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Challenges and potential solutions to enrollment in a clinical trial of arteriovenous fistula vs arteriovenous graft vascular access strategy.
JVS Vasc Insights
June 2024
Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem.
This article presents the rationale, challenges, and adaptive strategies employed during the initiation and execution of the arteriovenous (AV) access trial-a multicenter randomized controlled trial (RCT) comparing AV fistulas and AV grafts for hemodialysis in older adults with major comorbidities. Motivated by shifts in epidemiologic landscapes and evolving guidelines moving away from a fistula-first approach and to more patient-centric approaches, the objective of this randomized controlled trial was to fill critical knowledge gaps in determining the optimal vascular access for this complex patient population. We outline the challenges encountered in patient recruitment along with measures employed to overcome these obstacles in recruitment.
View Article and Find Full Text PDFNeural Determinants of Sedentary Lifestyle in Older Adults: A Brain Network Analysis.
Brain Behav
January 2025
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA.
Purpose: The prevalence of sedentary lifestyles (SL), which includes both high volumes of extended sitting behavior and a low volume of steps accumulated across the day, among older adults continues to rise contributing to increases in associated comorbidities and the loss of independence. The social, personal, and economic burdens are enormous. In recognition of the health implications of SL, current public health physical activity guidelines now emphasize the complimentary goals of sitting less by moving more.
View Article and Find Full Text PDFImpact of Modified Diet, Swallowing Exercises, and Neuromuscular Electrostimulation on Severity of Oropharyngeal Dysphagia of Geriatric Patients.
Medicina (Kaunas)
November 2024
Clinical Department of Geriatrics, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
: Oropharyngeal dysphagia is a common swallowing disorder, characterized by difficulties in moving food and liquids from the mouth to the esophagus; it is particularly prevalent among older adults with neurological conditions. This study aimed to evaluate the effectiveness of a short-term complex treatment protocol combining dietary modifications, swallowing exercises, and transcutaneous neuromuscular electrostimulation in reducing the oropharyngeal dysphagia severity and aspiration risk among geriatric patients. : A total of 64 participants aged 60 and older, with oropharyngeal dysphagia, at LSMU Kaunas Hospital between May 2021 and April 2023, were included in the study after excluding those with significant comorbidities.
View Article and Find Full Text PDFThe Association of Sarcopenia and Body Composition With Benign Positional Paroxysmal Vertigo in Older Adults.
Laryngoscope
January 2025
Department of Otorhinolaryngology, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey.
Objectives: One-third of older adults suffer from dizziness and vertigo. Benign positional paroxysmal vertigo (BPPV), which occurs due to otoconia moving into the semicircular canal, is the most common vestibular disorder. We evaluated the connection between BPPV and geriatric symptoms.
View Article and Find Full Text PDFObsessive-compulsive personality disorder increases cognitive inflexibility in people with coronary artery disease.
Compr Psychiatry
February 2025
Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas-Palanga, Lithuania.
Background: Cardiovascular diseases such as coronary artery disease (CAD) have a high prevalence of psychiatric comorbidities, that may impact clinically relevant outcomes (e.g., cognitive impairment and executive dysfunction).
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