Search

Background Hospitalized older adults have unique physical, emotional, and psychosocial needs. We sought to understand older patients' and care partners' experiences with multicomponent interventions that support age-friendly care and identify areas for improvement. Methods We conducted a mixed methods study using surveys and interviews to explore older adult patients' (65 years or older) and their care partners' experiences with hospital-delivered multicomponent initiatives. We recruited participants from the Geriatric Rehabilitation (GRU) and Musculoskeletal (MSK) Rehabilitation units in a Canadian academic hospital from October 2021 to April 2022 until we reached data saturation and no new themes emerged. Results We recruited 18 participants, 10 patients (mean age 78 years, 80.0% female) and 8 care partners (mean age 61, 87.5% female). Surveys revealed overall positive experiences with multicomponent interventions. Interviews revealed five themes: 1) various forms of companionship for patients, 2) recreation and entertainment, 3) physical activity, 4) communication, and 5) pleasant physical environment. Having forms of companionship and proper communication with the care team were highlighted as areas of importance. Physical activity was highly valued, but participants expressed hesitation around safety of mobilizing without physiotherapists. Recreational activities helped distract from social isolation during a hospital stay and participants had diverse preferences for activities. Participants had strong memories of the physical environment, including the lack of natural light, institutional-like décor, and smells. Conclusion Companionship, recreation and entertainment, physical activity, communication, and the physical environment were important to hospitalized patients and their care partners. Hospital administrators and policy makers should consider these when targeting areas to improve care for the aging population. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether antibiotics impact delirium outcomes in older adults with pyuria or bacteriuria in the absence of systemic signs of infection or genitourinary symptoms. Methods: We registered our systematic review protocol with PROSPERO (CRD42023418091). We searched the Medline and Embase databases from inception until April 2023 for studies investigating the impact of antimicrobial treatment on the duration and severity of delirium in older adults (≥60 years) with pyuria (white blood cells detected on urinalysis or dipstick) or bacteriuria (bacteria growing on urine culture) and without systemic signs of infection (temperature > 37.9C [>100.2F] or 1.5C [2.4F] increase above baseline temperature, and/or hemodynamic instability) or genitourinary symptoms (acute dysuria or new/worsening urinary symptoms). Two reviewers independently screened search results, abstracted data, and appraised the risk of bias. Full‐text randomized controlled trials (RCTs) and observational study designs were included without restriction on study language, duration, or year of publication. Results: We screened 984 citations and included 4 studies comprising 652 older adults (mean age was 84.6 years and 63.5% were women). The four studies were published between 1996 and 2022, and included one RCT, two prospective observational cohort studies, and one retrospective chart review. None of the four studies demonstrated a significant effect of antibiotics on delirium outcomes, with two studies reported a worsening of outcomes among adults who received antibiotics. The three observational studies included had a moderate or serious overall risk of bias, while the one RCT had a high overall risk of bias. Conclusions: Our systematic review found no evidence that treatment with antibiotics is associated with improved delirium outcomes in older adults with pyuria or bacteriuria and without systemic signs of infection or genitourinary symptoms. Overall, the evidence was limited, largely observational, and had substantial risk of bias. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has increased the risk of psychological distress for older adults during a period of reduced access to mental health support. We identified predictors of persistent depressive and anxiety symptoms among older adults throughout the initial 9 months of the pandemic. Methods: This was a longitudinal study using web‐based surveys sent to a convenience sample of Canadians aged ≥55 years. A baseline survey was sent in May 2020, with eight surveys sent monthly between June 2020 and January 2021. Data were separated into three study periods, corresponding to coronavirus case rates. Respondents who met predetermined thresholds for elevated depressive or anxiety symptoms using standardized mental health scales during all three periods were defined as having persistent symptoms. Multivariable Poisson regression was used to compare the risk of persistent symptoms across respondent characteristics selected a priori. Results: There were 835 respondents who answered questions about depressive symptoms and 865 who answered questions about anxiety symptoms across all three study periods. Among those with complete follow‐up data, 19.2% (n = 159/827) reported persistent depressive symptoms and 16.4% (n = 140/856) reported persistent anxiety symptoms. Respondents with persistent depressive symptoms were more likely to be women (adjusted relative risk [aRR] 1.71; 95% CI 1.19–2.46), and report multimorbidity (aRR 1.45; 95% CI 1.07–1.97), pre‐existing depression (aRR 2.00; 95% CI 1.45–2.77) and pre‐existing anxiety (aRR 1.50; 95% CI 1.10–2.06). The same respondent characteristics were correlates of persistently elevated anxiety symptoms. Conclusions: Older women, older adults with pre‐existing depression and anxiety, and those with multimorbidity were more likely to report persistent mental health symptoms during the first 9 months of the COVID‐19 pandemic. These individuals were known to have elevated risk prior to the pandemic, and expanded interventions targeted to these groups are necessary to adequately address their mental health needs. [ABSTRACT FROM AUTHOR]

Delirium is common among hospitalized older adults and frequently leads to the initiation of antibiotics when pyuria or bacteriuria is detected. However, bacteriuria and pyuria are commonly identified in healthy older adults, and because delirium can preclude an accurate assessment of lower urinary tract symptoms, it can be difficult to determine whether the pyuria and bacteriuria are the cause of delirium or incidentally identified. This article reviews the evidence and proposes a randomized trial to assess whether treating pyuria or bacteriuria with antibiotics hastens delirium resolution. [ABSTRACT FROM AUTHOR]

The article discusses factors associated with language-concordant cognitive testing among linguistically diverse older adults. A retrospective cohort study of patients aged 65 and older in Toronto, Canada, revealed that only 17.8% received language-concordant or interpreter-mediated cognitive testing. Patients referred for cognition, with curative treatment intent, and preferring a Chinese language had increased odds of language-concordant testing, while those with higher comorbidity and longer residency in Canada had reduced odds. The study highlights the importance of providing cognitive testing in patients' preferred languages to avoid delays in dementia diagnosis and management. [Extracted from the article]

The article "Sociodemographic and Linguistic Disparities in Tube Feeding Among Canadian Nursing Home Residents With Advanced Dementia" published in the Journal of the American Geriatrics Society in 2025 examines the rates of tube feeding among Canadian nursing home residents with advanced dementia. The study found that the annual prevalence of tube feeding decreased from 2006 to 2022, with disparities observed across various sociodemographic and linguistic factors. The research highlights the need to address language barriers and improve healthcare equity for nursing home residents living with advanced dementia. [Extracted from the article]

Introduction: Older adults are at increased risk of severe illness and mortality from Coronavirus disease of 2019 (COVID-19) infection. However, public health strategies aimed at reducing spread of COVID-19 may have resulted in increased mental health symptoms, particularly among older adults. Currently, little is known about whether older Veterans were more likely to experience persistent mental health symptoms during the COVID-19 pandemic than non-Veterans. The objectives of the current study were to (1) compare differences in persistent symptoms of anxiety, depression, and loneliness among a sample of Canadian Armed Forces Veterans and non-Veterans ≥55 years of age and (2) to evaluate potential sex-specific differences in persistent mental health symptoms., Material and Methods: The data for this study are drawn from a longitudinal survey of Canadian adults (55 years and older) during the COVID-19 pandemic. Ethical approval was received from the Women's College Hospital Research Ethics Board. Participants completed a baseline survey of sociodemographic, mental health-related, and COVID-19-related variables in May 2020 and 8 follow-up surveys monthly between May 2020 and January 2021. Modified Poisson regression models with robust standard errors were used to estimate risk of persistent symptoms of anxiety, depression, and loneliness., Results: Eight hundred twenty-nine participants (13.7% [n = 114] Veterans) were included in the analysis of persistent depressive symptoms, 859 participants (14.0% [n = 120] Veterans) were included in the analysis of persistent anxiety symptoms, and 862 (13.9% [n = 120] Veterans) were included in the analysis of persistent symptoms of loneliness. When comparing male Veterans and non-Veterans, there were small but statistically insignificant differences in persistent symptoms of anxiety (adjusted relative risk [aRR], 0.59; 95% confidence interval [CI], 0.24-1.46), depression (aRR, 1.54; 95% CI, 0.63-3.77), or loneliness (aRR, 0.79; 95% CI, 0.36-1.75); similar small but statistically insignificant differences were observed in persistent symptoms of anxiety (aRR, 1.26; 95% CI, 0.51-3.09), depression (aRR, 1.16; 95% CI, 0.49-2.73), and loneliness (aRR, 1.33; 95% CI, 0.61-2.90) when comparing female Veterans to female non-Veterans., Conclusions: Qualitative, but statistically nonsignificant sex-specific differences in persistent symptoms of anxiety, depression, and loneliness during the early months of the COVID-19 pandemic were observed in this study comparing Veterans and non-Veterans. Additional sex-stratified analyses using larger samples or qualitative interviews may be useful in understanding the unique mental health experiences of older men, women, and gender diverse Veterans during the COVID-19 pandemic., (© The Association of Military Surgeons of the United States 2024.)

Competing Interests: Competing interests: Christina Reppas-Rindlisbacher reports support from the Canadian Institutes of Health Research Vanier Scholarship Program and the Eliot Phillipson Clinician-Scientist Training Program at the University of Toronto. Lesley Wiesenfeld reports institutional support as the chief of psychiatry at Sinai Health and an honorarium for speaking at a geriatric psychotherapy national conference. She is chair of the Mental Health and Incapacity panel for the College of Physicians and Surgeons of Ontario. No other competing interests were declared.