A Brief Report on Sex-Specific Differences in Persistent Depression, Anxiety, and Loneliness Among Canadian Veterans During the COVID-19 Pandemic.

Introduction: Older adults are at increased risk of severe illness and mortality from Coronavirus disease of 2019 (COVID-19) infection. However, public health strategies aimed at reducing spread of COVID-19 may have resulted in increased mental health symptoms, particularly among older adults. Currently, little is known about whether older Veterans were more likely to experience persistent mental health symptoms during the COVID-19 pandemic than non-Veterans.

Language Preference, Surgical Wait Time, and Outcomes Among Older Adults With Hip Fracture.

Importance: Patients with a non-English language preference served within English-dominant health care settings are at increased risk of adverse events that may be associated with communication barriers and inequitable access to care.

Objective: To investigate the association of non-English language preference with surgical wait time and postoperative outcomes in older patients undergoing hip fracture repair.

Design, Setting, And Participants: This population-based, retrospective cohort study was conducted using linked databases to measure surgical wait time and postoperative outcomes among older adults (aged ≥66 years) in Ontario, Canada, who underwent hip fracture surgery between January 1, 2017, and December 31, 2022.

Antibiotics for delirium in older adults with pyuria or bacteriuria: A systematic review.

Background: It is unclear whether antibiotics impact delirium outcomes in older adults with pyuria or bacteriuria in the absence of systemic signs of infection or genitourinary symptoms.

Methods: We registered our systematic review protocol with PROSPERO (CRD42023418091). We searched the Medline and Embase databases from inception until April 2023 for studies investigating the impact of antimicrobial treatment on the duration and severity of delirium in older adults (≥60 years) with pyuria (white blood cells detected on urinalysis or dipstick) or bacteriuria (bacteria growing on urine culture) and without systemic signs of infection (temperature > 37.

Are Antibiotics Helpful for Older Adults with Delirium and Pyuria or Bacteriuria?

Antibiotics for Delirium and Pyuria or BacteriuriaDelirium is common among hospitalized older adults, frequently leading to initiation of antibiotics when pyuria or bacteriuria is detected. However, it is difficult to determine if pyuria or bacteriuria is the cause of delirium or incidentally identified. This article proposes a trial to assess if treatment with antibiotics hastens delirium resolution.

Cholinesterase inhibitors and falls, syncope and injuries in patients with cognitive impairment: a systematic review and meta-analysis.

Background: Cholinesterase inhibitors are commonly used to treat patients with neurocognitive disorders, who often have an elevated risk of falling. Effective use of these medications requires a thoughtful assessment of risks and benefits.

Objective: To provide an update on previous reviews and determine the association between cholinesterase inhibitors and falls, syncope, fracture and accidental injuries in patients with neurocognitive disorders.

Associations Between Patient Characteristics and Unplanned or Delayed Discharges From Geriatric Rehabilitation: A Retrospective Chart Review.

Returning home is considered an indicator of successful rehabilitation for community-dwelling older adults. However, the factors associated with unplanned discharge remain uncertain. This retrospective chart review included patients 65 yrs and older admitted to a geriatric rehabilitation unit from medical and surgical wards in an academic hospital.

Trends in Delirium and New Antipsychotic and Benzodiazepine Use Among Hospitalized Older Adults Before and After the Onset of the COVID-19 Pandemic.

Importance: The COVID-19 pandemic caused large disruptions to health care for hospitalized older adults. The incidence and management of delirium may have been affected by high rates of COVID-19 infection, staffing shortages, overwhelmed hospital capacity, and changes to visitor policies.

Objective: To measure changes in rates of delirium and related medication prescribing during the COVID-19 pandemic among hospitalized older adults.

Predictors of persistent depressive and anxiety symptoms among older adults during the COVID-19 pandemic in Canada.

Background: The COVID-19 pandemic has increased the risk of psychological distress for older adults during a period of reduced access to mental health support. We identified predictors of persistent depressive and anxiety symptoms among older adults throughout the initial 9 months of the pandemic.

Methods: This was a longitudinal study using web-based surveys sent to a convenience sample of Canadians aged ≥55 years.

Sleep monitoring challenges in patients with neurocognitive disorders: A cross-sectional analysis of missing data from activity trackers.

Background And Aims: Activity monitors, such as Fitbits®, are being used increasingly for research purposes and data have been validated in healthy community-dwelling older adults. Given the lack of research in older adults with neurocognitive disorders, we investigated the consistency of sleep data recorded from a wrist-worn activity monitor in this population.

Methods: Fitbit® activity monitors were worn by hospitalized older adults as part of a parent study investigating sleep and step count in patients recovering from hip fracture surgery in a tertiary care academic hospital in Hamilton, Canada between March 2018 and June 2019.

Gender Differences in Mental Health Symptoms Among Canadian Older Adults During the COVID-19 Pandemic: a Cross-Sectional Survey.

Background: Older women's mental health may be disproportionally affected by the COVID-19 pandemic due to differences in gender roles and living circumstances associating with aging.

Methods: We administered an online cross-sectional nationwide survey between May 1st and June 30th, 2020 to a convenience sample of older adults aged ≥55 years. Our outcomes were symptoms of depression, anxiety, and loneliness measured by three standardized scales: the eight-item Center for Epidemiological Studies Depression Scale, the five-item Beck Anxiety Inventory, and the Three-Item Loneliness Scale.

A Survey of Nurses' Perspectives on Delirium Screening in Older Adult Medical Inpatients With Limited English Proficiency.

The Confusion Assessment Method (CAM) is commonly used to detect delirium but its utility in patients with limited English proficiency (LEP) is not well-established. In the current study, internal medicine nurses at an acute care hospital in Canada were surveyed on the use of the CAM in older adults with LEP. Nurses' perspectives were explored with a focus on barriers to administration.

Loneliness among older adults in the community during COVID-19: a cross-sectional survey in Canada.

Objective: Physical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterise the extent of loneliness during the first wave in a sample of older adults living in the community and assess characteristics associated with loneliness.

Design: Online cross-sectional survey between 6 May and 19 May 2020.

Worries, attitudes, and mental health of older adults during the COVID-19 pandemic: Canadian and U.S. perspectives.

Background/objectives: Differences in older adults' worry, attitudes, and mental health between high-income countries with diverging pandemic responses are largely unknown. We compared COVID-19 worry, attitudes towards governmental responses, and self-reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID-19 pandemic.

Design: Online cross-sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada.

Implementation of a multicomponent intervention sign to reduce delirium in orthopaedic inpatients (MIND-ORIENT): a quality improvement project.

Delirium is a serious and common condition that leads to significant adverse health outcomes for hospitalised older adults. It occurs in 30%-55% of patients with hip fractures and is one of the most common postoperative complications in older adults undergoing orthopaedic surgery. Multicomponent, non-pharmacological interventions can reduce delirium incidence by up to 30% but are often challenging to implement as part of routine care.