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Background/research question: Loneliness is a common condition impacting productivity and wellbeing. Nature-based social prescribing (NBSP) may promote nature contact, activate and strengthen social structures, and improve longer term mental and physical health. In six studies (three observational [for full text, please go to the a.m. URL]

Iva Holmerová,1 Stefanie R Auer,2,3 Anna Beránková,1 Margit Höfler,2 Paulina Ratajczak,2 Michal Šteffl4 1Centre of Expertise in Longevity and Long-Term Care, Faculty of Humanities, Charles University, Prague, Czech Republic; 2Danube University Krems, 3500 Krems, Austria; 3MAS Alzheimerhilfe, 4820Bad Ischl, Austria; 4Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic Background: The treatment of pain and treatment of anxiety are two of the most complex issues in nursing homes worldwide, mainly because of the large numbers of people with cognitive impairment who reside in this environment. Aim: The aim of this study was to investigate the administration of analgesics and anxiolytics to people living in nursing homes, taking into account cognitive status. Methods: For this cross-sectional study, we used data from 404 residents who lived in nine randomly selected nursing homes in the Czech Republic and participated in the Czech-Austrian Long-Term Care Research Project called DEMDATA. Information about medication administration was obtained from medical records. Cognitive impairment was evaluated by the Mini-Mental State Examination, and pain was measured by the Pain Assessment in Advanced Dementia. To measure anxiety, we used the Behavioral Pathology in Alzheimer’s Disease Rating Scale in residents with severe-to-moderate dementia and also the standardized questionnaire EuroQol in other residents. Results: In all, 68% (95% CI 62–74) of residents with pain did not receive any analgesic medication and 31% (95% CI 25–38) of residents were administered some analgesics and continued to report pain. The lowest reported occurrence of pain, as well as the lowest prevalence of analgesic administration, was in residents with moderate-to-severe dementia. We found that an alarming percentage of residents in the nursing homes were not treated sufficiently. Conclusion: This study indicates that treatment effects should be better monitored. Keywords: pain, anxiety, dementia, analgesics, anxiolytics&nbsp

Objectives: To investigate associations between demographic and lifestyle factors and memory performance in European people aged &ge, 60 years. Methods: Data from 23,641 people with a mean age of 70.2 (95 % CI 70.1&ndash, 70.3) were analyzed and drawn from the fourth wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Generalized linear models were carried out to estimate the associations for both men and women. Memory performance was tested using two word-list learning tests with immediate and delayed recall in SHARE. Results: age, severe limitations in physical activities, and any past alcohol problem were all negatively associated with memory performance. Contrarily, education level, higher nonalcoholic fluid intake, and engagement in sports activities more than once a week and in activities requiring a moderate level of energy were all positively associated with memory performance. Smoking showed a significant negative association only in the immediate recall test for both men and women together, whilst long-term illness showed association only in the delayed recall. Alcohol consumption was positively associated with memory performance in women, but in men, it depended on the drinking frequency. Conclusions: Demographic and lifestyle factors are associated with memory performance in the older population.

Objectives: With rates of dementia continuing to rise, the impetus on improving care for people with dementia is growing. Unmet needs of people with dementia living in nursing homes have been linked with worsening neuropsychiatric symptoms, higher levels of depression, and reduced quality of life. Furthermore, proxy accounts exploring the needs of people with dementia have frequently been shown to be unreliable. Therefore, this literature review aims to explore the self-reported needs and experiences of people with dementia in nursing homes.Method: A scoping review of the literature was carried out using the databases PubMed and PsycINFO to search for relevant articles according to PRISMA guidelines. Search terms were designed to include both quantitative and qualitative study designs. Thematic synthesis was used to categorise findings into themes related to self-reported needs and experiences.Results: A total of 41 articles met the eligibility criteria. An analysis of study characteristics revealed more than half of studies used a qualitative design. Thematic synthesis resulted in eight themes: activities, maintaining previous roles, reminiscence, freedom and choice, appropriate environment, meaningful relationships, support with grief and loss, end-of-life care.Conclusion: Whilst the voice of people with dementia has previously been neglected in research, this review has shown that people with dementia in nursing homes are able to describe their experiences and communicate their needs. The findings in this review have provided a contribution towards guiding evidence-based practice that is tailored to the needs of nursing home residents with dementia.

Shima Mehrabian,1 Larissa Schwarzkopf,2 Stefanie Auer,3 Iva Holmerova,4 Milica G Kramberger,5 Marina Boban,6 Elka Stefanova,7 Catalina Tudose,8 Natalia Bachinskaya,9 Tibor Kovács,10 Petr Koranda,11 Todor Kunchev,1 Latchezar Traykov,1 Janine Diehl-Schmid,12 Katrina Milecka,12 Alexander Kurz12On behalf of the Danubian Network for Dementia Education Care (DANDEC) Consortium1UH “Alexandrovska”, Department of Neurology, Medical University Sofia, Sofia, Bulgaria; 2Helmholtz-Centre Munich, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Munich, Germany; 3Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria; 4CELLO Faculty of Humanities, Charles University, Prague, the Czech Republic; 5University of Ljubljana, Department of Neurology, Ljubljana, Slovenia; 6University of Zagreb, Department of Cognitive Neurology, Zagreb, Croatia; 7School of Medicine, University of Belgrade, Neurology Clinic, Belgrade, Serbia; 8University of Medicine and Pharmacy Carol Davila, Department of Clinical Neurosciences, Bucharest, Romania; 9Acacdemy of Medical Sciences Kiev, Department of clinical physiology and pathology of the central nervous system, Kiev, the Ukraine; 10Department of Neurology, Semmelweis University, Budapest, Hungary; 11MEDIWARE corp., Prague, the Czech Republic; 12Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, GermanyCorrespondence: Alexander KurzCentre for Cognitive Disorders at the Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar; Technische Universität München, Ismaninger Strasse 22Munich 81675, GermanyTel +49 894 140 4285Email a.kurz@tum.deBackground: Dementia is a particularly severe societal challenge in several countries of the Danube Region due to higher-than-average increment in population longevity, disproportionate increase of the old-age dependency ratio, and selective outward migration of health care professionals. A survey was conducted among dementia experts to obtain a deeper understanding of the dementia care structures and services in this geographical area, and to identify the educational needs of health care professionals, and the availability of assistive technology.Subjects and methods: A standardized questionnaire was sent out to 15 leading dementia experts/clinicians in 10 Danube Region countries inquiring about professional groups involved in dementia care, availability and reimbursement of services, inclusion of dementia in professional education and training, acceptability of Internet-based education, and availability of assistive technology. The authors are the survey respondents.Results: The majority of individuals with dementia receive care in the community rather than in institutions. The roles of medical specialties are disparate. General practitioners usually identify dementia symptoms while specialists contribute most to clinical diagnosis and treatment. Health care professionals, particularly those who work closely with patients and carers, have limited access to dementia-specific education and training. The greatest need for dementia-specific education is seen for general practitioners and nurses. An Internet-based education and skill-building program is considered to be equivalent to traditional face-to-face but offer advantages in terms of convenience of access. Assistive technology is available in countries of the Danube Region but is significantly underused.Conclusion: Dementia care in the Danube Region can be improved by an educational and skill-building program for health care professionals who work in the frontline of dementia care. Such a program should also attempt to enhance interdisciplinary and intersectorial collaboration, to intensify the interaction between primary care and specialists, and to promote the implementation of assistive technology.Keywords: dementia, Danube Region, expert survey, dementia care structures, education, assistive technology

Objective: The electronic patient record (EPR) has been introduced into nursing homes with the aim of reducing time spent on documentation, improving documentation quality and increasing transferability of information, all of which should facilitate care provision. However, previous research has shown that EPR may be creating new burdens for staff. The purpose of this literature review is to explore how EPR is facilitating or hindering care provision in nursing homes.Methods: An integrative literature review was carried out using four electronic databases to search for relevant articles. After screening, 22 articles were included for thematic synthesis.Results: Thematic synthesis resulted in six analytical themes linked to care provision: time for direct care; accountability; assessment and care planning; exchange of information; risk awareness; and person-centered care.Conclusion: For EPR to facilitate care provision in nursing homes, consideration should be given to the type of device used for documentation, as well as the types of applications, the functionality, content, and structure of EPR. Further research exploring the experiences of end users is required to identify the optimal characteristics of an EPR system specifically for use in nursing homes.

Michal Steffl,1 Jan Sima,2 Kate Shiells,3 Iva Holmerova3 1Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic; 2Department of Sport Management, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic; 3Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University, Prague, Czech Republic Abstract: Muscle weakness and associated diseases are likely to place a considerable economic burden on government health care expenditure. Therefore, our aim for this study was to estimate the direct and indirect costs associated with muscle weakness in the Czech Republic. We applied a cost-of-illness approach using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Six hundred and eighty-nine participants aged 70 years and over and without any long-term illnesses were included in our study. A generalized linear model with gamma distribution was used, and odds ratio (OR) was calculated in order to explore the effect of muscle weakness on direct and indirect costs. For both genders, muscle weakness had a statistically significant impact on direct costs (OR =2.11), but did not have a statistically significant impact on indirect costs (OR =1.08) or on total cost (OR =1.51). Muscle weakness had the greatest statistically significant impact on direct costs in females (OR =2.75). In conclusion, our study has shown that muscle weakness may lead to increased direct costs, and consequently place a burden on health care expenditure. Therefore, the results of this study could lead to greater interest in the prevention of muscle weakness among older people in the Czech Republic. Keywords: direct cost, indirect cost, economic burden, sarcopenia, frailty

Michal Steffl,1 Richard W Bohannon,2 Lenka Sontakova,1 James J Tufano,1 Kate Shiells,3 Iva Holmerova3 1Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University Prague, Prague, Czech Republic; 2Department of Physical Therapy, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC, USA; 3Faculty of Humanities, Centre of Gerontology, Charles University Prague, Prague, Czech Republic Abstract: Physical activity (PA) has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55). The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia. Keywords: aging, sarcopenia, physical activity&nbsp

Background Sarcopenia, a loss of muscle strength and mass, has serious implications for older adults. Some risk factors for sarcopenia are well established. The role of other factors such as alcohol consumption is less certain. The main aim of this study was to explore the relationship between sarcopenia and alcohol consumption in people over 65 years old. Methods Four electronic databases were searched to identify potentially relevant papers. Demographics and information on sarcopenia and alcohol consumption were extracted from relevant papers. The relationship between sarcopenia and alcohol consumption was described using odds ratios (ORs). Results Of 214 papers identified as potentially relevant, 13 were ultimately included in the meta-analyses. The papers provided data from 13,155 participants. The OR (95 % CI) for sarcopenia among alcohol drinkers was 0.67 (0.54–0.83) for males, 0.89 (0.73–1.08) for females, and 0.77 (0.67–0.88) for the overall population. Conclusions The results of this meta-analysis do not support alcohol consumption as a risk factor for sarcopenia.

The Dementia in Europe Yearbook 2014 focuces on care pathways for people with dementia living at home. It provides a comparative analysis of national policies and practices addresing different aspects of the pathways to diagnosis and to postdiagnosis support and care in the Members States of the European Union as well as in Jersey, Norway, Monaco, Switzerland and Turkey. Relevant topics addresed in this report include the timely diagnosis of dementia: refferal pathways ; pharmacological treatment and ongoing assessment of dementia ; disclosure of diagnosis and provision of information to people with dementia ; assessment of psychosocial needs and development of care plans ; and access to and transitions between the existing support and care services in these countries.