Gerontology and Geriatric Medicine (Geriatrics) – prof. Topinková
During the evaluated time period the research team of the Department of Geriatrics worked on several European research projects/research topics:
1. Research team working on frailty, sarcopenia, disability and nutrition
A large European research project SPRINTT ( Sarcopenia and physical frailty in older people: multi‐component treatment strategies, SPRINTT | IMI Innovative Medicines Initiative (europa.eu)) an Innovative Medicines Initiative (IMI) financed from European Union’s Seventh Framework Program and EFPIA was completed in 2022. This comprehensive project including a large RCT evaluated multimodal 3 years intervention in older adults with physical frailty and sarcopenia. The study confirmed significant effect of structured supervised physical activity combined with nutritional consultations and support on preventing mobility disability (24 % reduction at 2 years), gait characteristics and increase in Appendicular lean body mass. Results were published in British Medical Journal (Bernabei et al 2022, Q1, IF= 39,89, Billot et al 2020). The international collaboration in the area of frailty and sarcopenia resulted in the work of Prof. Topinkova as a member of the European Working Group on Sarcopenia in Older People 2 and the publication of the revised European consensus on sarcopenia definition and diagnosis. (Cruz-Jentoft et al 2019) This work, published in 2019 is being highly cited – has been cited 11019 times and is ranked among the top papers of highly cited publications with a significant scientific impact.
Department of Geriatrics 1st Faculty of Medicine CU is continuing its research activities in the area of nutrition (body composition, sarcopenia, obesity, sarcopenic obesity).
Our team collected data for multi-country analyses in SOGLI (Sarcopenic Obesity Global Leadership Initiative. Member Prof. Topinkova) and ESPEN (European Society of Parenteral and Enteral Nutrition) collaborative effort on sarcopenic obesity. (Capellari et al 2023) Further sarcopenia influence on quality of life (QoL) analysed confirmed profound negative impact of sarcopenia on worsening quality of life using SARQOL a novel health related QoL questionnaire. This health related tool, validated in Czech language by our research team, evaluates QoL in patients with sarcopenia. (Beaudart et al 2024)
Since 2021- 2025 Department of Geriatrics is a partner of the international European project SO-NUTS in the framework European JPI HDHL Initiative „Prevention of unhealthy weight gain and obesity during critical phases throughout the lifespan“. Prof. Topinková is a leader of Workpackage 6 WP6 – coordinating international feasibility clinical trial of the SO-NUTS Application for smart phones. Currently the clinical trial ended recruitment and continues the follow-up phase of the trial. The research collaboration with partner institutions resulted in collaborative publications of sarcopenia phenotyping, development of sarcopenia prediction index, systematic reviews and continuing work on longitudinal Rotterdam study analyses. (Schoufour et al 2021, Reiter et al 2023, Benz et al 2024, Pinel et al 2024, Vágnerová et al 2023). Several submitted manuscript are being reviewed (research on sarcopenic obesity: a scoping review of ongoing studies, development of sarcopenia predictive index, nutritional intake)
2. Research on Comprehensive Geriatric Assessment
Research on Comprehensive Geriatric Assessment (CGA) in clinical medicine and its use for clinical decision-making is another area of research focus.
A large observation multicentric European study EUROSAF (EURopean Study of Older Subjects with Atrial Fibrillation), aims to provide scientific data on anticoagulants treatment, its benefits and risks in older patients with atrial fibrillation (N=2012) taking into account different levels of geriatric frailty. A CGA-based Multidimensional Prognostic Index (MPI) was used to collect the data. MPI values and frailty level correlated with anticoagulants use and treatment related adverse drug events. (Pilotto et al 2022 a, Topinková et al 2022, Pilotto et al 2023a)
Research
team of the Department of Geriatrics during COVID times participated in two
observational multicentric European projects:
The MPI-COVID-19 Study which evaluated clinical usefulness of Multidimensional Prognostic Index (MPI) in predicting negative outcomes (hospital incident delirium) and low benefit from remdesivir treatment and from mechanical ventilation. MPI accurately predicted negative health outcomes and was recommended for clinical usage. (Pilotto et al 2022b, Pilotto et al 2023b, Morganti et al 2024, Custodero 2023. Veronese 2020).
The second COVID- related study was prospectiv observational multicentric study EU-COGER (The European Cooperation in Geriatric Rehabilitation study after COVID-19“). EU -COGER focused on geriatric rehabilitation of older patients who were hospitalized for COVID-19, lost their functional capacity and became dependent. EU - GOGER mapped the trajectory of functional recovery and quality of life during early rehabilitation and 6-month follow-up in 56 centers in 10 European countries and influence of frailty and delirium on functional outcomes (van Tol et al 2024a, Minnema et al 2024, van Tol et al 2024b).
Prof. Topinkova as a member of EUGMS Special Interest Group on Geriatric Rehabilitation served as national coordinator of the international survey on eHealth in geriatric rehabilitation (Kraajinkamp et al 2023)
3. Results of the research team working in geriatric pharmacotherapy led by Assoc. Prof. PharmDr. Fialová, PhD (Cooperatio Geriatrics and Gerontology, Pharmacology)
Assoc. Prof. Fialová´s
team worked in research area involving
safe geriatric prescribing, polypharmacy, inappropriate medication in old age
and deprescribing in collaboration with the Faculty of Pharmacy, Charles
university Hradec Kralove) on several collaborative publications in the EU
H2020 grant EuroAgeism (2017-2022), funded by MCSF-ITN (Marie-Curie Scientific
Foundation, International Training Network) as a multi-disciplinary,
multi-sectorial, science-policy oriented network of researchers, policy makers
(WHO, United Nations, Age Platform Europe) and health and social workers
investigating aspects of ageism. Our scientific effort specifically focused on ageism
in medication use in older adults as part of ESR7 program entitled
“Inappropriate prescribing and availability of medication safety and
medication management services in older patients in Europe and other
countries" . Publications obtained from scientific outputs were for
example: a scoping literature
review on Medication prescribing and aspects of ageism, systematic literature
reviews on potentially inappropriate
geriatric prescribing in Central and Eastern Europe (CEE), India and Ethiopia, current prospective evidence on potentially inappropriate prescribing in
older adults in CEE or Ethiopia, and several policy reports and policy briefs. (Fialova et al 2019, Brkič et
al 2022, Bhagavathula et al 2022a,b,c, 2023, Lukačišinová et al. 2024, Bobrová et
al 2022)
Assoc. Prof. Fialová currently also
collaborates on the I-CARE4OLD Horizon 2020 project- Individualized CARE for
Older Persons with Complex Chronic Conditions at home and in nursing homes (2021- ongoing) that investigates
changes in health trajectories of older adults after various pharmacological
and non-pharmacological interventions (some publications are summarized here Hoogendijk et al 2023,
Morris et al 2023, Kooijmans et al 2024)
In October 2022, our team contributed by plenary lecture of prof. Topinková on “Geriatric Frailty” and by Symposium on “20 years of cooperation of geriatrics and clinical pharmacy field in the Czech Republic” to the organization of the 50th ESCP congress entitled “Polypharmacy and ageing- highly individualized, inteprofessional, person-centred care“ (Prague, CZ).
In April 2023 Department of Geriatrics started collaboration on novel interdisciplinary education of geriatricians, clinical pharmacists and general practicioners in “basic specificities of rational geriatric pharmacotherapy" that meets current challenges of the population ageing and high individualization of complex drug regimens in older adults. This education was piloted successfully in 2023-2024 as collaborative effort Faculty of Pharmacy, Charles University and the Czech Socienta of Geriatrics and Gerontology, Czech Medical Association J.B. Purkyně and will continue in future years.
Prof. Topinkova´s work in the area of geriatric pharmacotherapy focused further on FRIDs (fall risk increasing drugs). She is a co-author of a novel tool STOPP-fall for use clinical practice while performing medication review in older patients with fall or high risk of falls (Seppala et al 2021). The STOPP-FALL tool was translated into Czech language and piloted nationally by the research team (Topinková and Fialová Vnitř Lék 2023) and implemented in national clinical guidelines for medication review in older patients with multimorbidity and polypharmacy of the Czech Society of Geriatrics and Gerontology CMA JEP (Topinková et al Geriatr Gerontol 2024). Two more clinical reviews on deprescribing antipsychotic medications and antimuscarinics and alpha-blockers in patients with fall risk and barriers for deprescribing FRIDs were published ( Ploegmakers et al 2022, Ilhan et al 2023, Korkatti-Puoskari N, et al 2023). Several additional publications resulted from international collaboration in the area of geriatric pharmacotherapy (Macan et al 2021 – osteoporosis treatment, Oudewortel L et al 2021 - anticholinergic medications, Giovanini et al 2020 – antidepressants, Lukačišinova et al 2021 – hypnotics, van Poelgeest et al. 2024 - diuretics).