PURPOSE: The COVID-19 pandemic has been a dramatic trigger that has challenged the intrinsic capacity of older adults and of society. Due to the consequences for the older population worldwide, the Special Interest Group on Comprehensive Geriatric Assessment (CGA) of the European Geriatric Medicine Society (EuGMS) took the initiative of collecting evidence on the usefulness of the CGA-based multidimensional approach to older people during the COVID-19 pandemic. METHODS: A narrative review of the most relevant articles published between January 2020 and November 2022 that focused on the multidimensional assessment of older adults during the COVID-19 pandemic. RESULTS: Current evidence supports the critical role of the multidimensional approach to identify older adults hospitalized with COVID-19 at higher risk of longer hospitalization, functional decline, and short-term mortality. This approach appears to also be pivotal for the adequate stratification and management of the post-COVID condition as well as for the adoption of preventive measures (e.g., vaccinations, healthy lifestyle) among non-infected individuals. CONCLUSION: Collecting information on multiple health domains (e.g., functional, cognitive, nutritional, social status, mobility, comorbidities, and polypharmacy) provides a better understanding of the intrinsic capacities and resilience of older adults affected by SARS-CoV-2 infection. The EuGMS SIG on CGA endorses the adoption of the multidimensional approach to guide the clinical management of older adults during the COVID-19 pandemic.

• Klíčová slova
• COVID-19, Comprehensive Geriatric Assessment, Decision-making, Intrinsic capacity, Multidimensional frailty, Prognosis, SARS-CoV-2,
• MeSH
• COVID-19 * epidemiologie   MeSH
• geriatrické hodnocení * metody   MeSH
• lidé MeSH
• pandemie MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• veřejné mínění MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

PURPOSE: Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group. The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe. METHODS: A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe was assembled. Using a modified Delphi procedure, a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters. The expert group identified the following eight subject areas to develop expert recommendations on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, medication reviews in the ED for older adults, family involvement, ED environment, silver trauma, end of life care in the acute setting. RESULTS: Eight posters with expert clinical recommendations on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/ . CONCLUSION: Expert clinical recommendations for Geriatric Emergency Medicine may help to improve care for older patients in the Emergency Department and are ready for dissemination across Europe.

• Klíčová slova
• Acute care, Emergency Medicine, Frailty, Geriatric Emergency Medicine, Geriatrics, Guidelines,
• MeSH
• geriatrické hodnocení MeSH
• geriatrie * MeSH
• křehkost * MeSH
• lidé MeSH
• senioři MeSH
• urgentní lékařství * MeSH
• urgentní služby nemocnice MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH

BACKGROUND: the European Union of Medical Specialists (UEMS-GMS) recommendations for training in Geriatric Medicine were published in 1993. The practice of Geriatric Medicine has developed considerably since then and it has therefore become necessary to update these recommendations. METHODS: under the auspices of the UEMS-GMS, the European Geriatric Medicine Society (EuGMS) and the European Academy of Medicine of Ageing (EAMA), a group of experts, representing all member states of the respective bodies developed a new framework for education and training of specialists in Geriatric Medicine using a modified Delphi technique. Thirty-two expert panel members from 30 different countries participated in the process comprising three Delphi rounds for consensus. The process was led by five facilitators. RESULTS: the final recommendations include four different domains: 'General Considerations' on the structure and aim of the syllabus as well as quality indicators for training (6 sub-items), 'Knowledge in patient care' (36 sub-items), 'Additional Skills and Attitude required for a Geriatrician' (9 sub-items) and a domain on 'Assessment of postgraduate education: which items are important for the transnational comparison process' (1 item). CONCLUSION: the current publication describes the development of the new recommendations endorsed by UEMS-GMS, EuGMS and EAMA as minimum training requirements to become a geriatrician at specialist level in EU member states.

• Klíčová slova
• European Union, consensus, curriculum, geriatric medicine, older people, postgraduate training,
• MeSH
• delfská metoda MeSH
• geriatrie výchova   normy   MeSH
• kurikulum MeSH
• lidé MeSH
• senioři MeSH
• studium lékařství specializační postgraduální metody   normy   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

The concept of geriatric medicine as a differentiated care of geriatric patients is discussed. Essential is the conception of a geriatric patient, endangered by specific geriatric risks and profiting from the specific geriatric care and regimen. Within the institutional geriatric elements, methodological issues of the development of the geriatric care namely the acute geriatric hospital wards in and subacute hospital wards are stressed. Significance of paramedic personnel (nurses, occupational therapy) in geriatric care is given and the necessity of follow up and long-term hospital care as well as primary non-medical care and community centers is shown. The potential of the district geriatric nurses employed by community centers parallel to the home care agencies is mentioned.

• MeSH
• geriatrie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• sociální opora MeSH
• zdravotní služby pro seniory * organizace a řízení   MeSH
• zdravotnické služby - potřeby a požadavky MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

Emergency departments in the Czech Republic have been established in recent years. Seniors are typical patients of these departments. Emergency medicine´s approach is based on symptoms' evaluation and on deciding about the priority of the care needed. The approach to older patients is specific both in diagnostics and in therapy. The triage of geriatric patients is more accurate when we also evaluate patient´s cognition, when we use geriatric frailty scales and screening tools for detection of delirium. Comprehensive geriatric evaluation is a time demanding process and thus inadequate for emergency department however we must maintain its basic components. The therapeutical approach must be complex, and it must include biological, psychological, and social aspects and environmental risk analysis. Trauma management in seniors requires evaluation of different vital function´s values compared to common triage criteria, the influence of medication on adaptive mechanisms and the risk of low energy trauma mechanisms. Therapy of trauma must be timely and complex and the continuity of care between intensive and standard level and then rehabilitation must be ensured. Palliative approach is appropriate for terminally ill patients.

• Klíčová slova
• geriatrics, emergency medicine, emergency department, frail elderly, triage, trauma, palliative care,
• MeSH
• geriatrické hodnocení * metody   MeSH
• lidé MeSH
• senioři MeSH
• třídění pacientů metody   MeSH
• urgentní služby nemocnice * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE: There is variation in organization of geriatric rehabilitation across Europe. The purpose of this study was to describe the selection criteria for referral to geriatric rehabilitation, care provided, and recovery trajectories of post-COVID-19 patients referred to geriatric rehabilitation in Europe. METHODS: This observational cohort study included 723 patients in 59 care facilities for geriatric rehabilitation across 10 countries. Patient data were collected from medical records on admission to geriatric rehabilitation (between September 2020 and October 2021), discharge, 6 weeks and 6 months follow-up. The primary and secondary outcomes were recovery in daily functioning (Barthel Index) and Quality of Life (EQ-5D-5L) from admission to discharge. These were examined using linear mixed models with two levels (measurements nested in patients) and country as an independent variable. Random intercept and random linear slope parameters were added when they improved model fit. A survey about organization of geriatric rehabilitation for post-COVID-19 patients was filled out by country coordinators and data were analyzed using descriptive statistics and inductive coding of answers to open questions. RESULTS: Patients had a mean age of 75.7 years old and 52.4% were male. Many countries used various combinations of the selection criteria, such as functional status, age, frailty, Comprehensive Geriatric Assessment, comorbidities, and cognitive impairments. Most patients received physiotherapy (88.8%) and occupational therapy (69.7%), but there was substantial variance between countries in the percentages of patients that received protein or calorie enriched diets, oxygen therapy, and other treatment components. In all countries, patients showed recovery in daily functioning and quality of life, although there was variation in between countries in rate of recovery. Daily functioning seemed to increase most rapidly in the Czech Republic, Germany, and Russia. The steepest increases in quality of life were seen in the Czech Republic, Germany, and Spain. CONCLUSION: Post-COVID-19 patients showed recovery during geriatric rehabilitation, albeit at variable rates. The observed variation may be explained by the heterogeneity in selection criteria and care provided. This study highlights the need for harmonization of measurements in geriatric rehabilitation order to perform explanatory research and optimize geriatric rehabilitation throughout Europe to ensure optimal patient recovery.

• Klíčová slova
• COVID-19, Europe, Geriatric rehabilitation, Recovery,
• MeSH
• činnosti denního života MeSH
• COVID-19 * rehabilitace   epidemiologie   MeSH
• geriatrické hodnocení MeSH
• kohortové studie MeSH
• kvalita života MeSH
• lidé MeSH
• obnova funkce MeSH
• SARS-CoV-2 fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

Pharmacist's geriatric assessment can provide valuable insights into potential deprescribing targets, while including important information on various health-related domains. Data collected from a geriatric assessment questionnaire, for 388 patients, from the Croatian cohort of the EuroAgeism H2020 ESR 7 international project, along with guideline-based deprescribing criteria, were used to analyse potentially inappropriate prescribing of four medication groups (benzodiazepines (BZN), proton pump inhibitors (PPI), opioids, and non-steroidal anti-inflammatory drugs (NSAID)), and to assess the deprescribing potential. Binary logistic regression was used to explore the effects of age, gender, number of medicines and diagnoses, self-reported health, frailty score, and healthcare utilization on the likelihood of needing deprescribing. More than half of participants (n = 216, 55.2%) are candidates for deprescribing, with 31.1% of PPI, 74.8% of NSAID, 75% of opioid, and 96.1% of BZN users meeting at least one criterion. Most common criteria for deprescribing were inappropriately long use and safety concerns. Women (aOR = 2.58; p < 0.001), those reporting poor self-reported health (aOR = 5.14; p < 0.001), and those exposed to polypharmacy (aOR = 1.29; p < 0.001) had higher odds of needing to have medicines deprescribed. The high rate of deprescribing potential warrants prompt action to increase patient safety and decrease polypharmacy. Pharmacist's geriatric assessment and deprescribing-focused medication review could be used to lead a personalised approach.

• Klíčová slova
• Deprescribing, Geriatric assessment, Geriatrics, Healthy ageing, Polypharmacy,
• MeSH
• antiflogistika nesteroidní MeSH
• depreskripce * MeSH
• farmaceuti MeSH
• geriatrické hodnocení MeSH
• lidé MeSH
• nevhodné předepisování prevence a kontrola   MeSH
• samostatný způsob života MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH

Although anemia is more prevalent as aging proceeds, it cannot be assumed that it happens due to aging alone. The biggest prevalence of anemia is in the oldest old who are hospitalized. An analysis of occurrence and charactertistics of anemia in the elderly 65+ y. admitted to acute geriatric department. During the period of two years the authors treated 2282 elderly patients aged 65+ y. Out of them a subgroup of 246 old anemic patients with hemoglobin <110 g/I (aged 81+/- 7.2 y.) was selected. The prevalence of anemic patients among all the acutely admitted seniors ranged between 7.1% and 20% (from 65 y. to 100 y.). All the data of these anemic patients (both clinical and laboratory) were collected and analyzed. Hemoglobin by hospital admission in average was 93.4 g/l +/- 12.9; below 80 g/l in 56 cases. The authors found anemic persons living lonely in the community more frequently (p = 0.005) than in elderly people living with somebody or in an institution. No significant gender differences in the occurrence of anemia were observed. MCV (Microtic Cell Volume) was normal in 73% of patients; below 80 fl in 23% and above 100 fl in 4% of all anemic patients. Low iron level though was present in 192-times (78%). Low zinc level was together in this anemic patient set present in 222 cases (90.2%). During hospitalization the status was as follows: worsened 18-times; stationary 160-times and significantly improved 68-times. Anemia in the elderly is often caused by a benign disease and, in fact, may simply be a marker of a chronic illness. It may be, however, a presenting sign of a serious disease, including cancer. The authors point out some aspects, risks and pitfalls of anemia in the elderly following their own experiences concerning anemia as a chronic disease.

• MeSH
• anemie * diagnóza   farmakoterapie   epidemiologie   MeSH
• geriatrie metody   MeSH
• lidé MeSH
• prevalence MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stárnutí krev   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

In the elderly population there are common permanent decrease of functional capacity, gradual emergence of various diseases leading to the wider multimorbidity and increased problems in the social sphere, which can develop frailty and social dependency. The paper analyzes the complex issue of geriatric multimorbidity and emphasizes its pitfalls, the need of an interdisciplinary approach and thinking of doctors, including the risks of modern pharmacotherapy. The aim of geriatric medicine is to optimize residual functions despite the decline in total functional capacity with increasing multimorbidity. The authors want to direct the attention of the professional community to the permanently growing numbers of the elderly and to emphasize the need of awareness of the problem so that they could understand and cope with this absolutely new reality.

• Klíčová slova
• ageing of population - atomization of medicine - geriatrization of medicine - holistic approach - multimorbidity.,
• MeSH
• geriatrie organizace a řízení   MeSH
• komorbidita MeSH
• lidé MeSH
• senioři MeSH
• stárnutí * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The author draws attention to the need of more profound knowledge of geriatrics in the training of specialists in internal medicine. He draws attention to the ageing population, trends in advanced countries and planned enlistment of general specialists in internal medicine into primary care.

• MeSH
• geriatrie * MeSH
• lidé MeSH
• senioři MeSH
• specializace * MeSH
• vnitřní lékařství * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH