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Healthcare
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Community Care of Older People with Chronic Diseases
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Community Care of Older People with Chronic Diseases

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 2561

Special Issue Editor

Dr. George Soulis

E-Mail Website
Guest Editor
1. Working Group on the Development of Geriatric Medicine, Greece of the Hellenic Society for the Study and Research of Aging, 15342 Athens, Greece
2. Henry Dunant Hospital Center, Outpatient Geriatric Assessment Unit, 11526 Athens, Greece
3. School of Social Sciences, Hellenic Open University, 26335 Patras, Greece
Interests: community based geriatrics; frailty; sarcopenia; geriatric pharmacology; preservation of autonomy and functionality

Special Issue Information

Dear Colleagues,

The aging population is a major challenge for healthcare systems and governments. Are we ready to deal with the continuously increasing healthcare demands of this population? What solutions can we provide them taking into account the fact that most of these people want to age at home? Do we have special services delivered locally to offer, and are we ready to invest in their wellbeing and the preservation of their autonomy and functionality at home within their community? What policies can be tailored to adequately respond to this new emerging demographic state.

It is true that there are important discrepancies and specificities across countries, and our aim is to highlight the existing frame of creative solutions and means that might be relevant to other professionals in similar or completely different settings. Our scope is to reveal the rich patchwork of interesting and useful interventions that really work within the communities and provide the opportunity to researchers and professionals from all over the world to contribute to a unique multidiscipline-oriented issue.

This Special Issue of Healthcare seeks commentaries, original research, short reports, and reviews on the challenges and difficulties that aging societies are inflicting on healthcare systems and solutions that work locally or more broadly. It is envisioned that this Special Issue will become a useful resource for policymakers, national and international organizations, and other stakeholders that are designing healthcare provision for the future that respects local particularities and end-user wishes and expectations.

Dr. George Soulis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • community-based geriatric care
  • older people
  • multimorbidity
  • chronic conditions
  • polypharmacy
  • multidisciplinary teams
  • care at home
  • rehabilitation at home
  • preservation of autonomy and functionality
  • functionality support
  • telemedicine
  • technological solutions

Published Papers (3 papers)

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Research

10 pages, 537 KiB  
Article
Pilot Testing of Useful Tools’ Validity for Frailty Assessment in Greece: Translated PRISMA-7 Tool, Modified Fried Criteria and Clinical Frailty Scale
by George Soulis, Efstathia Kyriakopoulou, Aristea Leventouri, Eleni Zigkiri, Vasiliki Efthymiou, Zikos Kentros and Anastasia Koutsouri
Healthcare 2024, 12(9), 930; https://doi.org/10.3390/healthcare12090930 - 30 Apr 2024
Viewed by 424
Abstract
The importance of frailty in older people is getting constant recognition as an important aspect both in terms of public health, as well as at a personal level, for the appropriate management of an older person’s health condition. This is reflected by the [...] Read more.
The importance of frailty in older people is getting constant recognition as an important aspect both in terms of public health, as well as at a personal level, for the appropriate management of an older person’s health condition. This is reflected by the continuously increasing number of research studies carried out in several settings across different countries. Sometimes, this is very solid, but in other cases, there is a considerable gap in terms of accurate and well-grounded documentation of frailty status. This is the case in Greece, where we are missing clinically validated tools to approach frailty. We are missing frailty screening tools, such as, for instance, Program of Research on Integration of Services for the Maintenance of Autonomy 7 (PRISMA 7), the gold standard tool of Fried criteria, is somehow problematic since the question referring to physical activity originates from a questionnaire that has not been translated and validated, while Clinical Frailty Scale (CFS) has been validated for translation but not for the capacity to detect frailty. The aim of this study is to validate these tools for their accuracy to detect frailty by using a measurable index of frailty, previously proposed for use in clinical studies: the Short Physical Performance Battery (SPPB). Seventy-four male and female participants (mean age 80.47 years SD = ±7.45 years, minimum–maximum age = 65–95) have been evaluated for their frailty status using different tools. We observed that the PRISMA 7 translation detects frailty only when one question is removed at a cut-off of ≥2 and indicates a sensitivity of 88.1% and specificity of 99.9% with a good correlation with SPPB measurements (r = −0.858; p < 0.001). When CFS was validated using SPPB, it demonstrated a very good correlation (r = −0.838; p < 0.001 respectively) as was the case for the modified Fried Criteria (r = −0.725; p < 0.001). All items demonstrated a good correlation between them. We here propose that we can accurately assess frailty status in the community setting by using a modified version of Fried criteria, Clinical Frailty Scale translation in Greek, and we can screen for frailty by using the Greek translation of PRISMA 7 only after removing item 6 of the questionnaire. Full article
(This article belongs to the Special Issue Community Care of Older People with Chronic Diseases)
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10 pages, 547 KiB  
Article
Sex Differences in the Impact of Dynapenic Abdominal Obesity on Mild Cognitive Impairment among Korean Elderly in the Community
by Jiyun Kim and Yuna Paik
Healthcare 2024, 12(6), 662; https://doi.org/10.3390/healthcare12060662 - 15 Mar 2024
Viewed by 665
Abstract
Abdominal obesity (AO) and dynapenia (DP) are associated with cognitive decline, and the relationship between dynapenic abdominal obesity (DAO), a combination of DP and AO, and mild cognitive impairment (MCI) has been confirmed. This study aims to determine whether this relationship exhibits potential [...] Read more.
Abdominal obesity (AO) and dynapenia (DP) are associated with cognitive decline, and the relationship between dynapenic abdominal obesity (DAO), a combination of DP and AO, and mild cognitive impairment (MCI) has been confirmed. This study aims to determine whether this relationship exhibits potential sex differences. The relationship between MCI and DAO was confirmed in 1309 community elderly individuals aged 65 years or older who were not diagnosed with dementia. The MCI was defined as a Korean mini-mental state examination (K-MMSE) score of 18–23 points. Multiple logistic regression analyses were conducted, categorizing participants into groups: a control group without AO or DP, an AO group, a DP group, and a DAO group. The study results showed that in women, both DP and DAO were significantly associated with MCI not only in the unadjusted Model 1 but also in Model 2, which adjusted for general characteristics and health behaviors, and Model 3, which additionally adjusted for chronic diseases and disease-related characteristics. In men, DP was associated with MCI in the unadjusted Model 1. The findings highlight sex differences in the impact of the DAO on MCI. These differences should be considered when studying the factors related to MCI in old age. Full article
(This article belongs to the Special Issue Community Care of Older People with Chronic Diseases)
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17 pages, 298 KiB  
Article
The (Mis)use of Psychotropic Drugs and Addiction to Anxiolytics among Older Adults Living at Home or in Retirement Homes: Implications for Quality of Life
by Mirjana Kralj, Krešimir Šolić and Robert Lovrić
Healthcare 2023, 11(21), 2908; https://doi.org/10.3390/healthcare11212908 - 6 Nov 2023
Viewed by 1071
Abstract
Nowadays, the growing number of people aged 65+ has become a global phenomenon. At that age, the most common medical problems are multimorbidity and inappropriate polypharmacy, which have a negative impact on the quality of life in older adults. The aim of this [...] Read more.
Nowadays, the growing number of people aged 65+ has become a global phenomenon. At that age, the most common medical problems are multimorbidity and inappropriate polypharmacy, which have a negative impact on the quality of life in older adults. The aim of this cross-sectional study was to examine comorbidity, the use of psychopharmaceuticals, and symptoms of addiction to anxiolytics among older adults living at home or in retirement homes, and to examine the differences in quality of life in relation to the use and misuse of psychotropic drugs. The research included 383 people aged 65+ living in the Republic of Croatia (EU). A standardized questionnaire CAGE was used to collect data about the use of psychotropic drugs. Quality of life was examined using the WHOQOL-BREF scale. The average age of respondents was 83 years. There is a significantly higher prevalence of anxiety disorders (p = 0.001) in respondents who live at home. Psychopharmaceuticals were used by 218 (56.9%) respondents, equally in both groups of respondents. A total of 77 (20.1%) respondents had been using anxiolytics for more than five years, while 26 (6.8%) of them had significant clinical symptoms of addiction to anxiolytics. All domains and the overall quality of life scale were significantly lower (p < 0.001) in respondents who have clinical symptoms of anxiolytic addiction. The results indicate that the use of psychotropic drugs by respondents is inappropriate. Respondents who inappropriately and excessively use psychotropic drugs have a significantly worse quality of life. Full article
(This article belongs to the Special Issue Community Care of Older People with Chronic Diseases)
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