Thomas Münzer

Effects of long-term continuous positive airway pressure on body composition and IGF1

OBJECTIVE To investigate the long-term effects of nasal continuous positive airway pressure (CPAP) ventilation in patients with obstructive sleep apnea syndrome (OSAS) on body composition (BC) and IGF1. DESIGN Observational study. SUBJECTS Seventy-eight (11 females and 67 males) OSAS patients who were compliant with CPAP (age 51+/-1.1 years) participated in the study. We assessed body mass index (BMI), total body mass (TBM), total body fat (TBF; kg) and lean body mass (LBM; kg), abdominal subcutaneous (SC) and visceral (V) fat (cm(2)), and waist circumference (WC; cm) by magnetic resonance imaging, and IGF1 (ng/ml) before and after 7.8+/-1.3 months of CPAP use of an average of 5.9+/-1.2 h. RESULTS Women had a higher BMI, WC; TBM, TBF, and more SC fat. Men had a higher LBM and more V fat. CPAP increased WC (+2.8+/-9.6 cm, P=0.02) and LBM (2.2+/-0.5 kg, P=0.006), but not IGF1. In men, CPAP increased BMI (0.5+/-0.2 kg/m(2), P=0.02), WC (1.7+/-6.9 cm, P=0.002), TBM (1.7+/-0.4 kg, P=0.0001), LBM (1.5+/-0.4 kg, P=0.0003), SC fat (12.9+/-5.1 cm(2), P=0.02), and IGF1 (13.6+/-4.2 ng/ml, P=0.002). Compliance with CPAP increased LBM in men aged <60 years, but not in those aged >60 years, and IGF1 increased in men aged 40-60 years only. CONCLUSIONS Long-term CPAP increased LBM in both sexes and IGF1 in men, while fat mass remained unchanged, suggesting a sexually dimorphic response of IGF1 to CPAP. The role of the GH axis activity and age to this response is unclear. The metabolic consequences of changes in LBM are still to be determined. Future studies on the effects of CPAP on BC should include LBM as an outcome.

Factors Affecting Self-Reported Sexuality in Men with Obstructive Sleep Apnea Syndrome

INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is known to induce erectile dysfunction and to reduce overall sexual satisfaction in affected men. Data on the effects of disease severity and other contributing factors such as the age of the patient are missing. AIM To compare self-reported sexuality in men with newly diagnosed sleep apnea with a group of disease-free men, and to evaluate the impact of disease severity and age on the response pattern. MAIN OUTCOME MEASURES Self-reported erectile function, desire, and frequencies for petting, tenderness, masturbation, sexual intercourse, and overall satisfaction with sexuality over a recall period of 3 months. METHODS A prospective survey in men admitted to a multidisciplinary sleep center using a standardized validated German questionnaire. RESULTS One hundred-sixteen men 51.1 +/- 11.4 years (mean +/- standard deviation) with OSAS (OSAS+) and 42 men age 46.6 +/- 13.7 years without OSAS (OSAS-) completed the survey. OSAS+ men were older (P = 0.01) and more often divorced (P = 0.048). OSAS was significantly associated with erection problems (P = 0.024) and decreased overall sexual satisfaction (P = 0.04). In contrast disease severity did affect masturbation frequency only (P = 0.02), whereas patient age affected erection (P = 0.001), and the desire for tenderness (P = 0.02) and intercourse (P = 0.0003). CONCLUSION Patient age might be a more important factor affecting sexuality in men with sleep apnea than the disease severity. Future studies assessing sexuality in men with OSAS should include age as an additional variable.

Continuous positive airway pressure improves exercise capacity and heart rate recovery in obstructive sleep apnea

BACKGROUND There is a relationship between obstructive sleep apnea (OSA) and heart failure (HF). Peak oxygen consumption (peak VO(2)), heart rate recovery, and N-terminal-pro-BNP (NT-proBNP) are strong prognostic predictors in HF. The effects of nasal continuous positive airway pressure (nCPAP) on these parameters in OSA patients are not well defined. METHODS Forty patients with newly diagnosed OSA [apnea-hypopnea index (AHI) 37 (20-65) h(-1)] underwent cardiopulmonary exercise testing for assessment of peak VO(2) and heart rate recovery at one (HRR-1) and two (HRR-2) minutes after exercise termination as well as NT-proBNP measurement at baseline and after 7.9+/-1.4 months of effective nCPAP (nightly usage>3.5 h). The effects of nCPAP were compared in patients with mild-to-moderate (AHI<30 h(-1); n=16) vs. severe (AHI>or=30 h(-1); n=24) OSA. RESULTS In the group as a whole, peak VO(2) (baseline: 31.9+/-9.3 vs. follow-up: 33.7+/-9.0 ml/kg/min; p=0.02) and HRR-2 [38 (32-43) vs. 42 (32-47) bpm; p=0.01] but not HRR-1 [22 (15-26) vs. 22 (16-27) bpm; p=0.16] improved from baseline to follow-up. The effect on peak VO(2) was mainly driven by a trend towards an increase in patients with mild-to-moderate OSA (31.8+/-10.7 vs. 33.9+/-10.2 ml/kg/min; p=0.08), whereas an effect on HRR-1 [20 (15-23) vs. 21 (16-26) bpm; p=0.03] and HRR-2 [38 (29-42) vs. 42 (33-47) bpm; p=0.004] was observed only in those with severe OSA. NT-proBNP levels remained unchanged [21 (11-45) vs. 26 (5-52) pg/ml; p=0.6]. CONCLUSIONS Treatment with nCPAP is associated with an improvement in peak VO(2) and heart rate recovery in patients with OSA.

Coronary Anatomy and Left Ventricular Ejection Fraction in Patients With Type 2 Diabetes Admitted for Elective Coronary Angiography

Patients with diabetes mellitus (DM) have more severe coronary artery disease and a two‐ to fourfold higher risk for myocardial infarction and death as compared to patients without DM. In this study, we analyzed coronary anatomy, left ventricular ejection fraction, and cardiac risk factors in patients with DM referred for coronary angiography and compared them with findings in nondiabetic patients. Coronary anatomy was assessed in a total of 6,234 patients and left ventricular ejection fraction in a subset of 4,767 (76.5%) patients. Diabetic patients (n = 641) were older (60.8 ± 9.6 vs. 58.5 ± 10.5 years; P < 0.0001) and had higher rates of hypertension (65% vs. 47%; P < 0.0001). Three‐vessel disease (DM 44.7% vs. no DM 25.4%; P < 0.0001) and reduced left ventricular ejection fraction (DM 58.4% ± 15.2 vs. no DM 63.9% ± 13.2; P < 0.0001) were significantly associated with DM. After adjustment for age and other vascular risk factors, the presence of DM was associated with a higher atherosclerotic burden. We conclude that advanced coronary heart disease and left ventricular dysfunction are highly prevalent in diabetic patients, independent of age and other cardiovascular risk factors. Thus, cardiac assessment in diabetic patients should, in addition to optimal diabetic control, involve screening for left ventricular dysfunction. Cathet Cardiovasc Intervent 2004;62:432–468.

Erhebung der Patientenzufriedenheit in der Geriatrie

UNLABELLED The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We examined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patients spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%. The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses. CONCLUSIONS An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.ZusammenfassungDie Erhebung von Patientenurteilen in der Akutmedizin ist ein Bestandteil der Qualitätssicherung im Gesundheitswesen. Die Bedürfnisse betagter Patienten und die interprofessionelle Vorgehensweise der Geriatrie wurden bei solchen Erhebungen kaum berücksichtigt. In der vorliegenden Arbeit überprüften wir eine für die Geriatrie entwickelte Befragung zur Erfassung der Zufriedenheit bei 1918 Patienten im Alter von 82 Jahren (Median, M) mit einem Minimental-Score (MMS) von 25 Punkten (M) in drei Schweizer Geriatriekliniken auf Akzeptanz, Durchführbarkeit und Eignung. Alle verwertbaren schriftlichen Antworten wurden auf psychometrischen Eigenschaften überprüft. Parallel dazu erfragten wir die Zufriedenheit von Familienangehörigen. Die Rücklaufquote bei den Patienten betrug 32% (Fragebogen) beziehungsweise 60% (Interviews) und war bei Fragebogen abhängig vom MMS. Die Rücklaufquote bei den Familienangehörigen betrug 35%. Das theoretische Konstrukt Patientenzufriedenheit in der Geriatrie erwies sich in vielen Domänen als reliabel und valide. Die Cronbach-Alpha Werte für unterschiedliche Bereiche lagen zwischen minimal 0,67 (Hotellerie, Zimmer) und 0,92 (Ärzte). Problematisch waren die Bereiche Qualität der therapeutischen Behandlung und Qualität der Schmerzbehandlung. Die Patienten waren mit den Dienstleistungen der teilnehmenden Geriatrien zufrieden. Angehörige hingegen kritisierten den Informationsfluss zwischen den medizinischen Diensten und den Angehörigen.Das vorliegende Instrument ist gut in geriatrischen Kliniken einsetzbar und kann wertvolle Informationen für die Optimierung der Qualität der verschiedenen Dienstleistungen in den Bereichen Pflege, ärztliche Betreuung und Hotellerie einer geriatrischen Institution liefern.AbstractThe assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We exam ined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient’s spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%.The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses.ConclusionsAn instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.

[Assessment of patient satisfaction in geriatric hospitals: a methodological pilot study].

UNLABELLED The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We examined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patients spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%. The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses. CONCLUSIONS An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.ZusammenfassungDie Erhebung von Patientenurteilen in der Akutmedizin ist ein Bestandteil der Qualitätssicherung im Gesundheitswesen. Die Bedürfnisse betagter Patienten und die interprofessionelle Vorgehensweise der Geriatrie wurden bei solchen Erhebungen kaum berücksichtigt. In der vorliegenden Arbeit überprüften wir eine für die Geriatrie entwickelte Befragung zur Erfassung der Zufriedenheit bei 1918 Patienten im Alter von 82 Jahren (Median, M) mit einem Minimental-Score (MMS) von 25 Punkten (M) in drei Schweizer Geriatriekliniken auf Akzeptanz, Durchführbarkeit und Eignung. Alle verwertbaren schriftlichen Antworten wurden auf psychometrischen Eigenschaften überprüft. Parallel dazu erfragten wir die Zufriedenheit von Familienangehörigen. Die Rücklaufquote bei den Patienten betrug 32% (Fragebogen) beziehungsweise 60% (Interviews) und war bei Fragebogen abhängig vom MMS. Die Rücklaufquote bei den Familienangehörigen betrug 35%. Das theoretische Konstrukt Patientenzufriedenheit in der Geriatrie erwies sich in vielen Domänen als reliabel und valide. Die Cronbach-Alpha Werte für unterschiedliche Bereiche lagen zwischen minimal 0,67 (Hotellerie, Zimmer) und 0,92 (Ärzte). Problematisch waren die Bereiche Qualität der therapeutischen Behandlung und Qualität der Schmerzbehandlung. Die Patienten waren mit den Dienstleistungen der teilnehmenden Geriatrien zufrieden. Angehörige hingegen kritisierten den Informationsfluss zwischen den medizinischen Diensten und den Angehörigen.Das vorliegende Instrument ist gut in geriatrischen Kliniken einsetzbar und kann wertvolle Informationen für die Optimierung der Qualität der verschiedenen Dienstleistungen in den Bereichen Pflege, ärztliche Betreuung und Hotellerie einer geriatrischen Institution liefern.AbstractThe assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We exam ined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient’s spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%.The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses.ConclusionsAn instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.

Older adults must hurry at pedestrian lights! A cross-sectional analysis of preferred and fast walking speed under single- and dual-task conditions

Slow walking speed is strongly associated with adverse health outcomes, including cognitive impairment, in the older population. Moreover, adequate walking speed is crucial to maintain older pedestrians’ mobility and safety in urban areas. This study aimed to identify the proportion of Swiss older adults that didn’t reach 1.2 m/s, which reflects the requirements to cross streets within the green–yellow phase of pedestrian lights, when walking fast under cognitive challenge. A convenience sample, including 120 older women (65%) and men, was recruited from the community (88%) and from senior residences and divided into groups of 70–79 years (n = 59, 74.8 ± 0.4 y; mean ± SD) and ≥80 years (n = 61, 85.5 ± 0.5 y). Steady state walking speed was assessed under single- and dual-task conditions at preferred and fast walking speed. Additionally, functional lower extremity strength (5-chair-rises test), subjective health rating, and retrospective estimates of fall frequency were recorded. Results showed that 35.6% of the younger and 73.8% of the older participants were not able to walk faster than 1.2 m/s under the fast dual-task walking condition. Fast dual-task walking speed was higher compared to the preferred speed single- and dual-task conditions (all p < .05, r = .31 to .48). Average preferred single-task walking speed was 1.19 ± 0.24 m/s (70–79 y) and 0.94 ± 0.27 m/s (≥80 y), respectively, and correlated with performance in the 5-chair-rises test (rs = −.49, p < .001), subjective health (τ = .27, p < .001), and fall frequency (τ = −.23, p = .002). We conclude that the fitness status of many older people is inadequate to safely cross streets at pedestrian lights and maintain mobility in the community’s daily life in urban areas. Consequently, training measures to improve the older population’s cognitive and physical fitness should be promoted to enhance walking speed and safety of older pedestrians.

Unmasking Acromegaly in Late Life

To the Editor: Advancing age is associated with an increase in facial skin folds due to a reduction of cutaneous type I collagen and changes in the skeleton and in body composition. The age-related increases in absolute and relative fat mass are furthermore associated with type 2 diabetes mellitus, hypercholesterolemia, and hypertension, 1,2 and aging per se is a risk factor for impaired glucose tolerance. 3 Osteoarthritis and other degenerative joint diseases with involvement of the lumbar spine are common in older people and can lead to immobility and dependence. Taken together, the presence of a variety of age-related diagnoses can sometimes obscure a rare endocrine disease, such as acromegaly.

Geriatrie: Todeswunsch im Alter: eine Realität. Was wissen wir darüber?

Im Medizinstudium lernen wir, dass der Tod so lange wie möglich mit allen uns zur Verfügung stehenden therapeutischen Mitteln bekämpft werden soll. Auch wenn wir dem Tod in der Folge immer wieder begegnen, erscheint er uns oft als etwas eigentlich Unzulässiges und kann als Versagen erlebt werden. So reagieren Ärzte und Pflegende oft ratlos und wissen nicht, was antworten, wenn ein Patient den Wunsch ausdrückt, er «wolle nicht mehr weiterleben». Die Vorstellung, beim Suizid Hilfe leisten zu müssen, ist ein weitverbreitetes Schreckgespenst. Die Betreuenden empfinden dann einen starken Widerspruch zwischen der Respektierung des autonomen Patientenwillens und dem Prinzip, Gutes zu tun. Die Folge ist meist ein unbeholfener Aktivismus, der von den Patienten manchmal als Unverständnis der Medizin gegenüber ihren Wünschen erlebt wird, und es entsteht oft ein Gefühl des Versagens beim Patienten wie den Betreuenden. Der Todeswunsch bleibt ein grosses Tabu in unserer jüdisch-christlich geprägten Gesellschaft, auch wenn diese heute weitgehend säkularisiert ist. Trotzdem beschäftigt die Frage der Endlichkeit unseres Daseins wohl viele unserer (sehr) alten Patienten. Es ist daher wichtig, dass wir uns dieser Realität stellen und sie besser verstehen lernen, wenn wir diese schwierige Frage mit unseren Patienten sinnvoll besprechen und auch auf gesellschaftlicher Ebene ruhig diskutieren wollen.

Erhebung der Patientenzufriedenheit in der Geriatrie@@@Assessment of patient satisfaction in geriatric hospitals: a methodological pilot study: Eine methodologische Pilotstudie

UNLABELLED The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We examined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patients spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%. The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses. CONCLUSIONS An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.ZusammenfassungDie Erhebung von Patientenurteilen in der Akutmedizin ist ein Bestandteil der Qualitätssicherung im Gesundheitswesen. Die Bedürfnisse betagter Patienten und die interprofessionelle Vorgehensweise der Geriatrie wurden bei solchen Erhebungen kaum berücksichtigt. In der vorliegenden Arbeit überprüften wir eine für die Geriatrie entwickelte Befragung zur Erfassung der Zufriedenheit bei 1918 Patienten im Alter von 82 Jahren (Median, M) mit einem Minimental-Score (MMS) von 25 Punkten (M) in drei Schweizer Geriatriekliniken auf Akzeptanz, Durchführbarkeit und Eignung. Alle verwertbaren schriftlichen Antworten wurden auf psychometrischen Eigenschaften überprüft. Parallel dazu erfragten wir die Zufriedenheit von Familienangehörigen. Die Rücklaufquote bei den Patienten betrug 32% (Fragebogen) beziehungsweise 60% (Interviews) und war bei Fragebogen abhängig vom MMS. Die Rücklaufquote bei den Familienangehörigen betrug 35%. Das theoretische Konstrukt Patientenzufriedenheit in der Geriatrie erwies sich in vielen Domänen als reliabel und valide. Die Cronbach-Alpha Werte für unterschiedliche Bereiche lagen zwischen minimal 0,67 (Hotellerie, Zimmer) und 0,92 (Ärzte). Problematisch waren die Bereiche Qualität der therapeutischen Behandlung und Qualität der Schmerzbehandlung. Die Patienten waren mit den Dienstleistungen der teilnehmenden Geriatrien zufrieden. Angehörige hingegen kritisierten den Informationsfluss zwischen den medizinischen Diensten und den Angehörigen.Das vorliegende Instrument ist gut in geriatrischen Kliniken einsetzbar und kann wertvolle Informationen für die Optimierung der Qualität der verschiedenen Dienstleistungen in den Bereichen Pflege, ärztliche Betreuung und Hotellerie einer geriatrischen Institution liefern.AbstractThe assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We exam ined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient’s spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%.The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses.ConclusionsAn instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.