Risk of Exclusion From Stroke Rehabilitation in the Oldest Old

Forti, Paola; Maioli, Fabiola; Magni, E.; Ragazzoni, Letizia; Piperno, Roberto; Zoli, Marco; Coveri, Maura; Procaccianti, Gaetano

doi:10.1016/j.apmr.2017.08.469

Cited by 13 publications

(17 citation statements)

References 41 publications

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“…However, in many countries older people continue to be treated much less intensively than younger people. 23,24 Reducing cardiovascular disease death rates in older people prevents many more deaths than does a similar reduction in younger people, since mortality is higher in older populations than younger populations. Individuals aged 70-79 years accounted for nearly half of all deaths that could have hypothetically been averted in the Americas region between 2000 and 2015.…”

Section: Discussionmentioning

confidence: 99%

Reducing the cardiovascular disease burden for people of all ages in the Americas region: analysis of mortality data, 2000–15

Lloyd‐Sherlock

Ebrahim

Martínez

et al. 2019

The Lancet Global Health

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Background In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30-69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare cardiovascular mortality for different age groups in the WHO Region of the Americas. MethodsWe extracted mortality data from the Pan American Health Organization regional mortality database for 36 countries for the period 2000 to 2015. We calculated age-standardised mortality rates (ASMRs) from cardiovascular diseases for different age groups for these countries. Joinpoint regression models were used to estimate mortality trends, providing estimates of the average annual percentage change for the period 2000-15.Findings Individuals aged 70 years or older accounted for the majority of cardiovascular disease deaths in all countries (range 52-82%). Considerable variation in cardiovascular deaths was observed between countries for all age categories. Between 2000 and 2015, in most countries, the largest reductions in ASMR were observed in the older age groups (aged ≥70 years). The total number of regional cardiovascular disease deaths that hypothetically could have been averted in 2015 for people aged 30-79 years was 440 777, of which 211 365 (48%) occurred among people aged 70-79 years.Interpretation Data for the WHO Region of the Americas are sufficiently robust to permit comparative analysis of cardiovascular disease mortality trends for people aged 70 years and older over time and across countries. Although the reduction of cardiovascular disease mortality in individuals aged 30-69 years is a valid policy goal for the Americas region, this objective should be expanded to include people at older ages.

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Section: Discussionmentioning

confidence: 99%

Reducing the cardiovascular disease burden for people of all ages in the Americas region: analysis of mortality data, 2000–15

Lloyd‐Sherlock

Ebrahim

Martínez

et al. 2019

The Lancet Global Health

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“…Inclusion criteria were: a first-time primary ICH with unilateral hemiparesis/hemiplegia confirmed via computed tomography; no contraindications to mobilization (early intervention) within 72 hours of stroke onset (based on the medical team’s clinical judgment, systolic blood pressure (SBP) <160 mm Hg at rest, resting heart rate <130 bpm, oxygen saturation >92% without supplementation, and no hydrocephalus before intervention); a National Institutes of Health Stroke Scale (NIHSS) score of <20 at admission 38 ; complete prestroke independence in ADL; and age 20 to 80 years. 39-41…”

Section: Methodsmentioning

confidence: 99%

Early Mobilization of Mild-Moderate Intracerebral Hemorrhage Patients in a Stroke Center: A Randomized Controlled Trial

Yen

Jeng

Chen

et al. 2019

Neurorehabil Neural Repair

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Background. Few studies have addressed early out-of-bed mobilization specifically in acute intracerebral hemorrhage (ICH) patients. Patient benefit in such cases is unclear, with early intervention timing and duration identical to those in standard care. Objective. We investigated the efficacy of an early mobilization (EM) protocol, administered within 24 to 72 hours of stroke onset, for early functional independence in mild-moderate ICH patients. Methods. Sixty patients admitted to a stroke center within 24 hours of ICH were randomly assigned to early mobilization (EM) or standard early rehabilitation (SER). The EM group underwent an early out-of-bed mobilization protocol, while the SER group underwent a standard protocol focusing on in-bed training in the stroke center. Intervention in both groups lasted 30 minutes per session, once a day, 5 days a week. Motor subscales of the Functional Independence Measure (FIM-motor; primary outcome), Postural Assessment Scale for Stroke Patients, and Functional Ambulation Category (FAC) were evaluated (assessor-blinded) at baseline, and at 2 weeks, 4 weeks, and 3 months after stroke. Length of stay in the stroke center was also recorded. Results. The EM group showed significant improvement in FIM-motor score at all evaluated time points ( P = .004) and in FAC outcomes at 2 weeks ( P = .033) and 4 weeks ( P = .011) after stroke. Length of stay in the stroke center was significantly shorter for the EM group ( P = .004). Conclusion. Early out-of-bed mobilization via rehabilitation in a stroke center, within 24 to 72 hours of ICH, may improve early functional independence compared with standard early rehabilitation. Clinical Trial Registration: NCT03292211.

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“…Ageism is an extensive phenomenon which can be found in many areas of life, including health care. Ageism in health care may have various manifestations, including overtreatment and undertreatment (Ouchida & Lachs, ), lower quality of health care, and limiting older adults' access to certain healthcare services, including rehabilitation care (Forti et al, ; Wilson et al, ). Researcher Becca Levy has found that ageism also results in significant increased healthcare costs as well as increased prevalence of certain medical conditions in people aged 60 and above in the United States (Levy, Slade, Chang, Kannoth, & Wang, ).…”

Section: Introductionmentioning

confidence: 99%

Ageist attitudes among healthcare professionals and older patients in a geriatric rehabilitation facility and their association with patients' satisfaction with care

Heyman

Osman

Natan

2020

Int J Older People Nursing

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Aim:The aim of this study was to explore the prevalence of ageist attitudes among older adults hospitalised in a geriatric rehabilitation facility, as well as the association between satisfaction with care and ageist attitudes. In addition, this study also explores the prevalence of ageist attitudes among healthcare professionals.Background: An ageist environment may potentially increase internalisation of stereotypes by older adults, which in turn may have a negative impact on care outcomes. Methods:In this quantitative correlational study, a questionnaire was completed by 100 older patients hospitalised in a rehabilitation department of a geriatric medical centre located in North-Central Israel, and 87 healthcare professionals working in the same department. Results:The attitudes of older patients towards their peers were neither definitely positive nor definitely negative, as were the attitudes held among healthcare professionals working in the facility. Patients with lower knowledge about old age, women and patients born in former Soviet Republics had more ageist attitudes. Older patients' satisfaction with care was relatively high and was not associated with ageist attitudes towards their peers. Conclusions:Both healthcare professionals and older patients held ageist attitudes to some extent. Certain older patients' sociodemographic characteristics, as well as lower knowledge about old age, have been found associated with more ageist attitudes towards their peers. In contrast, satisfaction with care does not seem to affect older patients' attitudes towards their peers. Healthcare professionals working in a geriatric facility should be aware of the prevalence of ageism among older patients. Implications for practice:The findings highlight the importance of educational interventions among healthcare professionals to increase awareness of the prevalence of ageism among older patients in a geriatric setting. K E Y W O R D Sageism, attitudes, geriatric rehabilitation, nurses, patients, satisfaction with care

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Risk of Exclusion From Stroke Rehabilitation in the Oldest Old

Cited by 13 publications

References 41 publications

Reducing the cardiovascular disease burden for people of all ages in the Americas region: analysis of mortality data, 2000–15

Reducing the cardiovascular disease burden for people of all ages in the Americas region: analysis of mortality data, 2000–15

Early Mobilization of Mild-Moderate Intracerebral Hemorrhage Patients in a Stroke Center: A Randomized Controlled Trial

Ageist attitudes among healthcare professionals and older patients in a geriatric rehabilitation facility and their association with patients' satisfaction with care

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