Search

Background: Older people living in long-term care facilities represent a particularly vulnerable segment of the population, who disproportionately bear the burden of infectious diseases, as recently highlighted by the COVID-19 pandemic. Summary: Older long-term care residents typically cumulate several risk factors for infection and experience serious life-threatening outcomes once infected. These common infections are often compounded by the collective living environment, where it is more difficult to contain the spread of infection. Moreover, the staff may represent an additional reservoir of potential infection and mode of transmission. In this paper, we review the burden of infectious respiratory diseases in residents in long-term care and discuss the potential gains from higher vaccine coverage in this older and most vulnerable population but also from higher vaccine coverage among the facility staff. We highlight the compelling need to integrate specific vaccine recommendations for residents of long-term care into national vaccination schedules, as well as the need to include vaccination campaigns in routine protocols for infection control. Surveillance, reporting, hygiene, and individual protective measures remain key aspects in basic infection control, both in ordinary times and during epidemics. Key Message: Vaccination of residents in long-term care facilities against respiratory diseases including influenza, pneumococcal disease, pertussis, and COVID is a simple, inexpensive, and effective means to reduce the burden of infection in this segment of the population. [ABSTRACT FROM AUTHOR]

In today's tormented world, it appears useful to take advantage of communication channels to promote life-course immunization and affirm its major role in healthy ageing. Instead of developing the argument of chronological age, we demonstrate the life-course principle here based on the P4 medicine concept. Are vaccines "preventive, personalized, predictive, and participatory?" Based on detailed analysis of research findings, we successively demonstrate the seminal role of vaccines on preventable infectious diseases, post-sepsis functional decline, non-communicable diseases (cardio-neuro-vascular, respiratory, and renal diseases), community protection, antimicrobial resistance, and perhaps even old-age dementia. Healthy ageing and the promotion of immunization are closely dependent on health literacy and provision of information by skilled health-care professionals. However, personal autonomy and individual freedom are influenced by psycho-cognitive hurdles (cultural approaches, beliefs, emotions, and behaviours), the opinions of the public/family/friends, and the increasing role of social media, which challenges scientific evidence. A similar phenomenon exists when dealing with the issue of healthy ageing, whose success depends greatly on life-course immunization. [ABSTRACT FROM AUTHOR]

As populations age globally, the health of older adults is looming larger on the agendas of public health bodies. In particular, the priority is to ensure that older adults remain healthy, independent, and engaged in their communities. In other words, ensuring that increasing life spans are matched by increasing "health spans," meaning years spent in good health. Chronic conditions such as cancer or respiratory and cardiovascular diseases account for the bulk of the disease burden in older adults, and the consensus is that these can best be tackled by effective primary prevention. However, given the diverse nature of older populations, whose prior health experiences can be complicated by multi-morbidity and poly-pharmacy, effective primary prevention can be challenging. One approach that is gaining momentum is what is called "precision" or P4 medicine. The acronym stands for "predictive, personalized, preventive, participatory" medicine, and is based on the premise that preventing disease is better than treating it. However, effective prevention requires the ability to predict disease risk for a given patient, the tailoring of treatment to their circumstances, and their consent for or participation in the offered treatment. A P4 approach may seem counter-intuitive, given that vaccination is generally considered a public health intervention. However, in this article, we discuss the application of P4 medicine as a complement to planning the vaccination of older individuals, with a special focus on the important role that vaccine-preventable infections play in the burden of non-communicable disease. [ABSTRACT FROM AUTHOR]

Background: Transcutaneous measurements of arterial blood gases (ABG) may decrease the need for repeated arterial puncture in older patients treated for acute cardiac or pulmonary disorders. However, age-related changes in skin perfusion, metabolism, or thickness may alter the validity of the technique. Objective: To analyse the agreement between transcutaneous and arterial measurement of PaO2 and PaCO2 in older adults. Design: Prospective descriptive study performed in the intermediate-care unit of a geriatric university hospital and a pulmonary rehabilitation centre. Methods: 40 patients, aged 82.5 ± 8 years (66–97), hemodynamically stable, without vasopressor treatment, underwent simultaneous measurement of arterial blood gases (ABG) and transcutaneous CO2 (TcPCO2) and O2 (TcPO2) with a Radiometer TINA TCM3® capnograph, and a probe T° set at 43°C. Results: Correlation between PaCO2 and TcPCO2 was high (r2 = 0.86) with a low bias (–0.1 mm Hg) and limits of agreement quite compatible with clinical use: (8.3; –8.5 mm Hg). The probe was well tolerated without any cutaneous lesion even after prolonged recordings (up to 8 h). Conversely, although TcPO2 and PaO2 were significantly correlated, the variability around the regression line precludes the use of transcutaneous measurements for monitoring PaO2 in a clinical setting. Conclusion: In older subjects, TcPCO2 (but not TcPO2) measurements are reliable when repeated assessment of ABG is warranted. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Changes of body composition occur with aging and influence health status. Thus accurate methods for measuring fat-free mass (FFM) in the elderly are essential.Objective: The purpose of this study was to compare FFM obtained by three bioelectrical impedance analysis (BIA) published formulas specific for the elderly and one equation intended for all age groups, with FFM derived from dual-energy X-ray absorptiometry (FFM(DXA)), in healthy elderly subjects.Methods: Healthy Caucasian subjects over 65 years (106 women, age 75 +/- 6.2, body mass index 25.2 +/- 4.1 and 100 men, age 74.6 +/- 6.6, body mass index 25.8 +/- 3.0) were measured by DXA (Hologic QDR-4500) and BIA (Xitron, 50 kHz). FFM(BIA) was calculated by the published formulas of Deurenberg, Baumgartner, Roubenoff and Kyle and compared to FFM(DXA) by a Bland-Altman analysis.Results: The Deurenberg and Roubenoff BIA formulas underestimated FFM compared to DXA by -7.1 and -2.9 kg in women and -6.7 and -2.3 kg in men, respectively. The Baumgartner formula overestimated FFM by 4.3 kg in women and 1.4 kg in men. The Kyle formula showed differences of 0.0 kg in women and 0.2 kg in men, and the limits of agreement of FFM(BIA (Kyle)) relative to FFM(DXA) were -3.3 and +3.3 kg for women and -3.8 and +4.3 kg for men.Conclusion: The Kyle BIA formula accurately predicts FFM in elderly Swiss subjects between 65 and 94 years, with a body mass index of 17 to 34.9 kg/m(2). The other BIA formulas developed especially for the elderly are not valid in this population. [ABSTRACT FROM AUTHOR]

Provides information on the European Academy for the Medicine of Ageing (EAMA). Establishment of the EAMA; Factors critical to the success of the EAMA; Courses related to geriatrics offered by EAMA.