Determinants of First Practice Location among Canadian Geriatric Medicine Trainees and Recent Graduates: Findings of a Cross-sectional Survey in 2023.

Background: There is a projected and growing gap of geriatricians in Canada. Geriatricians play a crucial role in addressing the health needs of older adults. We aimed to understand the factors that influence the choice of first-practice location for new geriatricians in the context of an aging Canadian population.

Standing middle cerebral artery velocity predicts cognitive function and gait speed in older adults with cognitive impairment, and is impacted by sex differences.

Upright posture challenges the cerebrovascular system, leading to changes in middle cerebral artery velocity (MCAv) dynamics which are less evident at supine rest. Chronic alterations in MCAv have been linked to hypoperfusion states and the effect that this may have on cognition remains unclear. This study aimed to determine if MCAv and oscillatory metrics of MCAv (ex.

Vascular Brain Lesions, Cognitive Reserve, and Their Association with Cognitive Profile in Persons with Early-Stage Cognitive Decline.

Background: Cognitive reserve may protect against the effects of brain pathology, but few studies have looked at whether cognitive reserve modifies the adverse effects of vascular brain pathology.

Objective: We determined if cognitive reserve attenuates the associations of vascular brain lesions with worse cognition in persons with subjective concerns or mild impairment.

Methods: We analyzed 200 participants aged 50-90 years from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study.

The impact of chronotype on circadian rest-activity rhythm and sleep characteristics across the week.

Circadian rhythms are maintained by a complex "system of systems" that continuously coordinates biological processes with each other and the environment. Although humans predominantly entrain to solar time, individual persons vary in their precise behavioral timing due to endogenous and exogenous factors. Endogenous differences in the timing of individual circadian rhythms relative to a common environmental cue are known as chronotypes, ranging from earlier than average (Morningness) to later than average (Eveningness).

Corrigendum: Evaluation of Wearable Technology in Dementia: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.3389/fmed.2020.

Development of digital measures for nighttime scratch and sleep using wrist-worn wearable devices.

Patients with atopic dermatitis experience increased nocturnal pruritus which leads to scratching and sleep disturbances that significantly contribute to poor quality of life. Objective measurements of nighttime scratching and sleep quantity can help assess the efficacy of an intervention. Wearable sensors can provide novel, objective measures of nighttime scratching and sleep; however, many current approaches were not designed for passive, unsupervised monitoring during daily life.

Evaluation of Wearable Technology in Dementia: A Systematic Review and Meta-Analysis.

The objective of this analysis was to systematically review studies employing wearable technology in patients with dementia by quantifying differences in digitally captured physiological endpoints. This systematic review and meta-analysis was based on web searches of Cochrane Database, PsycInfo, Pubmed, Embase, and IEEE between October 25-31st, 2017. Observational studies providing physiological data measured by wearable technology on participants with dementia with a mean age ≥50.

The Hawthorne Effect in Eye-blinking: Awareness that One's Blinks are Being Counted Alters Blink Behavior.

: Spontaneous eye-blink rate is the number of involuntary blinks performed during a certain period of time. Assessing blink rate in humans provides valuable physiological and behavioral data for studying neuropathology and emotional states. Cognitive states, including awareness on the part of the subject that his or her blinks are being counted, may influence blink activity and confound blink rate measurements.

mHealth and wearable technology should replace motor diaries to track motor fluctuations in Parkinson's disease.

Accurately monitoring motor and non-motor symptoms as well as complications in people with Parkinson's disease (PD) is a major challenge, both during clinical management and when conducting clinical trials investigating new treatments. A variety of strategies have been relied upon including questionnaires, motor diaries, and the serial administration of structured clinical exams like part III of the MDS-UPDRS. To evaluate the potential use of mobile and wearable technologies in clinical trials of new pharmacotherapies targeting PD symptoms, we carried out a project (project BlueSky) encompassing four clinical studies, in which 60 healthy volunteers (aged 23-69; 33 females) and 95 people with PD (aged 42-80; 37 females; years since diagnosis 1-24 years; Hoehn and Yahr 1-3) participated and were monitored in either a laboratory environment, a simulated apartment, or at home and in the community.

Variations in rest-activity rhythm are associated with clinically measured disease severity in Parkinson's disease.

The continuous, longitudinal nature of accelerometry monitoring is well-suited to capturing the regular 24-hour oscillations in human activity across the day, the cumulative effect of our circadian rhythm and behavior. Disruption of the circadian rhythm in turn disrupts rest-activity rhythms. Although circadian disruption is a major feature of Parkinson's disease (PD), rest-activity rhythms and their relationship with disease severity have not been well characterized in PD.

Use of Predictive Modeling to Plan for Special Event Medical Care During Mass Gathering Events.

Objectives: In 2010, South Africa (SA) hosted the Fédération Internationale de Football Association (FIFA) World Cup (soccer). Emergency Medical Services (EMS) used the SA mass gathering medicine (MGM) resource model to predict resource allocation. This study analyzed data from the World Cup and compared them with the resource allocation predicted by the SA mass gathering model.

A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack.

Background: Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population.

Objectives: The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk.

Methods: We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016.

Quantification of discrete behavioral components of the MDS-UPDRS.

Introduction: The Movement Disorder Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is the current gold standard means of assessing disease state in Parkinson's disease (PD). Objective measures in the form of wearable sensors have the potential to improve our ability to monitor symptomology in PD, but numerous methodological challenges remain, including integration into the MDS-UPDRS. We applied a structured video coding scheme to temporally quantify clinical, scripted, motor tasks in the MDS-UPDRS for the alignment and integration of objective measures collected in parallel.

The prevalence of unexplained falls and syncope in older adults presenting to an Irish urban emergency department.

Aim: There is growing evidence of an overlap between unexplained falls and syncope in older adults. Our aim was to examine the prevalence and associated resource utilization of these conditions in an urban emergency department (ED).

Patients And Methods: A single-centre, prospective, observational study was carried out over a 6-month period.

Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours.

Objective: This study aimed to evaluate the nature and type of communication and workflow arrangements between nurses and doctors out-of-hours (OOH). Effective communication and workflow arrangements between nurses and doctors are essential to minimize risk in hospital settings, particularly in the out-of-hour's period. Timely patient flow is a priority for all healthcare organizations and the quality of communication and workflow arrangements influences patient safety.

Falls, non-accidental falls and syncope in community-dwelling adults aged 50 years and older: Implications for cardiovascular assessment.

Objectives: To calculate the prevalence of all falls, non-accidental falls and syncope in an older population and characterize cardiovascular risk profiles.

Design: Prospective, longitudinal cohort study.

Setting: The first two waves of data from the Irish Longitudinal Study on Ageing (TILDA).

Long-term cardiac monitoring in older adults with unexplained falls and syncope.

Aims: Unexplained falls account for 20% of falls in older cohorts. The role of the implantable loop recorder (ILR) in the detection of arrhythmias in patients with unexplained falls is unknown. We aimed to examine the diagnostic utility of the ILR in detection of arrhythmogenic causes of unexplained falls in older patients.

The Association of Cardiovascular Disorders and Falls: A Systematic Review.

Objective: Cardiovascular disorders are recognized as risk factors for falls in older adults. The aim of this systematic review was to identify cardiovascular disorders that are associated with falls, thus providing angles for optimization of fall-preventive care.

Design: Systematic review.

The relationship between syncope, depression and anti-depressant use in older adults.

Background: syncope is a common problem which increases in older age groups. In syncope clinics, patients who are depressed have higher rates of unexplained syncope and higher rates of recurrent syncope.

Objectives: : we aim to examine the rates of depression in older patients reporting syncope and the effect of anti-depressants (ADs) on the rates of syncope.

Epidemiology of syncope/collapse in younger and older Western patient populations.

Syncope is a common problem which can be remarkably debilitating and associated with high health care costs; its true incidence is difficult to estimate due to variation in definition, differences in population prevalence and under reporting in the general population. The median peak of first syncope is around 15 years with a sharp increase after 70 years. Vasovagal syncope is the commonest cause of syncope for all age groups, but cardiac causes become more common with advancing age.