Article
Oncology
Katherine Hicks-Courant, Genevieve P. Kanter, Marilyn M. Schapira, Colleen M. Brensinger, Qing Liu, Emily Meichun Ko
Summary: This study examines the impact of primary oncologist specialty, gynecologic oncology versus medical oncology, on the intensity of care at the end of life for elderly patients with gynecologic cancer. The results show that there are differences between the two specialties in the provision of high-intensity end-of-life care, as well as in the rates of invasive procedures and Medicare spending.
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
(2022)
Article
Health Care Sciences & Services
Claire Sokas, Katherine C. Lee, Daniel Sturgeon, Jocelyn Streid, Stuart R. Lipsitz, Joel S. Weissman, Dae H. Kim, Zara Cooper
Summary: End-of-life care for older adults undergoing emergency general surgery is lacking in quality, especially for frail patients who experience higher intensity care and lower rates of hospice use. Targeted interventions are needed to reduce burdensome treatment for frail EGS patients.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2021)
Article
Geriatrics & Gerontology
Jordi Amblas-Novellas, Anna Torne, Ramon Oller, Joan Carles Martori, Joan Espaulella, Roman Romero-Ortuno
Summary: This study aimed to characterize transitions in frailty before, during, and after admission to an intermediate care facility and assess their impact on health outcomes. The results showed that frailty status varied before and during admission, with frailty on admission being the strongest predictor of mortality. Routine frailty measurement on admission could aid clinical management decisions.
Article
Oncology
Mellar P. Davis, Erin A. Vanenkevort, Alexander Elder, Amanda Young, Irina D. Correa Ordonez, Mark J. Wojtowicz, Halle Ellison, Carlos Fernandez, Zankhana Mehta, Bertrand Behm, Glen Digwood, Rajiv Panikkar
Summary: Early palliative care improves patient quality of life and reduces aggressive care at the end of life. Completed advance directives and palliative care consultation initiated at least 90 days prior to death are associated with reduced aggressive care indicators.
SUPPORTIVE CARE IN CANCER
(2022)
Article
Health Care Sciences & Services
Amber R. Comer, Linda S. Williams, Stephanie Bartlett, Lynn D'Cruz, Katlyn Endris, McKenzie Marchand, Isabel Zepeda, Sumeet Toor, Carly Waite, Areeba Jawed, Robert Holloway, Claire J. Creutzfeldt, James E. Slaven, Alexia M. Torke
Summary: This study investigated the utilization of palliative care consultations (PCC) and associated outcomes for patients hospitalized with severe ischemic stroke. The findings reveal that the majority of patients, including those who died in the hospital, did not receive PCC. This highlights missed opportunities to alleviate suffering after severe stroke.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2022)
Review
Anesthesiology
M. Tanaka Gutiez, N. Efstathiou, R. Innes, V. Metaxa
Summary: The transition from active, invasive interventions to comfort care for critical care patients often leads to misunderstandings, conflicts, and moral distress. This article aims to address common questions and provide practical guidance, using the best available evidence, to critical care clinicians in the UK. It clarifies the distinctions between withdrawing or withholding treatment and euthanasia, offers suggestions for sedation and analgesia use, and advocates for including family in decision-making when the patient lacks capacity. It also proposes a step-escalation approach for resolving family conflicts and emphasizes the importance of communication skills training in medical and nursing education.
Article
Geriatrics & Gerontology
Chia-Ter Chao
Summary: Our society is aging rapidly, and there is a need for better geriatric care. However, healthcare professionals often have a poor understanding of frailty, leading to suboptimal care for older adults. In order to improve this situation, we propose a structured program that includes digital technologies and hands-on practice opportunities to enhance medical students' understanding and care for frail older adults.
Article
Oncology
Johan A. F. Koekkoek, Pim B. van der Meer, Andrea Pace, Caroline Hertler, Rebecca Harrison, Heather E. Leeper, Deborah A. Forst, Rakesh Jalali, Kathy Oliver, Jennifer Philip, Martin J. B. Taphoorn, Linda Dirven, Tobias Walbert
Summary: This systematic review provides updated insights on palliative care for adults with malignant brain tumors based on the 2017 EANO guidelines. It highlights the importance of early interventions in defining care goals and reducing symptom burden.
Editorial Material
Geriatrics & Gerontology
Nisar Ahmed, Sam H. Ahmedzai, Rowan H. Harwood
Summary: Healthcare for older people aims to maintain independence, minimise suffering, and preserve dignity, even when predicting death is impossible. Thorough medical diagnosis and appropriate treatment can improve health outcomes and quality of life for older individuals.
Article
Oncology
Estela Garcia-Martin, Vicente Escudero-Vilaplana, Barbara Fox, Roberto Collado-Borrell, Belen Marzal-Alfaro, Maria Sanchez-Isac, Maria Luisa Solano-Garzon, Ricardo Gonzalez del Val, Jose Manuel Cano-Gonzalez, Nuria Perez de Lucas, Ana Isabel Bravo-Guillen, Javier Valero-Salinas, Eva Gonzalez-Haba, Maria Sanjurjo, Miguel Martin
Summary: The study found that end-of-life cancer care in the clinical practice of the hospital tended to be aggressive, with a significant proportion of patients receiving anti-cancer treatments close to death. However, the quality of care did not meet the high standards set by the Earle criteria. While more than half of the patients received hospice services before death, in some cases, this care started only shortly before the patients passed away.
SUPPORTIVE CARE IN CANCER
(2021)
Article
Gastroenterology & Hepatology
Roberta Jordan, Yousuf ElMokhallalati, Lynsey Corless, Michael Bennett
Summary: Patients with liver disease face difficulties in accessing end-of-life care, with a higher percentage of them dying in hospitals and receiving less specialized palliative care compared to those with malignant liver disease. Caregivers of patients with non-malignant liver disease were less likely to rate the quality of end-of-life care as outstanding/excellent.
LIVER INTERNATIONAL
(2023)
Editorial Material
Oncology
Adam Rapoport, Sumit Gupta
Summary: Children and adolescents with hematologic malignancies consistently receive higher rates of aggressive care at the end of life, prompting clinicians and researchers to focus on reducing this disparity.
Review
Gerontology
Renske Visser, Erica Borgstrom, Richard Holti
Summary: With the increasing aging population worldwide, there is a growing demand for both palliative care and geriatric medicine. This literature review in the UK identified three main themes: unclear boundaries between specialties, communication within and between specialisms, and ambiguity of how older people fit in the current health care system. It is suggested that more empirical research is needed to improve interprofessional working and patient care in the overlap between palliative care and geriatric medicine.
JOURNAL OF APPLIED GERONTOLOGY
(2021)
Article
Geriatrics & Gerontology
Jonathan K. L. Mak, Sara Hagg, Maria Eriksdotter, Martin Annetorp, Ralf Kuja-Halkola, Laura Kananen, Anne-Marie Bostrom, Miia Kivipelto, Carina Metzner, Viktoria Back Jerlardtz, Malin Engstrom, Peter Johnson, Lars Goran Lundberg, Elisabet Akesson, Carina Suhl Oberg, Maria Olsson, Tommy Cederholm, Juulia Jylhava, Dorota Religa
Summary: An electronic frailty index (eFI) developed from electronic health records (EHRs) has strong associations with adverse outcomes in hospitalized older adults, suggesting its potential use in risk stratification.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2022)
Article
Medicine, General & Internal
Jui-Kun Chiang, Yee-Hsin Kao
Summary: Research shows that palliative services are associated with improved quality of end-of-life care for patients with advanced illnesses receiving home-based care, leading to reduced likelihood of dying in a hospital.
Article
Geriatrics & Gerontology
Serena Sabatini, Anthony Martyr, Laura D. Gamble, Ian R. Jones, Rachel Collins, Fiona E. Matthews, Christina R. Victor, Catherine Quinn, Claire Pentecost, Jeanette M. Thom, Linda Clare
Summary: This study explored the social, cultural, and economic capital of spousal carers of people with dementia, and the profiles of carers with different levels of capital. The results showed that carers with lower capital experienced less stress and reported more positive experiences in caring over time. However, compared to carers with better capital, those with poorer capital were more likely to be depressed over time.
AGING & MENTAL HEALTH
(2023)
Article
Gerontology
Serena Sabatini, Anthony Martyr, Laura D. Gamble, Rachel Collins, Fiona E. Matthews, Robin G. Morris, Jennifer M. Rusted, Claire Pentecost, Catherine Quinn, Linda Clare
Summary: This study examines the involvement of people with dementia in everyday decision-making and the factors that explain the variability in their involvement. The results show that female, single, and younger people with dementia tend to have greater involvement in everyday decision-making. Factors such as better cognition, fewer functional difficulties, fewer neuropsychiatric symptoms, less caregiver stress, and better relationship quality are associated with higher involvement in everyday decision-making.
JOURNAL OF APPLIED GERONTOLOGY
(2023)
Article
Primary Health Care
Joy Adamson, Helen Hanson, Adam Todd, Rachel Duncan, Barbara Hanratty, Louise Robinson
Summary: This study explores the experiences of medication management among nonagenarians and its implications for primary care practice. The findings indicate that most older people do not experience significant problems with medication management. Taking medications becomes a habitual part of daily routines and is generally accepted. However, disruptions to steady states, such as new medical diagnoses or major life events, can cause challenges in medication management.
BRITISH JOURNAL OF GENERAL PRACTICE
(2023)
Review
Neurosciences
Hamidul Huque, Ranmalee Eramudugolla, Benjamin Chidiac, Nicole Ee, Lauren Ehrenfeld, Fiona E. Matthews, Ruth Peters, Kaarin J. Anstey
Summary: This study examines sex differences in the incidence and prevalence of dementia globally, and evaluates whether country-level indicators of gender inequality account for these differences. The results show that there are no sex differences in the incidence of dementia, Alzheimer's disease, and vascular dementia, except in the 90+ age group. However, the prevalence of Alzheimer's disease is higher in women, and this difference is associated with gender differences in life expectancy and education.
JOURNAL OF ALZHEIMERS DISEASE
(2023)
Article
Geriatrics & Gerontology
Connor D. Richardson, Hannah Roscoe, Emma Green, Racheal Brooks, Linda Barnes, Fiona E. Matthews, Carol Brayne
Summary: The prevalence of loneliness among older people has increased during the COVID-19 pandemic compared to before. Factors associated with prevalent loneliness include prior loneliness, living alone, being female, living in a deprived area, separation from family during the pandemic, and frequent pre-pandemic social contact at community groups. Weekly technology-mediated contact using telephone or video calls is associated with lower odds of loneliness.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Multidisciplinary Sciences
Deborah L. O. King, Richard Henson, Rogier Kievit, Noham Wolpe, Carol Brayne, Lorraine K. Tyler, James B. A. Rowe, Kamen A. Tsvetanov, Cam-CAN
Summary: Cardiovascular ageing is associated with cognitive impairment, but the specific contributions of different cardiovascular factors to cognitive function are not clear.
SCIENTIFIC REPORTS
(2023)
Article
Public, Environmental & Occupational Health
Serena Sabatini, Anthony Martyr, Laura D. Gamble, Ian R. Jones, Rachel Collins, Fiona E. Matthews, Martin Knapp, Jeanette M. Thom, Catherine Henderson, Christina Victor, Claire Pentecost, Linda Clare, IDEAL Programme Team
Summary: This study describes the levels of social, cultural, and economic capital among people with dementia and examines the differences in personal characteristics and quality of life over time based on different combinations of capital. The results show that people with dementia have relatively lower levels of social, cultural, and economic capital, although they are not significantly lower compared to older adults in the UK. The study identifies four groups of people with dementia based on their capital levels and finds that higher levels of capital are associated with higher quality of life and well-being. Therefore, efforts from the government and society are needed to address the social, cultural, and economic disadvantages among people with dementia.
SOCIAL SCIENCE & MEDICINE
(2023)
Review
Medicine, General & Internal
Ben Searle, Robert O. Barker, Daniel Stow, Gemma F. Spiers, Fiona Pearson, Barbara Hanratty
Summary: A systematic review of randomized controlled trials found that advance care planning and influenza vaccination can effectively reduce unscheduled hospital admissions of long-term care facility residents. Other interventions that show effectiveness include involvement of nurse practitioners/specialists, palliative care intervention, and enhancing access to intravenous therapies in long-term care facilities.
Article
Geriatrics & Gerontology
Asri Maharani, David R. Sinclair, Tarani Chandola, Peter Bower, Andrew Clegg, Barbara Hanratty, James Nazroo, Neil Pendleton, Gindo Tampubolon, Chris Todd, Raphael Wittenberg, Terence W. O'Neill, Fiona E. Matthews
Summary: This study investigated the relationship between household wealth and neighborhood deprivation with frailty status, and found that individuals with lower wealth and living in deprived neighborhoods are at a higher risk of frailty.
Article
Clinical Neurology
Richard Merrick, Fiona E. Matthews
Summary: A new study on neuropathology trends in autopsy results from two large US cohorts reveals the declining incidence of dementia. While the prevalence of neurodegenerative pathologies remained similar, a reduction in vascular pathologies suggests that improvements in cardiovascular health and cognitive reserve contribute to reducing dementia risk. This study on postmortem neuropathology trends over the past 25 years provides important insights into secular trends in dementia risk, highlighting the role of cardiovascular health and cognitive reserve in the reduced risk.
NATURE REVIEWS NEUROLOGY
(2023)
Article
Clinical Neurology
Mohammed D. Rajab, Emmanuel Jammeh, Teruka Taketa, Carol Brayne, Fiona E. Matthews, Li Su, Paul G. Ince, Stephen B. Wharton, Dennis Wang
Summary: This study applies machine learning approaches to identify critical features of Alzheimer-related pathologies associated with dementia. Results show that Braak neurofibrillary tangle stage, beta-amyloid, and cerebral amyloid angiopathy are the most important features for dementia classification. The best-performing dementia classifier achieved 79% sensitivity, 69% specificity, and 75% precision using the top eight neuropathological features.
ALZHEIMERS RESEARCH & THERAPY
(2023)
Review
Geriatrics & Gerontology
Anum Iqbal, Charlotte Richardson, Zain Iqbal, Hannah O'Keefe, Barbara Hanratty, Fiona E. Matthews, Adam Todd
Summary: This article conducted a systematic review and meta-analysis to investigate the association between polypharmacy and an individual's socioeconomic status. It found that older people with lower socioeconomic status are more likely to use multiple medications. Future research should further explore the reasons for these inequalities and the interplay between polypharmacy and multimorbidity.
Article
Clinical Neurology
Anthony Martyr, Madhumathi Ravi, Laura D. Gamble, Robin G. Morris, Jennifer M. Rusted, Claire Pentecost, Fiona E. Matthews, Linda Clare, DEAL study team
Summary: This study compared the trajectories of cognition and instrumental activities of daily living (iADL) in people with dementia. The results showed that cognition and self-rated iADL declined at a similar rate, while informant-rated iADL declined at a significantly higher rate than cognition. This suggests that either cognition and self-rated iADL decline at different rates or informants overestimate iADL difficulties compared to both cognition and self-ratings.
ALZHEIMERS & DEMENTIA
(2023)
Article
Medicine, General & Internal
Scherazad Kootar, Md Hamidul Huque, Kim M. Kiely, Craig S. Anderson, Louisa Jorm, Miia Kivipelto, Nicola T. Lautenschlager, Fiona Matthews, Jonathan E. Shaw, Rachel A. Whitmer, Ruth Peters, Kaarin J. Anstey
Summary: This study aims to develop and validate a risk tool for estimating an individual's risk of developing dementia and other non-communicable cardiometabolic diseases. Data from multiple high-quality cohort studies will be used to develop the predictive model and evaluate its performance.
Article
Geriatrics & Gerontology
Emma Nichols, Richard Merrick, Simon Hay, Dibya Himali, Jayandra J. Himali, Sally Hunter, Hannah A. D. Keage, Caitlin S. Latimer, Matthew R. Scott, Jaimie Steinmetz, Jamie M. Walker, Stephen B. Wharton, Crystal Wiedner, Paul K. Crane, Dirk Keene, Lenore J. Launer, Fiona E. Matthews, Julie Schneider, Sudha Seshadri, Lon White, Carol Brayne, Theo Vos
Summary: This study aimed to harmonise neuropathology measures across multiple community-based autopsy cohorts and assess the prevalence, correlation, and co-occurrence of neuropathologies in the ageing population. The results showed that the co-occurrence of neuropathologies in older adults was strongly associated with dementia status, highlighting the complexity of underlying brain pathologies. Rating: 9 out of 10.
LANCET HEALTHY LONGEVITY
(2023)