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Objective: To describe the creation of an educational podcast with 'living cases' of older adults to support students' learning on a gerontology course and report on students' evaluation of the project. Setting: Gerontology course in a graduate programme. Method: We developed a podcast series based on interviews with older adults in the community following recent guidelines for creating educational podcasts. The podcast episodes were used in a case-based group assignment to work on during the course and to present findings at the end. Evaluation: Student experiences were evaluated using a mixed-methods survey. Results: From November 2019 to January 2021, case-based podcasts, averaging 17 minutes in length, were created and evaluated. Most students found the content of the podcasts relevant to working with older adults and increased their understanding of the issues facing members of that population. Qualitative analysis of the survey findings found that the overall strengths of the podcasts were that they were well structured, provided an authentic, real-world experience, allowed listeners to experience an innovative teaching strategy, promoted reflection, and encouraged students to consider a future career working with older adults. Students also recommended ways to improve the podcasts. Conclusion: Delivering living case studies using podcasts is a feasible, inexpensive and effective teaching method for improving physiotherapy students' attitudes towards caring for older adults. Students enjoyed learning via the podcasts and found them a valuable way to better understand the issues facing older adults. The living case podcasts could have broad applicability to other aging and health courses.

We established the most commonly used clinician and patient-reported hip fracture outcome measures as of 2022, assessed their content validity using an International Classification of Functioning, Disability and Health (ICF) framework, and operationalized these results to contribute to an updated hip fracture core set. A literature search was conducted to identify articles utilizing outcome measures related to hip fracture. A total of five outcome measures were identified, linked to the ICF, and assessed for content validity via bandwidth percent, content density, and content diversity. Outcome measures were linked to 191 ICF codes, most of which were associated with Activities and Participation. Notably, no outcome measure contained concepts linked to Personal Factors and Environmental Factors were underrepresented across all outcome measures. The modified Harris Hip Score had the highest content diversity (0.67), the Hip Disability and Osteoarthritis Outcome Score had the highest bandwidth of ICF content coverage (2.48), and the Oxford Hip Score had the highest content density (2.92). These results clarify the clinical applicability of outcome measures and guide development of hip fracture outcomes that allow providers to assess the complex role of social, environmental, and personal factors in patient rehabilitation. Hip fracture is a complex and disabling pathology predominantly affecting older adults and represents a public health problem. There are a variety of outcome measures used to assess a patient's recovery following a hip fracture, each with distinctive objectives and modes of administration. Content validity metrics associated with the Harris Hip Score suggest it would be a suitable outcome measure during early-stage recovery, whereas the modified Harris Hip Score may be more suitable for tracking long-term recovery tracking. Choosing an outcome measure most appropriate for a hip fracture patient is an individualized decision that must consider aspects such as age, activity level, needs, and environmental factors. [ABSTRACT FROM AUTHOR]

Background The current measurement approach to frailty is to create an index of frailty status, rather than measure it. The purpose of this study is to test the extent to which a set of items identified within the frailty concept fit a hierarchical linear model (e.g., Rasch model) and form a true measure reflective of the frailty construct. Methods A sample was assembled from three sources: community organization for at-risk seniors (n=141); colorectal surgery group assessed post-surgery (n=47); and hip fracture assessed post-rehabilitation (n=46). The 234 individuals (age 57 to 97) contributed 348 measurements. The frailty construct was defined according to the named domains within commonly used frailty indices, and items drawn to reflect the frailty came from self-report measures. Performance tests were tested for the extent to which they fit the Rasch model. Results Of the 68 items, 29 fit the Rasch model: 19 self-report items on physical function and 10 performance tests, including one for cognition; patient reports of pain, fatigue, mood, and health did not fit; nor did body mass index (BMI) nor any item representing participation. Conclusion Items that are typically identified as reflecting the frailty concept fit the Rasch model. The Frailty Ladder would be an efficient and statistically robust way of combining results of different tests into one outcome measure. It would also be a way of identifying which outcomes to target in a personalized intervention. The rungs of the ladder, the hierarchy, could be used to guide treatment goals. [ABSTRACT FROM AUTHOR]

Introduction: Frailty is a complex geriatric syndrome with a multifaceted etiology. We aimed to identify the best combinations of risk factors that predict the development of frailty using recursive partitioning models. Methods: We analyzed reports from 1,724 community-dwelling men and women aged 65–74 years participating in the International Mobility in Aging Study (IMIAS). Frailty was measured using frailty phenotype scale that included five physical components: unintentional weight loss, weakness, slow gait, exhaustion, and low physical activity. Frailty was defined as presenting three of the above five conditions, having one or two conditions indicated prefrailty and showing none as robust. Socio-demographic, physical, lifestyle, psycho-social, and life-course factors were included in the analysis as potential predictors. Results: 21% of pre-frail and robust participants showed a worse stage of frailty in 2014 compared to 2012. In addition to functioning variables, fear of falling (FOF), income, and research site (Canada vs. Latin America vs. Albania) were significant predictors of the development of frailty. Additional significant predictors after exclusion of functioning factors included education, self-rated health, and BMI. Conclusions: In addition to obvious risk factors for frailty (such as functioning), socio-economic factors and FOFs are also important predictors. Clinical assessment of frailty should include measurement of these factors to identify high-risk individuals. [ABSTRACT FROM AUTHOR]

Older adults with heart disease (HD) are more likely to report a higher prevalence of falls compared to those without HD. A knowledge gap currently exists regarding the factors associated with fear of falling (FOF) among older adults with HD. Therefore, this study aimed to estimate FOF and identify factors associated with FOF among older adults with HD. Data came from a secondary analysis of the International Mobility in Aging Study (IMIAS) baseline (2012) data. FOF was measured using the Falls Efficacy Scale-International (FES-I). Stepwise linear regression was used to identify factors associated with FOF. A total of 429 participants identified themselves as having heart disease diagnosed by their physician (mean age 69.5 ± 2.9). Older adults with HD reported on average (25.6) higher FOF than those without HD. For older adults with HD, FES-I increased significantly by 1.3, 1.0, and 0.6 points, when the Short Physical Performance Battery, the Leganes Cognitive Test, and QOL total scores decreased by one point. FES-I also significantly increased by 3.2 when income was insufficient compared to sufficient or very sufficient income. FOF is multifactorial, and our findings provide a base for developing future management rehabilitation intervention programs aimed at decreasing FOF among older adults with HD. [ABSTRACT FROM AUTHOR]

Pain and muscles weakness often delays regaining independent mobility following hip fracture surgery. Electrical stimulation may relieve pain and improve muscle strength and function. To systematically review and evaluate available literature examining the effectiveness of using electrical stimulation to promote clinical outcomes after hip fractures. Two researchers independently searched MEDLINE, CINAHL, EMBASE, Web of Science, Cochrane Reviews, Physiotherapy Evidence Database, and PsycInfo from inception to July 1, 2018, with no restrictions. The quality and fidelity of the included interventions were assessed, and expert consultation was conducted to help explain the results. We identified 432 records through database searching. Initial screening indicated 24 articles were appropriate for full-text review, and four articles met the inclusion criteria. In included studies, electrical stimulation (i.e. TENS) reduced pain (mean difference (MD) = 3.3 points on 10-point Visual Analogue Scale, p <.001), improved range of motion (ROM) (MD: 25.7°, p <.001), and accelerated functional recovery immediately after hip fracture (p <.001). Conflicting evidence existed when using neuromuscular electrical stimulation to improve muscle strength and other functional outcomes (e.g. mobility); however, nine experts advised that longer-term interventions might be necessary to achieve significant improvment in muscle strength. Available evidence, albeit limited, supports the early application of noninvasive electrical stimulation (e.g. TENS) for improving clinical outcomes (i.e. reducing pain, improving ROM, and accelerating functional recovery after hip fractures). We could not find conclusive evidence on the effectiveness of using electrical stimulation to improve muscle strength. This review establishes the need for future additional high-quality trials in this field. [ABSTRACT FROM AUTHOR]