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Geriatrics Research
CN: 37-1522/R
ISSN: 2096-9058
Governed by: Health Commission of Shandong Province
Sponsored by: Shandong Provincial Hospital Affiliated to Shandong First Medical University
Editor-in-Chief: SUN Zhijian
Deputy Editor-in-Chief: WANG Jianchun
Founded in 2020, bimonthly.
Indexed by: CNKI, Wanfang, Weipu, Chaoxing, CBM.
Evidence application review of fall prevention management and barrier factor analysis based on the CFIR framework among elderly hospitalized patients
XIAO Tian;WANG Yumei;LI Ling;YU Jianing;CAI Jiajia;WANG Qiong;ZHANG Huijuan;Objective To conduct evidence-based practice on fall prevention management for elderly hospitalized patients, establish evidence-based audit indicators, systematically analyze the barrier factors, and thereby provide references for clinical action strategies. Methods The evidence clinical transformation model of the Evidence-Based Nursing Center of Fudan University was adopted to establish an evidence-based team, develop evidence-based audit indicators and conduct baseline surveys. Furthermore, based on the CFIR theoretical framework, barrier factors were analyzed and corresponding change strategies were formulated. Results A total of 20 audit indicators were established based on evidence for clinical review. The average compliance rate of these indicators was <80%, with 4 indicators showing compliance rates <50% and 2 indicators <20%. By analyzing barriers to evidence-based practice transformation using the CFIR framework, key obstacles were identified across 5 dimensions:internal factors,external factors,individual characteristics, intervention characteristics, and process, encompassing 11 specific elements. Conclusions Significant gaps remain between best evidence and clinical practice in fall prevention management for elderly hospitalized patients. By systematically and in-depthly analyzing barriers to evidence application, targeted change strategies can be developed to integrate evidence into clinical practice and enhance patient safety.
A scoping review of fall fear intervention programs for elderly patients after hip replacement surgery
KUAN Yan;YUAN Jincha;ZHAO Ziqi;LI Suting;LIU Tianyun;Objective To summarize and synthesize the specific content and intervention outcomes of fall fear intervention programs for elderly patients after hip replacement surgery. Methods Based on the scoping review guidelines issued by JBI as the methodological framework, a systematic search was conducted in Chinese databases including CNKI, Wanfang, VIP, and CBM, as well as foreign databases such as PubMed, Web of Science, Cochrane Library, CINAHL, and Scopus. The search period spanned from the establishment of each database up to May 21, 2025. Results A total of 14 studies were included: 9 randomized controlled trials, 2 retrospective studies, and 3 quasi-experimental studies. The interventions for fall fear in elderly hip replacement surgery patients were diverse, encompassing exercise interventions, mirror interventions, multidisciplinary team collaboration interventions, and rehabilitation nursing interventions. These interventions demonstrated positive effects on fall fear, health clinical outcomes, psychological status, and safety indicators. Conclusions The contents, formats, and outcome measures of fall fear intervention programs for elderly hip replacement surgery patients require refinement and optimization. Future researchers should prioritize psychological aspects of the research and develop personalized intervention plans tailored to patients' distinct characteristics and needs.
Construction and validation of a frailty risk prediction model for elderly hypertension patients
GU Yuqi;DIAO Yangdan;XIONG Yi;LIANG Xuemei;Objective To investigate the influencing factors of frailty in elderly hypertensive patients and construct a frailty risk prediction model for this population. Methods A total of 223 elderly hypertensive patients who were treated in the Affiliated Hospital of Southwest Medical University from October 2024 to April 2025 were selected as the research subjects by convenience sampling. Frailty was assessed using the clinical frailty scale(CFS). General data and laboratory indicators were compared between frail and non-frail patients. Multivariate logistic regression analysis was used to identify risk factors for frailty and construct a risk prediction model. The predictive efficacy of the model was systematically verified in terms of sensitivity, specificity, calibration, and clinical applicability using the receiver operating characteristic(ROC) curve, calibration curve, and clinical decision curve analysis. Results Among the 223 elderly hypertensive patients, 89 cases were identified as frail, with the incidence of frailty being 39. 91%. Multivariate logistic regression analysis showed that age(OR=1. 11, 95% CI: 1. 06-1. 17), grip strength(OR=0. 89, 95% CI: 0. 85-0. 94), total protein(TP) level(OR=0. 93, 95% CI: 0. 89-0. 98), and albumin/globulin ratio(A/G)(OR=0. 13, 95% CI: 0. 04-0. 46) were influencing factors for frailty in elderly hypertensive patients(all P<0. 05). Based on age, grip strength, TP, and A/G, a nomogram model for predicting frailty risk in elderly patients was established. The sensitivity and specificity of this prediction model were 0. 72(95% CI: 0. 64-0. 79) and 0. 81(95% CI: 0. 73-0. 89), respectively. The Hosmer-Lemeshow test （χ2=4. 763, P=0. 783） indicated a good fit between the predicted values of the model and the actual observed values. Decision curve analysis confirmed that the model had good clinical applicability. Conclusions Advanced age, low grip strength, low TP level, and low A/G ratio are independent risk factors for frailty in elderly hypertensive patients. The nomogram prediction model constructed based on the above factors has reliable predictive efficacy, which can provide a quantitative reference tool for clinical early screening of high-risk groups of frailty and formulation of intervention strategies.
Application of integrated multicomponent exercise and respiratory training in managing perioperative frailty in elderly patients undergoing coronary artery bypass grafting
CHEN Liujing;GAO Huihui;HAN Jing;CHEN Shuyuan;ZHOU Liqin;GAO Chunzhi;Objective To explore the effects of multicomponent exercise combined with integrated respiratory training on frailty status, postoperative recovery efficacy and quality of life in elderly patients undergoing coronary artery bypass grafting. Methods A convenience sampling method was adopted to enroll 82 elderly patients who underwent elective coronary artery bypass grafting in the Department of Cardiovascular Surgery, Tangshan Workers' Hospital between September 2024 and May 2025. The patients were randomly assigned to control group and experimental group, with 41 cases in each group. The control group received routine perioperative nursing care, while the experimental group was implemented with a multicomponent exercise intervention program integrated with respiratory training on the basis of routine perioperative nursing. The intervention efficacy was assessed using the Tilburg Frailty Indicator(TFI), 15-item Quality of Recovery scale(QoR-15) and Chinese Cardiovascular Quality of life Questionnaire(CQQC). Postoperative indicators, including the time to first postoperative ambulation, time to first postoperative defecation, length of ICU stay, and total length of hospital stay, were compared between the two groups. Results After intervention, the experimental group exhibited lower TFI scores(including physical dimension and total score) and higher QoR-15 and CQQC scores compared with the control group(all P < 0. 05). Additionally, the experimental group had shorter time to first postoperative ambulation, first postoperative defecation, length of ICU stay, and total length of hospital stay relative to the control group(all P < 0. 05). Conclusion Multicomponent exercise intervention integrated with respiratory training effectively ameliorates frailty status, accelerates postoperative recovery and improves quality of life in elderly patients after coronary artery bypass grafting.
Effects of progressive resistance training on muscle strength, physical function, and vascular function in elderly patients with type 2 diabetes mellitus
JIA Huimin;YUAN Huiping;NIU Wenchang;HUANG Jiarong;GAO Mingxia;JIA Zhumin;Objective To investigate the effects of progressive resistance training(PRT) on muscle strength, physical function, and vascular function in elderly patients with type 2 diabetes mellitus(T2 DM). Methods This was a randomized controlled trial. A total of 32 elderly patients with T2 DM were recruited from the community between January and June 2025 using convenience sampling method. They were randomly divided into a control group and an experimental group using a random number table, with 16 cases in each group. The control group received health education, while the experimental group received PRT in addition to health education. Differences in muscle strength, physical function, and vascular function were compared between the two groups before and after the intervention. Intention-to-treat(ITT) and perprotocol(PP) analyses were used to evaluate the intervention effects. Results At week 4, one patient dropped out from the experimental group and one from the control group. At week 8, two patients dropped out from the experimental group. Finally, 13 patients in the experimental group and 15 patients in the control group completed the study. Before the intervention, there were no statistically significant differences between the two groups in grip strength(left and right hands), Short Physical Performance Battery(SPPB) score, brachial-ankle pulse wave velocity(baPWV), or ankle-brachial index(ABI). After the intervention, the grip strength(left and right hands) and SPPB score in the experimental group were significantly higher than those before the intervention and also higher than those in the control group(all P < 0. 05). No statistically significant differences were found in baPWV or ABI between the two groups either before or after the intervention. The results of PP analysis were consistent with those of ITT analysis. Conclusion A 12-week PRT intervention can effectively improve muscle strength and physical function in elderly patients with T2 DM.
