalization. This cross-sectional study investigates the association between mobility-related behavior and subjectively rated circadian chronotypes in healthy older adults. The physical activity of 81 community-dwelling older adults was measured over seven consecutive days and nights using lower-back-worn hybrid motion sensors (MM+) and wrist-worn actigraphs (MW8). A 30-min and 120-min active period for the highest number of steps (MM+) and activity counts (MW8) was derived for each day, respectively. Subjective chronotypes were classified by the Morningness-Eveningness Questionnaire into 40 (50%) morning types, 35 (43%) intermediate and six (7%) evening types. Analysis revealed significantly earlier starts for the 30-min active period (steps) in the morning types compared to the intermediate types (p ≤ 0.01) and the evening types (p ≤ 0.01). The 120-min active period (steps) showed significantly earlier starts in the morning types compared to the intermediate types (p ≤ 0.01) and the evening types (p = 0.02). The starting times of active periods determined from wrist-activity counts (MW8) did not reveal differences between the three chronotypes (p = 0.36 for the 30-min and p = 0.12 for the 120-min active period). The timing of mobility-related activity, i.e., periods with the highest number of steps measured by hybrid motion sensors, is associated to subjectively rated chronotypes in healthy older adults. The analysis of individual active periods may provide an innovative approach for early detecting and individually tailoring the treatment of circadian disruptions in aging and geriatric healthcare.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    URL: Article
    DOI: 10.3390/s21062121
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2052857-7
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  • 8
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    Assessing Older Adults’ Daily Mobility: A Comparison of GPS-Derived and Self-Reported Mobility Indicators
    MDPI AG ; 2019
    In:  Sensors Vol. 19, No. 20 ( 2019-10-19), p. 4551-
    Details
    In: Sensors, MDPI AG, Vol. 19, No. 20 ( 2019-10-19), p. 4551-
    Abstract: Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to be used to extract those as well as limited knowledge about their validity. Using 7 days of GPS and diary data of 35 older adults, we make the following three main contributions. First, we perform a sensitivity analysis to investigate how using spatial and temporal thresholds to compute TOH and #ALs affects the agreement between self-reported and GPS-based indicators. Second, we show how daily self-reported and GPS-derived mobility indicators are compared. Third, we explore whether the type and duration of self-reported activity events are related to the degree of correspondence between reported and GPS event. Highest indicator agreement was found for temporal interpolation (Tmax) of up to 5 h for both indicators, a radius (Dmax) to delineate home between 100 and 200 m for TOH, and for #ALs a spatial extent (Dmax) between 125 and 200 m, and temporal extent (Tmin) between 5 and 6 min to define an activity location. High agreement between self-reported and GPS-based indicators is obtained for TOH and moderate agreement for #ALs. While reported event type and duration impact on whether a reported event has a matching GPS event, indoor and outdoor events are detected at equal proportions. This work will help future studies to choose optimal threshold settings and will provide knowledge about the validity of mobility indicators.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    URL: Article
    DOI: 10.3390/s19204551
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2052857-7
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