Oscar J de Vries

OLVG · Department of Internal Medicine

Importance Although inadequate sleep has a proven negative association with health care outcomes, to date, no large-scale studies have examined sleep in general hospital wards. Objectives To assess the subjective quantity and quality of sleep and to identify the hospital-related factors associated with sleep disturbances in hospitalized patients....

Background and purpose: Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated w...

Background: because the few randomised placebo-controlled trials investigating the potential role for prophylactic haloperidol in delirium prevention have focused on specific surgical populations, we investigated its efficacy and safety in acutely hospitalised older patients. Methods: this multi-centre, double-blind, stratified, block randomised...

Background The use of Fall-Risk-Increasing-Drugs (FRIDs) has been associated with increased risk of falls and associated injuries. This study investigates the effect of withdrawal of FRIDs versus ‘care as usual’ on health-related quality of life (HRQoL), costs, and cost-utility in community-dwelling older fallers. Methods In a prospective multicent...

Objective: To investigate whether the CYP2C9*2 and *3 variants modify benzodiazepine-related fall risk. Design: Three prospective studies; the Rotterdam Study, B-PROOF, and LASA. Setting: Community-dwelling individuals living in or near five Dutch cities. Participants: There were 11,485 participants aged ≥55 years. Measurements: Fall incid...

Background: Orthostatic hypotension (OH) is common in older adults and associated with increased morbidity and mortality, loss of independence and high health-care costs. Standing up slowly is a recommended non-pharmacological intervention. However, the effectiveness of this advice has not been well studied. Objectives: The aim of this study was...

Objectives: to investigate the effect of withdrawal of fall-risk-increasing-drugs (FRIDs) versus 'care as usual' on reducing falls in community-dwelling older fallers. Design: randomised multicentre trial. Participants: six hundred and twelve older adults who visited an Emergency Department (ED) because of a fall. Interventions: withdrawal o...

The increased fall risk associated with the use of psychotropic drugs might be caused by underlying problems in postural control that are induced by sedative side-effects of these drugs. The current literature on the effects of psychotropics on postural control only examined acute single-drug effects, and included relatively healthy young elderly....

Detailed mathematical description of the PLS regression analysis. (PDF)

Dataset containing the prevalence of the population characteristics, comorbid diseases, and medication-use per ATC-drug class (as listed in Table 1), and the raw values of the gait parameters. (XLS)

Prevalence of the medications used by the study’s participants and the dosage range. (PDF)

Objective: Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for the prevention and treatment of delirium in hospitalized patients. Methods: PubMed, Embase, Cumulative Index to Nursing and Allied Health (...

Objectives: Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. Methods: Data wer...

Inappropriate drug use has been identified as one of the most important problems affecting the quality of care in older people. Inappropriate drug use may increase the risk of the occurrence of 'geriatric giants' such as immobility, instability, incontinence and cognitive impairment. There are indications that clinical medication reviews (CMR) can...

Background: Delirium is associated with substantial morbidity and mortality rates in elderly hospitalised patients, and a growing problem due to increase in life expectancy. Implementation of standardised non-pharmacological delirium prevention strategies is challenging and adherence remains low. Pharmacological delirium prevention with haloperido...

Background Fall-induced injuries in persons aged 65 years and older are a major public health problem. Data regarding circumstances leading to specific injuries, such as traumatic brain injury (TBI) and hip fractures in older adults are scarce. Objective To investigate the activity distributions leading to indoor and outdoor falls requiring an Eme...

The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in B...

To investigate whether serum 25-hydroxy vitamin D (25(OH)D) is associated with physical performance in men and women. Cross-sectional. Emergency departments (EDs) of five hospitals. Older adults who visited an ED because of a fall (N = 616). Physical performance was assessed using the Timed Up and Go Test, the Five Time Sit to Stand Test, handgrip...

Background: Currently, Dutch emergency care systems focus on rapid emergency department (ED) patient management with short completion times, which may not meet specific geriatric care needs. Methods: Six-week observational study in patients aged ≥70 years, attending the ED of VU University Medical Center (VUmc, Amsterdam, the Netherlands) during...

the STOPP criteria advise against the use of long-acting benzodiazepines (LBs). to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤10 h). we used base-line data and prospective fall follow-up from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study including 1,...

Background & aims: Few data is available on the nutritional status of geriatric outpatients. The aim of this study is to describe the nutritional status and its clinical correlates of independently living geriatric older individuals visiting a geriatric outpatient department. Methods: From 2005 to 2010, all consecutive patients visiting a geriat...

A frailty concept that includes psychological and cognitive markers was prospectively shown to be associated with increased risk of multiple falls and fractures among 1,509 community dwelling older adults, especially in those aged 75 and over. The predictive ability of frailty is not superior to falls history. Introduction The concept of frailty ha...

Vitamin D deficiency and polypharmacy are common in the elderly. However, knowledge on the associations between the use of specific medicines and serum 25-hydroxyvitamin D (25(OH)D) is limited. The aim of this study was to (better) define the associations between the use of specific medicines and serum 25(OH)D. Two different cohorts (1995/1996 and...

Fall incidents represent an increasing public health problem in aging societies worldwide. A major risk factor for falls is the use of fall-risk increasing drugs. The primary aim of the study is to compare the effect of a structured medication assessment including the withdrawal of fall-risk increasing drugs on the number of new falls versus 'care...

Ondervoeding is een groot probleem binnen alle sectoren van de gezondheidszorg. Vroege herkenning en behandeling van ondervoeding zijn belangrijk om negatieve gezondheidsgevolgen van ondervoeding te voorkomen of te verminderen. Vooral fragiele ouderen en chronisch zieken zijn een belangrijke risicogroep als het gaat om ondervoeding. Het Centrum voo...

Falls in frail elderly are a common problem with a rising incidence. Gait and postural instability are major risk factors for falling, particularly in geriatric patients. As walking requires attention, cognitive impairments are likely to contribute to an increased fall risk. An objective quantification of gait and balance ability is required to ide...

This study evaluated the cost-effectiveness of multifactorial evaluation and treatment of fall risk factors in community-dwelling older persons at high risk of falling. The intervention and usual care groups did not differ in fall risk or costs. The multifactorial approach was not cost-effective compared to usual care in this group. International g...

Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls. A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geri...

The effects of a cognitive dual task on gait coordination in 24 older geriatric day clinic patients while walking at self-selected speed was studied and related to cognitive function. Trunk accelerations were registered (DynaPort ®; McRoberts) and used to calculate gait and trunk parameters. The Mini Mental State Examination and the Seven Minute Sc...

To investigate the assessment of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and white matter changes (WMCs) in patients screened at a memory clinic with a 64-detector row computed tomography (CT) brain protocol, in comparison with the reference standard, magnetic resonance (MR) imaging. The study protocol was approved by the...

Doel Beschrijven van de opzet van een studie naar het effect van multidisciplinaire interventie ter preventie van vallen bij ouderen met een hoog valrisico. Methode Design: gerandomiseerde trial met economische evaluatie. Deelnemers: recent gevallen, zelfstandigwonende ouderen (≥65 jaar). Na screening op valrisico wordt de hoogrisicogroep blind ger...

Annually, about 30% of the persons of 65 years and older falls at least once and 15% falls at least twice. Falls often result in serious injuries, such as fractures. Therefore, the prevention of accidental falls is necessary. The aim is to describe the design of a study that evaluates the efficacy and cost-effectiveness of a multidisciplinary asses...

The goal of therapeutic drug monitoring (TDM) is to maximise the effect of drug therapy and to minimise toxicity. TDM is meaningful if on the one hand there is a relationship between the serum concentration of the drug and its effect and on the other hand there is no obvious relationship between dose and efficacy due to wide interindividual variabi...