http://hdl.handle.net/10993/102 Search this channel search https://orbilu.uni.lu/simple-search http://hdl.handle.net/10993/41551 Title: Transition into a Nursing Home: Theoretical Framework on the Influence of Cultural Factors <br/> <br/>Author, co-author: Boll, Thomas <br/> <br/>Abstract: OBJECTIVES: To create a theoretical framework for analyzing cultural influences on older people’s transition into a nursing home (NH). THEORIES: Action theories in cultural and developmental psychology (Boesch, 2001; Brandtstädter, 2006), social representations theory (Marková, 2012), theory of culture as a semiotic regulation system (Valsiner, 2007). METHODS: (1) Conceptualization of NH care and family care as alternative action paths for meeting the needs of older persons and their relatives. (2) Conceptualization of culture as a product of human actions and as offering different possibilities of care-related actions. (3) Systematization of care-related goals and instrumental values of NH care versus family care. (4) Theoretical mapping of cultural factors on proximal determinants of elder care decisions and actions. RESULTS: The framework contains the following propositions. Older people and family caregivers hold multiple goals (e.g., welfare of family carers, welfare of old person). NH care can meet some goals and simultaneously frustrate others. The effects and choice of NH care depends on a variety of cultural factors: Legal regulations for warranting care quality (e.g., nursing home laws), economic concepts and practices (e.g., business models of elder care) and professionalization (e.g., staff training). Family care depends on institutionalized options for reconciling job-, care- and other family-related duties (e.g., mobile care services, day care units) and for compensating expenses (e.g., care insurance). Cultural concepts of care dependency influence the meanings that individuals attribute to NH care. CONCLUSIONS: The framework specifies cultural factors relevant for older peoples’ transition into a NH and delineates mediating paths. It invites other sciences specialized on relevant cultural factors (e.g., law, political science, social economics) to further refine the analysis. An identification of cultural factors affecting NH care opens new options for improving care quality or living conditions of older persons, family and professional carers. http://hdl.handle.net/10993/35131 Title: Burden of cardiovascular disease across 29 countries and GPs’ decision to treat hypertension in oldest-old <br/> <br/>Author, co-author: Streit, Sven; Gussekloo, Jacobijn; Burman, Robert A.; Collins, Claire; Gerasimovska Kitanovska, Biljana; Gintere, Sandra; Gomez Bravo, Raquel; Hoffmann, Kathryn; Iftode, Claudia; Johansen, Kasper L.; Kerse, Ngaire; Koskela, Tuomas H.; Kreitmayer Pe"sti!c, Sanda; Kurpas, Donata; Mallen, Christian D.; Maisonneuve, Hubert; Merlo, Christoph; Mueller, Yolanda; Muth, Christiane; Ornelas, Rafael H.; Petek Ster, Marija; Petrazzuoli, Ferdinando; Rosemann, Thomas; Sattler, Martin; Svadlenkova, Zuzana; Tatsioni, Athina; Thulesius, Hans; Tkachenko, Victoria; Torzsa, Peter; Tsopra, Rosy; Tuz, Canan; Verschoor, Marjolein; Viegas, Rita P. A.; Vinker, Shlomo; de Waal, Margot W. M.; Zeller, Andreas; Rodondi, Nicolas; Poortvliet, Rosalinde K. E. <br/> <br/>Abstract: Objectives: We previously found large variations in general practitioner (GP) hypertension treatment probability in oldest-old (>80 years) between countries. We wanted to explore whether differences in country-specific cardiovascular disease (CVD) burden and life expectancy could explain the differences. Design: This is a survey study using case-vignettes of oldest-old patients with different comorbidities and blood pressure levels. An ecological multilevel model analysis was performed. Setting: GP respondents from European General Practice Research Network (EGPRN) countries, Brazil and New Zeeland. Subjects: This study included 2543 GPs from 29 countries. Main outcome measures: GP treatment probability to start or not start antihypertensive treatment based on responses to case-vignettes; either low (<50% started treatment) or high (!50% started treatment). CVD burden is defined as ratio of disability-adjusted life years (DALYs) lost due to ischemic heart disease and/or stroke and total DALYs lost per country; life expectancy at age 60 and prevalence of oldest-old per country. Results: Of 1947 GPs (76%) responding to all vignettes, 787 (40%) scored high treatment probability and 1160 (60%) scored low. GPs in high CVD burden countries had higher odds of treatment probability (OR 3.70; 95% confidence interval (CI) 3.00–4.57); in countries with low life expectancy at 60, CVD was associated with high treatment probability (OR 2.18, 95% CI 1.12–4.25); but not in countries with high life expectancy (OR 1.06, 95% CI 0.56–1.98). Conclusions: GPs’ choice to treat/not treat hypertension in oldest-old was explained by differences in country-specific health characteristics. GPs in countries with high CVD <br/> <br/>Commentary: KEY POINTS - General practitioners (GPs) are in a clinical dilemma when deciding whether (or not) to treat hypertension in the oldest-old (>80 years of age). - In this study including 1947 GPs from 29 countries, we found that a high country-specific cardiovascular disease (CVD) burden (i.e. myocardial infarction and/or stroke) was associated with a higher GP treatment probability in patients aged >80 years. - However, the association was modified by country-specific life expectancy at age 60. While there was a positive association for GPs in countries with a low life expectancy at age 60, there was no association in countries with a high life expectancy at age 60. - These findings help explaining some of the large variation seen in the decision as to whether or not to treat hypertension in the oldest-old. http://hdl.handle.net/10993/34329 Title: Variation in GP decisions on antihypertensive treatment in oldest-old and frail individuals across 29 countries <br/> <br/>Author, co-author: Streit, Sven; Verschoor, Marjolein; Rodondi, Nicolas; Bonfim, Daiana; Burman, Robert A.; Collins, Claire; Kitanovska Biljana, Gerasimovska; Gintere, Sandra; Gomez Bravo, Raquel; Hoffmann, Kathryn; Iftode, Claudia; Johansen, Kasper L.; Kerse, Ngaire; Koskela, Tuomas H.; Kreitmayer Peštić, Sanda; Kurpas, Donata; Mallen, Christian D.; Maisoneuve, Hubert; Merlo, Christoph; Mueller, Yolanda; Muth, Christiane; Petek Šter, Marija; Petrazzuoli, Ferdinando; Rosemann, Thomas; Sattler, Martin; Švadlenková, Zuzana; Tatsioni, Athina; Thulesius, Hans; Tkachenko, Victoria; Torzsa, Peter; Tsopra, Rosy; Canan, Tuz; Viegas, Rita P. A.; Vinker, Shlomo; de Waal, Margot W. M.; Zeller, Andreas; Gussekloo, Jacobijn; Poortvliet, Rosalinde K. E. <br/> <br/>Abstract: Background In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision. Methods Using a survey, we compared treatment decisions in cases of oldest-old varying in SBP, CVD, and frailty. GPs were asked if they would start antihypertensive treatment in each case. In 2016, we invited GPs in Europe, Brazil, Israel, and New Zealand. We compared the percentage of cases that would be treated per countries. A logistic mixed-effects model was used to derive odds ratio (OR) for frailty with 95% confidence intervals (CI), adjusted for SBP, CVD, and GP characteristics (sex, location and prevalence of oldest-old per GP office, and years of experience). The mixed-effects model was used to account for the multiple assessments per GP. Results The 29 countries yielded 2543 participating GPs: 52% were female, 51% located in a city, 71% reported a high prevalence of oldest-old in their offices, 38% and had >20 years of experience. Across countries, considerable variation was found in the decision to start antihypertensive treatment in the oldest-old ranging from 34 to 88%. In 24/29 (83%) countries, frailty was associated with GPs’ decision not to start treatment even after adjustment for SBP, CVD, and GP characteristics (OR 0.53, 95%CI 0.48–0.59; ORs per country 0.11–1.78). Conclusions Across countries, we found considerable variation in starting antihypertensive medication in oldest-old. The frail oldest-old had an odds ratio of 0.53 of receiving antihypertensive treatment. Future hypertension trials should also include frail patients to acquire evidence on the efficacy of antihypertensive treatment in oldest-old patients with frailty, with the aim to get evidence-based data for clinical decision-making. http://hdl.handle.net/10993/29929 Title: Social inequalities in dementia care, cure, and research <br/> <br/>Author, co-author: Leist, Anja <br/> <br/>Abstract: Social inequalities in dementia can be found in diagnosis, cure, care, and research. Less advantaged groups are women, persons with ethnic minority status, lower income, lower education, and living in more deprived or rural areas. These social inequalities suggest that funding of research and medical and care expenses related to dementia may not be equitably allocated to those in need, even in the most advanced countries. Experience from the field of heart disease gives an estimate on the timescale and efforts it takes to successfully address social inequalities related to gender. Strong concerted efforts will be needed to mitigate social inequalities in dementia. http://hdl.handle.net/10993/28201 Title: Diagnosi precoce delle demenze in medicina generale <br/> <br/>Author, co-author: Marzo, Carla; Lygidakis, Charilaos http://hdl.handle.net/10993/28199 Title: Definizione della multimorbidità in MG: una revisione sistematica <br/> <br/>Author, co-author: Marzo, Carla; Lygidakis, Charilaos; Rigon, Sara; Nabbe, Patrice; Lazic; Asenova, Radost; Doerr, Cristina; Ligner, Heidrun; Czachowski, Slawomir; Muñoz, Miguel; Argyriadou, Stella; Claveria, Anna; Hasaganic, Melinda; Le Floch, Bernard; Deriennic, Jeremy; Van Marwijk, Harm; Van Royen, Paul; Le Reste, Jean Yves http://hdl.handle.net/10993/28087 Title: Explaining later-life cognitive function and decline: Methodological issues and evidence for social and contextual influences <br/> <br/>Author, co-author: Leist, Anja http://hdl.handle.net/10993/26120 Title: Deficits in Selective Attention Alter Gait in Frail Older Adults <br/> <br/>Author, co-author: Cornu, Véronique; Steinmetz, Jean-Paul; Federspiel, Carine <br/> <br/>Abstract: A growing body of research demonstrates an association between gait disorders, falls, and attentional capacities in older adults. The present work empirically analyzes differences in gait parameters in frail institutionalized older adults as a function of selective attention. Gait analysis under single- and dual-task conditions as well as selective attention measures were collected from a total of 33 nursing-home residents. We found that differences in selective attention performances were related to the investigated gait parameters. Poorer selective attention performances were associated with higher stride-to-stride variabilities and a slowing of gait speed under dual-task conditions. The present findings suggest a contribution of selective attention to a safe gait. Implications for gait rehabilitation programs are discussed http://hdl.handle.net/10993/23353 Title: Good friends, high income or resilience? What matters most for elderly patients? <br/> <br/>Author, co-author: Mertens, Vera-Christina; Bosma, H.; Groffen, D.; van Eijk, T.J. http://hdl.handle.net/10993/21830 Title: Inference of longevity-related genes from a robust co-expression network of seed maturation identifies new regulators linking seed storability to biotic defense-related pathways <br/> <br/>Author, co-author: Righetti, Karima; Vu, Joseph Ly; Pelletier, Sandra; Vu, Benoit Ly; Glaab, Enrico; Lalanne, David; Pasha, Asher; Patel, Rohan V; Provart, Nicholas; Verdier, Jerome; Leprince, Olivier <br/> <br/>Abstract: Seed longevity, the maintenance of viability during storage is a crucial factor to preserve genetic resources and to ensure proper seedling establishment and high crop yield. A systems biology approach was used to identify key genes regulating the acquisition of longevity during seed maturation of Medicago truncatula. Using 104 transcriptomes of seed developmental time courses obtained under five growth environments, a robust, stable co-expression network (MatNet) was generated, thereby capturing the conserved backbone of maturation. Using a trait-based gene significance measure, a co-expression module related to the acquisition of longevity was inferred from MatNet. Comparative analysis between maturation processes in Medicago and A. thaliana seeds and mining Arabidopsis interaction databases revealed conserved connectivity for 87% of longevity module nodes between both species. Arabidopsis mutant screening for longevity and maturation phenotypes demonstrated high predictive power of the longevity cross-species network. Overrepresentation analysis of the network nodes indicated biological functions related to defense, light and auxin. Characterization of defense-related wrky3 and nfxl1 mutants demonstrated that these genes regulate part of the network nodes and exhibit impaired longevity acquisition during maturation. These data suggest that seed longevity evolved by co-opting existing genetic pathways regulating activation of defense against pathogens. http://hdl.handle.net/10993/20105 Title: Zusammenhang zwischen Gang und selektiver Aufmerksamkeit im Alter <br/> <br/>Author, co-author: Cornu, Véronique; Steinmetz, Jean-Paul; Federspiel, Carine <br/> <br/>Abstract: Der Zusammenhang zwischen Gang, Sturzrisiko und kognitiven Funktionen (insbesondere Aufmerksamkeit), im Alter gilt als empirisch gesichert. Als verlässliche Sturzprädiktoren haben sich eine erhöhte Gangvariabilität und eine Verringerung der Ganggeschwindigkeit, insbesondere unter kognitiv-motorischer Dual-Task (DT)-Bedingung, bewährt. Ziel der vorliegenden Arbeit ist es, Gangunterschiede in Abhängigkeit der Leistung in einem Test zur selektiven Aufmerksamkeit zu untersuchen. Die Stichprobe setzt sich zusammen aus N=33 (Durchschnittsalter: 83.7; SD=6.2) Pflegeheimbewohnern. Die Gangparameter wurden anhand einer elektronischen räumlich-temporalen Ganganalyse erfasst Die Aufmerksamkeitsleistung wurde anhand eines altersadaptierten Aufmerksamkeitstestes (AKT) erhoben. Die Teilnehmer wurden in Abhängigkeit ihrer Leistung im AKT in eine von zwei Gruppen eingeteilt: Gruppe 1 mit guter Aufmerksamkeitsleistung oder Gruppe 2 mit schlechter Aufmerksamkeitsleistung. In der Gruppe mit schlechter Aufmerksamkeitsleistung zeigt sich ein signifikant höherer Anstieg der Gangvariabilität (p < .05) unter der DT-Bedingung im Vergleich zur Gruppe mit guter Aufmerksamkeitsleistung. Zusätzlich reduziert Gruppe 2 ihre Ganggeschwindigkeit stärker unter der DT-Bedingung als Gruppe 1. Die vorliegenden Ergebnisse heben die Bedeutung höherer kognitiver Funktionen zur Unterstützung angemessener Gangstabilität und folglich zur Vermeidung von Stürzen im Alter hervor. Hieraus ergibt sich die Annahme, dass kognitive Interventionsansätze zur Reduzierung des Sturzrisikos im Alter beitragen können. http://hdl.handle.net/10993/20104 Title: Effets d’un entraînement cognitif sur la marche chez les personnes âgées <br/> <br/>Author, co-author: Cornu, Véronique; Steinmetz, Jean-Paul; Federspiel, Carine <br/> <br/>Abstract: Plusieurs études ont pu démontrer l´association entre troubles de la marche, chutes et fonctions cognitives (attention, fonctions exécutives) chez les personnes âgées. Il semble ainsi prometteur dans le cadre de la prévention de chutes, d´analyser les effets d´un entraînement cognitif sur la marche. En ce qui concerne les paramètres de la marche, une variabilité du pas élevée et un ralentissement de la vitesse de marche sous condition de double tâche, sont des indicateurs sensibles permettant d’évaluer le risque de chutes. La présente étude a analysé les effets d´un entraînement neurocognitif sur ces différents paramètres. L´échantillon est composé de 24 personnes âgées (âge moyen : 85, écart-type : 5.69). Les participants ont été affectés soit à un groupe d´intervention participant à un entraînement cognitif de six semaines (n=14), soit à un groupe contrôle (n=10). Un design quasi-expérimental avec des mesures pré- et posstest a été utilisé. L´analyse de la marche a été effectué à l´aide du système Gaitrite® qui permet de mesurer e.a. la vitesse, la variabilité de la durée du cycle de marche et la variabilité de la longueur du cycle de marche. Sous la condition double tâche, des effets d’importance clinique ont pu être observés dans le groupe d’intervention après l’entraînement cognitif. Une réduction de la vitesse de marche moins importante après l’entraînement (taille d’effet, δ = |.25|) ainsi qu’une réduction de la variabilité de la longueur du cycle de marche ont pu être observés (taille d’effet, δ = |.54|). Ces premiers résultats sont prometteurs et suggèrent qu´un entraînement cognitif peut avoir le potentiel d´améliorer les troubles de marche. Néanmoins, des recherches ultérieures avec des échantillons plus grands sont nécessaires afin de confirmer et de renforcer les résultats trouvés lors de l´étude présente. http://hdl.handle.net/10993/20103 Title: Marche et attention sélective chez les personnes âgées <br/> <br/>Author, co-author: Cornu, Véronique; Steinmetz, Jean-Paul; Federspiel, Carine <br/> <br/>Abstract: Un lien entre troubles de la marche, chutes et fonction cognitives (fonctions exécutives et attention), chez les personnes âgées peut être considéré comme établi. En ce qui concerne les paramètres de la marche, une variabilité du pas élevée et un ralentissement de la vitesse de marche sous condition de double tâche, sont des indicateurs sensibles permettant d’évaluer le risque de chute. La présente étude s´est intéressée aux différences de ces paramètres de marche en fonction de la performance dans un test d´attention sélective. L´échantillon est composé de 33 personnes âgées en long séjour (âge moyen : 83.7, écart-type : 6.2). L´analyse de la marche a été effectué à l´aide du système Gaitrite® qui permet de mesurer e.a. la vitesse, la variabilité de la durée du cycle de marche et la variabilité de la longueur du cycle de marche. L´attention sélective a été mesurée avec un test d´attention sélective adapté aux personnes âgées. Les personnes ont été regroupées sur la base de leur performance dans ce test (temps requis et erreurs commises) afin d´obtenir deux groupes : un groupe plus performant et un groupe moins performant. On a pu observer des différences de marche en fonction de l´attention sélective. Plus précisément, dans le groupe moins performant considérant les erreurs commises lors du test, la variabilité de la longueur du cycle de marche sous condition double tâche était sifnificativement supérieure à celle du groupe plus performant (U = 175.0, p < .05). Ces résultats mettent en évidence les différences dans les paramètres de marche, et le risque de chute associé, en fonction de la capacité d´attention sélective chez les personnes âgées.