Defining Aging Phenotypes and Related Outcomes: Clues to Recognize Frailty in Hospitalized Older Patients

Marcucci, Maura; Franchi, Carlotta; Nobili, Alessandro; Mannucci, Pier Mannuccio; Ardoino, Ilaria; Investigators, Reposi

doi:10.1093/gerona/glw188

Cited by 48 publications

(47 citation statements)

References 27 publications

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“…Participation was voluntary, and all participants signed an informed consent. More detailed description of the data set is available elsewhere . The REPOSI project was approved by the local ethical committees of the participating centers.…”

Section: Methodscontrasting

confidence: 87%

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Pattern of in‐hospital changes in drug use in the older people from 2010 to 2016

Franchi

Ardoino

Nobili

et al. 2017

Pharmacoepidemiology and Drug

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Section: Methodscontrasting

confidence: 87%

“…More detailed description of the data set is available elsewhere. 12 The REPOSI project was approved by the local ethical committees of the participating centers.…”

Section: Settingmentioning

confidence: 99%

Pattern of in‐hospital changes in drug use in the older people from 2010 to 2016

Franchi

Ardoino

Nobili

et al. 2017

Pharmacoepidemiology and Drug

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“…In fact, considering each year of the study period, the proportion of patients prescribed at discharge with 0 to 1 drugs (very low drug use) with respect to those prescribed 2 or more increases from 2.7 to 9.2%, while patients exposed to 5 to 9 drugs decrease from 83.8% in 2010 to 76.8% in 2016 [31]. Furthermore, among hospitalized older patients, we are able to distinguish a gender dimorphism in the demographic and morbidity profiles of hospitalized elderly people [32,33], different clusters of diseases [34][35][36] and frailty phenotypes (the healthiest, those with multimorbidity, the functionally independent women with osteoporosis and arthritis, and the functionally dependent "oldest old" patients with cognitive impairment), differently associated with adverse events [37], emphasizing once more the need for a personalized process of healthcare. Finally, we also observe that the increasing score of the Frailty Index (FI) (according to the model of the age-related accumulation of deficits) is significantly associated with in-hospital and overall mortality, also after adjustment for age and gender.…”

Section: Main Reposi Findingsmentioning

confidence: 78%

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

2018

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As a consequence of population aging, we have witnessed in internal medicine hospital wards a progressive shift from a population of in-patients relatively young and mainly affected by a single ailment to one of ever older and more and more complex patients with multiple chronic diseases, followed as out-patients by many different specialists with poor integration and inevitably treated with multiple medications. Polypharmacy (defined as the chronic intake of five or more drugs) is associated with increased risks of drug-drug interactions and related adverse effects, prescription and intake errors, poor compliance, re-hospitalization and mortality. With this background, the Italian Society of Internal Medicine chose to start in 2008 a prospective register called REPOSI (REgistro POliterapie SIMI, Società Italiana di Medicina Interna) in internal medicine and geriatric hospital wards. The country wide register is an ongoing observatory on multimorbidity and polypharmacy in the oldest old, with the goal to improve prescription appropriateness and, thus to avoid potentially inappropriate medications. The main findings of the register, that has accrued so far, 7005 older patients throughout a 10 year period, are summarized herewith, with special emphasis on the main patterns of poor prescription appropriateness and related risks of adverse events.

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“…Our result showed the elderly inpatients, aged ≥65 years, account for 41.73% of all inpatients, indicating that the population of hospitalised patients is trending towards the ageing individuals 20 . The majority of NDDs occurred in the elderly population and is significantly correlated with ageing 21 .…”

Section: Discussionmentioning

confidence: 67%

The outcome and burden of Chinese patients with neurodegenerative diseases: A 10‐year clinical feature study

Li²,

Lin

et al. 2020

Int J Clin Pract

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Background As the Chinese population continues to age, the incidence of neurodegenerative diseases (NDDs) has increased dramatically, which results in heavy medical and economic burden for families and society. Objective The objective of this study was to evaluate NDDs in a southern Chinese hospital over a 10‐year period and examine trends in demographics, outcome, length of stay (LOS) and cost. Methods Retrospective medical records of patients from January 2010 to December 2019 were collected, including 7231 patients with NDDs (as case group) and 9663 patients without any NDDs (as control group). The information of social demographic data, admission source, reasons for admission, outcomes, LOS, and cost were extracted and analysed. Result The average hospitalisation age of the patients with NDDs is over 65 years (peak age 70‐89 years). Compared with the control group, the case group had a longer LOS and a higher cost and the numbers of patients with NDDs increased yearly from 2010 to 2019. The LOS shortened while the cost increased. Clinical features affected LOS and cost. Patients suffering from infection, abnormal blood pressure and the imbalance of water‐electrolyte homoeostasis as main reasons for admission were decreased; however, heart disease, cerebrovascular accident and mental diseases were significantly increased, the overall change trend of fracture/trauma remained stable. The rate of discharge to home care and mortality declined; discharge to other medical or community facilities increased over 10 years. Conclusion The majority of NDDs patients tended to be older. During the last 10 years from 2010 to 2019, the numbers of NDDs patients increased yearly, the trend of LOS became shortening and the cost gradually increasing. The main reasons of admission and outcomes of hospital showed different trends.

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Defining Aging Phenotypes and Related Outcomes: Clues to Recognize Frailty in Hospitalized Older Patients

Cited by 48 publications

References 27 publications

Pattern of in‐hospital changes in drug use in the older people from 2010 to 2016

Pattern of in‐hospital changes in drug use in the older people from 2010 to 2016

Polypharmacy in older people: lessons from 10 years of experience with the REPOSI register

The outcome and burden of Chinese patients with neurodegenerative diseases: A 10‐year clinical feature study

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