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  1. Article ; Online: Estudio transversal multicéntrico sobre la prevalencia de delirium en unidades de ortogeriatría: protocolo de «Estudio DELFRA 24».

    Lozano-Vicario, Lucía / Robles-Raya, María José / Del Val-Lafaja, Alodia / Cancio-Trujillo, José Manuel / Sánchez-García, Elisabet / García-Meana, Javier / Ferrara, María Cristina / Bellelli, Giuseppe / Gual, Neus

    Revista espanola de geriatria y gerontologia

    2023  Volume 59, Issue 1, Page(s) 101431

    Abstract: Introduction: Delirium is the most common perioperative complication in older adults with hip fracture (HF), leading to a catastrophic impact on their functional recovery and cognitive status. Currently, the true prevalence of this syndrome is unknown ... ...

    Title translation Multicenter cross-sectional study on the prevalence of delirium in orthogeriatric units: «DELFRA 24 study» protocol.
    Abstract Introduction: Delirium is the most common perioperative complication in older adults with hip fracture (HF), leading to a catastrophic impact on their functional recovery and cognitive status. Currently, the true prevalence of this syndrome is unknown as its detection and management are not standardized in clinical practice.
    Methods: A multicenter observational cross-sectional study will be conducted nationwide, involving different orthogeriatric units in Spain. The prevalence of delirium will be assessed using the 4AT scale, along with its characteristics and its relationship with other geriatric syndromes, sociodemographic variables, surgical characteristics, and laboratory parameters.
    Results: Data collection is scheduled to take place on World Delirium Day (Wednesday, March 13, 2024), and therefore, the results are expected during the second or third quarter of 2024.
    Conclusions: Understanding the real prevalence and characteristics of delirium in older adults with HF could contribute to the development of strategies for its detection and management, reducing the impact of its consequences.
    MeSH term(s) Aged ; Humans ; Cross-Sectional Studies ; Delirium/diagnosis ; Delirium/epidemiology ; Delirium/etiology ; Hip Fractures/complications ; Hip Fractures/epidemiology ; Hip Fractures/diagnosis ; Multicenter Studies as Topic ; Prevalence ; Spain/epidemiology ; Observational Studies as Topic
    Language Spanish
    Publishing date 2023-11-01
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 605609-x
    ISSN 1578-1747 ; 0211-139X
    ISSN (online) 1578-1747
    ISSN 0211-139X
    DOI 10.1016/j.regg.2023.101431
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  2. Article ; Online: Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study.

    Gandossi, Chiara Maria / Zambon, Antonella / Ferrara, Maria Cristina / Tassistro, Elena / Castoldi, Giuseppe / Colombo, Francesca / Mussi, Chiara / Martini, Emilio / Sergi, Giuseppe / Coin, Alessandra / Zatti, Giovanni / Trevisan, Caterina / Volpato, Stefano / Ungar, Andrea / Bellelli, Giuseppe

    Aging clinical and experimental research

    2023  Volume 35, Issue 11, Page(s) 2499–2506

    Abstract: Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF).: Methods: Multicenter prospective observational study ... ...

    Abstract Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF).
    Methods: Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes.
    Results: 984 patients (median age 84 years, IQR = 79-89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19-2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02-3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85-7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21-4.66, p < 0.001).
    Conclusions: POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.
    MeSH term(s) Humans ; Aged, 80 and over ; Frailty/complications ; Emergence Delirium ; Functional Status ; Delirium ; Prospective Studies ; Hip Fractures/surgery ; Risk Factors
    Language English
    Publishing date 2023-08-05
    Publishing country Germany
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-023-02522-8
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    Zs.A 3343: Show issues Location:
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  3. Article ; Online: Sustained improvement of intrinsic capacity in community-dwelling older adults: The +AGIL Barcelona multidomain program.

    Ferrara, Maria Cristina / Pérez, Laura Mónica / Sole, Aida Ribera / Villa-García, Lorena / Ars, Joan / Soto-Bagaria, Luis / Bellelli, Giuseppe / Cesari, Matteo / Enfedaque, María Belén / Inzitari, Marco

    Journal of internal medicine

    2023  Volume 294, Issue 6, Page(s) 730–742

    Abstract: Background: Different programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older ... ...

    Abstract Background: Different programs promote healthy ageing through the optimization of intrinsic capacity. However, a major challenge is to assess their sustained effects over time. +AGIL Barcelona, a consolidated multidomain program, aims to optimize older adults' intrinsic capacity through a coordinated approach among primary care, geriatrics and community resources, in agreement with the integrated care for older people (ICOPE) guidelines. We aimed to evaluate the +AGIL Barcelona longitudinal effect on older adults' physical performance.
    Methods: All +AGIL Barcelona consecutive participants since 2016 were enrolled. After a comprehensive geriatric assessment, a tailored, multidisciplinary intervention aligned with the ICOPE guidelines is offered. It includes a 10-week boost multicomponent exercise program, nutritional and sleep-hygiene counselling, revision and optimization of pharmacological treatments and screening for cognitive impairment, depression and loneliness. Changes in physical performance after 3 and 6 months were assessed using mixed models including baseline frailty degree, time and all potential significant confounders.
    Results: We included 194 participants in the analysis (mean age = 81.6 [standard deviation = 5.8], 68% women). An independent, clinically and statistically significant improvement in physical performance (Short Physical Performance Battery [SPPB] test, combining gait speed, strength and balance) was found at 3 months (SPPB mean change: 1.4; 95% CI: 1.1-1.6) and 6 months (SPPB mean change: 1.1; 95% CI 0.8-1.5). Equivalent results were observed for all the SPPB sub-tests.
    Conclusions: A coordinated, multidisciplinary and integrated program can benefit older adults' intrinsic capacity. The participants' empowerment and the connection with the available community resources are critical points for a successful intervention.
    MeSH term(s) Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Independent Living ; Exercise ; Frailty/diagnosis ; Frailty/therapy ; Exercise Therapy/methods ; Walking Speed ; Geriatric Assessment/methods
    Language English
    Publishing date 2023-08-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 96274-0
    ISSN 1365-2796 ; 0954-6820
    ISSN (online) 1365-2796
    ISSN 0954-6820
    DOI 10.1111/joim.13710
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  4. Article ; Online: Frailty and long-COVID: is COVID-19 responsible for a transition in frailty status among older adults who survived hospitalization for COVID-19?

    Ferrara, Maria Cristina / Zarcone, Cristina / Tassistro, Elena / Rebora, Paola / Rossi, Emanuela / Luppi, Fabrizio / Foti, Giuseppe / Squillace, Nicola / Lettino, Maddalena / Strepparava, Maria Grazia / Bonfanti, Paolo / Bellelli, Giuseppe

    Aging clinical and experimental research

    2022  Volume 35, Issue 2, Page(s) 455–461

    Abstract: Background: There is a paucity of knowledge about the effects of COronaVIrus Disease-19 (COVID-19) on long-term frailty development or progression over time.: Aim: This study aims to assess transitions in frailty status in older adults who survived ... ...

    Abstract Background: There is a paucity of knowledge about the effects of COronaVIrus Disease-19 (COVID-19) on long-term frailty development or progression over time.
    Aim: This study aims to assess transitions in frailty status in older adults who survived hospitalization for COVID-19.
    Methods: This is a longitudinal panel study. A multidisciplinary outpatient follow-up service was established since summer 2020, for the evaluation of individuals discharged alive, after hospitalization due to COVID-19. Frailty status was assessed in-hospital and at follow-up using the clinical frailty scale (CFS). Main patients' characteristics, including health, functional, cognitive, and psychological status were collected.
    Results: A total of 177 patients aged 65 years and older were evaluated until June 2022. They were predominantly male, with a median age of 70 (Q1-Q3 67-75) years and a median body mass index of 27.5 (Q1-Q3 24.9-30.6) kg/m
    Discussion and conclusion: This study shows that one out of three older patients previously hospitalized for COVID-19 had an unfavorable transition in CFS score during a median follow-up of nearly 6 months. Specific interventions to prevent frailty development or progression should be considered for patients at risk. Further studies are required to confirm our findings.
    MeSH term(s) Aged ; Humans ; Male ; Female ; COVID-19/epidemiology ; Frailty ; Frail Elderly ; Post-Acute COVID-19 Syndrome ; Cohort Studies ; Hospitalization ; Geriatric Assessment
    Language English
    Publishing date 2022-11-29
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-022-02308-4
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    Zs.A 3343: Show issues Location:
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  5. Article ; Online: Frailty, post-operative delirium and functional status at discharge in patients with hip fracture.

    Gandossi, Chiara Maria / Zambon, Antonella / Oliveri, Giulia / Codognola, Martina / Szabo, Hajnalka / Cazzulani, Ilaria / Ferrara, Maria Cristina / Mottadelli, Chiara / Galeazzi, Marianna / Amoroso, Isabella / Zarcone, Cristina / Principato, Giulia / Corsi, Maurizio / Mazzola, Paolo / Zatti, Giovanni / Foti, Giuseppe / Bellelli, Giuseppe

    International journal of geriatric psychiatry

    2021  Volume 36, Issue 10, Page(s) 1524–1530

    Abstract: Objective: To explore the effect of frailty, alone and in combination with post-operative delirium (POD), on the risk of poor function at discharge in patients with hip fracture (HF).: Methods: This is a prospective cohort study of patients with HF ... ...

    Abstract Objective: To explore the effect of frailty, alone and in combination with post-operative delirium (POD), on the risk of poor function at discharge in patients with hip fracture (HF).
    Methods: This is a prospective cohort study of patients with HF admitted to an Orthogeriatric Unit (OGU) between October 1, 2011 and March 15, 2019. POD was assessed using the 4AT and the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5-edition criteria. A 22-items Frailty Index (FI) was created using the data collected on admission. The outcome measure was the Cumulated Ambulation Score (CAS) score at discharge. A log-binomial regression model was used to assess the effect of frailty and POD on CAS.
    Results: A total of 988 patients (median age = 84.9 years, Interquartile range = 80.6-89.2) were included: 360 patients (36.4%) were frail and 411 (42%) developed POD. Poor functional status at discharge (CAS score ≤2) was more common in frail than non-frail patients (68.3% vs. 53.8%, p < 0.001) In a regression adjusted for confounders, frailty alone (Relative Risk, RR = 1.33, 95% Confidence Intervals, CI = 1.14-1.55) and POD alone (RR 1.38, 95% CI = 1.2-1.59) were associated with poor functional status at discharge; when combined, frailty and POD had an interaction, yielding a mild increase in the risk of poor outcome (RR 1.47, 95% CI = 1.28-1.69).
    Conclusions: In older patients undergoing HF surgery, frailty, POD and their combination, are associated with poor functional status at discharge.
    MeSH term(s) Aged ; Aged, 80 and over ; Delirium ; Frail Elderly ; Frailty ; Functional Status ; Geriatric Assessment ; Humans ; Patient Discharge ; Prospective Studies ; Risk Factors
    Language English
    Publishing date 2021-05-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 806736-3
    ISSN 1099-1166 ; 0885-6230
    ISSN (online) 1099-1166
    ISSN 0885-6230
    DOI 10.1002/gps.5561
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    Zs.A 2208: Show issues Location:
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  6. Article ; Online: Three-year National report from the Gruppo Italiano di Ortogeriatria (GIOG) in the management of hip-fractured patients.

    Ferrara, Maria Cristina / Andreano, Anita / Tassistro, Elena / Rapazzini, Piero / Zurlo, Amedeo / Volpato, Stefano / Mussi, Chiara / Corsi, Maurizio / Lunardelli, Maria Lia / Martini, Emilio / Castoldi, Giuseppe / De Filippi, Francesco / Pizzonia, Monica / Monacelli, Fiammetta / Barone, Antonella / Pilotto, Alberto / March, Albert / Ungar, Andrea / Capelli, Roberto /
    Galmarini, Valter / Franzoni, Simone / Terragnoli, Flavio / Bianchetti, Angelo / Cazzulani, Ilaria / Gandossi, Chiara / Valsecchi, Maria Grazia / Bellelli, Giuseppe

    Aging clinical and experimental research

    2020  Volume 32, Issue 7, Page(s) 1245–1253

    Abstract: Background: Hip fractures (HF) are a major issue worldwide. We aimed at evaluating the practices in delivering care to patients with HF among several Italian Orthogeriatric centers.: Methods: The study took place from February 2016 to July 2018. ... ...

    Abstract Background: Hip fractures (HF) are a major issue worldwide. We aimed at evaluating the practices in delivering care to patients with HF among several Italian Orthogeriatric centers.
    Methods: The study took place from February 2016 to July 2018. Seven performance indicators (pre-surgical cognitive assessment, surgery performed ≤ 48 h from fracture, removal of urinary catheter/absence of delirium/start of physiotherapy on the first post-operative day, prescription of bone protection at discharge, and discharge toward rehabilitation) were collected.
    Results: The 14 participating hospitals totally recruited 3.017 patients. Patients were old (median age 86 years; Inter Quartile Range [IQR] 80-90), mostly females (77%). Nearly 55% of them were already impaired in mobility and about 10% were nursing home residents. Median time-to-surgery was 41 h (IQR 23-62). Models of care greatly varied among centers, only 49.3% of patients being co-managed by geriatricians and orthopedics. There was high variability across centers in four indicators ("pre-surgical cognitive assessment", "bone protection prescription", "use of urinary catheter" and "start of physiotherapy"), moderate in two indicators ("surgery performed ≤ 48 h from fracture" and "discharge toward rehabilitation" and low in one ("absence of delirium on day following surgery"). Comparison with international studies suggests very different ways of providing care to HF Italian patients.
    Conclusions: The study results suggest high inter-center variability in the key-performance indicators, and different approaches in providing care to our HF patients in comparison to other countries. A National debate on the topic is required in Italy to harmonize practices of orthogeriatric care.
    MeSH term(s) Aged, 80 and over ; Female ; Health Services for the Aged ; Hip Fractures/epidemiology ; Hip Fractures/therapy ; Humans ; Italy/epidemiology ; Male ; Orthopedic Procedures ; Patient Discharge ; Time Factors
    Language English
    Publishing date 2020-02-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2104785-6
    ISSN 1720-8319 ; 1594-0667
    ISSN (online) 1720-8319
    ISSN 1594-0667
    DOI 10.1007/s40520-020-01488-1
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