268 results on '"Olde Rikkert, Marcel"'
Search Results
2. The new US and European guidelines in hypertension: A multi-dimensional analysis.
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Fernandes, Michael and Olde Rikkert, Marcel G.M.
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DIMENSIONAL analysis , *HYPOTENSION , *HYPERTENSION , *SYSTOLIC blood pressure , *GUIDELINES - Abstract
The Systolic Blood Pressure Intervention Trial (SPRINT) compared the clinical outcomes between target systolic blood pressure (SBP) levels between 140 and 120 mmHg or lower. Both,the 2017 ACC/AHA and the 2018 ESC/ESH guidelines in hypertension are derived from the SPRINT trial and advise initiation and/or intensification of treatment at lower blood pressure thresholds. The ACC/AHA guidance supersedes the 2014 Eight Joint National Committee guideline (JNC-8) which advised initiation of treatment when the BP was 140/90 mmHg or higher; in adults 60 years or over, the target was 150/90 mmHg. Compared to JNC-8, the new guidelines lower the SBP target by 10 mmHg in patients under age of 60 years, and by 20 mmHg in the elderly. We performed a qualitative multi-dimensional analysis in order to answer two key questions: will the new guidelines deliver the stated benefits? and, will translation to the clinic be simple, risk-free, and affordable? A major investment by national healthcare administrations will be necessary for the initiation and support of this program but this decision can only be justified by a valid expectation of clinical benefit. At this time, a definitive answer is not available and a "wait and see" attitude appears appropriate and reasonable. In the interim, efforts are best directed to the immediate problem of untreated hypertension worldwide. [ABSTRACT FROM AUTHOR]
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- 2019
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3. Using Patient Reported Outcomes Measures to Promote Integrated Care.
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Olde Rikkert, Marcel G. M., van der Wees, Philip J., Schoon, Yvonne, and Westert, Gert P.
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HEALTH outcome assessment , *QUALITY of life , *PATIENTS - Abstract
Introduction: Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life. Discussion: We describe innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice. We show that PROMs can show meaningful outcomes in older subjects' patient journeys, which can at the same time serve individuals and groups of both patients and professionals. Key lesson: PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records. [ABSTRACT FROM AUTHOR]
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- 2018
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4. Slowing Down of Recovery as Generic Risk Marker for Acute Severity Transitions in Chronic Diseases.
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Olde Rikkert, Marcel G. M., Dakos, Vasilis, Buchman, Timothy G., de Boer, Rob, Glass, Leon, Cramer, Angélique O. J., Levin, Simon, van Nes, Egbert, Sugihara, George, Ferrari, Michel D., Tolner, Else A., van de Leemput, Ingrid, Lagro, Joep, Melis, René, Scheffer, Marten, and Boer, Rob de
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CHRONIC diseases , *ARRHYTHMIA , *MENTAL depression , *PATHOLOGICAL physiology , *DISEASE exacerbation , *ASTHMA , *MIGRAINE , *BIOLOGICAL models , *CRITICAL care medicine , *PATIENT-family relations , *PSYCHOLOGICAL tests , *RISK assessment - Abstract
Objective: We propose a novel paradigm to predict acute attacks and exacerbations in chronic episodic disorders such as asthma, cardiac arrhythmias, migraine, epilepsy, and depression. A better generic understanding of acute transitions in chronic dynamic diseases is increasingly important in critical care medicine because of the higher prevalence and incidence of these chronic diseases in our aging societies.Data Sources: PubMed, Medline, and Web of Science.Study Selection: We selected studies from biology and medicine providing evidence of slowing down after a perturbation as a warning signal for critical transitions.Data Extraction: Recent work in ecology, climate, and systems biology has shown that slowing down of recovery upon perturbations can indicate loss of resilience across complex, nonlinear biologic systems that are approaching a tipping point. This observation is supported by the empiric studies in pathophysiology and controlled laboratory experiments with other living systems, which can flip from one state of clinical balance to a contrasting one. We discuss examples of such evidence in bodily functions such as blood pressure, heart rate, mood, and respiratory regulation when a tipping point for a transition is near.Conclusions: We hypothesize that in a range of chronic episodic diseases, indicators of critical slowing down, such as rising variance and temporal correlation, may be used to assess the risk of attacks, exacerbations, and even mortality. Identification of such early warning signals over a range of diseases will enhance the understanding of why, how, and when attacks and exacerbations will strike and may thus improve disease management in critical care medicine. [ABSTRACT FROM AUTHOR]- Published
- 2016
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5. Tolerability and Safety of Souvenaid in Patients with Mild Alzheimer's Disease: Results of Multi-Center, 24-Week, Open-Label Extension Study.
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Olde Rikkert, Marcel G.M., Verhey, Frans R., Blesa, Rafael, von Arnim, Christine A.F., Bongers, Anke, Harrison, John, Sijben, John, Scarpini, Elio, Vandewoude, Maurits F.J., Vellas, Bruno, Witkamp, Renger, Kamphuis, Patrick J.G.H., and Scheltens, Philip
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ELEMENTAL diet , *SYNAPSES , *ALZHEIMER'S disease treatment , *MEMORY research , *COGNITION research - Abstract
Background: The medical food Souvenaid, containing the specific nutrient combination Fortasyn Connect, is designed to improve synapse formation and function in patients with Alzheimer's disease (AD). Two double-blind randomized controlled trials (RCT) with Souvenaid of 12 and 24 week duration (Souvenir I and Souvenir II) showed that memory performance was improved in drug-naïve mild AD patients, whereas no effects on cognition were observed in a 24-week RCT (S-Connect) in mild to moderate AD patients using AD medication. Souvenaid was well-tolerated in all RCTs. Objective: In this 24-week open-label extension (OLE) study to the 24-week Souvenir II RCT, long-term safety and intake adherence of the medical food Souvenaid was evaluated. Methods: Patients with mild AD (n = 201) received Souvenaid once-daily during the OLE. Main outcome parameters were safety and product intake adherence. The memory domain z-score from a revised neuropsychological test battery was continued as exploratory parameter. Results: Compared to the RCT, a similar (low) incidence and type of adverse events was observed, being mainly (68.3%) of mild intensity. Pooled data (RCT and OLE) showed that 48-week use of Souvenaid was well tolerated with high intake adherence (96.1%). Furthermore, a significant increase in the exploratory memory outcome was observed in both the active-active and control-active groups during Souvenaid intervention. Conclusion: Souvenaid use for up to 48-weeks was well tolerated with a favorable safety profile and high intake adherence. The findings in this OLE study warrant further investigation toward the long-term safety and efficacy of Souvenaid in a well-controlled, double-blind RCT. [ABSTRACT FROM AUTHOR]
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- 2015
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6. Differences in Nutritional Status Between Very Mild Alzheimer's Disease Patients and Healthy Controls.
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Olde Rikkert, Marcel G.M., Verhey, Frans R., Sijben, John W.C., Bouwman, Femke H., Dautzenberg, Paul L.J., Lansink, Mirian, Sipers, Walther M.W., van Asselt, Dieneke Z.B., van Hees, Anneke M.J., Stevens, Martijn, Vellas, Bruno, and Scheltens, Philip
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ALZHEIMER'S disease , *ALZHEIMER'S patients , *FATTY acids , *ERYTHROCYTES , *CELL membranes , *NUTRITION - Abstract
Background: Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD. Objective: This study compares the nutritional status between mild AD outpatients and healthy controls. Methods: A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥⃒20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included. Nutritional status was assessed by measuring levels of several nutrients, conducting the Mini Nutritional Assessment (MNA®) questionnaire and through anthropometric measures. Results: In total, data of 93 healthy cognitively intact controls (MMSE 29.0 [23.0-30.0]) and 79 very mild AD patients (MMSE = 25.0 [20.0-30.0]) were included. Plasma selenium (p < 0.001) and uridine (p = 0.046) levels were significantly lower in AD patients, with a similar trend for plasma vitamin D (p = 0.094) levels. In addition, the fatty acid profile in erythrocyte membranes was different between groups for several fatty acids. Mean MNA screening score was significantly lower in AD patients (p = 0.008), but not indicative of malnutrition risk. No significant differences were observed for other micronutrient or anthropometric parameters. Conclusion: In non-malnourished patients with very mild AD, lower levels of some micronutrients, a different fatty acid profile in erythrocyte membranes and a slightly but significantly lower MNA screening score were observed. This suggests that subtle differences in nutrient status are present already in a very early stage of AD and in the absence of protein/energy malnutrition. [ABSTRACT FROM AUTHOR]
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- 2014
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7. Differences in nutritional status between very mild Alzheimer's disease patients and healthy controls.
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Olde Rikkert, Marcel G M, Verhey, Frans R, Sijben, John W C, Bouwman, Femke H, Dautzenberg, Paul L J, Lansink, Mirian, Sipers, Walther M W, van Asselt, Dieneke Z B, van Hees, Anneke M J, Stevens, Martijn, Vellas, Bruno, and Scheltens, Philip
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- 2014
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8. Development and evidence base of a new efficient assessment instrument for international use by nurses in community settings with older people.
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Olde-Rikkert, Marcel G.M., Long, Judith F., and Philp, Ian
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GERIATRIC assessment , *COMMUNITY health nursing , *STATISTICAL correlation , *EXPERIMENTAL design , *HEALTH status indicators , *RESEARCH methodology , *MEDICAL cooperation , *NURSING assessment , *PRIMARY health care , *RESEARCH , *STATISTICS , *WORLD health , *PATIENT-centered care , *RESEARCH methodology evaluation , *OLD age ,RESEARCH evaluation - Abstract
In a world where 12% of the population, and 22% of that of more developed regions, will be older than 65 years by 2030, new targeted programs and social protections will be needed for older people in many countries. As economic and human resources become more scarce, efficient instruments are needed to realize sustainable health care for these large populations of older subjects. To address this need a new assessment instrument was developed. The core of the instrument consists of focused geriatric assessment by a health or social care practitioner working in primary or community care, most often a nurse. The assessment data result in an efficiently targeted care and welfare action plan based on the patients' priorities This instrument was initially developed, tested and spread within Europe, and then in validation studies across all WHO regions of the world. Because of the urgent societal questions on quality and sustainability of primary health care, especially for older people, we briefly review and summarize the development and evidence base of the instrument, which was called EASY-Care Standard. In a series of studies across many populations it proved to have high acceptability, reliability, validity and cost-effectiveness. Therefore, EASY-Care has great potential as a universal tool for global use in promoting independence in old age, and can make an important contribution to the quality and sustainability of health and social care in our aging societies [ABSTRACT FROM AUTHOR]
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- 2013
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9. Dynamic Cerebral Autoregulation in the Old Using a Repeated Sit-Stand Maneuver
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van Beek, Arenda H.E.A., Olde Rikkert, Marcel G.M., Pasman, Jaco W., Hopman, Maria T.E., and Claassen, Jurgen A.H.R.
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ULTRASONIC imaging , *CEREBRAL circulation , *HEMODYNAMICS , *BLOOD pressure , *SPECTRAL energy distribution , *TRANSFER functions - Abstract
Abstract: The aim of this study was to assess the feasibility and reproducibility of a simple and nonobtrusive repeated sit-stand maneuver to assess cerebral autoregulation (CA) in healthy old subjects >70 years. In 27 subjects aged 76 (SD 4) years, we continuously measured blood pressure using photoplethysmography and cerebral blood flow velocity in the middle cerebral artery (transcranial Doppler ultrasonography) during 5min of sitting rest and again during repeated sit-stand maneuvers at 10 s (0.05Hz) and 5 s (0.1Hz) intervals. In 11 randomly selected subjects, these measurements were repeated after 3 months. Both maneuvers induced substantial periodic oscillations in pressure and flow. For example, the maneuvers at 0.05Hz increased the power spectral density (magnitude) of blood pressure and cerebral blood flow velocity oscillations with 16.3 (mm Hg)2 and 14.5 (cm/s)2, respectively (p <0.001). These larger oscillations led to an increase in transfer function coherence compared with spontaneous oscillations from 0.46 to 0.60 for 0.05Hz maneuvers and from 0.56 to 0.76 for 0.1Hz maneuvers (p <0.01), allowing for more confident assessment of CA through transfer function phase and gain. This increased coherence was not associated with improved reproducibility however. In conclusion, we were able to investigate CA in old patients using these repeated sit-stand maneuvers, which, compared with spontaneous oscillations, produced a stronger and more clinically relevant hemodynamic challenge for CA. (E-mail: j.claassen@ger.umcn.nl) [Copyright &y& Elsevier]
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- 2010
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10. A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation.
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Thölking, Thessa W., Lamers, Eef C.T., Olde Rikkert, Marcel G.M., Thölking, Thessa W, Lamers, Eef C T, and Olde Rikkert, Marcel G M
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OLDER people , *COGNITION disorders , *SLEEP , *ACCIDENTAL fall prevention , *FEAR , *MATTRESSES , *HOME ownership , *LIGHTING , *RESEARCH , *RESEARCH methodology , *ECOLOGY , *GERIATRIC assessment , *EVALUATION research , *MEDICAL cooperation , *COMPARATIVE studies , *ACCIDENTAL falls , *INDEPENDENT living - Abstract
Background: Even though poor lighting at nighttime is an important risk factor for falls (and most falls occur during the night), lighting interventions to improve nightly lighting from bed to bathroom are rarely evaluated for fall prevention.Objective: We tested the hypothesis that an automated guiding light would reduce nightly fear of falling (FOF) and increase sleep quality of community-dwelling older people.Methods: This study had a pragmatic uncontrolled before-after design, including participants during a period of 8 months if they (i) were aged at least 65 years, (ii) ambulated independently at night, and (iii) had no cognitive or audiovisual impairments obstructing outcome measurement. Automated LED strips (GightTM) were installed in the participants' homes. The primary outcome measure was overnight FOF on a scale of 0-10. Secondary outcome measures included sleep quality on a scale of 0-10 and fall rate. Additionally, a sample of participants was interviewed about their experiences with Gight.Results: Sixty-four participants were included (mean age: 80.8 ± 8.1 years; 89% living independently). Mean study length was 118 days (range: 30-231). In the intention-to-treat analysis, overnight FOF declined from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001), and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012). The fall rate during the study was too low to detect changes. Participants appreciated Gight (8.4 ± 0.8 on a scale of 10), and the majority (57%) reported a subjective decrease in FOF.Conclusion: Gight shows promising results for overnight FOF and sleep quality, but the effect of lighting interventions on fall rate should be evaluated further before widespread implementation. [ABSTRACT FROM AUTHOR]- Published
- 2020
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11. A method to standardize gait and balance variables for gait velocity
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van Iersel, Marianne B., Olde Rikkert, Marcel G.M., and Borm, George F.
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SPEED , *PATH analysis (Statistics) , *REGRESSION analysis , *METHODOLOGY - Abstract
Abstract: Many gait and balance variables depend on gait velocity, which seriously hinders the interpretation of gait and balance data derived from walks at different velocities. However, as far as we know there is no widely accepted method to correct for effects of gait velocity on other gait and balance measures. We developed a simple statistical method to obtain gait and balance variables for each participant that are independent of gait velocity. The first step of our standardization method was the transformation of the gait and balance data to obtain a normal distribution and decrease the influence of outliers. Thereafter, we constructed a formula, based on regression analysis that described how these data varied with gait velocity in each participant during walking without an additional task. Last, this formula was used to standardize the gait and balance data for the effect of gait velocity for each individual participant. As example we present the analysis of mediolateral displacements of the trunk in fit elderly people during walking with and without a dual task. [Copyright &y& Elsevier]
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- 2007
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12. Is stair negotiation measured appropriately in functional assessment scales?
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van Iersel, Marianne B, Olde Rikkert, Marcel G M, and Mulley, Graham P
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GERIATRIC assessment , *FUNCTIONAL assessment , *STAIRS - Abstract
Background: A decline in mobility may result in problems with the negotiation of stairs, which can potentially be hazardous. In practice, stair negotiation is an important aspect of daily living and therefore needs to be assessed carefully. Methods: We conducted a systematic literature review to identify the way functional assessment scales assess stair negotiation. We evaluated whether stair negotiation could be assessed in a valid and reliable way with these scales. Results: Forty-three of the 92 identified scales have an item on stair negotiation. In these scales, the definition of 'negotiation of stairs' varies, as does the definition of independence. Important aspects such as safety on stairs are missing from all scales. In contrast to older scales, newer scales consist of items that have been tested for validity and reliability. In none of the scales was the stair negotiation item tested separately for validity. Only two scales examined test-retest reliability and only one measured inter-observer agreement. Discussion: In current functional assessment scales stair negotiation is measured with great heterogeneity and insufficient validity. In patients and in studies in which assessment of stair negotiation ability is a key part of functional assessment, an improved, well-validated scale is needed. This scale should include not only the subject's physical ability to negotiate stairs, but also safety and change in ability over time. [ABSTRACT FROM AUTHOR]
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- 2003
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13. Experiences and preliminary effects of the Comprehensive chrOnic caRe outpatiEnt (CORE) clinic for patients with multimorbidity in the hospital setting.
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Remers, Toine E. P., Jeurissen, Patrick P. T., Coremans, Annemiek, Olde Rikkert, Marcel G. M., and Dulmen, Simone A.
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OUTPATIENT medical care , *PATIENT satisfaction , *HOSPITAL patients , *PATIENTS' attitudes , *PATIENT experience - Abstract
Rationale Aims and Objectives Methods Results Conclusion Healthcare systems remain disease oriented despite growing sustainability concerns caused by inadequate management of patients with multimorbidity. Comprehensive care programmes (CCPs) can play an important role in streamlining care delivery, but large differences in setup and results hinder firm conclusions on their effectiveness. Many elements for successful implementation of CCPs are identified, but strategies to overcome barriers and embed programmes within health systems remain unknown.To address this knowledge gap through a detailed study of implementing a CCP in a Dutch hospital setting, including patient experiences, facilitators, barriers and ways to overcome those barriers. Additionally, this study aims to explore effects on patient satisfaction and healthcare use.A qualitative study design with 39 semistructured interviews and focus groups between July 2020 and February 2023 with 16 patients and 17 involved professionals. Additionally, effects on quantitative outcomes for patient satisfaction (PACIC‐20) and healthcare use were explored.Professionals expressed a wide range of topics related to implementation and ways to overcome barriers at hospital and system level. Alterations in the design to accommodate varying care demands, focus on inclusions through referrals, and lack of long‐term support and appropriate financing were key topics. Patients expressed varying experiences, stated a strong desire for comprehensive information, and emphasised the importance of trust in caregivers. Patient satisfaction showed no effects, while healthcare use showed slight decreases in trends, but patient numbers were limited.The introduction of a CCP is feasible, and exploratory analysis on effectiveness shows lower hospital care use without decreasing patient satisfaction. However, this is accompanied by several challenges that show current fragmented systems still do not support implementation of integrated care initiatives. Overcoming those comes with substantial costs and may require a strong bottom‐up implementation within a motivated team and actions on all levels of healthcare systems. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Letter by Olde Rikkert and Fernandes Regarding Article, "Potential Cardiovascular Disease Events Prevented With Adoption of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline".
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Olde Rikkert, Marcel G.M. and Fernandes, Michael
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BLOOD pressure , *CARDIOVASCULAR diseases , *MEDICAL personnel , *CARDIOLOGY , *HYPERTENSION - Published
- 2019
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15. Malnutrition research: high time to change the menu.
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Olde Rikkert, Marcel G.M. and Rigaud, Annie-Sophie
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MALNUTRITION , *RESEARCH , *DISEASES , *SYNDROMES , *NUTRITION - Abstract
Editorial. Deals with malnutrition research. Categories of malnutrition; Reason for considering malnutrition as a geriatric syndrome; Syndromes related to malnutrition.
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- 2003
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16. Prognostic Information on Progression to Dementia: Quantification of the Impact on Quality of Life.
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Vermeulen, Robin Jeanna, Roudijk, Bram, Govers, Tim Martin, Rovers, Maroeska Mariet, Olde Rikkert, Marcel Gerardus Maria, and Wijnen, Ben Franciscus Martinus
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MILD cognitive impairment , *DEMENTIA , *QUALITY of life , *DISEASE risk factors , *LOGISTIC regression analysis , *ALZHEIMER'S disease , *VASCULAR dementia - Abstract
Background: The increasing interest in early identification of people at risk of developing dementia, has led to the development of numerous models aimed at estimating the likelihood of progression from mild cognitive impairment (MCI) to dementia. It is important to study both the need for and possible outcomes related with such prediction models, including the impact of risk predictions on perceived quality of life (QoL). Objective: This study aimed to quantify the impact that receiving a risk prediction on progression from MCI to dementia has on QoL. Methods: A Discrete Choice Experiment (DCE) and Time Trade Off (TTO) study were performed. Participants completed choice tasks related to dementia prognosis while imagining having MCI. We collected DCE data by an online survey, and TTO data via videoconferencing interviews. DCE data were analyzed using a mixed multinomial logit model and were anchored to a health state utility scale using mean observed TTO valuations. Results: 296 people participated in the DCE and 42 in the TTO. Moderate and high predicted dementia risks were associated with decrements in utility (–0.05 and –0.18 respectively), compared to no prognostic information. Low predicted risk was associated with an increase in utility (0.06), as well as the availability of medication or lifestyle interventions (0.05 and 0.13 respectively). Conclusions: This study shows a significant impact of dementia risk predictions on QoL and highlights the importance of caution when sharing information about expected MCI disease courses. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Visual estimation of biological age of elderly subjects: good interrater agreement.
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Olde Rikkert, Marcel G.M. and Olde Rikkert, M G
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AGE , *OLDER people , *VISUAL perception , *VISION , *GERONTOLOGY , *AGING , *GERIATRICS , *LIFE expectancy , *PHYSICAL diagnosis , *RESEARCH bias - Abstract
Background: Visual estimation of age can be used as a measure of biological age (BA) and has become useful in predicting life expectancy.Objective: The aim of this study was to quantify the interrater agreement of experienced geriatricians in visual estimation of BA.Methods: In a prospective controlled study, 4 experienced geriatricians estimated the BA of 43 elderly subjects (mean age 82.5 +/- 6.0 years) during a short standardized interview, using a checklist of age-associated changes in appearance, communication and mobility. Interrater agreement was calculated by analysis of variance and expressed as the intra-class coefficient of correlation (ICCC).Results: The ICCC of the BA estimation was 0.76 (p < 0.001). Within-subject standard deviation of the estimate was 3. 4 years. On average, BA was 4.8 (+/-4.4) years lower than chronological age (p < 0.001).Conclusion: Visual estimation of BA based on a simple checklist has a good interrater agreement and therefore should be part of geriatric assessment. [ABSTRACT FROM AUTHOR]- Published
- 1999
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18. Perseverance Time of Informal Caregivers for Institutionalized Elderly: Construct Validity and Test-Retest Reliability of a Single-Question Instrument.
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Richters, Anke, Olde Rikkert, Marcel G., van Exel, N. Job, Melis, René J., and van der Marck, Marjolein A.
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ELDER care , *CAREGIVERS , *LONG-term health care , *RESEARCH methodology , *STATISTICAL reliability , *BURDEN of care , *MULTITRAIT multimethod techniques , *RESEARCH methodology evaluation - Published
- 2016
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19. COVID‐19 and dementia: experience from six European countries.
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Burns, Alistair, Lobo, Antonio, Olde Rikkert, Marcel, Robert, Philippe, Sartorius, Norman, Semrau, Maya, and Stoppe, Gabriela
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COVID-19 , *DEMENTIA , *OLDER people , *SOCIAL services , *PANDEMICS - Abstract
The effects of coronavirus disease 2019 (COVID‐19) have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis. [ABSTRACT FROM AUTHOR]
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- 2021
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20. Do Not Harm Older Persons in Primary Care by Case Finding of Cognitive Decline, Instead Assess Cognition Only Following Loss of Well-being.
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Olde Rikkert, Marcel G.M., Claassen, Jurgen A.H.R., and Koopmans, Raymond T.C.M.
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COGNITION disorders , *GERIATRIC assessment , *COGNITIVE testing , *PRIMARY health care , *OLD age , *PREVENTION - Published
- 2016
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21. Diagnostic accuracy of office blood pressure compared to home blood pressure in patients with mild cognitive impairment and dementia.
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de Heus, Rianne AA, Tumelaire, Maxime V, Olde Rikkert, Marcel GM, and Claassen, Jurgen AHR
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ACADEMIC medical centers , *BLOOD pressure measurement , *COGNITION disorders in old age , *CONFIDENCE intervals , *DIAGNOSTIC errors , *HYPERTENSION , *MEDICAL records , *QUESTIONNAIRES , *RESEARCH funding , *SENILE dementia , *SPHYGMOMANOMETERS , *LOGISTIC regression analysis , *CROSS-sectional method , *DATA analysis software , *ODDS ratio , *KRUSKAL-Wallis Test , *BARTHEL Index , *OLD age - Abstract
Background: Hypertension and cognitive impairment often coexist in older people. Office blood pressure measurement is a poor indicator for diagnosing hypertension in the general population. However, its diagnostic accuracy has not been substantially studied in patients with cognitive impairment. Aim: The aim of this study was to determine the proportion of misdiagnosis of hypertension in patients with mild cognitive impairment and dementia compared to no cognitive impairment, by comparing office blood pressure measurement with home blood pressure measurement. Methods: A cross-sectional study including consecutive patients visiting a memory clinic between 2014 and 2017. Home blood pressure was measured for one week according to the European guidelines. Office blood pressure was assessed during routine clinical practice. Using guideline definitions for normal blood pressure and hypertension, we investigated the proportion of disagreement between office blood pressure measurement and home blood pressure measurement. Univariable and multivariable logistic regression compared disagreement in diagnosis between patients with dementia, mild cognitive impairment and no cognitive impairment. Results: Of 213 patients (aged 73.4±9.0 years, 42% women) 82 had dementia, 65 had mild cognitive impairment and 66 had no cognitive impairment. Mean office blood pressure was 156/84±23/11 mmHg and mean home blood pressure was 139/79±16/10 mmHg. In 31% of patients, there was disagreement in hypertension diagnosis. This proportion was higher for mild cognitive impairment (38.5%) and dementia (35.4%) compared to no cognitive impairment (18.2%), with adjusted odds ratios of 3.7 (95% confidence interval 1.5–9.0), P =0.005 for mild cognitive impairment and 3.4 (1.3–8.6), P =0.011 for dementia. Conclusions: In memory clinic patients with dementia and mild cognitive impairment, the diagnostic accuracy of office blood pressure measurement is lower compared to patients without cognitive impairment. To avoid the risk of making improper treatment decisions in this vulnerable group, a diagnosis of hypertension should be based on home blood pressure measurement, not office blood pressure measurement. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Determinants of quality of life in family caregivers in MCI: a comparison with mild dementia.
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Tan, Eva Y. L., Janssen, Niels, Handels, Ron, Ramakers, Inez H. G. B., Verhey, Frans R. J., van der Flier, Wiesje M., Melis, René J. F., Olde Rikkert, Marcel G. M., Schols, Jos M. G. A., and de Vugt, Marjolein E.
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COGNITION disorders , *STATISTICS , *SOCIAL determinants of health , *MULTIPLE regression analysis , *HEALTH outcome assessment , *REGRESSION analysis , *MANN Whitney U Test , *PSYCHOLOGICAL tests , *T-test (Statistics) , *QUALITY of life , *PSYCHOLOGY of caregivers , *DEMENTIA , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *RESEARCH funding , *DATA analysis software , *DATA analysis , *SECONDARY analysis , *EDUCATIONAL attainment - Abstract
The aim of the current study was to investigate the health-related quality of life (HRQol) of the family caregiver in MCI, explore possible determinants and study possible differences with mild dementia. This secondary data analysis included 145 persons with MCI and 154 persons with dementia and their family caregivers from two Dutch cohort studies. HRQoL was measured with the VAS of the EuroQol-5D-3L version. Regressions analyses were conducted to examine potential demographic and clinical determinants of the caregiver's HRQoL. The mean EQ5D-VAS in family caregivers of persons with MCI was 81.1 (SD 15.7), and did not significantly differ from family caregivers in mild dementia (81.9 (SD 13.0)). In MCI, patient measurements were not significantly associated with caregiver mean EQ5D-VAS. Concerning caregiver characteristics, being a spouse and a lower educational level were associated with a lower mean EQ5D-VAS (in a multiple linear regression model: unstandardized B −8.075, p = 0.013 and unstandardized B −6.162, p = 0.037 resp.). In mild dementia, the NPI item irritability showed an association with caregiver EQ5D-VAS in bivariate linear regression analyses. Results indicate that especially family caregiver characteristics seem to influence family caregiver HRQoL in MCI. Future research should include other potential determinants such as burden, coping strategies and relationship quality. [ABSTRACT FROM AUTHOR]
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- 2023
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23. Reducing the risks of nuclear war: the role of health professionals.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins-Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
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NUCLEAR warfare , *MEDICAL personnel , *NUCLEAR arms control - Abstract
Current nuclear arms control and non-proliferation efforts are inadequate to protect the world's population against the threat of nuclear war by design, error, or miscalculation. A pathway to nuclear abolition was created with the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017, for which the International Campaign to Abolish Nuclear Weapons was awarded the 2017 Nobel Peace Prize. [Extracted from the article]
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- 2023
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24. Reducing the Risks of Nuclear War-The Role of Health Professionals.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins-Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
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MEDICAL personnel , *NUCLEAR warfare , *NUCLEAR arms control - Published
- 2023
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25. Reducing the risks of nuclear war – The role of health professionals.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins‐Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
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NUCLEAR warfare , *MEDICAL personnel , *NUCLEAR arms control , *NUCLEAR disarmament , *NUCLEAR weapons - Abstract
The article discusses the increasing risk of nuclear war and the role of health professionals in reducing these risks. It highlights the inadequacy of current nuclear arms control efforts and the potential catastrophic consequences of a nuclear war. The health community, particularly organizations like the International Physicians for the Prevention of Nuclear War (IPPNW), has played a crucial role in raising awareness about the medical consequences of nuclear war and advocating for nuclear disarmament. The article calls on health professional associations to inform their members about the threat of nuclear war and support efforts to reduce these risks, including adopting a no first use policy and eliminating nuclear weapons. [Extracted from the article]
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- 2023
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26. Reducing the Risks of Nuclear War.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins-Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
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NUCLEAR warfare , *WARNING labels , *NUCLEAR arms control , *HEALTH policy - Published
- 2023
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27. Reducing the risks of nuclear war—the role of health professionals.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins‐Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
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- *
NUCLEAR warfare , *MEDICAL personnel , *NUCLEAR accidents , *CLIMATE change & health , *NUCLEAR arms control - Published
- 2023
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28. Oral Presentation of Patients with Multimorbidity Needs Adaptation and Teaching.
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Iersel, Marianne and Olde Rikkert, Marcel
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ABILITY , *CLINICAL competence , *COMMUNICATIVE competence , *DECISION making , *HOSPITAL medical staff , *MEDICAL preceptorship , *PATIENTS , *PHYSICIAN-patient relations , *TRAINING , *ACCESS to information - Abstract
A letter to the editor is presented which is concerned with the challenges that are associated with treating patients with multimorbidity.
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- 2013
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29. The gap in postoperative outcome between older and younger patients with stage I-III colorectal cancer has been bridged; results from the Netherlands cancer registry.
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Brouwer, Nelleke P.M., Heil, Thea C., Olde Rikkert, Marcel G.M., Lemmens, Valery E.P.P., Rutten, Harm J.T., de Wilt, Johannes H.W., and van Erning, Felice N.
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AGE distribution , *COLON tumors , *DECISION making , *POSTOPERATIVE period , *SURVIVAL analysis (Biometry) , *TUMOR classification , *TREATMENT effectiveness , *PROGNOSIS ,RECTUM tumors - Abstract
Previous studies have shown that older patients benefited less than younger patients from surgical treatment for colorectal cancer (CRC). However, CRC care has advanced over time, and it is time to assess whether the difference in postoperative mortality between older and younger CRC patients is still present. Patients with primary stage I-III CRC diagnosed between 2005 and 2016 were selected from the Netherlands Cancer Registry (N = 111,778). Trends in postoperative mortality and 1-year postoperative relative survival (RS) were analysed, stratified according to age (<75 versus ≥75 years) and tumour location (colon versus rectum). One-year postoperative RS was analysed to correct for background mortality in the older population. Between 2005 and 2016, 30-day postoperative mortality showed a stronger decrease for older patients (from 10.0% to 4.0% for colon cancer [p < 0.001] and from 8.3% to 2.7% for rectal cancer [p < 0.001]) compared with younger patients (from 2.0% to 0.9% for colon cancer [p < 0.001] and from 1.4% to 0.7% for rectal cancer [p = 0.01]). Between 2005 and 2016, also 1-year RS increased more for older patients (from 84.8% to 94.6% for colon cancer and from 86.1% to 97.2% for rectal cancer) compared with younger patients (from 94.0% to 97.8% for colon cancer and from 96.3% to 98.8% for rectal cancer). Between 2005 and 2016, differences in postoperative mortality between older and younger CRC patients decreased. One-year postoperative RS was almost equal for older and younger patients in 2015–2016. This information is crucial for shared decision-making on surgical treatment. • Differences in mortality between older and younger CRC patients decreased. • One-year relative survival became nearly equal for older and younger patients. • Previous literature is no longer representative of the current clinical practice. [ABSTRACT FROM AUTHOR]
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- 2019
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30. Defining Patient Complexity.
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Olde Rikkert, Marcel G. M., Schers, Henk J., Melis, Rene J. F., Cerimele, Joseph M., Peccoralo, Lauren A., Grant, Richard W., Hong, Clemens S., and Atlas, Steven J.
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LETTERS to the editor , *PRIMARY care , *PHYSICIANS , *COHORT analysis , *PATIENTS - Abstract
Several letters to the editor are presented including two in response to the article "Defining patient complexity from the primary care physician's perspective: a cohort study" by R. W. Grant, J. M. Ashburner, C. C. Hong, Y. Chang, M. J. Barry and S. J. Atlas in a previous issue, and one which is a response from above authors to the letters to the editor about their article.
- Published
- 2012
31. Early warning signals for critical transitions in cardiopulmonary health, related to air pollution in an urban Chinese population.
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Wang, Ce, Bi, Jun, and Olde Rikkert, Marcel G.M.
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CARDIOPULMONARY system , *AIR pollution , *AUTOCORRELATION (Statistics) , *POPULATION health ,CORONARY artery abnormalities - Abstract
Abstract Respiratory, and cardio-cerebrovascular health-related diseases significantly threaten human health and together with air pollution form a complex pathophysiological system. Other complex biological systems show that increased variance and autocorrelations in time series may act as valid early warning signals for critical transitions. On population level, we determined the likelihood that increased variance and autocorrelation of hospital visit on cardiopulmonary disease preceded critical transitions in population health by human-pollution interactions. We investigated long-term hospital visits from a hospital in Nanjing City, China during 2006–2016 for the most important cardiopulmonary diseases likely to be influenced by air pollution: cerebrovascular accident disease (CVAD), coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), lung cancer disease (LCD), and the grouped categories of respiratory system disease (RESD) and cardio-cerebrovascular system disease (CCD). The time series of standard deviations (SDs) and autocorrelation at-lag-1 (AR-1) were studied as potential Early-Warning Indicators (EWIs) of transitions in population health. Elevated SDs provided an early warning for critical transitions in visit for LCD and overall CCD and CVAD, for the period of 2012–2013, after which a real transition of increased visit occurred for these disease categories. Statistical testing showed that these SDs were significantly increased (p < 0.1). The long-term air pollution together with intermittent pollution episodes may have triggered critical transitions in population health for cardiopulmonary disease. It is recommended to consider significant increases in variability in time series of relevant system parameters, such as visit, as early warning signs for future transitions in populations' health states. Graphical abstract Unlabelled Image Highlights • The human-pollution interaction can be considered as a complex nonlinear system. • The likelihood of loss of resilience of cardiopulmonary health was investigated. • Elevated standard deviation provides an early warning for critical transitions. • Air pollution may play a pivotal role for transitions in population health. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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32. Shared decision-making in older patients with colorectal or pancreatic cancer: Determinants of patients' and observers' perceptions.
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Geessink, Noralie H., Ofstad, Eirik H., Olde Rikkert, Marcel G.M., van Goor, Harry, Kasper, Jürgen, and Schoon, Yvonne
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PANCREATIC cancer , *DECISION making , *OLDER patients , *COLON cancer , *QUALITY of life , *COLON tumors , *COMMUNICATION , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *PANCREATIC tumors , *SENSORY perception , *PHYSICIAN-patient relations , *QUESTIONNAIRES , *RESEARCH , *PATIENT participation , *EVALUATION research , *CROSS-sectional method , *TUMOR treatment ,RECTUM tumors - Abstract
Objective: To identify determinants of older patients' perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions.Methods: Patients' perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers' perceptions were constructed by the OPTION5, OPTION12, and MAPPIN'SDM. Convergent validities were calculated between the patient-sided and observer instruments using Spearman's correlation coefficient. Linear regression was used to identify determinants per criterion.Results: 58 CRC and 22 PC patients were included (mean age: 71.8 ± 5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients' impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers' perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills.Conclusion: Due to evident differences in determinants, older CRC/PC patients' and observers' perceptions of involvement should both be collected in evaluating the quality of medical decision-making.Practice Implications: General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction. [ABSTRACT FROM AUTHOR]- Published
- 2018
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33. Self-management tasks to improve mobility and reduce fall risk are not leading to lower research participation in older adults.
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Bongers, Kim T.J., Schoon, Yvonne, and Olde Rikkert, Marcel G.M.
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EXPERIMENTAL design , *ACCIDENTAL falls , *MEETINGS , *PARTICIPATION , *RISK management in business , *HEALTH self-care , *GROUP process , *RESIDENTIAL patterns , *BODY movement , *COMMUNITY services , *INDEPENDENT living , *HUMAN research subjects , *PATIENT selection , *OLD age - Abstract
Purpose of study The first aim is to evaluate, in a sub-study, the recruitment process of the Senior Step Study, which was an intervention study on the self-management of mobility and fall risk; the second aim is to explore the reasons mentioned by older people, from three different settings, for (not) participating. Methods Subjects were community-dwelling older persons, residents of homes for the elderly, and older persons regularly visiting community centres. The effectiveness of different recruitment procedures was analysed for each setting separately. We also analysed reasons for accepting and declining participation between the settings. Results The total inclusion rate was 27.9%. A personal initial approach (i.e., first contact was face-to-face or in a group meeting) did not improve the inclusion rate. More subjects consented to participate after an introductory meeting (which was planned after the first face-to-face contact) compared to persons not having one (p < 0.01). At different settings, subjects gave different reasons for participation. No differences were found in the reasons for refusing participation. Especially in homes for the elderly, people refused to participate because the research was too burdensome. Conclusions The inclusion rates in this study are comparable to other self-management studies with older people. An introductory meeting during which the study design and benefits of participating are explained and formal interim evaluations of the recruitment process may benefit recruitment. Recruiting older persons for self-management tasks is possible with the appropriate recruitment process, enabling more research on this increasingly important research topic. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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34. Cognitive and functional progression in Alzheimer disease: A prediction model of latent classes.
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Haaksma, Miriam L., Calderón-Larrañaga, Amaia, Olde Rikkert, Marcel G. M., Melis, René J. F., Leoutsakos, Jeannie‐Marie S., and Leoutsakos, Jeannie-Marie S
- Subjects
- *
ALZHEIMER'S disease , *MENTAL illness , *LOGISTIC regression analysis , *DEMENTIA , *MENTAL health - Abstract
Objective: We sought to replicate a previously published prediction model for progression, developed in the Cache County Dementia Progression Study, using a clinical cohort from the National Alzheimer's Coordinating Center.Methods: We included 1120 incident Alzheimer disease (AD) cases with at least one assessment after diagnosis, originating from 31 AD centres from the United States. Trajectories of the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating sum of boxes (CDR-sb) were modelled jointly over time using parallel-process growth mixture models in order to identify latent classes of trajectories. Bias-corrected multinomial logistic regression was used to identify baseline predictors of class membership and compare these with the predictors found in the Cache County Dementia Progression Study.Results: The best-fitting model contained 3 classes: Class 1 was the largest (63%) and showed the slowest progression on both MMSE and CDR-sb; classes 2 (22%) and 3 (15%) showed moderate and rapid worsening, respectively. Significant predictors of membership in classes 2 and 3, relative to class 1, were worse baseline MMSE and CDR-sb, higher education, and lack of hypertension. Combining all previously mentioned predictors yielded areas under the receiver operating characteristic curve of 0.70 and 0.75 for classes 2 and 3, respectively, relative to class 1.Conclusions: Our replication study confirmed that it is possible to predict trajectories of progression in AD with relatively good accuracy. The class distribution was comparable with that of the original study, with most individuals being members of a class with stable or slow progression. This is important for informing newly diagnosed AD patients and their caregivers. [ABSTRACT FROM AUTHOR]- Published
- 2018
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35. SUDDEN DECLINE IN MOBILITY AS AN INDICATOR OF INFECTION AND DISCLOSURE OF SUBCLINICAL SARCOPENIA: FOUR CASES.
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van Iersel, Marianne B. and Olde Rikkert, Marcel G.M.
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- *
LETTERS to the editor , *INFECTION - Abstract
A letter to the editor is presented concerning four cases of older patients who experienced sudden function decline as a result of infection.
- Published
- 2010
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36. FRAILTY CRITERIA GIVE HETEROGENEOUS RESULTS WHEN APPLIED IN CLINICAL PRACTICE.
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van Iersel, Marianne B. and Olde Rikkert, Marcel G. M.
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LETTERS to the editor , *FRAIL elderly - Abstract
A letter to the editor is presented in response to the article related to the use of frailty criteria in geriatric patients.
- Published
- 2006
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37. Implementation of interprofessional digital communication tools in primary care for frail older adults: An interview study.
- Author
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Oostra, Dorien L., Fierkens, Carlien, Alewijnse, Marloes E. J., Olde Rikkert, Marcel G. M., Nieuwboer, Minke S., and Perry, Marieke
- Subjects
- *
CAREGIVER attitudes , *OCCUPATIONAL roles , *FRAIL elderly , *HEALTH services accessibility , *MEDICAL transcription , *RESEARCH methodology , *INTERVIEWING , *PRIMARY health care , *HUMAN services programs , *EXPERIENCE , *QUALITATIVE research , *PSYCHOSOCIAL factors , *INTERPROFESSIONAL relations , *TELECOMMUNICATION , *PSYCHOLOGY of caregivers , *RESEARCH funding , *MEDICAL coding - Abstract
Communication and coordination between primary healthcare professionals and informal caregivers involved in the care for frail older adults is suboptimal and could benefit from interprofessional digital communication tools. Implementation in daily practice however frequently fails. We aim to identify generic barriers and facilitators experienced by healthcare professionals and informal caregivers during implementation of interprofessional communication tools to improve their long-term use. Qualitative content analysis using individual semi-structured interviews was used for evaluating three different digital communication tools used by interprofessional primary care networks for frail older adults by 28 professionals and 10 caregivers. After transcription and open coding, categories and themes were identified. Barriers and facilitators were related to: tool characteristics, context of use, involvement of professionals and caregivers. The tool improved availability, approachability and users' involvement. The large number of digital systems professionals simultaneously use, and different work agreements hampered tool use. The tools facilitated care coordination, and professionals declared to be better informed about patients' current situations. Overall, interprofessional digital communication tools can facilitate communication in networks for primary elderly care. However, integration between digital systems is needed to reduce the number of tools. Organizations and policy makers have an important role in realizing the tools' long-term use. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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38. The Rainbow Model of Integrated Care Measurement Tool: validation for the primary elderly care setting.
- Author
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Oostra, Dorien, Nieuwboer, Minke, Olde Rikkert, Marcel, Valentijn, Pim, and Perry, Marieke
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- *
MATHEMATICAL models , *CONFERENCES & conventions , *PRIMARY health care , *THEORY , *ELDER care - Abstract
Introduction: Implementing integrated care in primary care settings is essential to establish a sustainable health care system for older adults living at home. Measuring integrated care performance facilitates implementation and improvement of integrated care services in daily practice, yet valid instruments are still lacking. Based on the Rainbow Model of Integrated Care (RMIC) a measurement tool (MT) has been validated for renal care patients and care providers. In the present study we aimed to validate the RMIC-MT for healthcare professionals working in an integrated primary elderly care setting. Theory/Methods: The RMIC-MT is a 36-item questionnaire, covering all aspects of integrated care according to the RMIC. Per integration domain professionals are asked to rate a set of questions. In a cross-sectional study, the RMIC-MT was sent to local networks of primary elderly care professionals in the Netherlands by email between February 2020 and February 2021. Confirmatory factor analysis (CFA) was used to build upon the previous results of the RMIC-MT for renal care by using the standard fit indices: root-mean-square error of approximation (RMSEA) (=0.06), standardized root-mean-square residual (SRMR) (=0.08), comparative fit index (CFI) (=0.90) and Tucker-Lewis index (TLI) (=0.90). Maximum likelihood was used to estimate the model parameters and goodness-of-fit indices. Results: 323 professionals filled out the RMIC-MT, the majority were general practitioners, community nurses, practice nurses and case managers. Median time needed to complete the RMIC-MT was 14 minutes. Some professionals did not complete the questionnaire because the questionnaire was too long or perceived as irrelevant. The model passed the goodness-to-fit test by confirmatory factor analysis: RMSEA=0.046, SRMR=0.055, CFI=0.895, TLI=0.882. The factor structure of 9 categories with a total of 36 items was thereby confirmed. Conclusions: We successfully validated the RMIC-MT for the primary elderly care setting. We adjusted the name of one category from 'triple aim' to 'outcome measurements'. Application of the RMIC-MT enables professional networks in this setting to evaluate and improve their care integration and contribute to better quality and more sustainable primary elderly care. Implications for applicability/transferability, sustainability, and limitations: The sample size was small but sufficient for the CFA. Recruitment was difficult which may reflect difficulties in future use in daily practice. The RMIC-MT was considered too long by some professionals. Developing a shorter version may be a promising strategy to increase completion in daily practice. RMIC-MT application can enable professionals to improve people-centered integrated primary care by using the feedback reports for improvement plans. Feasibility and added value of the tool should be studied after this small-scale implementation. Broader implementation of the RMIC-MT for elderly care should be investigated, including other contexts and countries. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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39. Longitudinal multiple case study on effectiveness of network-based dementia care towards more integration, quality of care, and collaboration in primary care.
- Author
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Richters, Anke, Nieuwboer, Minke S., Olde Rikkert, Marcel G. M., Melis, Rene J. F., Perry, Marieke, and van der Marck, Marjolein A.
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TREATMENT of dementia , *MEDICAL quality control , *PRIMARY care , *LONGITUDINAL method , *ACQUISITION of data - Abstract
Introduction: This study aimed to provide insight into the merits of DementiaNet, a network-based primary care innovation for community-dwelling dementia patients. Methods: Longitudinal mixed methods multiple case study including 13 networks of primary care professionals as cases. Data collection comprised continuously-kept logs; yearly network maturity score (range 0–24), yearly quality of care assessment (quality indicators, 0–100), and in-depth interviews. Results: Networks consisted of median nine professionals (range 5–22) covering medical, care and welfare disciplines. Their follow-up was 1–2 years. Average yearly increase was 2.03 (95%-CI:1.20–2.96) on network maturity and 8.45 (95%-CI:2.80–14.69) on quality indicator score. High primary care practice involvement and strong leadership proved essential in the transition towards more mature networks with better quality of care. Discussion: Progress towards more mature networks favored quality of care improvements. DementiaNet appeared to be effective to realize transition towards network-based care, enhance multidisciplinary collaboration, and improve quality of dementia care. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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40. Assessment of goals and priorities in patients with a chronic condition: a secondary quantitative analysis of determinants across 11 countries.
- Author
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Vermunt, Neeltje P. C. A., Westert, Gert P., Olde Rikkert, Marcel G. M., and Faber, Marjan J.
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CHRONIC diseases , *COMMUNICATION , *CONTINUUM of care , *GOAL (Psychology) , *MEDICAL personnel , *NEEDS assessment , *PHYSICIAN-patient relations , *PSYCHOLOGICAL stress , *LOGISTIC regression analysis , *QUANTITATIVE research , *SECONDARY analysis , *LIFESTYLES , *INDEPENDENT living , *PATIENT-centered care , *HEALTH & social status , *DESCRIPTIVE statistics , *ODDS ratio , *PSYCHOLOGY - Abstract
Objective:To assess the impact of patient characteristics, patient-professional engagement, communication and context on the probability that healthcare professionals will discuss goals or priorities with older patients. Design:Secondary analysis of cross-sectional data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults. Setting:11 western countries. Subjects:Community-dwelling adults, aged 55 or older. Main outcome measure:Assessment of goals and priorities. Results:The final sample size consisted of 17,222 respondents, 54% of whom reported an assessment of their goals and priorities (AGP) by healthcare professionals. In logistic regression model 1, which was used to analyse the entire population, the determinants found to have moderate to large effects on the likelihood of AGP were information exchange on stress, diet or exercise, or both. Country (living in Sweden) and continuity of care (no regular professional or organisation) had moderate to large negative effects on the likelihood of AGP. In model 2, which focussed on respondents who experienced continuity of care, country and information exchange on stress and lifestyle were the main determinants of AGP, with comparable odds ratios to model 1. Furthermore, a professional asking questions also increased the likelihood of AGP. Conclusions:Continuity of care and information exchange is associated with a higher probability of AGP, while people living in Sweden are less likely to experience these assessments. Further study is required to determine whether increasing information exchange and professionals asking more questions may improve goal setting with older patients.Key points A patient goal-oriented approach can be beneficial for older patients with chronic conditions or multimorbidity; however, discussing goals with these patients is not a common practice.The likelihood of discussing goals varies by country, occurring most commonly in the USA, and least often in Sweden.Country-level differences in continuity of care and questions asked by a regularly visited professional affect the goal discussion probability.Patient characteristics, including age, have less impact than expected on the likelihood of sharing goals. [ABSTRACT FROM PUBLISHER]
- Published
- 2018
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41. Physical Activity and Cognitive Function of Long-Distance Walkers: Studying Four Days Marches Participants.
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Wouters, Hans, Aalbers, Teun, Maessen, Martijn F.H., Verbeek, André L.M., Rikkert, Marcel G.M. Olde, Kessels, Roy P.C., Hopman, Maria T.E., Eijsvogels, Thijs M.H., Maessen, Martijn, Verbeek, André, Olde Rikkert, Marcel, Kessels, Roy, Hopman, Maria, Eijsvogels, Thijs, Verbeek, André L M, and Olde Rikkert, Marcel G M
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PHYSICAL activity , *COGNITIVE ability , *LONG distance walking , *EXECUTIVE function , *SHORT-term memory , *BRAIN physiology , *AGING , *COGNITION , *DEMOGRAPHY , *EXERCISE , *WALKING - Abstract
Studies show physical activity to be beneficial for cognitive function. However, studies usually included individuals who were not particularly inclined to exercise. Following research among master athletes, we examined associations between physical activity and cognitive function in participants of the International Nijmegen Four Days Marches. These individuals are also inclined to exercise. On 4 consecutive days >40,000 participants walk a daily distance of 30-50 km (120-200 km or 75-125 miles in total). Four Days Marches participants and less active or inactive control participants from the Nijmegen Exercise Study were examined. Self-reported current and lifelong physical activities were quantified in Metabolic Equivalent of Task minutes/day, and training walking speed was estimated in km/h. Cognitive functioning in the domains of working memory, executive function, and visuospatial short-term memory was assessed using the validated Brain Aging Monitor. Data from 521 participants (mean age 54.7, standard deviation 12.9) showed neither positive associations between lifelong physical activity and working memory, executive function, and visuospatial short-term memory nor positive associations between current physical activity and cognitive functioning in these domains (p-values >0.05). However, a positive association between training walking speed and working memory was revealed (age adjusted β = 0.18, p-value <0.01). Walking speed as a surrogate marker of fitness, but not lifelong and current physical activity levels was associated with cognitive function. Therefore, walking speed deserves more attention in research aimed at unraveling associations between physical activity and cognitive function. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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42. Reducing the risks of nuclear war—the role of health professionals.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins‐Domingo, Kirsten, Olde Rikkert, Marcel G. M., Haines, Andy, Helfand, Ira, Horton, Richard, Mash, Bob, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinski, Chris
- Subjects
- *
PREVENTION of nuclear warfare , *COMMUNITIES , *PUBLIC health , *WEAPONS , *INTERPROFESSIONAL relations - Abstract
An editorial is presented on the increasing threat of nuclear war and implores healthcare professionals to take action. It highlights the health community's historical role in advocating for nuclear disarmament and urges immediate steps like a "no first use" policy, reducing nuclear alert levels, and discouraging the use of nuclear weapons in conflicts, ultimately calling for global nuclear disarmament.
- Published
- 2023
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43. REDUCING THE RISK OF NUCLEAR WAR - THE ROLE OF HEALTHCARE PROFESSIONALS.
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Abbasi, Kamran, Ali, Parveen, Barbour, Virginia, Bibbins-Domingo, Kirsteen, Olde Rikkert, Marcel G. M., Haines, Andy, Helfland, Ira, Horton, Ricard, Mash, Robert, Mitra, Arun, Monteiro, Carlos, Naumova, Elena N., Rubin, Eric J., Ruff, Tilman, Sahni, Peush, Tumwine, James, Yonga, Paul, and Zielinki, Chris
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NUCLEAR warfare , *MEDICAL personnel , *NUCLEAR arms control - Published
- 2023
- Full Text
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44. Sitting aids communication...
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Olde Rikkert, Marcel
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COMMUNICATIVE competence , *PHYSICIAN-patient relations - Abstract
A letter to the editor is presented indicating that Rashid's suggestion that consultations in primary care should be held standing up is against basic communication skills requiring eye contact, full attention and being at the same level.
- Published
- 2014
45. Head Turning-Induced Hypotension in Elderly People.
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Schoon, Yvonne, Olde Rikkert, Marcel G. M., Rongen, Sara, Lagro, Joep, Schalk, Bianca, and Claassen, Jurgen A. H. R.
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HYPOTENSION , *DISEASES in older people , *CAROTID sinus , *ALLERGIES , *BLOOD pressure , *EVERYDAY life , *HEART beat - Abstract
Carotid sinus hypersensitivity has a high prevalence in the elderly and is a possible cause of falls. In carotid sinus hypersensitivity, external triggers cause sudden reductions in blood pressure, leading to dizziness or syncope, resulting in falls. Turning of the head is considered an important example of such an external trigger in everyday life, wherein rotation of the neck is thought to manipulate the hypersensitive carotid sinus. However, direct evidence for this is lacking. The aim of this study was to investigate the effects of head turning in elderly with carotid sinus hypersensitivity. We performed a prospective, observational study in 105 elderly patients who visited a geriatric falls clinic in a university teaching hospital and in 25 community dwelling healthy elderly subjects. Continuous measurements of blood pressure and heart rate (Finapres) were performed before, during, and after head turning. Head turning-induced hypotension was defined as a drop in systolic blood pressure of at least 20 mmHg during head turning. Carotid sinus hypersensitivity was examined with carotid sinus massage. We also tested for two other common geriatric hypotensive syndromes, orthostatic hypotension and post prandial hypotension, using active standing and a meal test. All three hypotensive syndromes were defined using consensus definitions. Head turning resulted in hypotension in 39% of patients (mean systolic blood pressure drop 36 mm Hg) and in 44% of the healthy elderly, irrespective of the direction of the head movement. Carotid sinus hypersensitivity was associated with head-turning induced hypotension (OR= 3.5, 95% CI= 1.48 to 8.35). We conclude that head turning is indeed an important cause of sudden drops in blood pressure in elderly with carotid sinus hypersensitivity. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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46. Older Adults' Views on Social Interactions and Online Socializing Games – A Qualitative Study.
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Janssen, Jeroen H. M., Kremers, Evi M., Nieuwboer, Minke S., Châtel, Bas D. L., Corten, Rense, Olde Rikkert, Marcel G. M., and Peeters, G. M. E. E.
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SOCIALIZATION , *FRAIL elderly , *SOCIAL support , *INTERNET , *SOCIAL networks , *RESEARCH methodology , *DIGITAL technology , *FUNCTIONAL status , *INTERVIEWING , *QUALITATIVE research , *SOCIAL isolation , *INTERPERSONAL relations , *LONELINESS , *RESEARCH funding , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *VIDEO games , *DATA analysis software , *OLD age - Abstract
Age-related difficulties and quarantine restrictions impede the possibilities to maintain contact with one's social network. Maintaining these contacts may be supported by digital games. To develop effective and feasible digital tools to foster social interaction, we aimed to explore what older adults find important in social contact and what barriers and enablers they foresee in digital gaming interventions as network support aids. Two focus groups and 20 semi-structured interviews (N = 29) with older adults (aged 55–87) were held to explore the research questions. Furthermore, a questionnaire was administered (N = 29) containing measures of loneliness, frailty, and social network size. Participants found 'reciprocity', 'in-person contact', and 'personal connection' important in contact with strong ties. Online games were not used much for socializing but may be used in the future, particularly by less mobile older adults. Future social gaming interventions should be challenging, user-friendly, and offer the possibility to communicate. Digital co-designed interventions that are feasible, challenging, intuitive, and trigger meaningful communication may strengthen social interactions in older adults. They may be a relevant social support tool in periods of interaction limitations due to functional impairment or social isolation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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47. Effects of tetrahydrocannabinol on balance and gait in patients with dementia: A randomised controlled crossover trial.
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Van Den Elsen, Geke A. H., Tobben, Lieke, Ahmed, Amir I. A., Verkes, Robbert Jan, Kramers, Cornelis, Marijnissen, Radboud M., Olde Rikkert, Marcel G. M., Van Der Marck, Marjolein A., van den Elsen, Geke Ah, Ahmed, Amir Ia, and Olde Rikkert, Marcel Gm
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TETRAHYDROCANNABINOL , *DEMENTIA patients , *NEUROBEHAVIORAL disorders , *CANNABINOIDS , *ALZHEIMER'S patients , *DISEASES , *PATIENTS , *THERAPEUTICS , *CANNABIS (Genus) , *COMPARATIVE studies , *CROSSOVER trials , *DEMENTIA , *POSTURAL balance , *GAIT in humans , *RESEARCH methodology , *MEDICAL cooperation , *POSTURE , *RESEARCH , *STATISTICAL sampling , *EVALUATION research , *RANDOMIZED controlled trials , *BLIND experiment - Abstract
Oral tetrahydrocannabinol (THC) is currently studied for its possible efficacy on dementia-related neuropsychiatric symptoms (NPS), but might lead to increased risk of falling. This was a randomised, double-blind, crossover study to evaluate the effects of THC on mobility in dementia patients. Eighteen community-dwelling patients ( Mage=77 years) received 1.5 mg of oral THC twice daily and placebo, in random order, for three days, separated by a four-day washout. Balance and gait were assessed using SwayStarTM and GAITRiteTM within two hours after administration, in two consecutive intervention periods, under the following conditions: standing with eyes open (EO) and eyes closed (EC), preferred speed walking with and without a cognitive dual task. THC significantly increased sway during standing EC (roll angle 0.32[±0.6]°, p=0.05; pitch angle 1.04[±1.5]°, p=0.009; pitch velocity 1.96[±3.3]°/s, p=0.02), but not during standing EO. During preferred speed walking, THC increased stride length (4.3[±5.4] cm, p=0.005) and trunk sway (pitch angle 1.18[±1.6]°, p=0.005). No effects were observed during dual task walking. No differences in the number and type of adverse events were found, and no falls occurred after administration of THC. This study showed that 3 mg of THC per day has a benign adverse event profile regarding mobility and was well tolerated by community-dwelling dementia patients. [ABSTRACT FROM AUTHOR]
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- 2017
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48. A profile of The Clinical Course of Cognition and Comorbidity in Mild Cognitive Impairment and Dementia Study (The 4C study): two complementary longitudinal, clinical cohorts in the Netherlands.
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Weiqi Liao, Hamel, Renske E. G., Olde Rikkert, Marcel G. M., Oosterveld, Saskia M., Aalten, Pauline, Verhey, Frans R. J., Scheltens, Philip, Sistermans, Nicole, Pijnenburg, Yolande A. L., van der Flier, Wiesje M., Ramakers, Inez H. G. B., and Melis, René J. F.
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MILD cognitive impairment , *DIAGNOSIS of dementia , *COGNITION , *COMORBIDITY , *QUALITY of life , *DIAGNOSIS - Abstract
Background: Heterogeneous disease trajectories of mild cognitive impairment (MCI) and dementia are frequently encountered in clinical practice, but there is still insufficient knowledge to understand the reasons and mechanisms causing this heterogeneity. In addition to correlates of the disorder, patient characteristics such as their health status, social environment, comorbidities and frailty may contribute to variability in trajectories over time. The current paper outlines the study design and the study population of and provides an overview of the data collected in the Clinical Course of Cognition and Comorbidity in Mild Cognitive Impairment (4C-MCI cohort, n = 315) and Dementia (4C-Dementia cohort, n = 331) Study. Methods: The two complementary longitudinal cohorts part of the 4C study began enrolment in March 2010. Participants were prospectively recruited from three collaborating Dutch Alzheimer Centers, with three annual follow-up assessments after baseline. Extensive neuropsychological assessments, and detailed profiling of comorbidities, health and frailty at each follow up were the key features of the 4C study. As such, the 4C study was designed to study if and how patients' comorbidities and frailty are associated with the course of MCI and dementia measured with a comprehensive and multidimensional set of outcomes including cognition, daily functioning, quality of life, behavioral disturbances, caregiver burden, institutionalization and death and whether the effects of medical health and frailty differ between MCI and dementia stages of cognitive disorders. Conclusion: Sampled in a clinical setting, the 4C study complements population-based studies on neurodegenerative disorders in terms of the type of assessment (e.g. comorbidity, frailty, and functional status were repeatedly assessed). The 4C study complements available clinical cohorts of MCI and dementia patients, because the exclusion criteria were kept to a minimum, to obtain a sample that is representative for the average patient visiting a memory clinic. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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49. The International Dementia Alliance Instrument for Feasible and Valid Staging of Individuals with Dementia by Informal Caregivers.
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Richters, Anke, Melis, Rene J.F., Olde Rikkert, Marcel G.M., and Marck, Marjolein A.
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DIAGNOSIS of dementia , *ACADEMIC medical centers , *CAREGIVERS , *CONFIDENCE intervals , *STATISTICAL correlation , *DEMENTIA , *PSYCHOMETRICS , *RESEARCH funding , *MULTITRAIT multimethod techniques , *CROSS-sectional method , *RESEARCH methodology evaluation , *DESCRIPTIVE statistics - Abstract
Objectives To assess the feasibility and validity of the International Dementia Alliance ( IDEAL) instrument for Informal Caregivers ( IDEAL- IC), which is based on the IDEAL instrument for professionals ( IDEAL-P), for staging individuals with dementia. Design Cross-sectional. Setting Memory clinic of a university hospital. Participants Informal caregivers of 73 community-dwelling elderly adults referred to a memory clinic and six geriatric registrars. Measurements Caregivers completed the IDEAL- IC; physicians completed the original IDEAL-P and the Clinical Dementia Rating sum of boxes ( CDR- SB). Missing items and floor and ceiling effects were reviewed to assess feasibility. To test construct validity, a priori hypotheses were defined for expected correlations between IDEAL- IC, IDEAL-P, and CDR- SB scores. Results Seventy-three IDEAL- IC instruments were completed, 86% of which had no missing items. Three percent of all 730 individual items were missing. No floor or ceiling effects were detected. CDR scores were 0 7%, 0.5 in 33%, 1 in 27%, 2 in 10%, and unknown in 23%. IDEAL- IC scores correlated highly with IDEAL-P scores (correlation coefficient ( r) = 0.70) and with CDR- SB scores ( r = 0.65) as expected; the difference between these two correlations was smaller than expected. Agreement between IDEAL- IC and IDEAL-P scores was 34% within a range of 1 point difference on 36-point scales, 57% within a range of two points, and 81% within a range of five points. Correlation between IDEAL-P and CDR- SB was very high ( r = 0.85). Conclusion Results of this study indicate good feasibility and high validity of staging dementia by informal caregivers using the IDEAL- IC. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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50. Reply.
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Olde Rikkert, Marcel G. M. and Rigaud, Anne-Sophie
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LETTERS to the editor , *MALNUTRITION - Abstract
Presents a response by Marcel G. M. Olde Rikkert and Anne-Sophie Rigaud to a letter to the editor about their article "Malnutrition Research: High Time to Change the Menu," in the 2003 issue of the "Age and Ageing."
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- 2004
- Full Text
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