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Introduction: Population ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland.Material and Methods: The project was conducted in the period 2018-2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests.Results: In the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection.Conclusions: In recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to obtain a consensus on oral health policy, access to dental care, oral hygiene measures and training levels.Background: Poor oral health is widespread in care-dependent older people, but no consensus for a minimum standard of oral health care exists yet.Methods: The e-Delphi approach was applied to a selected panel of interdisciplinary experts. Data analysis was based on three measurements: (a) ≥70% of experts' opinion fall into category "agree or strongly agree," (b) median score on the 5-point Likert scale ≥4, (c) interquartile range ≤1.Results: A total of 31 experts from 17 European countries participated in this survey. Agreement was achieved for a compulsory dental examination when an elder is admitted to a long-term care (LTC) facility. Older people should brush their teeth twice/day and regularly clean interproximal spaces and oral mucosa. Dentures should be rinsed after meals and cleaned twice/day. The use of denture cleansing tablets was considered necessary. Dentures should be removed before sleeping and stored dry. A 5000 ppm fluoride toothpaste should be applied daily in elder with high caries risk. A short report on the oral health status of the elder should be included in the geriatric assessment. All experts concluded that the knowledge and the training in oral health care for caregivers and family members of care-dependent older people were imperative.Conclusions: Using the e-Delphi method, multidisciplinary healthcare professionals from different countries agreed on certain cardinal recommendations for a standard oral health care for care-dependent older people. [ABSTRACT FROM AUTHOR]

We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (uopt) to physical functioning in 28 women aged 50-87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, i)opt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and uopl than to strength. Functional gains obtained with rehabilitation were not related to changes in power or x»opi, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls.Methods: The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects.Results: Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79-1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81-1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74-1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67-1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63-1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62-2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29-1.89) and injurious falls (OR = 1.58, 95%CI = 1.14-2.19), and such associations were confirmed in all multivariable models.Conclusions: Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes.Trial Registration: This study was registered on 25th February 2016 at clinicaltrials.gov ( NCT02691546 ). [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is known to be associated with several co-occurring conditions. We aimed at exploring multimorbidity patterns associated with CKD, as well as the impact of physical performance and CKD severity on them in a population of older outpatients.Methods: Our series consisted of 2252 patients enrolled in the Screening of CKD among Older People across Europe multicenter observational study. Hypertension, stroke, transient ischemic attack, cancer, hip fracture, osteoporosis, Parkinson's disease, asthma, chronic obstructive pulmonary disease, congestive heart failure, angina, myocardial infarction, atrial fibrillation, anemia, CKD (defined as GFR < 60, < 45 or < 30 ml/min/1.73 m2), cognitive impairment, depression, hearing impairment and vision impairment were included in the analyses. Physical performance was assessed by the Short Physical Performance Battery (SPPB) and used as stratification variable. Pairs of co-occurring diseases were analyzed by logistic regression. Patterns of multimorbidity were investigated by hierarchical cluster analysis.Results: CKD was among the most frequently observed conditions and it was rarely observed without any other co-occurring disease. CKD was significantly associated with hypertension, anemia, heart failure, atrial fibrillation, myocardial infarction and hip fracture. When stratifying by SPPB, CKD was also significantly associated with vision impairment in SPPB = 5-8 group, and hearing impairment in SPPB = 0-4 group. Cluster analysis individuated two main clusters, one including CKD, hypertension and sensory impairments, and the second including all other conditions. Stratifying by SPPB, CKD contribute to a cluster including diabetes, anemia, osteoporosis, hypertension and sensory impairments in the SPPB = 0-4 group. When defining CKD as eGFR< 45 or 30 ml/min/1.73 m2, the strength of the association of CKD with hypertension, sensory impairments, osteoporosis, anemia and CHF increased together with CKD severity in pairs analysis. Severe CKD (eGFR< 30 ml/min/1.73 m2) contributed to a wide cluster including cardiovascular, respiratory and neurologic diseases, as well as osteoporosis, hip fracture and cancer.Conclusions: CKD and its severity may contribute significantly to specific multimorbidity patterns, at least based on the cluster analysis. Physical performance as assessed by SPPB may be associated with not negligible changes in both co-occurring pairs and multimorbidity clusters.Trial Registration: The SCOPE study is registered at clinicaltrials.gov ( NCT02691546 ). [ABSTRACT FROM AUTHOR]

Key summary points: Aim: The aim of the paper is to give insight into MOOCs in general and to specifically describe a MOOC developed in the course of the SCOPE project "Screening for Chronic Kidney Disease (CKD) among older People across Europe". Findings: The major target of the MOOC was the improvement of knowledge for a broad audience. The SCOPE MOOCs are freely accessible, structured in three modules, offer additional learning material and guarantee knowledge dissemination about aging and chronic kidney diseases. Message: The MOOCs represent a contemporary example of how modern technology is supporting a transition to modern training in geriatrics. Purpose: To cover the increasing need for professional knowledge, skills and competences in the care of older people, new learning techniques have been developed. Using the Internet to provide educational material has come into focus of many academic institutions as the learning content can easily be transferred to a larger audience. Since the first launch of a "massive open online course" (MOOC) in 2008, this educational format has raised increasing interest among education experts. The current publication provides insight into the new format of MOOCs in general and specifically describes a MOOC developed by a Pan-European Consortium "Screening for Chronic Kidney Disease (CKD) among Older People across Europe" (SCOPE), a project funded by the European Commission under the umbrella of the Horizon 2020 program. Methods: Technical background, learning theories and content of the MOOC of the SCOPE project are presented in this overview. Results: The MOOC of the SCOPE project is provided on the MOOC ICT platform iMoox. The courses are built up of video clips, textual descriptions, graphics, animations and audio designed with a clear structure and learning goals. The concise video clips with a maximum length of 15–20 min are equipped with additional learning material such as documents, links and asynchronous communication opportunities. Conclusion: MOOCs are recognized as a contemporary approach to transfer required knowledge and skills not only in general but also in geriatric medicine, as the health and social care environment is ever-changing and becoming more complex. [ABSTRACT FROM AUTHOR]

Describes the application of the inverse dynamic method for measuring the mechanical properties of knee extensor muscle under ballistic conditions among elderly men. Measurement of friction and inertial effects of the muscle; Magnitude of torque and power during extension; Applicability of ergometer in the measurement of isokinetic values of the muscle.

Key summary points: Aim: To investigate whether the cognitive or functional status is related to basic platelet indices in hospitalized older adults. Findings: After adjustment for multiple confounders, the Mini-Mental State Examination Scale, the seven-point Clock Drawing Test, the Katz ADL scale, the Lawton IADL scale and VES-13 are, except one weak association, not directly related to basic platelet indices measured in the routine complete blood count. Message: The basic platelet indices measured in the routine complete blood count are not consistently associated with the cognitive and functional status evaluated by screening tests. The lack of translation of these associations in clinical use could be due to the multifaceted effect of diseases other than dementia. Purpose: Activated platelets have been suggested to play an important role in the pathogenesis of dementia. Recent studies have shown contradictory results concerning the relationship between blood platelet indices and cognitive performance. Methods: This cross-sectional study evaluates the relationship between basic platelet indices and cognitive and functional performance of 754 men and women, aged 60–105 years old, admitted to the geriatric hospital unit. Assessment of global cognitive function and functional ability were performed using Mini-Mental State Examination, the seven-point Clock Drawing Test, the Katz Activities of Daily Living, the Lawton Instrumental Activities of Daily Living Scale and the Vulnerable Elders Survey Questionnaire. As platelet indices, platelet count, mean platelet volume, plateletcrit and platelet distribution width were measured. Results: There was no significant correlation between cognitive performance and platelet indices. Out of the functional dependence questionnaires, only the Katz Activities of Daily Living and the Vulnerable Elders Survey Questionnaire were weakly correlated with platelet count (r = − 0.080 and r = 0.096) and plateletcrit (r = − 0.075 and 0.082, respectively), but these associations diminished in sex-specific analyses. Conclusions: Cognitive and functional status are not systematically related to platelet indices in multimorbid hospitalized older adults. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to determine whether cardiovascular risk factors may differ according to occupational status and whether physical activity related to total energy expenditure (PA-EE) and related to healthrelated behaviours (PA-HRB) is associated with common cardiovascular risk factors or metabolic syndrome in preelderly subjects. Methods Three hundred subjects aged 60-65 were recruited and divided into three equal groups of whitecollar, blue-collar workers and unemployed subjects; 50% were women. The subjects were tested for major cardiovascular risk factors such as smoking, anthropometric indices, blood pressure, lipid levels, glucose, uric acid and homocysteine. PA-EE and PA-HRB were assessed with PA questionnaires. Results Blue-collar workers displayed higher anthropometric indices, blood pressure and higher PAEE in comparison with other two groups. PA-HRB had a positive impact on body mass indices, lipids, glucose, uric acid and the prevalence of metabolic syndrome, with no such relationship observed for PA-EE. Conclusions The greatest cardiovascular risk was observed in the blue-collar workers group. Only PA-HRB had a positive association with cardiometabolic risk profile. No relationship was observed for PA-EE. Thus, promoting everyday life and leisure time PA behaviours is crucial for preventing cardiometabolic risk in pre-elderly subjects, even in blue-collar workers with high work-related EE. [ABSTRACT FROM AUTHOR]

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Objectives: As plasma and salivary total antioxidant capacity (TAC) is mainly contributed by uric acid (UA), the present study measures non-urate TAC (Nu-TAC). The aim of the study was to correlate plasma native TAC, Nu-TAC and UA with their salivary analogues, and compare the UA contribution in both body fluids using two different methods. Methods: The study involved 55 middle-aged and older subjects (66.7 ± 4.5 years). TAC was determined simultaneously with two methods (ferric reducing ability of plasma - FRAP, 2.2-diphenyl-1-picryl-hydrazyl - DPPH and countertypes for saliva - FRAS and DPPHS test), with and without UA (native TAC and Nu-TAC, respectively). Plasma UA and salivary UA (SUA) were assessed. Results: Subjects with increased FRAP, DPPH and UA had higher FRAS, DPPHS and SUA, respectively (P < 0.05). Plasma Nu-TAC indices did not correlate with salivary Nu-TAC. The contribution of UA to the plasma and salivary DPPH tests was similar: 75.7 ± 10.3% and 75.2 ± 14.0%, respectively. However, the contribution of UA to FRAS was higher than that for FRAP (71.6 ± 13.9% vs. 64.0 ± 8.1%; P < 0.001). Discussion: Our findings suggest that saliva is a good predictor for native plasma TAC but not for Nu-TAC. UA level is comparably dominant in saliva and in plasma according to DPPH, but lower in plasma according to FRAP. [ABSTRACT FROM AUTHOR]

The relationship of quadriceps maximal muscle power ([P.sub.max]), corresponding optimal shortening velocity ([[Upsilon].sub.opt]), and relative fatigability (Pmax%D) to maximal oxygen uptake ([VO.sub.2]max) and habitual physical activity (PA) was examined in healthy community-dwelling subjects (29 women and 25 men) aged more than 65 years old. PA was evaluated by a questionnaire and expressed using two activity indices: mean habitual daily energy expenditure (MHDEE) and the daily energy expenditure corresponding to leisure time sports activities (Sports Activity). In women, [P.sub.max] correlated positively with [VO.sub.2]max (r = .56) and with Sports Activity (rho = .41). Both Sports Activity and [P.sub.max] were significant independent predictors of [VO.sub.2]max and accounted for 62% of variance in [VO.sub.2]max. In men, [[Upsilon].sub.opt] was significantly negatively related to MHDEE (r =-.59) and to Sports Activity (rho = -.40). Neither in women nor in men was Pmax%D correlated with [VO.sub.2]max or PA indices. The different relationship of [P.sub.max] and [[Upsilon].sub.opt] with [VO.sub.2]max and PA indices suggests that habitual PA may be sufficient in active older women, but not in men, to positively influence quadriceps muscle function. These gender differences may suggest different approaches in exercise programming for elderly women and men.