Geriatrics - Science topic

Thank you!

In clinical studies evaluating antidepressants, response is often defined by a 50% decrease in the initial score, and remission by a score below the threshold defining the depressive state, i.e. 10/30 for the GDS

Today I’m admiring the life of Kane Tanaka, who was the world’s oldest person. She was born in 1903 and died last week, aged 119. She spent her last years playing the strategy board game Othello and studying mathematics. When she became the world’s oldest person, Tanaka was asked about her happiest moment. Her answer was “now”...

I think it would be interesting to include the topic of frailty in the discussion, caused among other things by a sedentary lifestyle. Low functional capacity is an important factor related to cognition and depression...

For mental agility the MMSE I agree with the previous posts’ answers that this is a very standarized tool. For geriatric depression, there’s also Beck’s depression inventory and Hamilton depression rating scale.

You can see some of how this is used in research below:

Yang, H. L., Chan, P. T., Chang, P. C., Chiu, H. L., Hsiao, S. T. S., Chu, H., & Chou, K. R. (2018). Memory-focused interventions for people with cognitive disorders: a systematic review and meta-analysis of randomized controlled studies. International journal of nursing studies, 78, 44-51. https://pubmed.ncbi.nlm.nih.gov/29110906/

Chu, H., Yang, C. Y., Lin, Y., Ou, K. L., Lee, T. Y., O’Brien, A. P., & Chou, K. R. (2014). The impact of group music therapy on depression and cognition in elderly persons with dementia: a randomized controlled study. Biological research for Nursing, 16(2), 209-217.

If you already have a sample population, due to covid pandemic i believe home visit is better and the chance of loosing samples due to missing the visit time is less but if haven't yet choose your sample population, the cohort sampling method is better. I used cohort method in my thesis that was related to healthy elderly and in the end statically it presented the city population

I take population from 4 routs according the population of each

1. Geriatric homes (34)

2. From retirement associations (345)

3. Advertisement (253)

4. Public health centers (only those who had no disease) (179)

Thanks Sharon W Stark for your contributions.

Have a look at the following RG links.

I am interested in sharing with you in your upcoming projects, if you interested plz contact me mostafashaban42@gmail.com

It appears this tool should be used at intervals, like the PHQ 9. (Like admission and discharge, for example, or at each patient visit...). It could measure change over time only by comparison with a previously filled out one.

Patient’s Name:

Date:

Instructions: Choose the best answer for how you felt over the past week. Note: when asking the patient to complete the form, provide the self-rated form (included on the following page).

No. Question

Answer

Score

1. Are you basically satisfied with your life?

YES / NO

2. Have you dropped many of your activities and interests?

YES / NO

3. Do you feel that your life is empty?

YES / NO

4. Do you often get bored?

YES / NO

5. Are you in good spirits most of the time?

YES / NO

6. Are you afraid that something bad is going to happen to you?

YES / NO

7. Do you feel happy most of the time?

YES / NO

8. Do you often feel helpless?

YES / NO

9. Do you prefer to stay at home, rather than going out and doing new things?

YES / NO

10. Do you feel you have more problems with memory than most people?

YES / NO

11. Do you think it is wonderful to be alive?

YES / NO

12. Do you feel pretty worthless the way you are now?

YES / NO

13. Do you feel full of energy?

YES / NO

14. Do you feel that your situation is hopeless?

YES / NO

15. Do you think that most people are better off than you are?

YES / NO

TOTAL

(Sheikh & Yesavage, 1986)

Scoring:

Answers indicating depression are in bold and italicized; score one point for each one selected. A score of 0 to 5 is normal. A score greater than 5 suggests depression.

Sources:

•

Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986 June;5(1/2):165-173.

•

Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull. 1988;24(4):709-711.

•

Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-83;17(1):37-

We have not consistently recorded this information, but it could be interesting doing so (also on a retrospective basis). Hence, what I am saying is purely empirical. Transfusion increments are widely around 1 g/dl, sometimes the benefit is minimal, sometimes around 2 g/dl. Of course values may be subject by a host of different variables: test variables (timing of second hb determination - during transfusion - sampling error - or just after transfusion? infusion of packed RBC requires some time - maybe in older patients more - to redistribute fluids from the extravascular compartment to "dilute" the concentrated RBC transfused; type of determination - with CBC or with POCT/ABG testing?), besides patient's variables that I assume may be of some importance (body size, state of hydration and of concomitant i.v. fluid/diuretic therapy, ongoing overt/occult bleeding...)

Moreover sometimes physicians administer a pro re nata dose of i.v. diuretic (eg furosemide) in patients with congestive heart failure after the transfusion to counteract the possible haemodynamic consequence of an acute expansion of circulating volume, so it is possible that further haemoconcentration may be due to this practice.

Nice question and I sharing my view...

I not a from physics or from any modern medicine stream...

In our Ayurveda literature we consider every human being has his own unique identity and each individual is different from each other.

We called it as Prakruti (Basic constitution of each individual). And this Prakruti decides his Structural-Physical and mental abilities in future.

We consider Sahas (Extreme Courageous physical activity) is responsible for debilitating disorders including neuro-spine diseases.

So it all depends on the physical strength or we call it as Sharira Prakruti (Human body Constitution) of each individual and we may can adopt a appropriate range according to specific age group for 'energy cost and relationship with gait performance'.

Yes, it will be required.

Nice Contribution Dirk Cysarz

Following

Kavisha Mehta

sure, generally one of the advantages of this device is the ability to perform exercises in the form of home games. they can buy this equipment and then do the exercises under the supervision of the therapist. a variety of games and software are designed for this purpose. if you want more information i can send you the related articles.

Anael Barberan-Garcia

i do agree: indeed papers report the context they refer to

best wishes to everybody, MC

Although the JALTC has completed its first year in publication, it is currently indexed by thirteen internationally recognized indexes around the world.

Please take a look at this useful RG link.

Hi, in my opinion measuring frailty in cardiac rehabilitation patients is really important, you can have many informations on the prognosis of the intervention.

In 2017 the European Association of Preventive Cardiology made a call to action in order to promote the assessment of frailty in elderly patients entering cardiac rehabilitation programmes.

You can find it at this link:

I hope I have answered your question!

70 to 80 % of persons elder than 70 years have at least two up to 8 chronic disorders. These patients suffer from multimorbidity and even more than half of people with multimorbidity and nearly two thirds with physical-mental health comorbidity are younger than 65 years (Barnett et al. Lancet 2012). The question to be answered is about the competence of the treating persons (medical doctors, nurses, allied health professionals etc.) Does a specialist in a medical discipline have an overview about the diagnosis and therapy of all other disciplines and does the geriatric specialist have the competence for medical specialties like neurology , nephrology, psychiatry etc.? If the answer is NO then the problem to be solved is to organise the comming together of all these specialists to the patients benefit for diagnosis and therapy as well. Specialised geriatric wards would be helpful if beyond this general geriatric competence the knowledge of other medical disciplines is always at hand. This may be done by installing an obligatory consultancy service by the other specialties for elder people and vice versa by looking at all aged persons in other wards by the geriatric specialist to identify geriatric multimorbidity because geriatric problems are often overseen by specialists due to a specialist view.

As an example about the importance of polypharmacy and the question put, I draw your attention to the dependence of the risk of hip fracture due to psychotropic drug use which is from a publication of Ray et al. in 1987. You can easily see that the occurance of hip fractures conincides with the dosis of drugs per day.

In Germany Borchelt 1995 (Berlin study of aged people) investigated that:

People elder than 70 , which you know suffer from multimorbidity , receive on average 3 different medical drugs per day

35 % of people over 70 years receive 5 to 8 different medical drugs per day

15 % even receive more than 13 different medical drugs per day

The group of 80 to 85 receives the highest number of medical drugs to take per day

Typical consequences of this polypharmacy are

1 falls and mortality 2 risk of interactions

3 cascading of prescriptions 4 poor medication adherence

In another study with patients over 60 the number of not desired side effects and interactions is more than double as with younger people, the higher the number of medical drugs, the higher will be the adverse drug events.

Up to 5 medical drugs at the same time go along with (3,4 % pharmacological interactions), but more than 6 medical drugs at the same time go along with (25 % adverse drug events.)s Mühlberg und Platt already realized in 1999

And the netherland study group of opondo an coworkers found by a systematic review of 19 studies in 2012 that the median rate of inappropriate medication prescription was 20% in elderly persons in primary care.

Best greetings

Wolfgang

Thanks Enrique and Michael!

well PHQ-9 would be of help

You may find the following reference of help to you.

Reference:

A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study.

Bott N, Kumar S, Krebs C, Glenn JM, Madero EN, Juusola JL.

JMIR Res Protoc. 2018 Aug 13;7(8):e11368.

doi: 10.2196/11368.

PMID: 30104186

Free Article

Hi Nageeb, unfortunately animal models of diseases dictate that they show the full blown pathology within a year if you are looking to get funded.

An animal model of sporadic AZ might be out there, but it will probably not get funded since they are sporadic and non-reproducible unless you have a large cohort of animals.

Advances in Pre and post operative optimisation of patient and overall bone health and rehab part should play good role in making most patients lead optimal outcome and should be the focus than stem cells as of now.

The intent is a mutually beneficial exchange of information and knowledge - so sharing will bring benefits. While the focus is on SAGE and SAGE-related data, we actively encourage comparisons to other data sets and interactions/exchanges on that to better understand the drivers of differences in health created by unique policy and cultural issues.

Hello,

Teaching is generally regarded as one of the safest professions in the world because it requires fixed hours of work, involves a hygienic and clean environment and very little physical strain. Surprisingly, however, the profession is not completely free from work-related illnesses and trauma. It seems that teachers suffer from a number of physical and health hazards troubling them after retirement including ENT tract, skin, eyes, legs, and lower urinary tract. Amazingly, many teachers also suffer from mental problems and need to access psychological help for work stress.

Best regards,

R. Biria

The exercise study in obese individuals that may provide information of acute myocardial infarction may be essential for the proposed study as asked in the question. The Ethical committee that wants to see some statistics on rates of acute cardiovascular events may not be familiar with recent work with biomarkers that may indicate that an acute myocardial infarction may occur with exercise. Sirt 1 is now closely involved in cardiovascular disease and other global chronic diseases. The biomarkers discussed in the references below may assist with uncontrolled cell apoptosis that may lead to infarction with exercise and various preventative therapies that may need to be undertaken before an exercise studies in obese individuals to prevent acute myocardial infarction. Biomarker Tests and Ageing Science. Ageing Sci Ment Health Stud Volume 2017, 1(1): 1–2 ONLINE: The Future of Biomarkers Tests and Genomic Medicine in Global Organ Disease. Arch Infect Dis Ther. 2017; 1(1): 1-6. ONLINE: Anti-Aging Genes Improve Appetite Regulation and Reverse Cell Senescence and Apoptosis in Global Populations. Advances in Aging Research, 2016, 5, 9-26 ONLINE: Magnesium Therapy Prevents Senescence with the Reversal of Diabetes and Alzheimer’s Disease. Health, 2016, 8, 694-710.

In Hungary very well work the "3. age university" system for education and mental pervention of elderly. In that system we do curs, presentations, and essence the slowing down the process of aging, maintaining self-sufficiency.

One that I am aware of is available at

These are available in English, German and Spanish at https://www.canchild.ca/en/resources/137-critical-review-forms-and-guidelines

I'm sure there are others out there too, but this is what I use with my students.

Ewgsop is a consensual definition of sarcopenia wich Come from an expert task force 

to my best knowledges there is no assessment of diagnostic performance of this algorithm 

best regards

Elsa!

Your question is a philosophical one. 

The ideal index should be the one that could be used in every scenario. However, such instrument does not exist, especially when talking about frailty.

Several keys should be considered, such as validity, generalizability, stability, repeatability.

It is more important to have a clear objective. If you are aiming to treatment, then use an instrument which is sensitive to change in a short period. If you are aiming to diagnosis, then use an instrument with appropriate sensitivity and specificity. In case you are aiming to measure the economic impact of the diseases, then... ...and so on.

We must keep in mind that a specific objective will have as many advantages as limitations. And everything comes to the researcher choice, considering that limitations should be justified properly.

Dear Julia,

If the SPPB is being performed in an acute phase after hip fracture it's understandable the difficult of the patients, and it will be biased as a measure of sarcopenia. I believe that handgrip strength is a good alternative as suggested above.

Kind Regards,

Alessandra

Pain is always subjective and it is difficult to quantify but i think chinease researcher make an app for kids to examine the intensity of pain 

WHO SAGE Waves 1 and 2 include gait speed (normal and rapid pace) and ethnicity/race variables - for China, Ghana, India, Mexico, Russia and South Africa - you are welcome to examine this information at:

Research on mobility attached.

Trahan, M. A., Kahng, S., Fisher, A. B., & Hausman, N. L. (2011). BEHAVIOR-ANALYTIC RESEARCH ON DEMENTIA IN OLDER ADULTS. Journal of Applied Behavior Analysis, 44(3), 687–691

you can find more literature in behavioral gerontology special interest group website

kind Elisa,

maybe the old [Spanish !] work might be useful to you

sorry that the normative Italian data are available in the web only as abstract

best regards, Mauro

Dear Ms.Dalton and other readers on this string or outside,

                            While it is socially very important that healthcare be delivered to the marginalised it is equally important to ask in the context of any industrialised market economy why that is not already happening. This is the scientific problem we believe. We have used Econophysics to discover this Insurance Markets Functor and Sector category (using first principles of category theory (Mallick, Hamburger, Mallick (2016)) and found that with a Insurance Information System which is String Theoretically Systems Integrated "with pretrading learning" by the population, will very scientifically reach systems integrated equilibrium over spacextime factorisation using our developed Dbranes String Functor and Sector category Algebra and Calculus which satisfies transitivity with the design of Artificial Genetic Gravity Neural Networks over spacextime. Network Physics can solve the problem and achieve modified Pareto Optimality with Walrasian Auctioneer Category Arrow-Debreu Price Engineering for Insurance categories (also Mallick (2011)). An application in terms of "God does not play dice" Einsteinian Principle which the Swedish School of Physics had waylead to show can be solved by suitable integration (Ingelman (1982)) for example. If you care to you can take alook at our publications including the ones on Pharmaceutical Industry Classification Categories which are the Econophysical solutions also. Sorry if we sound too technical but it is a 'bypass' solution using systems Physics and of course Economics and Medical Sciences.

Soumitra K. Mallick

for Soumitra K. Mallick, Nick Hamburger, Sandipan Mallick

Dear Marianna,

the World Alzheimer Report might be helpful too:

Prince M, Wimo A, GuerchetM, Ali G-C,Wu Y-T, Prina M.World Alzheimer Report 2015: The Global Impact of Dementia: An Analysis of Prevalence. London, England: Alzheimer’s Disease International; 2015.

Dear Marilyn, there's a lot of work on psychological rehabilitation in cancer survivorship, but mostly on therapies for distress etc. The literature on this is somewhat mixed and suffers from a number of methodological issues, such as selective recruitment and dropout, indicating that while many patients may be distressed, many of these do not want or feel they need help to cope.  Our own work indicates that, contrary to popular belief, most cancer patients are not distressed or depressed, and rates of depression and anxiety are little different from those seen in the general population. In people who are depressed, there is growing evidence that these people may have pre-existing vulnerabilities.  There is also controversy about what constitutes PTSD in the context of cancer. Often the measures used to diagnose used tools not designed to detect PTSD or included a re-definition of what PTSD might be.  David Speigel has good examples of both of these issues. His early work in the Lancet implying that group therapy increases survival of women with advanced breast cancer in fact reflected sampling bias, while a recent review in the Lancet Oncology sensible cautions about PTSD in cancer. Hope this is useful.

Thank you very much Mr.Glenn

Thank you for your answer.

Hi 

Yes the latest published one is from 2010, however you can find the data from http://qof.digital.nhs.uk/ as gp collects the data around prevalence of hypertension

data : http://www.content.digital.nhs.uk/catalogue/PUB22266

Regards

Hi

nursing journal of Isfahan University of Medical Siences probabaly will pbublish your study

With a right balance of support and education, i would think so. Heterogeneity among older adults make it more challenging. In a pilot study completed with pre-frail older people (75+ nonMaori and 60+Maori), we notice that support, particular transport, seem to be more important for those who are frailer and have lower SES.  We will be writing up the findings in the next month. 

Chère amie,

A Toulouse, une publication de Rolland and coll de l'équipe de Bruno Vellas, pense que 31 cm est la réponse que vous me demandez.

A ma connaissanc, aucun autre papier ne donne une autre valeur

Bien à Vous

Jean-Pierre

I'm looking into the effectiveness of caffeine, especially when ingestion after creatine supplementation on anaerobic power and isoenzyme creatine kinase in male athletes. is there anyone that could enlighten me on this subject?

The medical examination is important especially in establish the so called "indennità di accompagnamento", i.e. the inability of the patient to walk without unaided or to carry out daiily Activities of live (ADL).

The most important word in your question is "conclusively". Because most studies involving the subject are performed using various model systems (both in vitro and animal models), it is likely to be difficult to "conclusively" prove a strong relationship among various topics (telemeres, telomerase, cancer, and aging). However, there is ample evidence to support the idea that (i) immortalization is the first step for cancer cells; and (ii) defects in telomere that lead to activation of a DNA-damage response (DDR) contribute to premature aging in cells/organisms.

Plase see this paper:

de Souza Barbosa JF, Zepeda MU, Béland F, Guralnik JM, Zunzunegui MV, Guerra RO. Clinically relevant weakness in diverse populations of older adults participating in the International Mobility in Aging Study.

Age (Dordr). 2016 Feb;38(1):25. doi: 10.1007/s11357-016-9888-z. Epub 2016 Feb 11.

Dear Mauro,

Thanks for your information. The assessment tools you suggested are very useful not just on my research but also on my daily clinical practice. I will apply it when I need to assess the ADL functions of my clients with dementia.

I'm currently conducting a research on the assessment tools for the physical performance of people with dementia, specifically on functional mobility and exercise tolerance. It would be interesting to see the results.

Many thanks,

Wayne 

Yes, it seems that many groups have studied the "aerobic" models of in vitro myotube stimulation, but I would check out the following paper from Keith Baar's lab: http://www.ncbi.nlm.nih.gov/pubmed/19807268. They were able to modulate the frequency to more of a "resistance" model, and demonstrated an anabolic like response.

David Hood's group at York (Canada) has also completed quite a bit of research in the in vitro e-stim area, although they focused more on mitochondrial biogenesis. You may want to also check them out for some experimental designs.

Hope this helps. Best of luck.

What are   "non-urgent ED visits " ? This should be specified  first ,. 

I agree with Michele  G  that involvement of primary care general practitioners is crucial but regretably their knowledge in basic geriatrics is limited,

Thank you for the response Prof . Beatrice., Much appreciate the effort. thanks

Thank you Prof. Ahmad, I understand the available literature which used depression scales might have had the employment status as a variable. But I am concerned specifically about the comparison of the Post-retirement age group & the self employed group.

For example:

Group - I - Retired from employement in the recent  past

Group - II - was always Self Employed (was never in full time public job) 

Both Groups in the age group of 60 to 70 years.

Regards

I found some very useful information on age-equivalency of mice and humans on the Jackson Lab website for their research labs.

Figure v3 at https://www.jax.org/research-and-faculty/research-labs/the-harrison-lab/gerontology/life-span-as-a-biomarker.  Based upon maturational and senescence changes, they suggest that mice are mature adults from 3-6 mo, middle aged from 10-14 mo, and old from 18-24 mo, with 50% surviving to 28 mo.  They also have a table comparing maturational rates at different mouse ages relative to humans.

Here are some possible publications related to a 3 week, outpatient based multidisciplinary pain program that could be helpful for you to review--W. Michael Hooten had been the main physician champion in the past.

Hello  Hemal,

I agree with the previous answer, and I believe that CTB can help patients to perform better after surgery.  A paper from 2014, indicated that after decrease in pain and disability (after surgery) was associated with a reduction in catastrophizing and kinesiophobia. In other words, fear of pain (particularly pain), may be the main reason most patients who will not participate Actively in Rehabilitation Protocol after surgery are the ones showing higher levels of kinesiophobia.

During my clinical work in a multi-disciplinary centre, our rehab group identified some patients who performed poorly after surgery. The approach from our OTs were very helpful, not forgetting that family did play an important role.

During our rounds, we had the opportunity to discuss whether patients should be asked about previous experiences with pain and surgery and how long it took for their complete recovery. The number and quality of research suggesting whether prior intervention (CTB) would be effective are very rare. But, I can tell you that those who indicated long recovery after previous joint surgery or any surgery that resulted in some pain or difficulty to be mobile were the ones presenting long term recovery after TKR or THR. Yes, we could not intervene before surgery as we did not have the resources, but because we already expected hard recovery from these patients, our approached was different and that helped to improve and accelerate their recovery and discharge from hospital.

All the best on your research and clinical work,

Clearly the beneficial effects of avastin (or other anti-VEGF-medications) overweight negative effects in nAMD.  

There are a couple of things to remember.  First, it has been shown that it is not only the ARDS patients but all ventilated patients should be ventilated at a volume of 6ml/kg to prevent barotrauma along with ARDS or multisystem failure..  Second,  it is not only the pulmonary disease that affects how you manage a ventilator.  You could be more limited in adding PEEP when a patient is septic, you are more limited on the rate when someone has Asthma or severe bronchospasm and have to accept or even use permissive hypercapnia as a plan.  There is no absolute perfect way to ventilator all patients based on age or disease process because there is usually more than one process going on.  The art of ventilation is titrating and adjusting to the individual patient.  Managing for a pH, not a PaCO2 maintain adequate oxygenation but not hyperoxygenating and making sure the patient is in sync with the ventilator.  This requires close observation of the patient and adjusting the ventilator settings to the patient.  These concepts apply to all patients from newborn to geriatric across all types of disease processes. 

This review may be of interest: 

(Skelton et al., 2013. Environmental and behavioural interventions for reducing physical activity limitation in community-dwelling visually impaired older people. Cochrane Database Syst Rev. 2013 Jun 5;6:CD009233. doi: 10.1002/14651858.CD009233.pub2).

What doe you mean APRN and what do you mean by geriatric? Do you mean older than 50? I think you mean advanced nurses but I reckon that the nurse has to be holistic in the true sense of the word and to know the person in front of her and then she or he can work well with an older adult particularly if the person has dementia.

The CSNAT has been successfully trialed in Australia and this has been reported in three publications early this year (below). A copy of the tool can be obtained from Gail Ewing: ge200@cam.ac.uk

Aoun SM, Grande G, Howting D, Deas K, Toye C, Stajduhar K, Ewing G. The

impact of the Carer Support Needs Assessment

Tool (CSNAT) in community palliative care

using a Stepped Wedge Cluster Trial. PLos One

2015;10(4):e0123012. DOI:10.1371/

journal.pone.0123012

Aoun SM, Deas K, Toye C, Ewing G, Grande G,

Stajduhar K. Supporting family carers to

identify their own needs in end of life care:

Qualitative findings from a stepped wedge

cluster trial. Palliative Medicine 2015;29(6):

508–17. DOI:10.1177/0269216314566061

Aoun SM, Toye C, Deas K, Howting D, Ewing G, Grande G, Stajduhar K. Enabling a family carer-led assessment of support needs in homebased

palliative care: Potential translation into

practice. Palliative Medicine 2015 April 20; Epub

ahead of print. DOI:10.1177/0269216315583436

Interesting question. Accreditation of nursing homes in Australian largely focus on "paper-recorded" process issues - a lot of  meaningless stuff is recorded for the sake of it but hugely detracts spending time with residents. Process has a poor correlation to quality of care. 

A quick search found 2 potentially helpful articles 

Looks there is scope to explore this further from a practitioner and patient perspective.

Yes it is true, because you get poorer when you grow older and cannot visit the doctor so often. 

I think it would be appropriate to look at is it Benefit or Burden?

Holistic assessment would identify the trajectory of frailty on this person and if already bed and chair fast or close to moribund state? what is the advanced care directive they have chosen. 

Geriatric atrophy will play a big impact if the patient has co morbidity in 2 or more facets of frailty.. One being mobility and examine the SPICES tool. Good nursing process here would be recommended as choosing a palliative approach will improve the quality of life the person is receiving whilst planning the end of life pathway. 

Shocking to the medical node of colleagues, however we cant live forever and what quality to we want in the end???

The Push tool allows you to monitor how it is healing, so could predict likelihood, not aware of a tool designed specifically for this purpose

Thanks everyone for your answers. Hope we can start quickly and publish soon the results! I am crossing my fingers!

Besides the obvious negativity of receiving a diagnosis, knowing about the diagnosis can help ppl with dementia, and their family members/carers to access support services, and receive medication and interventions to delay the onset of severe symptoms. 

Hello!

it depends on the content of the tool that you have selected. Basically the tool is made considering the target population. If the illiterate population has to be included, a picture based tool could be useful. The numbers of hours of sleep one had had could be marked in the specified box or space denoting the 

There are scales that measure INDEPENDENCE, not "dependence."  From these measurements, we determine if the older adult is able to live in the community or does that person require assistance?  ADL, IADL, Frailty Wheel, GDS-SF, Nestle Nutritional Assessment, and add a cognitive assesment such as SLUMS or GP-COG Modified.  Also, if the individual drives, a driving assessment is in order [with simulator].  These assessments must be conducted by an experienced and qualified geriatrician [not a novice or student].  They are available from PAR.  If they approve you to buy them, you can administer them.  Don't be tempted by using bootleg copies, as it could really get you into trouble.  Jan Vinita White, PhD Gerontologist

It is not known as "dual tasking."  Search "multitasking elderly" in the TITLE and you should get lots of great scholarly sources.  There is a lot of material out there on this topic.  Some people believe they have dementia but they don't, it is just multitasking.  It becomes more difficult to do as we age.  Jan Vinita White, PhD Gerontologist

Hello,

in my publication are in addition to the estimated need of rehabilitation staff, patients eligible for an Italian province of about 350,000 people, with a breakdown of low-medium and high type of assistance. I hope to help

Silvia

In the UK they are and have published much on the CDC through their local councils as they are in control of the budgets and home care funding