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Context Current osteoporosis pharmacological treatment has undesirable side effects. There is increasing focus on naturally derived food substances that contain phytonutrients with antioxidant effects in promoting health and regulating immune response. Objective This review aims to systematically evaluate the effectiveness of anthocyanin-rich foods on bone remodeling biomarkers in middle-aged and older adults (≥40 y old) at risk of osteoporosis. Data Sources Randomized controlled trials were searched on 8 bibliographic databases of PubMed, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Food Science and Technology Abstracts, Cochrane Library, and ProQuest. Data Extraction and Analysis Thirteen studies were included in the meta-analysis. Receptor activator of nuclear factor kappa-B ligand (RANKL) is exhibited from osteoblastic cells that gathered osteoclasts to bone sites for bone resorption, accelerating bone loss. Anthocyanin-rich food consumption showed statistically nonsignificant effects, with no substantial heterogeneity on bone remodeling biomarkers. However, there was a significant increase in lumbar spine L1–L4 bone mineral density. Mild-to-small effects were seen to largely favor the consumption of anthocyanin-rich foods. Berries (d = –0.44) have a larger effect size of RANKL than plums (d = 0.18), with statistically significant subgroup differences. Random-effects meta-regression found body mass index, total attrition rate, total energy, and dietary carbohydrate and fat intake were significant covariates for the effect size of RANKL. All outcomes had low certainty of evidence. Conclusion Anthocyanin-rich foods may improve bone health in middle-aged and older adults at risk of osteoporosis. This review contributes to the growing interest in nutrient-rich foods as a low-cost and modifiable alternative to promote human health and reduce disease burden. Future high-quality studies with larger sample sizes and longer treatment durations are required to fully understand the effect of anthocyanin-rich foods on bone health. Systematic Review Registration PROSPERO registration no. CRD42022367136. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of mindfulness‐based interventions (MBIs) on mental and cognitive outcomes including, anxiety, depression, attention, memory, global cognition and neuroplastic changes in older adults with mild cognitive impairment (MCI). Design: Systematic review and meta‐analysis. Data source: A three‐step search strategy was conducted on eight electronic databases, grey literature and reference lists from inception to February 2022. Review methods: Randomized controlled trials (RCTs) examining MBIs on older adults with MCI were screened and assessed for risk of bias using the Cochrane Risk of Bias Tool. Meta‐analysis was conducted using RevMan using a random‐effect model. Narrative synthesis was performed for studies where results could not be pooled statistically. Results: Ten RCTs were included in the review. Results suggested that right frontal parietal and left inferior temporal gyrus of the brain showed increased cortical thickness after receiving MBIs. There were significant interaction effects for global efficiency and significant interactions in the insular and gyrus regions. Functional connectivity between the posterior cingulate cortex, bilateral medial prefrontal cortex and left hippocampus were increased in participants undergoing MBIs. Nevertheless, meta‐analysis showed non‐significant pooled effects, favouring control groups on anxiety, depression, attention, memory and global cognition. Conclusion: This review suggested the potential effects of MBIs in improving cortical thickness and connectivity in regions associated with memory and attention. Nevertheless, the effects of MBIs compared to active control groups on depression, anxiety, attention, memory and global cognition are inconclusive due to the lack of studies and non‐significant results. Impact: The review advocates for more rigorous studies with larger sample size and utilizing wait‐list controls to evaluate the effects of MBIs. MBIs can be considered as an adjunct with other therapies to further enhance the effect on psychological and cognitive outcomes for older adults with MCI. No Patient or Public Contribution as this is a meta‐analysis. [ABSTRACT FROM AUTHOR]

Context The prevalence of age-related cognitive decline has been on the rise as the global population age, putting the independence and quality of life of elderly at risk. Anthocyanin, as a subclass of dietary flavonoids, may have a beneficial impact on cognitive outcomes. Objectives To examine the effects of dietary anthocyanin supplementation on cognition of the cognitively healthy middle-aged and older adults. Data Sources PubMed, ScienceDirect, CINAHL, EMBASE, ProQuest and Cochrane databases were searched. Data Extraction and Analysis Thirteen studies were included in this meta-analysis. Anthocyanin-rich supplementation was found to significantly improve the processing speed of the older adults (95%CI 0.08, 0.44; P = 0.004). No significant differences were observed between intervention and control groups on memory, attention, executive function and psychomotor performance. Current neuroimaging studies have found promising effects of anthocyanin supplementation on brain activation and cerebral perfusion. Conclusion Anthocyanin-rich supplementation may preserve cognitive processing speed and neuro-activities in older adults, which improves their daily functioning and quality of life. This review provides useful insights to guide direction and methodological designs for future studies to explore the underlying mechanisms of anthocyanins. Systematic Review and Meta-analysis Registration PROSPERO registration No. CRD42021228007. [ABSTRACT FROM AUTHOR]

Aims: To map the nursing skills required for different types of disasters. Design: This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute. Data Sources: A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi‐Web. Articles published in Chinese, English and Japanese were selected for the review. Review Methods: The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized. Results: We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man‐made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills. Conclusion: This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario‐based simulation training programs to provide more insights into future disaster precision nursing. Impact This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of technology‐based interventions in reducing psychological morbidities such as depressive symptomology, anxiety, burden and improving quality of life and self‐efficacy in informal caregivers of stroke survivors. Design: A systematic review and meta‐analysis. Data Sources: An extensive search was systematically undertaken at CENTRAL, PubMed, Embase, Scopus, CINHAL, Web of Science and PsycInfo until January 2021. Grey literature and dissertations were searched in Google Scholar, ProQuest & Scholarbank@NUS. Studies involving registered trials were retrieved from Clinicaltrials.gov and CENTRAL, respectively. Review Methods: Two reviewers independently screened the trials, conducted quality appraisal and extracted the data. Quality of the studies included in the review was assessed using Cochrane Risk of bias tool. Meta‐analysis was conducted using RevMan 5.4. Narrative synthesis was performed for studies where results could not be pooled statistically. The results were reported abiding Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results: This review included 15 trials with a total of 1276 informal caregivers of stroke survivors. Eleven trials were included in the meta‐analysis. Subgroup analyses revealed that technology‐based interventions with structured educational programs were statistically significant in reducing depressive symptoms (d = −0.27, 95% CI [−0.49 to −0.05], p =.02). Technology‐based interventions with structured educational programs <3‐month revealed significant effects (d = −0.31, 95% CI [−0.49 to −0.13], p =.0009). Results of narrative synthesis reported technology‐based intervention with face‐to‐face training minimized depressive symptoms of informal caregivers. Notably, there were no statistically significant effects on anxiety, burden, quality of life and self‐efficacy outcomes. Conclusion: Technology‐based interventions had beneficial effects in alleviating depressive symptoms among informal caregivers. Impact: Technology‐based interventions serve as a support mechanism for informal caregivers of stroke survivors who face time‐constrains. Further high‐quality randomized controlled trials are warranted to elucidate sustainability, optimal format and dosage of intervention. [ABSTRACT FROM AUTHOR]

This review aimed to examine available evidence concerning the effectiveness of psychosocial interventions in improving memory, executive function, depression and activities of daily living (ADL) in older adults with MCI. Eight electronic databases were used to conduct a comprehensive literature search for published and unpublished studies. A primary outcome was cognitive function, including memory and executive function. Secondary outcomes were depression and ADL. Two researchers independently appraised quality of included studies and extracted data. Meta-analysis, heterogeneity test, subgroup analysis and sensitivity analyses were performed. Ten studies (out of 1,265 records) were included in this review. Psychosocial interventions contributed to a significant improvement in memory, not executive function, depression and ADL. Subgroup analyses suggested that interventions with a longer duration, more therapeutic sessions, and individual format had larger effect sizes. Strategies found to enhance memory entailed behavior modification and activation, memory training, visual imagery, storytelling, memory aids, journaling, and exercise. Healthcare providers may offer psychosocial interventions to client with MCI in clinical settings. Higher quality trials should be conducted to increase solid evidence in this domain. [ABSTRACT FROM AUTHOR]

Aim: To examine the literature on Traditional Chinese Medicine (TCM) used in the treatment, prevention and supportive care in patients with COVID‐19. Design: A narrative review was performed. Data Sources: A systematic and comprehensive search was conducted on both Chinese and English electronic databases: China National Knowledge Infrastructure, Wanfang Data, CINAHL, Embase, Cochrane, PubMed, PsycINFO. Articles published from 1 December 2019 ‐1 April 2020 were included in this review. Review Methods: Studies reporting on the treatment and prevention of COVID‐19 using TCM regardless of study designs were included. In addition, grey literatures, including media reports on Chinese government websites or official media websites and treatment guidelines were searched for TCM treatment and prevention on COVID‐19. Results: Limited research has been published on the use of TCM for COVID‐19. We qualitatively described and synthesized the published research and current clinical practice on the use of TCM for COVID‐19, and focused on the following areas: TCM treatment used in SARS, MERS, H1N1; TCM treatment plan for COVID‐19; TCM in Prevention and Treatment at Early Stage of COVID‐19; TCM emotional therapy; and personalized TCM treatment plan. Conclusion: The combination of western medicine and TCM in treatment, and treatment based on the local condition, isolation, personal protective measures are of great significance for the prevention and treatment of COVID‐19. Relevant laboratory research and clinical evaluation should be continued to collect scientific evidences on the efficacy of TCM. Impact: TCM has been used in the treatment and prevention of COVID‐19 in China, and the clinical evidences indicated that TCM regulates immunity and exerts anti‐viral effect simultaneously. This review provides practical recommendation for the policymakers in the selection process of the treatment and preventive measures for the global pandemic of COVID‐19. [ABSTRACT FROM AUTHOR]

Chronically ill older patients are often vulnerable to detrimental health outcomes and have increased risk of preventable readmission. Tele-transitions of care interventions utilizing telecommunications and surveillance technologies help monitor patients' conditions after discharge to prevent negative health outcomes. This systematic review and meta-analysis aimed to identify and synthesize available evidence on the effectiveness of tele-transitions of care interventions on various health outcomes in older adults at high risk for readmission discharged from acute setting. Published, unpublished studies and gray literatures were identified through searching PubMed, Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, ProQuest Dissertations and theses and Google Scholar from inception to December 2021. Only randomized controlled trials published in English language assessing tele-transitions of care interventions on high-risk older adults were included. Meta-analyses were performed using random-effects model in RevMan 5.4. Sensitivity and subgroup and narrative analyses were conducted. Fourteen studies were included, of which thirteen were considered for meta-analyses. Tele-transitions of care interventions were effective in reducing readmission rate (RR = 0.59, 95%CI 0.50–0.69, z = 6.28, p < 0.00001), mortality rate (RR = 0.72, 95%CI 0.53–0.98, z = 2.12, p = 0.03), and improving health-related quality of life (SMD = 0.24, Z = 2.04, p = 0.04). However, reduction of emergency department visit (RR = 1.10, 95%CI 0.59–2.06, z = 0.31, p = 0.76) and improvement of functional status (SMD = -0.06, Z = 0.19, p = 0.85) was not observed following intervention. Subgroup analysis found that the positive effects of tele-transitions of care interventions persist up to 180 days even after the intervention. This systematic review and meta-analysis concluded that tele-transitions of care interventions have promising effects on readmission, mortality rate and health-related quality of life. Tele-transitions of care interventions are cost-effective and suitable for large-scale implementation in healthcare settings. The protocol was registered on PROSPERO (CRD42022295665). Systematic review demonstrates that monitoring older patients at high risk of readmission, following discharge from hospital, using telecommunication and surveillance technologies significantly reduces readmission and mortality rates and improves their quality of life. [ABSTRACT FROM AUTHOR]

High prevalence of delirium superimposed on dementia (DSD) was previously reported, with associated negative impact on hospitalized older adults. However, data were conflicting, and no meta-analysis has been conducted. Although dementia is the leading risk factor for delirium, risk factors for DSD have not been adequately studied. This systematic review and meta-analysis aims to elucidate the prevalence, risk factors, and impact of DSD in hospitalized older adults. Comparisons were made between older adults with DSD and persons with dementia alone (PWDs). Systematic review and meta-analysis. Observational studies reporting prevalence, risk factors, or impact of DSD in hospitalized older adults. Database search was conducted till December 2020 in PubMed, Embase, CENTRAL, PsycINFO, CINAHL, Scopus, Web of Science, ProQuest, and OpenGrey for relevant primary and secondary studies. A piloted data collection form was used for data extraction, and methodological quality was assessed using Joanna Briggs Institute critical appraisal checklists. Meta-analyses, with risk ratio and mean differences as effect measures, were performed using random effects model with Review Manager software. Cochran's Q and I 2 statistics were used to assess heterogeneity, which was investigated using subgroup analyses. A total of 81 studies were eligible. The pooled prevalence of DSD was 48.9%, with the highest prevalence found in the Americas and orthopedic wards. Risk factors, including nonmodifiable hospital-, illness-, and medication-related factors, were found to precipitate DSD. Patients with DSD had longer length of hospitalization, disclosed worse cognitive and functional outcomes, and a higher risk of institutionalization and mortality than patients with dementia. These findings suggested high prevalence and detrimental impact of DSD in hospitalized older adults, highlighting a need for early identification, prevention, and treatments. Further research on risk factors of DSD should be conducted as data were sparse and conflicting. Future high-quality studies regarding DSD are warranted to improve knowledge of this common but under-recognized phenomenon. [ABSTRACT FROM AUTHOR]

Aging is one of the most important public health issues. The World Health Organization (WHO) expects the number of older adults aged 65 and above to triple from 2010 to 2050. A major challenge would be to consider how functional ability and quality of life could be enhanced in older age. Reminiscence-based interventions are widely reported as having positive effects on psychological outcomes among older adults with dementia, but its effects on cognitively intact older adults have not been clearly evaluated. The aim of the current systematic review is to evaluate the existing evidence on the effects of reminiscence-based intervention on psychological outcomes in cognitively intact older adults. Commonly used English databases, including CINAHL, EMBASE, MEDLINE and PsycINFO, were searched from inception till 31 Mar 2020. Studies were included if they examined the effects of reminiscence-based intervention on psychological outcomes among cognitively intact older adults aged 60 and above. Meta-analysis was conducted to synthesise the effects on different psychological outcomes. Thirty-one studies involving 1,829 older adults were included. The pooled standardized mean difference for depressive symptoms and life satisfaction were -0.38 (95% CI: -0.69–-0.07) and 0.33 (95% CI: 0.14–0.52) respectively. Positive effects were observed on self-esteem, psychological well-being and happiness, though meta-analysis could not be conducted. Significant reduction of depressive symptoms and improvement of life satisfaction were revealed from the reminiscence-based intervention among cognitively intact older adults. In addition, reminiscence-based intervention has been effective in enhancing self-esteem, and promoting psychological well-being and happiness. Our results suggest that reminiscence-based intervention could be an effective solution to improve psychological well-being among cognitively intact older adults. Such non-pharmacological approach can be recommended for older adults at the community level. [ABSTRACT FROM AUTHOR]

Falls in older adults result in serious, life-limiting consequences. An increasing number of fall prevention interventions have used technology to reduce the number of falls in community-dwelling adults. Various types of e-interventions are being tested in clinical trials and in the community. These include telehealth, exergames, cognitive games, socialized training, smart home systems and non-conventional balance training. Currently, no systematic review and meta-analysis has assessed the overall effectiveness of e-interventions and compared the effectiveness of the different types. The aim of this review was to synthesize best available evidence concerning the effectiveness of e-interventions on fall, neuromuscular functions and quality of life in community-dwelling older adults. A rigorous three-step search was conducted in nine online databases for published and unpublished randomized controlled trials studying e-interventions. Studies were screened and assessed for individual and overall risk of bias by two independent reviewers. Six fall-related outcomes were evaluated in the meta-analysis: fall risk, balance, lower extremity strength, fall efficacy, cognitive function and health-related quality of life. Subgroup and sensitivity analysis were conducted during meta-analysis. Thirty-one studies fit the eligibility criteria and had an overall 74.7% low risk of bias. A total of 4,877 older adults from 17 countries were included in narrative synthesis and meta-analysis. Telehealth combined with exercise programmes and smart home systems were able to reduce fall risk significantly (risk ratio=0.79, 95% CI [0.72, 0.86]). E-interventions also significantly improved balance and fall efficacy (standardized mean difference=0.28, 95% CI [0.04, 0.53]). However, lower extremity strength, cognitive function and health-related quality of life did not show significant improvements. Telehealth combined with exercise and smart home systems demonstrated the best evidence of effectiveness in reduction of falls in community-dwelling older adults. Future research should focus on forecasting falls using smart home technology and Artificial Intelligence, and testing promising e-interventions on larger samples to improve the strength of evidence of fall prevention by e-interventions. [ABSTRACT FROM AUTHOR]