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3. Osteoporose

Author

Emmelot-Vonk, M. H., Visser, M., editor, Kok, A.A.L., editor, Spies, P.E., editor, and Buurman, B.M., editor

Published
2020
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5. Dietary habits and compliance with dietary guidelines in patients with established cardiovascular disease.

Author

Bonekamp, Nadia E., Geleijnse, Johanna M., van der Schouw, Yvonne T., Dorresteijn, Jannick A. N., van der Meer, Manon G., Ruigrok, Ynte M., Teraa, Martin, Visseren, Frank L. J., Koopal, Charlotte, Cramer, M. J., Nathoe, H. M., van de Meer, M. G., de Borst, G. J., Teraa, M., Bots, M. L., van Smeden, M., Emmelot-Vonk, M. H., de Jong, P. A., Lely, A. T., and van der Kaaij, N. P.

Subjects
CARDIOVASCULAR disease prevention, PATIENT compliance, NUTRITION policy, MYOCARDIAL infarction, RESEARCH funding, FOOD consumption, QUESTIONNAIRES, DAIRY products, CARDIOVASCULAR diseases risk factors, RETROSPECTIVE studies, DESCRIPTIVE statistics, FISHES, MEAT, LONGITUDINAL method, FOOD habits, MEDICAL records, ACQUISITION of data, DISEASE relapse, CONFIDENCE intervals, DIET, PROPORTIONAL hazards models, LEGUMES
Abstract

Background: Unhealthy dietary habits are an important risk factor for cardiovascular disease (CVD) and adopting a healthy diet is a central recommendation in CVD prevention. This study assessed the dietary habits of patients with established CVD, their compliance to dietary guidelines, and the relationship between guideline-compliance and recurrent cardiovascular event risk. Methods: 2656 patients with established CVD from the Utrecht Cardiovascular Cohort-Secondary Manifestations of ARTerial disease (UCC-SMART) prospective cohort study, were included between 1996 and 2022. Data on dietary intake was retrospectively collected for all participants in December 2022 using a 160-item food frequency questionnaire. Compliance with dietary guidelines was quantified using an amended version of the Dutch Healthy Diet 2015 (DHD-15) index (range: 0–135). Cox proportional hazard models were used to quantify the relationship with cardiovascular events (stroke and myocardial infarction). Results: Among 2656 CVD patients (77% male, mean age 59 ± 9 years), median energy intake was 1922 [IQR: 1536–2351] kcal/day. The median DHD-15 index was 81.7 [IQR 71.2–92.0], with high compliance scores for recommendations on legumes and fish, and low scores for recommendations on whole grains, red meat, processed meat, and dairy. A higher DHD-15 score was associated with lower stroke risk (HR 0.78, 95% CI 0.66–0.92 per 10-point increase) but not with myocardial infarction. Conclusion: Compliance with dietary guidelines was suboptimal in patients with established CVD. High compliance was associated with a clinically significant reduction in stroke risk in patients with established CVD, emphasizing the importance of dietary counseling. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Sex differences in modifiable risk factors for stroke incidence and recurrence: the UCC-SMART study.

Author

Rissanen, Ina, Basten, Maartje, Exalto, Lieza G., Peters, Sanne A. E., Visseren, Frank L. J., Geerlings, Mirjam I., For the UCC-SMART-Study Group, Cramer, M. J., van der Meer, M. G., Nathoe, H. M., de Borst, G. J., Bots, M. L., Geerlings, M. I., Emmelot-Vonk, M. H., de Jong, P. A., Lely, A. T., van der Kaaij, N. P., Kappelle, L. J., Ruigrok, Y. M., and Verhaar, M. C.

Subjects
SEX factors in disease, DISEASE risk factors, DYSLIPIDEMIA, HEMORRHAGIC stroke, PROPORTIONAL hazards models, STROKE
Abstract

Background and purpose: Risk factors for stroke differ between women and men in general populations. However, little is known about sex differences in secondary prevention. We investigated if sex interacted with modifiable risk factors for stroke in a large arterial disease cohort. Methods: Within the prospective UCC-SMART study, 13,898 patients (35% women) with atherosclerotic disease or high-risk factor profile were followed up to 23 years for stroke incidence or recurrence. Hypertension, smoking, diabetes, overweight, dyslipidemia, high alcohol use, and physical inactivity were studied as risk factors. Association between these factors and ischemic and hemorrhagic stroke incidence or recurrence was studied in women and men using Cox proportional hazard models and Poisson regression models. Women-to-men relative hazard ratios (RHR) and rate differences (RD) were estimated for each risk factor. Left-truncated age was used as timescale. Results: The age-adjusted stroke incidence rate was lower in women than men (3.9 vs 4.4 per 1000 person-years), as was the age-adjusted stroke recurrence rate (10.0 vs 11.7). Hypertension and smoking were associated with stroke risk in both sexes. HDL cholesterol was associated with lower stroke incidence in women but not in men (RHR 0.49; CI 0.27–0.88; and RD 1.39; CI − 1.31 to 4.10). Overweight was associated with a lower stroke recurrence in women but not in men (RHR 0.42; CI 0.23–0.80; and RD 9.05; CI 2.78–15.32). Conclusions: In high-risk population, sex modifies the association of HDL cholesterol on stroke incidence, and the association of overweight on stroke recurrence. Our findings highlight the importance of sex-specific secondary prevention. [ABSTRACT FROM AUTHOR]

Published
2024
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10. EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

Author

Seppala, L. J., van der Velde, N., Masud, T., Blain, H., Petrovic, M., van der Cammen, T. J., Szczerbińska, K., Hartikainen, S., Kenny, R. A., Ryg, J., Eklund, P., Topinková, E., Mair, A., Laflamme, L., Thaler, H., Bahat, G., Gutiérrez-Valencia, M., Caballero-Mora, MA, Landi, F., Emmelot-Vonk, M. H., the EuGMS Task and Finish Group on  Fall-Risk-Increasing Drugs, Cherubini, A., Baeyens, J. P., Correa-Pérez, A., Gudmundsson, A., Marengoni, A., O’Mahony, D., Parekh, N., Pisa, F. E., Rajkumar, C., Wehling, M., Ziere, G., and the EuGMS Special Interest Group on Pharmacology

Published
2019
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14. Eeg en innovatieve behandeling van verminderde hersenconnectiviteit bij delirium

Author

Onderzoek Brain at Risk, AIOS Anesthesiologie, Psychiatrie_Medisch, MS Geriatrie, Circulatory Health, Affectieve & Psychotische Med., Brain, AIOS Psychiatrie, van der A, J, Ottens, T H, Lodema, D Y, de Haan, W, Tendolkar, I, Emmelot-Vonk, M H, Schutter, D J L G, van Dellen, E, Slooter, A J C, Onderzoek Brain at Risk, AIOS Anesthesiologie, Psychiatrie_Medisch, MS Geriatrie, Circulatory Health, Affectieve & Psychotische Med., Brain, AIOS Psychiatrie, van der A, J, Ottens, T H, Lodema, D Y, de Haan, W, Tendolkar, I, Emmelot-Vonk, M H, Schutter, D J L G, van Dellen, E, and Slooter, A J C

Published
2023

16. Correction: Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer (European Geriatric Medicine, (2023), 14, 3, (565-572), 10.1007/s41999-023-00750-9)

Author

Onderzoek Medische Oncologie, Cancer, MS Geriatrie, Circulatory Health, Scheepers, E R M, Vink, G R, Schiphorst, A H W, Emmelot-Vonk, M H, van Huis-Tanja, L H, Hamaker, M E, Onderzoek Medische Oncologie, Cancer, MS Geriatrie, Circulatory Health, Scheepers, E R M, Vink, G R, Schiphorst, A H W, Emmelot-Vonk, M H, van Huis-Tanja, L H, and Hamaker, M E

Published
2023

17. Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer

Author

Onderzoek Medische Oncologie, Cancer, MS Geriatrie, Circulatory Health, Scheepers, E R M, Vink, G R, Schiphorst, A H W, Emmelot-Vonk, M H, van Huis-Tanja, L H, Hamakerl, M E, Onderzoek Medische Oncologie, Cancer, MS Geriatrie, Circulatory Health, Scheepers, E R M, Vink, G R, Schiphorst, A H W, Emmelot-Vonk, M H, van Huis-Tanja, L H, and Hamakerl, M E

Published
2023

25. Deprescribing tool for STOPPFall (screening tool of older persons prescriptions in older adults with high fall risk) items

Author

Seppala, L. J., Petrovic, M., Jesper Ryg, Bahat, G., Topinkova, E., Szczerbińska, K., Cammen, T. J., Hartikainen, S., Ilhan, B., Landi, F., Morrissey, Y., Mair, A., Gutiérrez-Valencia, M., Emmelot-Vonk, M. H., Caballero Mora, M. A., Michael Denkinger, Crome, P., Jackson, S. H. D., Correa-Pérez, A., Knol, W., Soulis, G., Adalsteinn Gudmundsson, Ziere, G., Wehling, M., O’mahony, D., Antonio Cherubini, and Nathalie van der Velde

Subjects
screening, fall risk, Medicine and Health Sciences, Deprescribing tool, older persons prescriptions, STOPPFall
Abstract

Background: Health care professionals are often reluctant to deprescribe fall-risk-increasing drugs (FRIDs). Lack of knowledge and skills form a significant barrier. To support clinicians in the management of FRIDs and to facilitate the deprescribing process, a deprescribing tool was developed by a European expert group for STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk) items. Methods: STOPPFall was created using an expert Delphi consensus process in 2019 and in 2020, 24 panellists from EuGMS SIG on Pharmacology and Task and Finish on FRIDs completed deprescribing tool questionnaire. To develop the questionnaire, a Medline literature search was performed. The panellists were asked to indicate for every medication class a possible need for stepwise withdrawal and strategy for withdrawal. They were asked in which situations withdrawal should be performed. Furthermore, panellists were requested to indicate those symptoms patients should be monitored for after deprescribing and a possible need for follow-ups. Results: Practical deprescribing guidance was developed for STOPPFall medication classes. For each medication class, a decision tree algorithm was developed including steps from medication review to symptom monitoring after medication withdrawal. Conclusion: STOPPFall was combined with a practical deprescribing tool designed to optimize medication review. This practical guide can help overcome current reluctance towards deprescribing in clinical practice by providing an up-to-date and straightforward source of expert knowledge.

Published
2020

27. The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis

Author

Unit Opleiding Geriatrie, Nefro Vasculaire Geneeskunde, Circulatory Health, Regenerative Medicine and Stem Cells, MS Geriatrie, Goto, N A, Weststrate, A C G, Oosterlaan, F M, Verhaar, M C, Willems, H C, Emmelot-Vonk, M H, Hamaker, M E, Unit Opleiding Geriatrie, Nefro Vasculaire Geneeskunde, Circulatory Health, Regenerative Medicine and Stem Cells, MS Geriatrie, Goto, N A, Weststrate, A C G, Oosterlaan, F M, Verhaar, M C, Willems, H C, Emmelot-Vonk, M H, and Hamaker, M E

Published
2020

29. The admission of very old patients to our intensive care units: a review

Author

Medische Staf Intensive Care, Other research (not in main researchprogram), MS Geriatrie, Circulatory Health, NVIC bedrijfsvoering, Brain, Infection & Immunity, Haas, L. E. M., Kerckhoffs, M. C., Bakhshi-Raiez, F., Emmelot-Vonk, M. H., de Lange, D. W., Medische Staf Intensive Care, Other research (not in main researchprogram), MS Geriatrie, Circulatory Health, NVIC bedrijfsvoering, Brain, Infection & Immunity, Haas, L. E. M., Kerckhoffs, M. C., Bakhshi-Raiez, F., Emmelot-Vonk, M. H., and de Lange, D. W.

Published
2020

35. Two-year persistence with teriparatide improved significantly after introduction of an educational and motivational support program

Author

van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, van den Bergh, J P W, van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, and van den Bergh, J P W

Abstract

This study evaluated the 2-year persistence with teriparatide in the Netherlands. Analyses showed that the risk of non-persistence was 28% lower in patients who were followed according to an additional educational and motivational support program.INTRODUCTION: Until recently, teriparatide (TPTD) was a third-line treatment option for severe osteoporosis in the Netherlands, which could only be prescribed by medical specialists based on a specific medical statement. We aimed to determine whether an educational and motivational support program (EMSP) increased 2-year treatment persistence with TPTD in patients with severe osteoporosis.METHODS: We evaluated persistence in 1573 Dutch patients treated with TPTD from January 2013 until January 2018. From January 2013 onwards, all patients received a basic support program (BSP) consisting of an educational home visit to initiate TPTD treatment and phone calls (at 1, 2.5 and 8 weeks). Since May 2015, all patients received the EMSP consisting of the BSP extended with evaluation of medication adherence during phone calls, an additional phone call (at 12 months), and motivational letters at 9 and 14 months.RESULTS: The EMSP showed a statistically significantly higher 2-year persistence (78%) with TPTD as compared with the BSP (72%). Reasons for treatment discontinuation were comparable between groups, except for the proportion of patients who had stopped TPTD administration due to side effects, which was significantly lower in the EMSP group (8% vs. 15% in BSP, p < 0.001). Overall, the risk of non-persistence was 28% lower in the EMSP compared with the BSP group (HR: 0.72; 95% CI: 0.55-0.93).CONCLUSION: The introduction of the EMSP has demonstrated to improve the persistence with TPTD, resulting in 78% of the patients being persistent with TPTD during the 2-year treatment period.

Published
2019

38. Two-year persistence with teriparatide improved significantly after introduction of an educational and motivational support program

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, van den Bergh, J P W, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, and van den Bergh, J P W

Published
2019

40. Reply to comment on 'Sarcopenia is a prognostic factor for overall survival in elderly patients with head and neck cancer'

Author

MS Hoofd-Hals Chirurgische Oncologie, Researchgr. Systems Radiology, Regenerative Medicine and Stem Cells, Cancer, Infection & Immunity, Circulatory Health, MS Geriatrie, Chargi, N., Bril, S. I., de Jong, P. A., Emmelot-Vonk, M. H., de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Researchgr. Systems Radiology, Regenerative Medicine and Stem Cells, Cancer, Infection & Immunity, Circulatory Health, MS Geriatrie, Chargi, N., Bril, S. I., de Jong, P. A., Emmelot-Vonk, M. H., and de Bree, Remco

Published
2019

41. EuGMS Task and Finish group on Fall-Risk-Increasing Drugs (FRIDs): Position on Knowledge Dissemination, Management, and Future Research

Author

MS Geriatrie, Circulatory Health, Seppala, L. J., van der Velde, N., Masud, T., Blain, H., Petrovic, M., van der Cammen, T. J., Szczerbinska, K., Hartikainen, S., Kenny, R. A., Ryg, J., Eklund, P., Topinkova, E., Mair, A., Laflamme, L., Thaler, H., Bahat, G., Gutierrez-Valencia, M., Caballero-Mora, M. A., Landi, F., Emmelot-Vonk, M. H., Cherubini, A., Baeyens, J. P., Correa-Perez, A., Gudmundsson, A., Marengoni, A., O'Mahony, D., Parekh, N., Pisa, F. E., Rajkumar, C., Wehling, M., Ziere, G., MS Geriatrie, Circulatory Health, Seppala, L. J., van der Velde, N., Masud, T., Blain, H., Petrovic, M., van der Cammen, T. J., Szczerbinska, K., Hartikainen, S., Kenny, R. A., Ryg, J., Eklund, P., Topinkova, E., Mair, A., Laflamme, L., Thaler, H., Bahat, G., Gutierrez-Valencia, M., Caballero-Mora, M. A., Landi, F., Emmelot-Vonk, M. H., Cherubini, A., Baeyens, J. P., Correa-Perez, A., Gudmundsson, A., Marengoni, A., O'Mahony, D., Parekh, N., Pisa, F. E., Rajkumar, C., Wehling, M., and Ziere, G.

Published
2019

42. Thoracic vertebral fractures and hyperkyphosis in elderly patients with end-stage kidney disease; do these patients have different clinical outcomes?

Author

Unit Opleiding Geriatrie, Unit Opleiding Aios, Nefro Vasculaire Geneeskunde, Circulatory Health, Regenerative Medicine and Stem Cells, MS Geriatrie, Goto, N. A., Koele, M. C., van Loon, I. N., Boereboom, F. T. J., Verhaar, M. C., Emmelot-Vonk, M. H., Hamaker, M. E., Willems, H. C., Unit Opleiding Geriatrie, Unit Opleiding Aios, Nefro Vasculaire Geneeskunde, Circulatory Health, Regenerative Medicine and Stem Cells, MS Geriatrie, Goto, N. A., Koele, M. C., van Loon, I. N., Boereboom, F. T. J., Verhaar, M. C., Emmelot-Vonk, M. H., Hamaker, M. E., and Willems, H. C.

Published
2019

44. Two-year persistence with teriparatide improved significantly after introduction of an educational and motivational support program

Author

MS Geriatrie, Circulatory Health, van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, van den Bergh, J P W, MS Geriatrie, Circulatory Health, van Maren, M A, Wyers, C E, Driessen, J H M, Visser, J V, de Vries, F, van de Wijdeven, K, Gevers, S, Lems, W F, Emmelot-Vonk, M H, and van den Bergh, J P W

Published
2019

47. Links Between Atherosclerosis and Osteoporosis in Middle Aged and Elderly Men

Author

Cardiovasculaire Epi Team 1, MS Geriatrie, Circulatory Health, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, van Den Bos, Frederiek, Emmelot-Vonk, M. H., Verhaar, H. J., van der Schouw, Y. T., Cardiovasculaire Epi Team 1, MS Geriatrie, Circulatory Health, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, van Den Bos, Frederiek, Emmelot-Vonk, M. H., Verhaar, H. J., and van der Schouw, Y. T.

Published
2018

49. High fall incidence and fracture rate in elderly dialysis patients

Author

Polinder-Bos, H. A., Emmelot-Vonk, M. H., Gansevoort, R. T., Diepenbroek, A., Gaillard, C. A.J.M., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), and Internal Medicine

Subjects
NURSING-HOME, geriatric, HEMODIALYSIS-PATIENTS, INJURIOUS FALLS, OLDER PERSONS, COGNITIVE IMPAIRMENT, elderly, COMMUNITY, MORTALITY RISK, fracture, REGISTRY, RISK-FACTORS, dialysis, Falls, PRIMARY HYPERPARATHYROIDISM
Abstract

Background: Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. Methods: A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. Results: 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Conclusions: Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

Published
2014

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