in this cohort of very old inpatients, demented patients, non-demented patients and patients with MCI had similar levels of comorbidity, but demented patients had a poorer functional and nutritional status.
ABSTRACT. Background and aims: Increased gait variability is associated with a high risk of falling in old- (OR 13.3, p=0.018 for usual walking; OR 8.6, (Aging Clin Exp Res 2008; 20: 123-130)
Dementia in very old medically ill inpatients was predictive only of discharge to a nursing home. Higher levels of comorbidity and poor functional status were more predictive than dementia for the other three hospitalization outcomes. Thus, comorbid medical conditions, functional and nutritional status should be considered, together with cognitive assessment, when predicting hospitalization outcome.
Patients with diabetes and chronic neurological disorders are most commonly "at-risk" with foot problems. The identification of that population is therefore mandatory to prevent severe foot lesions. However, not all health care providers (HCPs) are involved in the screening process in institutions. The authors' aim was to develop and evaluate an educational program for HCP in the field of at-risk foot. All HCPs of the Loëx Hospital (Department of Rehabilitation and Geriatrics, University Hospitals of Geneva) participated in a longitudinal prospective study. Different professions of HCP (doctors, nurses, nursing aides, physiotherapists, occupational therapists, speech-language therapists, and psychologists) attended a structured educational program during a 1-year period based on a specific consultation that the authors developed. During the sessions, risk factors and therapeutic and preventive interventions are discussed with both the patient and care givers. A questionnaire was developed and used to evaluate (1) initial knowledge of HCP in the field of at-risk foot and (2) the impact of the program on the knowledge of HCP 12 months after starting the program. Twelve months after initiating the program, a significant knowledge improvement was noted in all groups of HCP except medical doctors. Nurses presented the most significant rise in knowledge score (P < .001). In conclusion, the consultation is an acceptable and effective form of long-term educational program for HCP in a hospital setting with a huge majority of patients suffering from chronic vascular and neurological conditions and loss of protective pain sensation at the lower limb.
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